Until last week, I had not seen my friend, Dr. Greg “Grammy” Gramelspacher, in 20 years. Not since he had become a doctor specializing in care for the dying poor. Not since he and his wife, Mary Lou, and their three children moved to Kenya to work in the poorest villages there for two years in the mid ’90s, then back to Indianapolis, where today he’s on the faculty of the Indiana University Medical School and works in Palliative Care at Wishard Hospital in the heart of the city. Not since he appeared in Bill Moyers’ series On Our Own Terms on PBS a few years ago.

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There’s been a lot of water under the bridge in those 20 years, but we picked up like it was just yesterday back in Jasper, Indiana, when we were dreaming about the bigger world away from there, and aching to get at it.

Well, here we are. Still aching, but with the aches in different places. And I am so profoundly moved and humbled by what my friend has done, and how he has chosen to live his life.

Grammy has made it his business to help people who would otherwise die alone under a bridge somewhere have their last days be good days. He has made it possible for human beings who would otherwise be forgotten to be remembered, made it possible for love to have one last chance to live on.

GrammyBetty1He has raised millions of dollars for programs and facilities that care for the dying poor. He gave me a tour of the Abbie Hunt Bryce Home in Indianapolis run by Visiting Nurse Service (VNS), Inc., for which he helped raise the funding and is the staff physician. He introduced me to Betty, a resident there who was the happiest person I met all day. She wanted to dance. Residents come here with no caregivers, and no place to live. Upon moving in, they have both. Over fifty volunteers from the community cook meals and provide services to the Home.

At Wishard Hospital, I sat in on a class in palliative care Grammy taught to third year med school students. He tried to get them to feel for people and families with end-of-life decisions to make, but it was not a very feeling audience. He had them read aloud poetry (which he then repeated from memory) by writers whose spouses had died. When the students read the poetry, it was empty and unemotional. When Grammy read it, it was straight from the heart.

He offered the students this insight: When someone near the end of their life says to their doctor, “Do everything you can,” maybe they are not talking about hooking them up to machines in the ICU. “Maybe,” he suggested, “what they’re saying is do everything you can to contact my family. Do everything you can to save me from dying alone, out on the street. Do everything you can to find a Veterans check I’m owed and give it to my sister. Do everything you can to keep me off the machines. Do everything you can to listen to me, because I have something to say.”

On the cellular level of our biology — and a process called apoptosis that allows our entire physical makeup, every cell in our body, to die so that new cells can grow — we all experience death on a daily basis. The death of each cell holds the potential to initiate the life of a new one. Stronger cells grow in place of weak ones. Healthy cells in place of diseased ones. Or the reverse can be true. The choice is most often ours to make. In letting the fate of a person’s death bring bring about a better reality, Grammy is simply honoring a fact of our shared biology.

CowboyCowgirl1He told me about a patient named Cowboy Smith, originally from Chicago, a homeless man who lived under a bridge in Indianapolis when they first met. Grammy brought him an electric generator to help him through one extra harsh winter. When Cowboy finally had to check into the hospital where he was diagnosed with incurable lung cancer, he was at first wary and defensive, but Grammy got him to open up, and Cowboy ended up singing the blues in a beautiful voice for the staff. When he began disappearing from the hospital for a day or two at a time, Grammy learned that he was picking up uneaten food from hospital trays and taking it to his dog, Cowgirl, who was still living back under the bridge.

Grammy tracked down Cowboy’s son, a Harvard graduate with a doctorate in Divinity, and he and Cowboy re-united after being estranged for many years, and Cowboy got to meet his son’s new wife. He introduced Cowboy to a writer, David Wendell Moller, who included Cowboy’s story in his book, Dancing With Broken Bones.

CowboyCowgirl2On Cowboy’s final day, as he lay dying in his bed at the Bryce Home, someone asked, “Where’s Cowgirl?”

Grammy sent for the dog. When she arrived at the Bryce Home, where she’d never been before, she ran straight to Cowboy’s bed and jumped in next to him, and rested her head on his chest until he died.

It has never been more apparent than it is today that we are in this game together. Most of us have many freedoms for choosing how we are going to play it. My friend Grammy plays it with his own particular gifts of calling attention to what would otherwise go unnoticed, feeling what would otherwise go untouched, listening to what would otherwise go unheard. And little by little, in a thousand subtle ways, the game changes, and something new and better comes to life.

GrammyDancing

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