The Last Hours-2

As the days passed, the family began telling relatives about her condition. This was during the COVID-19 pandemic, when seeing a seriously ill relative could be extraordinarily difficult. For a long time, some family members had not been able to visit. Now, suddenly, there was a window. The hospice ward allowed family members to come. The pandemic situation in Guangxi happened to ease for a brief period. Travel restrictions were relaxed, and relatives were able to make the journey.

So the family began calling. One by one, relatives came. Some of them were doctors. Others simply wanted to see her. They gathered in the room that, despite being a hospital room, had been designed to feel almost like a living room. They turned on the television. There was simply something comforting about having a little background sound in the room. The television played in the background while everyone talked quietly. They ate fruit. They sat around the table. They watched her. They waited. 

For my aunt, the atmosphere was remarkably peaceful. She had expected death to make the room frightening. Instead, the room felt almost ordinary. The lights outside the balcony were still on. There was traffic below. The television was playing. People were talking. And her mother was surrounded by the people who loved her. She did not look as though she had been abandoned in a medical institution. She looked as though she was still part of a family gathering.

At some point, my aunt realized that her mother probably understood more than she was able to say. Her speech had become difficult. She could not always communicate clearly. But she could hear. My aunt decided to ask her something. She told her that they were going to notify other relatives and let them come to see her. Then she asked: "Is there anyone else you want to see? Is there anything else you want to say?"

Her mother answered: "No more." There was no confusion in those words. Her mother knew what she was asking.

Only a few words. But this time, my aunt remembered them as extraordinarily clear. The family understood that this was probably as close as they would get to a final conversation.

So they continued calling relatives. And because the hospice ward allowed them to stay, those relatives actually had time to come. That became one of the greatest gifts the family received from the ward. They did not have to stand outside an ICU waiting for a visiting period. They did not have to wonder whether someone had missed their last chance. They simply came and stayed with her.

And then, eventually, the family knew that the end was approaching.

The final evening began almost normally. My aunt and the others had gone home to eat. The caregiver remained at the hospital. Then the phone rang. The caregiver told her that something seemed wrong, "Maybe she isn't going to make it." 

My aunt immediately rushed back. When she arrived, the medical team intervened. They gave her mother adrenaline that helped restore her breathing and circulation. For a while, it seemed as though she had stabilized again. She continued until around eleven that night. By then, more relatives from Baise had arrived. Among them were several family members who were doctors themselves. They understood what was happening. They watched her condition and the medication keeping her stable. Eventually, they told my aunt something difficult.

The medication was no longer changing the underlying situation. Her mother was being maintained by the medication. If it was stopped, they believed she would die very shortly afterward.

My aunt had already understood the principle behind the hospice ward. The goal was not to keep someone alive at any cost. It was to relieve suffering. So she asked whether they should continue. The answer from her relatives was no. There was no meaningful benefit left. The family made the decision together. They would ask the doctors to stop injecting new medication.

There were eight people in the room that night. No one rushed out. No one was shouting. No one was trying to force another intervention. The television remained on. People continued talking quietly. My aunt stayed beside her mother. The medication that was already in the syringe was allowed to finish. And then they waited.

The change came quickly. Within roughly half an hour, her mother's breathing stopped. The room became still. There was no dramatic scene. There was simply a family sitting together when one of its members died. 

For my aunt, that memory became important precisely because of how ordinary it was. She had seen other relatives die at home. Those memories were very different. She remembered the confusion afterward—the sudden realization that the person was gone, followed immediately by the practical questions. What do we do? Who do we call? What happens next? Where do we take them? The family would be frightened and grieving at the same time, while also being expected to make decisions they had never had to make before. Those experiences had stayed with her. They had sometimes even frightened her long afterward.

She told me that there were scenes from previous deaths that she still remembered vividly. But this time was different. Her mother died in a room where there were still people around her. And once she died, the hospital already knew what came next. There was a system. There were people responsible for handling the next steps. The staff helped the family contact the funeral service and explained the procedures. No one simply disappeared after declaring the patient dead. Someone came to tell them what to do. Someone was there to guide them. The family did not have to figure everything out while they were still trying to understand that the person beside them had just died. That difference stayed with my aunt.

Later, some of the relatives who were doctors reflected on the experience too. They had spent years working in hospitals. They had seen ICUs and ordinary wards. They understood how medical systems worked. And yet they were surprised by the hospice ward. One of them looked around and essentially asked: "How did we not know this existed?"

That question became increasingly important to my aunt. She began telling her classmates and friends about what had happened. Many of them had never heard of hospice care. Some initially assumed that a hospice ward must be frightening. Some imagined something like a waiting room before death. Others thought that sending a relative there meant giving up. 

My aunt tried to explain that this was not what she had experienced. The hospice ward was not simply a place where people went because doctors had nothing left to do. It was a place where the goal of medicine had changed. In the ICU, the central question had been: How do we keep this person alive? In hospice, the question became: How do we make the time they have left as comfortable and peaceful as possible? And there was another question underneath it: How do we help the family get through those days too?

That second question, she came to realize, was just as important. She told me that the family had originally been terrified of hospice care because of the word itself. "临终关怀." End-of-life care. The phrase sounded frightening. People who were healthy did not want to hear it. If you suddenly told an ordinary person, "Have you considered hospice care?" they might immediately think: Why are you talking to me about death? But my aunt's attitude changed once her mother became critically ill. At that point, there was no longer any abstract fear. The family knew. The question was no longer whether death existed. The question was how to face it.

That was why she believed hospice care needed to be introduced to people before they reached an emergency. Not necessarily because everyone needed it immediately, but because families needed to know that the option existed. Otherwise, when a relative suddenly became critically ill, they might know only two choices: ICU or home. And neither was necessarily right. She had almost chosen the ICU herself. Not because she thought it would save her mother, but because nobody had told her that there was another possibility. The option appeared only after she had spent an entire night arguing, asking questions, refusing to make a rushed decision, and insisting that her family should be allowed to stay together. 

That, she felt, should not be necessary. A family should not have to discover hospice care by accident.

The experience also changed how she thought about the meaning of "treatment." Before her mother's illness, she had naturally associated good medical care with more treatment. More examinations. More medication. More interventions. More attempts to keep the body going. 

But in those final days, she saw another form of medicine. There was still medication. There was still oxygen. There was still monitoring. There were still doctors and nurses. But the purpose had changed. The medical team was not pretending that the cancer could be defeated. They were trying to keep her mother comfortable. When she needed pain relief, they could provide it. When the family became frightened, someone could explain what was happening. And when death finally came, the medical team did not treat it as a failure. They treated it as something that could be prepared for.

That distinction became one of the most important things my aunt took away from the experience.

She also began comparing hospice with the experience of other relatives. A few years later, another family member developed advanced liver cancer. He was only around fifty. Again, the family faced the same problem. The ordinary hospital could no longer continue treatment indefinitely. The family could send him home. They could pursue intensive care. 

Or they could choose hospice. My aunt recommended the third option. They eventually transferred him there too. She remembered visiting him with his elderly parents. His parents were devastated. He was still relatively young. There was nothing easy about telling two elderly parents that their child was nearing the end of his life. But even then, my aunt felt that the hospice environment helped. The family could sit with him. They could talk. They could say what needed to be said. And they could leave knowing that they had not abandoned him.

That became another reason she believed hospice care would gradually become more accepted. When families reached the point where they could no longer change the outcome, they did not necessarily need another miracle. Sometimes they needed somewhere safe to stand.

When I asked her what she thought hospice care ultimately gave her family, she did not answer with a medical term. She talked about peace of mind. She said that the final days were hard for everyone. The patient suffered. The family suffered. But hospice meant that the family did not have to suffer from uncertainty on top of everything else. It could not cure her mother. But it could make the remaining time less frightening. That, my aunt eventually realized, was a form of care in itself.

And perhaps that was why the memory of her mother's death did not remain only a memory of loss. It also became a memory of a room. A room with a television playing softly. A room with eight relatives sitting together. A room with an orange sofa and a balcony. A room where no one was being asked to pretend that death was not coming.

And, for the first time, a room where the family did not have to run from it. Her mother had entered the hospice ward because there was nothing left to cure. But the family discovered that "nothing left to cure" did not mean "nothing left to do." There were still conversations to have. There were still relatives who needed one last visit. There was still a family that needed to sit together. And there was still one final thing medicine could offer them: not more time, but a gentler way to spend the time they had.