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When I walked onto the unit the first thing I could hear was the cough. There is always coughing, choking coughing, especially at mealtimes. And in January, and February. I did not expect that sound or his face. His small face with his small eyes, open and unfocused, and his open mouth, coughing and coughing, with an aide still trying to spoon something yellow and pureed in it. I looked at K., who was doing her notes at the counter, she looked at me. We were thinking the same thing. Not yucky cough. Not bad cough. Wrong cough. Terribly terribly wrong cough. We're good guests on the floors. We don't get righteous and we work with the staff. How can they be spooning into his mouth still? Alarm, alarm, alarm. Something wrong.

His whole self feels like it slams me in the chest, at the instant I first see him. I am drawn to him, somehow, I want him. I want him on service. I want him to be ours so I have something I can do. His suffering is immediate and pure. Not quiet weeping in the dayroom after dinner, waiting for an aide to come put you to bed. Not the quiet lying in bed shifted onto one side, with pillows, then the other, with an open hole on your buttock or sacrum, perhaps with foul drainage, but contained, under bandages and sheets, stabilized and you on pain meds so its there and not there. This is active drowning and it is immediate and pure and I am not expecting it and I feel compelled and I can see K. does too.

I know that if you have dementia, eventually you will lose the ability to swallow. Thickened, honey thick, nectar thick liquids. Gray water you can stand a spoon up in. Soft diet, ground diet, puree. Then this. And this was his moment. Mid-meal, the swallow disappeared. No more swallow.

They're good. They realize, call the doctor, an ambulance, send him out. Its not long but it feels like an eternity. I keep thinking, 15 minutes, 20, he will be in the ER, they will suction him, clear what he's drowning in, give him something to make him more comfortable. I am antsy waiting for 20 minutes to pass, even though he's gone, even though 20 minutes may have nothing to do with it.

K. gets him on service. I hear it on report this morning, I go straight there. He is nothing by mouth, he is in bed, he is in a quiet room by himself, hiss of oxygen. I read the chart. I'm so happy he is ours, that I can go to him. He's from East Africa. He prefers to be called by a diminutive name that suits him somehow, is sweet. He's actively dying, of course. He was brought here months ago by family, from there, from atrocities he was victim of. I will write this in my note, later, though no one may read it. To be aware of this trauma, as he approaches death. Of his full suffering, though we'll never really know the all of it.

He speaks a little English, Swahili. I know a little Swahili. I feel hesitant and a little silly speaking it out loud the way I always do in saying any foreign word. I hate saying, Au Bon Pain. Bad actress. I try to make the best marriage of the words I can remember, and what is appropriate to say. What I feel and what I want him to know, and feel.

I am here. My name is B. I am here. It is morning. Its good here. Hello, hello, yes I am here.

He doesn't respond, I pull the covers up to his shoulders, his face is so thin and sunken the oxygen mask won't sit flush on his face for the concave hollows of his cheeks. I stroke his cheek with the back of my index finger. I close my eyes. I smell his smell and I think, this is what he smells like. This is his smell.

I push play on the CD player in his room. He is Christian and fervent. Hymns in English, nice recordings of them. I'll fly away. I pull a chair over so that we are facing each other, in case he awakens, so he can see I am there. I start typing my note. Its misty, raining, green outside. I am acutely aware that I want to stay exactly here until the moment of his death and that I cannot. I am acutely aware of feeling an intense and profound gratitude that I am having this opportunity to be with him like this. I feel love for him. I love to pause in my writing and look at him and watch to see if he is breathing or not. I love to see his face, still and calm, his breathing, him in bed, with soft pillows, soft johnnie, clean sheets, cool air. Comfortable. Now a hymn about for all the suffering I have been through, still there is joy. Something like that. I wonder if he feels like that, now, or ever did. I am not tempted to believe he does, or did. Because maybe he didn't. It doesn't have to be a miracle, a storybook. This as it is is enough, to me.

I finish. I skip the hymns back to the first song so they will play longer, when I'm gone. I think he will be fine. I feel like something was given to me, that I got to be with him today. I did not have to endure not seeing him like this. It was my gift. I speak to him again, Swahili, no less awkward inside about it. I am here.

I think about it. Its true and not true. Its borderline appropriate, maybe. I think its OK to say. I say, I love you. When I say it, I mean it. I don't say it for him, to try to create something, or do something for him. I say it because when I say it it is the truth. It is honest.

I leave. I think about going back, after work, to sit more with him. I do not. I wonder for how long I will keep thinking of him like this. Relief, and humility, and gratitude, and love. How long I will feel this slam in the chest when I picture his face, last week and choking, today, with the hiss and quiet and rainy green and the sound of my typing.