The Power of a Letter on Memorial Day Weekend, 2020

From the 5/29/2020 newsletter



The Power of a Letter on Memorial Day Weekend, 2020



Adrienne Klement, MD - Hospital and Palliative Care Medicine




Hours to days. This is the prognosis required to allow a patient up to two visitors in the VA hospital.


It was a Memorial Day to remember. The Wood National Cemetery looked bare without flags marking each tombstone. Instead, a wreath ceremony took place. Celebrations were virtual and the day subdued.


For our veterans and their families, Memorial Day is for celebration and mourning to honor fallen brothers and sisters, family members, and loved ones in service. It is a day to reflect on the price and sacrifice of military duty.


For many of our patients, celebrations took a backseat to the longing for everyday living. For veterans facing difficult decisions ahead, those recovering from a long battle with the coronavirus, those at end-of-life, those living with dementia, or those with hidden injuries like post-traumatic stress disorder, the lack of usual (and necessary) sensory inputs – the warmth of sunlight hitting a cheek, the sound of birds chirping on a spring morning, the sound of a familiar voice, or the touch and scent of a familiar hand – was missed more than ever.


Similarly, the toll on their families and the hospital staff did not go unrecognized. Many found innovative ways to cope and adapt.


Some patients and families bring prior experiences and learned coping skills from their military mindset. Skills – such as managing uncertainty in uncontrollable situations, sending mail to reduce feelings of isolation during wartime, and handling multiple crises at once – seem all too familiar. On the other hand, memories of confinement, past trauma, and lost freedoms resurface, too.


Hours to days. The pressure for prognostic precision feels immense.


The power to grant meaningful touch and physical presence at the expense of fending off the enemy virus feels costly and unnatural. For patients on our palliative care unit at the VA and for veterans admitted whose care needs exceed their caregiver’s abilities at home, bridging the separation with video chats and phone calls feels inadequate during a very vulnerable time. For those with hearing and vision impairments, this medium is exceptionally difficult.


So, on Memorial Day weekend, sparked by memories of our past and past traditions, we asked families and friends to write letters to help bring coveted familiarity to the bedside. Through the extra efforts of our social workers, nursing assistants, nurses, recreational therapists, and restorative aides, we received and delivered more than 25 letters (and counting).


The letters had an impact - not only on the writers and the patients – but also on the staff members who were fortunate to read them. One patient’s wife wrote, “I pray that the Lord will allow me to kiss those lips, hold your hands, and our eyes lock on each other one more time. If He does allow it, I will be happy, if He doesn’t, I will save my kisses for when we meet again this time in heaven.”


On this Memorial Day, as these letters are read, I sit outside counting my blessings. I hug and kiss my husband and kids. As I do so, my mind wanders to all of the families remembering their fallen soldiers and to the families longing to embrace their soldiers confined to the hospital. Some of them have only hours to days before they, too, will be remembered on Memorial Day.



Adrienne Klement, MD is an Assistant Professor in the Department of Medicine (Hospice and Palliative Medicine, Inpatient General Medicine) at MCW. She practices at the Zablocki Veterans Affairs Medical Center.