By Sue Checchio

Photo by Kelly Sikkema

We can’t help but feel helpless when someone we care about faces the end of their life. We offer to bring meals to them or their family; we volunteer to do errands, walk the dog, or even help clean. We pray. But, we don’t often think about offering to write letters for the patient, which can bring great comfort to the letter writer and the recipient.

Letters last forever. In letters, you can say whatever you want, even if it would normally be uncomfortable for you to express your feelings. In a letter, one can convey love and gratitude, remember special shared moments and emotions associated with the memories, feelings about the present, and hopes for the future. One can apologize. One can forgive. One can say goodbye.

A dear friend of mine died on a winter’s day in early 2015. Kelly* was a well-loved member of our community and a respected breast radiologist with a quick smile and a twinkle in her eye. Her second marriage brought her Jason, who she always said was the love of her life. Kelly was diagnosed with ALS a few years before she passed, and, in 2014, mere moments before she was to share her diagnosis with the staff at her radiology center, Kelly, the doctor, diagnosed her own aggressive form of breast cancer. In shock, she suddenly had two terminal diagnoses to share.

Early in 2015, I suggested to Kelly that she might want to write letters to her husband and children, and she asked me to help her with that project. I brought a small tape recorder to her home on two separate occasions, and we just talked. Sometimes I would ask her questions that would lead to stories — sprinkled with tears, but laughter as well. I would continue with prompting questions such as, “How did that make you feel?” or “What did she do then?”. Later, at home, I played the tapes back and turned our conversations into draft letters. Kelly finished them up with her sister, who would give them out when the time came. I read a Facebook post a few months after Kelly’s passing written by one of her daughters. She had saved her letter and finally, on her birthday, was ready to read it. Letters are an intimate way for those left behind to read their loved one’s words anytime they need to feel their presence.

Volunteering in a hospice allowed me to write letters for Catherine. Catherine called the hospice a “rehabilitation center,” so I wasn’t sure that she knew where she was. Nevertheless, I carefully wrote down every word she said in letters penned to three of her dear ones. The letters were not poetic. No regrets, no grand expressions. Simple, lovely letters, each with an “I love you” at the end. I read each of them back to her to be sure her letters said precisely what she wanted. They were perfect, she said. When it was time for me to leave, as I stood at the doorway between her room and the hallway, Catherine called my name.” Sue,” she said, “You are holding my heart in your hands.”

I realized then that Catherine knew she was not in a rehabilitation center; she knew just where she was. I turned to leave with her most extraordinary letters.

How can you help someone begin a letter-writing process? Work with one recipient at a time and start by listening. Prompts may not even be necessary! Don’t be afraid of long pauses, as the letter writer thinks. If a bit of help is needed, the following questions can help jog thoughts:

  • Tell me about a special moment with this person.
  • What details do you remember about that day?
  • How did you feel?
  • Is there anything you wish you told (the person) that day … or about that day … or at all?
  • What makes you proud of that person?
  • What makes you smile about when you think of that person?
  • What qualities do you see in that person that impress you?
  • Is there anything you would like to say in your letter that you have not shared, or would you like to reiterate your feelings toward them?
  • Are there any stories from your past that you would like to share with them? Words that you would like them to carry into the future?

*All names have been changed.

Sue Checchio experienced the unexpected deaths of her parents (aged 69 and 72) due to medical mistakes. Her desire to understand the medical “business” and help educate others to prevent the same thing from happening to them led her to Boston University, where she graduated with an MSc in Health Communication. Sue believes in the importance of education in empowering patients and their loved ones.

EOLCNY provides advocacy, education, counseling, and support to expand end of life options and improve care for New Yorkers.