Aunt Jaew’s last mission – a story of forgiveness from Thailand

Written by: Sutera Pimrose, APHN member

Sutera Pimrose, palliative care nurse at Karunruk Palliative Care Center, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, shares a beautiful story of families and palliative care professionals working together towards spiritual freedom before death.

“Suppang aparatangkamathamaypanteaugasatavarratayenagatangsuppangaparathang kamathameapanteaugasakhamami pantea…”

“Whether by body, by words, by the mind, whether in front of you, or behind your back, if we have ever shown any rudeness to you, we ask for you, Mother Tone, to forgive us. We will behave with all goodness in the future.

“May our merit that has been made and accumulated in the past, and will be conducted in the future, come back with a good result to us and to you, Mother Tone. May your grandchildren be prosperous and grow old with wisdom, health, strength, luck, good rank and all other good things. May all sufferings and ill health be kept away and may your suffering we pray finally be finished.”

Rituals of forgiveness

After these Pali words had been prayed, they were followed by a pardon. I asked the four daughters to bend down at their mother’s feet, and they whispered their pardon: “Please forgive any misconduct or rudeness we may have done to you in our lives”.

Their mother looked restless and her breathing was weak, she was hardly able to say a word. But when she realized that her daughters had come to ask pardon she said: “May all of the merit you have made today come back to you, your mother forgives you everything.” I assisted her to press her hands together at her chest while she tried to say “Satu!”

“Mother will be gone soon, this is the last thing she needed to do, she has no worries now and she can go in peace.” This was said amongst the nurses and her daughters at end of Mother Tone’s life in the hospital bed.

The benefits of setting an Advance Care Plan

My work that day in caring for Mother Tone and her daughters was not the first encounter with this family. Our palliative care team – led by Dr Srivieng Pairojkul and Khun Parichard – had already talked with the family about an advance end of life care plan and we were able to find out the patient and family’s wishes.

They wanted Mother Tone to die in hospital and did not want any resuscitation efforts but only required her to be made comfortable. Our team began to relieve her terrible feelings of breathlessness, starting with small doses of regular morphine to reduce her fear and anxiety, so she could at least sleep.

While this was happening, her daughters wanted their mother to make merit and they themselves to ask for pardon. Whenever I have a chance to assist families and patients in asking for pardon, I am reminded of one of the first patients I cared for in this situation.

Aunt Jaew’s story

I was reminded of Aunt Jaew. She was a middle aged, tall and round lady with a deep voice. Our team had a chance to know her because she was the wife of Uncle Pook, a patient with end stage Cholangiocarcinoma. Aunt Jaew told us that she and Uncle Pook had loved each other very much and had been together for 40 years without being separated.

“Whenever you see Aunt Jaew, you will see Uncle Pook,” she said. They are a couple who have gone through thick and thin together. The day Uncle Pook had to go to hospital; Aunt Jaew had never thought that it would be for the final stage of his life. It made it very hard for Aunt Jaew to accept that Uncle Pook was dying.

However, Aunt Jaew’s strength did not wane and even though she now knew that there was no cure for her husband’s cancer, she would not let it affect her. She had been a village chief; she was tough in making decisions and she seemed determined not to show weakness or fear.

On the day, I and Parichart, another nurse from our team, talked with Aunt Jaew and explained the need to work with the family to relieve Uncle Pook’s physical and emotional suffering, the family agreed that this is what they also wanted.

Controlling Uncle Pook’s pain was difficult; he was in liver and kidney failure. After assessment and treatment by Dr Srivieng, morphine was finally effective, given every eight hours to relieve his pain. He was able to sleep during the night and the family was very happy. After the physical symptoms were managed, we were requested to arrange a forgiveness rite.

“I was rude to him quite often before and he was also rude to me. When I was a village chief, we quarrelled. He chased me with a gun and burned my village chief  uniform. I couldn’t blame him. I have forgiven him. We want to conduct mutual forgiveness in front of him, would you help me?” asked Aunt Jaew.

“So, we will meet tomorrow, we will prepare five aggregates for you,” I said.

Accomplishing spiritual freedom

The next day, our team got together on Uncle Pook’s ward. We were ready to work with cheerfulness, because ‘working is merit making’. Lord Buddha said that “a part of giving alms is forgiveness; the effect of forgiveness and dedicating the merit made to someone else; such a practice will produce more effective merit than giving to Lord Buddha himself or to a hundred Arahant, a perfect one.”

We all got together beside Uncle Pook’s bed. I acted as the leading speaker. After the very emotional forgiveness ritual was over, we quietly cheered and asked Aunt Jaew and Uncle Pook to exchange kisses. “Oh! I have never done such a thing before, kissing! Oh! I have never done it, really,” said Aunt Jaew. Eventually she couldn’t resist our encouragement and she bent her cheek down for Uncle Pook to kiss and she kissed Uncle Pook in return. It made a cheerful sound in the quiet room. Uncle Pook was smiling, as was everyone else present.

A ‘Smiling Death’

My work with the team that day will not be the last one in serving the patients and striving to provide spiritual care. But for Aunt Jaew, this was the last time for her as a wife to ease her beloved husband’s spiritual needs and allow him to leave this world peacefully.

Both Aunt Jaew and Uncle Pook now have spiritual freedom. They have accomplished their last mission here on earth. From the last look of him before he died he looked like a person asleep with a small smile on his face. It seemed that Uncle Pook had left this world with acceptance. He was the first patient who showed me a ‘Smiling Death’. May you sleep happily, Uncle Pook.

From ehospice at http://www.ehospice.com/ArticleView/tabid/10686/ArticleId/14754/language/en-GB/View.aspx