The Jack and Jill nursery rhyme from an unknown author goes like this:
Jack and Jill Went up the hill To fetch a pail of water, Jack fell down And broke his crown And Jill came tumbling after. Up Jack got And home did trot As fast as he could caper, Went to bed To mend his head With vinegar and brown paper.
So what happened to Jill?
Here is my real life version:
The story of a middle-aged man named Jack and middle-aged woman named Jill occurred at the oncology floor of the Hospital where I started my career. Both Jack and Jill admitted within days of each other. Both with the same Stage 5 lung cancer (I couldn’t remember if it was Small Cell or Adenocarcinoma). Both with similar life expectancy and both at the end of the road of their lives. Three months to live was what the Oncologist told me.
Being a young Physical Therapist, I never encountered patients with cancer at the end of their lives. My job was to help keep the remaining parts of their quality of life up and mobile. Walking programs and some stretches or exercises.
I found this time of my career impressionable and the lessons would shape me as a person and professional forever.
Black and White
Jack and Jill lived across the hall at Room 311 and Jill in Room 312. All seemed similar from the get-go, but both of them approached the end of their life differently. The first day I walked into Jack’s room first to evaluate his condition. I came into a dark room with window shade’s shut tight and a chilling feeling that I this man would not be kind to me. A sharp-tongued former oncologist screamed at me and refused therapy, and I quickly shut the door and ran out scared.
I gathered myself and moved to the room across the hall hoping I wasn’t going to get much of the same. I walked into 312 and came across a woman standing to prune the sunflowers in her vase with window shades open. I think I even heard her singing. She invited me in, sat down to chat a little. I told her how I could help her and she agreed to continue the rest of the evaluation.
We took a stroll and Jill wanted to get to know me and experiences in my life. At the time, I was sure it didn’t mean much to her where I came from or my story, until that point. I think today I see it as a way of her trying to remember humanity and value the fragility of life.
For many weeks after, I would still visit Jack and try to encourage him to come out of his cave. I saw a man with lots of regret and anger. I watched Jack decline, become thin, and gaunt looking not once flashing a smile or something worthy of a life worth living. He threw things at me to discourage me from helping or even wanting to tell his story.
It would eventually come to find out Jack had wished the door would be closed saying “Do Not Disturb.” The other side of the hall was open and had some music playing and always, vases of flowers.
Alternatively, Jill pushed herself even on days she was weak. She lost her hair, but she always greeted me and was still up for a walk and a talk. I was always impressed how she could see the brighter side of things despite her dire situation. She knew her time was up soon.
I think the rest of our children’s rhyme ends something like this...Jill got back up and fetched that pail water.
Paths continue, with or without pain
In the end, the outcome was the same for my real-life Jack and Jill; they passed near days of each other while moving to hospice care. Both saw their lives at the end in different ways. Jack pushed all the loved ones in his life out, while Jill embraced all newcomers and the final relationships she could harness. It has been about 11 years now, and I realize it was a story about courage in the face of death and how each of them chose to redefine the end of their lives. So the question is...how do you want to go out?
We can, and we will get better together,
Dr. Lin
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