I believe in the inner knowledge of dying people. In the last several years I’ve been listening to them as a music therapist at hospice. My patients often say, “I want to die”, when they grow tired of living with their illnesses. When their words change to something like, “I am dying”, I believe that their death is near, because they know their fates better than anyone else. Such patients tend to die within a few days. I don’t know how, but the dying, even those with impaired cognitive abilities, seem to know their impending deaths. Some articulate this awareness verbally, and others use outlets such as music to express it.
Herb was one of my first patients as a music therapy intern. For several months I visited him in an old, over-crowded nursing home. He was often agitated and combative, unable to communicate or understand his environment; he was in the last stage of Alzheimer’s disease. One thing that gave him comfort was music.
On one fall afternoon I visited Herb and played some of his favorite songs on a guitar. His face brightened up, recognizing the familiar melodies. At the end of the session, he said, “I’m going to sing for you.” I had not heard him speak a clear sentence like that in a long time. I knew he had been a singer once, but he had always refused to sing with me, saying, “I can’t sing anymore.” When he sang a beautiful jazz song that day, I saw him for the first time as he once was. Underneath the terrible disease there was a whole person. I thought he would never be able to tell me why he decided to sing that day or what the song meant to him, but I was wrong.
Two days later Herb died. His death surprised everyone including the hospice staff and myself. His daughter, Katy, was upset that the hospice nurse didn’t notify her of Herb’s impending death. The nurse explained that he wasn’t showing any signs of decline in the past few weeks, and that she and the doctor couldn’t have predicted that Herb was going to die so soon. She also told Katy about the music therapy session and his singing two days before his death. Katy said she had an idea about which song he sang, because there was one special song he used to sing all the time. It was a jazz song. Katy found comfort in knowing that her father was himself again even for a brief moment.
Did Herb know he was dying, if not in his mind, then in his soul? After having met countless patients like him, I’ve come to believe that he did, and that the dying have the inner awareness of their own deaths. Herb’s song was a last gift for his daughter, and it was a gift for me too, because it taught me the mystery of dying.