When I get the call that a pediatric hospice patient has died, it’s never an easy moment. No matter how many times it happens, sadness immediately sweeps over me, and sometimes there are no words to comfort. Many times, they are families I have never even met. That is why when I walk through the door of their home, I want silence to proceed me. I want what I do for these families to have more impact than what I say. Their child has just died in their arms. What can I say to make any of that any better? Nothing. Absolutely nothing. I have learned that sometimes, compassion and comfort can be better communicated with silence than with words.
Here is what it is like to embrace silence: When you are called to the house, the child’s father leads you to the living room. You look at his face, stained with tears as he tries to be strong. He walks around the house aimlessly looking for things to do. The mother is lying on the couch, sobbing uncontrollably while embracing her 6-year-old son, who has just taken his last breath. The grandparents are trying to comfort their daughter and son-in-law while grieving themselves.
You quietly walk over to the mom and stand frozen, so as not to interrupt her last moment with her child. She sees you out of the corner of her eye and starts to unloosen the tight embrace of her son so you can do your exam. You gently place her arm back around him so she doesn’t have to leave his side.
When she begins to remove the Teddy bear that her son held to his heart, making space for you to listen, you place it back on his chest and put your stethoscope under the bear on his heart. You listen for a minute, and in that minute, the silence is deafening. The only comforting thought that goes through your mind is a small sigh of relief that their precious little one is no longer in pain, but in peace.
You take your other hand and gently rub the mom’s back, all the while silently praying for her. Praying for her to feel even an ounce of comfort that her son has no more pain and no more tears—as you watch her become full of pain and full of tears. You quietly back away, and for a split second, your eyes lock with hers. You see and feel her pain, and you hope she sees and feels your empathy. There are no words exchanged.
For me, moments like these are ever so sacred. I know I can’t change the situation, but I can be present in a family’s pain, whatever that may look like. I count it a privilege to be there for a family at the worst moments of their lives.
I think silence is a lost art in our world. Sometimes we can be afraid of how loud silence can be, so instead of embracing it, we fill it with empty words. Although words can express our thoughts and feelings, they can’t always make things better. Words can’t always fix things, and sometimes words can even make things worse. Words are healing, and words are good—but words are not always necessary. Sometimes silence is enough.