She only wanted to be home.
The woman, who was around 40, had terminal cancer, and she wanted to go back to Brazil, where she was born and raised. She would first need to pack her belongings; settle her affairs in New York; endure the flight.
But her disease took a sudden and fierce turn, and when she reached Mount Sinai Hospital she had less than a week to live and little energy for anything but sleep.
She wasn’t fixated on the more trivial tasks of winding down a life. Really, just one concern loomed: If she did not arrange for her own burial, she would be interred in the potter’s field at New York’s Hart Island, where more than 1 million of the city’s most destitute have been laid to rest in vast trenches.
She wanted to deliver herself, in death, to her family.
The doctors on her floor, which serves hospice patients and others, had been in this and other impossible situations before, and the answer was always the same. They wished they could help.
She had been admitted in February. She was a quiet person on a quiet floor, where patients who are near life’s end are not tethered to loud machines. On one wall hung a Rumi quote: “Don’t think the garden loses its ecstasy in winter. It’s quiet, but the roots are down there riotous.”
It was one of the warmest winters in memory, and she could have seen children playing in Central Park’s East Meadow across the avenue. She would have looked through bare trees to the sunset beyond the park.
She wouldn’t have known the visitor was on his way. But when he appeared, clinicians would later recall, he was wearing roughly the same outfit he would choose throughout that short week: dress pants and a dress shirt. A workbag was slung over one shoulder.
A doctor asked gingerly about his relationship to the patient. The man said he had been one of her two roommates for the past few years. There was no romantic connection. But he was determined to help.
He stepped into the room, and for the first time the medical staff saw her smile.
“I’m going to take care of this,” he told her. “I’m going to get you home.”
He didn’t know how much time she had left, but there was much to do: secure documents verifying the family’s burial arrangements in Brazil; arrange a hospital visit by a consulate official to verify the need for expedited services; work with a church to raise money to help.
He spent his days on these tasks. And he would keep returning to the hospital, making his way toward the elevator, taking it up to the sixth floor, and then heading down the hall to the nurse’s station, where he would ask how she was doing.
He would take her hand and wait until she stirred before telling her he was there. “If you want to rest, rest,” he would say. “If you want to talk, we can talk.”
After an hour or so, much of it spent in silence, he would rise to leave, each time telling her the same thing: “I’m going to make sure you get home. I promise.”
Dr. Emily Chai, one of the woman’s primary caregivers during the week, pieced the story together in the months after her patient’s death, and without reminders from the roommate, with whom the staff has since lost contact, and whose name and contact information have been since lost as well in the typical chaos of these matters.
She said she asked the man where he drew his energy. He said that when he was young, his mother used to cook extra food to bring to a less fortunate man down the street. The boy found out that the man abused drugs, and tried to convince his mother that her generosity was misdirected.
She set her son straight. “You do the right thing,” the man told Chai, recalling the story of his mother. Then, referring to his roommate, he said: “This is the right thing to do for her.”
Chai said she’s seen other patients who lack family and friends and who don’t have the support they need to get their affairs in order.
Pro bono specialists are scarce, so many patients die knowing they’ll be buried where no one will mourn them. Or knowing that their children will end up in foster care because no guardian has been named.
Mount Sinai last month announced plans to launch one of the nation’s first hospital-backed, free legal service for patients in such situations. Chai calls it a dream come true. But she remembers those who, like the woman from Brazil, had no formal help.
What she had was the man in the dress pants. He made arrangements with the consulate. He found a funeral home to prepare her body for the flight. And he secured documents from her family showing that everything would be taken care of on arrival. A local church raised some money.
Still, the man did not have enough money to get her home.
There was another option: The woman could give him access to her bank account. But she would need to give him power of attorney. And for that she would need a notary public, and for that she would need to be awake and clearly lucid enough in what were, now, the final waking hours of her life.
Chai said it briefly occurred to the medical staff that this could be an elaborate ruse, set up to extract $3,000 in savings from a dying woman. Too many signs suggested otherwise, including, among other things, the fact that the roommate had forfeited a week’s worth of work to this cause.
The staff escorted the notary to the woman’s room, where the roommate awaited. They hoped she would wake.
“Earlier in the day I wasn’t sure if she’d be able to sign,” Chai said. “I didn’t know if she’d be able to go back home.”
She awoke. She saw her roommate and tried to smile.
The doctors asked if she knew the purpose of the notary. She nodded. They asked her if she trusted him to make all decisions for her, financial and otherwise.
“Yes,” she said. “He’s my friend.”