To Go On Her Way
By Susa Silvermarie
Dorothy is lying on her side unable to speak
since her stroke three weeks ago.
The bedrail is down, my chair drawn close.
We are eye to eye.
Dorothy managed apartments all her life.
This once independent woman never married,
has no family to protect her
from medical meddling. Tomorrow,
the nursing home physician plans,
contrary to Dorothy’s Living Will,
to insert a feeding tube.
I’m the nursing home social worker.
who wants to put some power
back into Dorothy’s hands.
I slip my hand into Dorothy’s good one.
I ask her to squeeze, if she wishes to answer yes.
“Do you want your Advance Directive to stand,
the request for no tube-feeding you signed?”
She squeezes my hand.
“Dorothy, “I say, “the nursing home doctor
has written an order that overrides your wishes—
an order for a feeding tube.”
Her eyes go wide.
“A way around it is to change doctors.
Do you understand?”
Dorothy squeezes my hand.
“I can help you sign the form.
Do you want to change doctors?”
Dorothy squeezes my hand.
I need a witness, since staff
expects resistance from the doc.
Down the hall I find Ellen,
a regular visitor to the nursing home.
Ellen follows me back to Dorothy’s room.
We pull our chairs up to the edge of her bed.
“I’m 76 myself,” Ellen says, “ and Dorothy,
I’d be proud to help you go,
the way you want to.”
This time, to verify the squeezing,
Ellen places her hand in Dorothy’s good one.
I ask the questions once more.
Yes! Dorothy wants her Directive to stand.
Yes! Dorothy wants to change physicians.
Yes! Dorothy wants to sign the request.
Ellen releases Dorothy’s hand,
which I gently wrap around my pen.
I position my clipboard within her reach,
and guide her hand to the signature line.
We hold our breath, for a moment outside time.
What hangs in the balance
is Dorothy’s route of death.
With a feeding tube, she could wake up here,
every day for a long, long time.
she faces her mortality square in the face,
and keeps the dignity of controlling her passage.
Dorothy scripts her D exactly the way it looked
on her Advance Directive.
She continues looping across the signature line.
For a few more minutes we stay
to visit with Dorothy.
When I mention her job,
that she managed “an” apartment building,
Dorothy holds up three fingers,
and gives us a lopsided grin.
Ellen and I rise.
“Wishing you well, my friend” I say.
“You aren’t alone,” Ellen says.
“Spirits and angels and guardians
are watching all around you.”
Dorothy lifts her good hand,
and waves farewell.
Four days later, I learn
she passed in the night.
“Just left,” the nurse says,
snapping her fingers, “like that!”
When I tell Ellen, she nods.
“A great honor,” she says,
“to help another human being
go on her way.”
Originally published in my 1996 book Tales from My Teachers on the Alzheimer’s Unit (out of print) but now available on Amazon (and all platforms) as an eBook at
For more information about Lake Chapala visit: www.chapala.com