Saturday, July 16, 2016

Vigil the Poetry of Presence by Pamela Heinrich MacPherson

Vigil the Poetry of Presence
by Pamela Heinrich MacPherson
Red Barn Books
Shelburne, VT 05482
Copyright 2015
ISBN: 9781935922964

The collection’s title, as Pamela Heinrich MacPherson says in her introduction, comes from the “Latin, viglio, ‘to be awake,’ be vigilant; a period of watchful attention; wakefulness that holds calm; bearing quiet witness." The poems were produced from her diary entries accumulated over 30 decades of sitting in vigil with the dying. She was drawn to end-of-life issues while in nursing school in the 60s and eventually would serve as Hospice Volunteer Coordinator for the Visiting Nurse Association of Chittenden and Grand Isle Counties in Vermont between 1988 and 2004. She has continued to sit in vigil following her retirement.

These poems have an artistic innocence; they are what she wrote in the moment and their meaning and much of their power comes from that immediacy; they do not seem to have been worked on, shaped or changed in search of meaning. Here are a two examples the first is a good description of what, in my experience, the approach of death may look like.

Endings and Beginnings

Cold hands
Mottled on their undersides.

As you rhythmically breathe
Your seven breaths
Ascend and descend
And then give way to
Thirty seconds of apnea,
A transition
Not unlike labor and birth.
The intervals of labor
Grow shorter with each contraction;
The intervals between breaths
Grow longer in dying.

This second example should disabuse you of the notion that the process is always peaceful:

Nothing Dignified

There is nothing dignified
About teeth being out,
The urgency of a bowel movement,
Flatulence released,
Ecchymotic hands that are
The extension of tissue paper arms.

The poems are not arranged chronologically but in nine thematic chapters. One is devoted to "Quality of Care," which has a poem, "Mediocre," that begins with these lines:

A level of nursing care
Not without polite exchanges
Or meeting basic needs.
Absent was a lingering touch that knows.

Mediocre care can be compounded by indifferent or unaware families as "Care: Acceptance on My Part" illustrates. Pam arrives to sit with a woman who is,

Tiny and frail and barely a shadow of who she was,
This nonagenarian's petite features
Are immersed deeply in somnolence.

The woman has discolored hands, which "tell of medical misfortune." She then discovers the woman has a swollen arm because of a leaking IV. With some difficulty she is able to get a nurse to inspect the patient.

He arrives in the room,
Examines her arm and intravenous site.
"Another must be placed," he announces.
"Her family wants it," he defends…
The sentence is hard for me to hear;
My heart questions.
Her family? What about her wishes?

That question, "What about her wishes?" Is an example of the utilitarian importance of these poems; take heed to be sure that your wishes are known.

            These poems are strongest when they are detailed and specific. My reservations (I always have my reservations – in spite of all the Robert Frost I have memorized I still think some of his poetry is flat) are for the times when they stray from the particulars and a good poem ends with lines of greeting card verse such as these, "May your soul have a gentle landing/In a peaceful place of contentment." But, if you will ignore those lines, Vigil the Poetry of Presence will serve you well; the wisdom these poems share should be of use to all of us when we support family and friends as they are dying and we can only hope that our family and friends will have access to their wisdom by the time we need their support as we begin our near death experience.

By Wendell Smith MD, ret.

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