I sat in the corner and observed her upright posture, refusing to recline in the hospital bed. Her hands are restless, but her voice is clear: “I just want to go home.” The nurses call her name. She wants to be seen and given a good report, but she longs just to go home. Her body is speaking something deeper.

As I watch her being treated, I can see her negotiating with the caregivers. She is ok – She says. I just want to go home. As the nurses clear out, my mom and I have a short conversation on letting my wife and I help her more. About her moving in with us so we can “help her”. She is stoic and needs no help. Although frustrating for me, I had a calm in this discussion. The calm was in understanding what helping and caring is about. In those moments I realized just how important it is to honor someone’s identity in helping them.

Last Tuesday I called to check on my mom and see how she was doing. As I was traveling back from my own doctor’s appointment, my mind was drawn to checking on her.

My wife and I usually have lunch with my mom each Sunday and I had noticed she was not herself. Others did not notice but I did. She would never tell me she didn’t feel well, but I could tell something was wrong.  I checked on her later that evening and she told me she was ok.

Something told me to check on her Tuesday morning and I am glad I did. She has been having many health issues, so I knew she was concerned. As we talked, she grew more anxious, so I decided to take her to the emergency room.

I have entered that stage in life where it is required of me to care for my mom daily. Most do not like to think about this time, much less live in it. I am honored to care for her. It is just hard to experience as she gets weaker and has more health issues. No one likes to watch a parent diminish over time.

But hospital waits are a necessary part of this stage. We were about to be in the emergency room for 10 hours.

The people who work in these areas are saints let me tell you. Such a hard job and on many days it is thankless.

In studying SPoR in recent years, we have discussed Ethics, Care, and Helping on numerous occasions. But here in this environment, you really do experience it. As I wait, SPoR is on my mind as I sit with her. I am deep in thought at times while I wait of how all this relates to how I practice safety.

A few notes from my SPoR journals that I cling to these days. I said cling to – not good at yet.

Attunement over action: My mom’s gestures are not symptoms – they are expressions of self.

Dialogical help: The invitation to move in with my wife and I must be a conversation, not a solution. I was not being invited to help – I was being invited to listen.

Relational risk: The risk of losing dignity/identity is as real as any clinical diagnosis or injury at work.

Embodied meaning: Her refusal to recline is a semiotic act – a symbol of her story.

I used to think safety was about preventing harm to people. But as I watched my mom resist the hospital bed, I realized safety is also about preserving identity. About seeing the person, not just the patient. About staying with, not fixing.

More SPoR notes that I cling to…

Ethics is relational, not a regulation: In past safety practice, I would have been all about the systems and compliance. Ethics begins in relationship, not in rules. In the ER, honoring my mom meant seeing her not as a patient to be processed, but as my mom – a person to be with.

Helping is not about control – it is about consent: Ethical help must be dialogical.  It’s not about doing TO someone but being with them. My mom’s resistance was not being defiant – it was her plea for dignity.  Ethical care listens before it acts.

Risk includes loss of meaning: My mom was at risk of losing her autonomy, identity, and story. Her refusing to recline in the bed was symbolic – her way of saying,” I’m still here, I am still me.”

The body is a site of ethical meaning: My semiotics lens was clear and active in the emergency room. It is important for me to read gestures, posture, and silence of expressions of lived experience. My mom’s upright spine – when she did not feel well, her handwringing, these were not symptoms. They were messages.

Ethics begins in listening, not fixing: This is so hard to do. Ethical practice starts with attunement. Before we can help, we must hear. I was tempted to – but I did not rush to solve. I stayed, listened, and honored her story.

I must confess that I am still learning so much within SPoR. In the emergency room, I realized that ethical care is not efficient – it is quiet. My mom did not need a bed that day. She needed to be seen. In those moments I understood and continue to reflect as I care for her – help must honor identity, or it is not help at all.

One thing that helps me through this time of caring is knowing that I am honoring my dad’s wishes for me.

A few days before my dad went into hospice 10 years ago, he handed me a brief note. I knew what it was about, and I did not think I needed to read it.

This lesson was whispered to me 10 years ago.

A few weeks before he would pass, I would see him a few times each day just to sit with him and encourage him. I would begin to cry before I got to his room, but always managed to fight back the tears and man up before I entered the room. I was grieving what was to come. Once as I was walking the halls to his room while crying, I waited outside, and I overheard my dad and his nurse talking back and forth and he had her laughing and crying all at once. I did not understand how someone with such a poor quality of life could be oriented towards the person who was caring for him. He was attuned to her and holding her laughter and tears with attention. That was true care.

As I walked in, dry eyed of course, the nurse left, and he just winked at me and said – It is all about people Billy – It’s all about people.

Ten years apart, these stories stay with me. Dad facing death and orienting towards the nurse who is caring. My mom in resisting the hospital bed, guarding the rest of her life – not wanting to give in.

I am learning that help is not about doing. Its about staying. It is about honoring.

Rob Long says that ethical care is not efficient – its relational. I am still learning that, slowly.

Dad’s note did not mean control. It meant stay. Honor her.

So, I sit. I put my phone away. I listen. I do not fix.

It is all about people!