Friday night is pizza night in our family.  About this time of day, at the end of a long week of work, the thought of piping hot pizza accompanied by a glass of red wine is absolute bliss for me.  I crave Friday night pizza for a lot of reasons, not only for tangy sauce and melted cheese.  It has a meaningful history in my spouse’s side of the family; my mother-in-law would order pizzas every Friday night in later years, and her grown-up children and grandchildren would come to visit over slices of pizza and her homemade oatmeal cookies.  It’s become a tradition in our household, too.  Sometimes we make fresh, homemade dough and get fairly gourmet in pizza presentation.  Other times, it’s trying out a variety of pizza places on a family taste tour for the best in town.  Still others times, like tonight, it is carryout freedom at the end of a long work week.  Yes, there is a lot to crave about pizza.

Ed craved pizza, too.  He was a long-term resident of mine in the residential health care facility where I worked first in the activities department as a student, and then as the Director of Social Services after I graduated with my BSW and MSW degrees. Ed was a big guy, with a big appetite, and a big voice, and a big sense of humor.  He had trouble finding words because he had significant impairment from a stroke.  But, he always got his point across.  He wasn’t fond of the food served from the cafeteria, and he really wasn’t happy that his nightly dinner didn’t come with cold beer.  On the last Friday of every month, we hosted a resident happy hour with full service beer, wine, and cocktails (unless contraindicated medically, and even then we had “mocktails” and near-beer).  I had served Ed a number of beers when I worked in that facility as an activities assistant.  It was now several years later, and I was back working in that facility in my new role.  Time had taken a toll on Ed, and he had developed esophageal cancer.  Sadly, his small joys in life…pizza and beer…were stripped from him.

The day that I helped Ed and his family sign paperwork to admit him to Hospice was a very emotional one.  Ed had some challenges speaking from a stroke, but his indication was quite clear: no feeding tube, no resuscitation, no life prolonging measures.  He wanted to live as well as he could, as long as he could.  But, that end was approaching for him and we all knew it.  He knew it, too.

One of the things I respect most about Hospice is the focus on quality of life, and the active pursuit of comfort.  Comfort isn’t simply viewed as the absence of pain.  Comfort is the creation of the kind of circumstances that maximize our humanness and give us deep appreciation for the present moment.  The doctors and nurses helped Ed be free of pain.  I worked on some other areas of comfort.  I started with pizza.

“Ed” I said, “what do you want to eat?”  He looked at me and grinned.  “Pizza.  And beer.”

I left the unit and went to see our dietitian.  The swallowing evaluation indicated that only pureed foods and thickened liquids, in very small quantities, were safe for Ed at this stage.  He hadn’t been eating much of anything they were sending, though.  I asked her if we could puree pizza and thicken up beer.  She said she thought that was probably possible.  So, the plan came together.

That evening, Ed got a plate delivered to his room that surprised his wife.  A perfectly formed piece of pizza to look at, just with a very different consistency.  We had made a mold, pureed the pizza and fitted it back together to look like the real deal.  And next to it, a can of his favorite beer, with a glass in which the right amount of thickening agent had been added to allow small “sips.”  We fixed her a tray, too, with the matching non-pureed version.  And then we slipped away and gave them time to eat together.

I’m told it was Ed’s favorite meal.  He died, very comfortably, a few days later.  Comfort maintained, in all ways.

What we crave in life isn’t really just the favorite foods we consume.  It is being known, and loved.  It is living…and dying…with integrity of who we are.  It is the comfort and companionship of those we share with, and the respect of those who know us.

Cheers, Ed.  It’s pizza night.