Nebraska Farm Scenes

Nebraska Farm Scenes


Lisa Schuman, NP

Accompanying artwork: Nebraska Farm Scenes by Ryan Alexander-Tanner

Perm J 2018;22:15-092 [Full Citation]
E-pub: 04/13/2018

This is a story and illustration from the upcoming book 100 Little Stories of Big Moments published by The Permanente Press.

The stories were written by clinicians in 15 minutes in writing workshops about meaningful moments in their work and life of practicing medicine. Professional artists were asked to create a visual representation of the story.

Nebraska Farm ScenesMy patient was 85 years old and dying of metastatic pancreatic cancer. It seemed as though her daughters, in expressing their angst over the death and dying of their mother, overshadowed the real patient. They consumed her waking moments, suffered loudly their mother’s pain so that she could not allow her own pain to push out of her; not through movement, no writhing, no crying, no moaning.

The girls, in their 60's, insisted that pictures of their dead father surround the patient’s head so that when she opened her eyes they would be all she would see.

The mother disclosed that she was distressed by these photographs. Her husband had abused her, suppressed her and her spirit. He took her from the Nebraska farm where she was born and belonged. He took her away to Seattle when she was 16 years old and never fulfilled his promise to allow her to go home.

She wanted the pictures replaced with images of farmland and cattle but without disclosing to her daughters how terrorized she felt by the images of their father. She asked to be kept asleep so she wouldn’t have to bear her children’s loud crying, disturbing her busy thoughts about her own life. They would wake her to her pain and scream when they saw agony on their mother’s face, forcing her to beat down her pain. She could manage only a few minutes. They woke her over and over in search of their mother’s comfort—Mommy is leaving.

I had to orchestrate replacing the pictures with Nebraska farm scenes and keep her sedated against her childrens’ need … making up rules about noise, visits, needed procedures just to give her the privacy she needed for her dying moments.

She ultimately got her solitary wish, her private review and her beautiful cow-covered grasslands and, I am sure, in her thoughts, made it back home.

How to Cite this Article

Schuman L. Nebraska Farm Scenes. Perm J 2018;22:14-061. DOI:

The story “Nebraska Farm Scenes” was originally published in leaflet, 2017;5(1). Available from:

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