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November 1, 1985

Numbered Blessings

JAMA. 1985;254(17):2458. doi:10.1001/jama.1985.03360170098041

It isn't easy to enter a hospice room and think of the right words to say. The cheerful "How are you today?" or "Hope you'll feel better tomorrow!" or "See you next week!" all carry loaded meanings and sound hollow, to both the "sayer" and the "listener."

My weekly visits as a volunteer started that Thursday evening with Helen, an elderly heavy-set woman with extensive bone metastases from a breast carcinoma treated many years ago. She lay on her bed slightly propped up, breathing heavily and moving her head monotonously from side to side. She alternately moaned and spoke in a soft, guttural tone as I walked to her side. I held her hand and began groping for some useful words to say. Then, gently stroking her hand, I tried to convey to her a nonverbal feeling that I cared about her. I slowly told her that I knew she wasn't