In the past three weeks, Charlton Fisher went from wanting to die to wanting desperately to live.
From his bed at Forbes Hospice, Mr. Fisher, a maintenance worker from Jamaica whose heart is nearly nonfunctional, made a dying wish -- to see his wife, Marion, and daughters, Ashley, 11, and Asha-kay, 3, one last time.
The anticipation of their visit from Jamaica and Saturday night's reunion has revived Mr. Fisher. Where on Dec. 31, his first day in hospice care, his skin was gray and he was unable to stand up or talk without sacrificing too much energy, on Sunday he was walking around, slow and weak, but improved.
That's not the typical trajectory of a hospice patient.
"I don't have a medical explanation," said Randy Hebert, medical director at Forbes.
"I've been doing hospice medicine for six years and this is the second time I've seen this," he said.
The other case involved a woman who had to be discharged from hospice because she became "too healthy" and lived for several more years before succumbing to her bad heart.
Mr. Fisher could go that route or his heart could fail, Dr. Herbert said.
To survive, Mr. Fisher would need a heart transplant, and that's not likely to happen.
"I hung in there," he said. "What I would love now is to get a heart replacement.
"I don't want to die and leave my kids. I want to live some more. I want to live 10, 20 more years."
Mr. Fisher came to the U.S. from his native Jamaica for work and ended up in Pennsylvania in February 2013, working as a maintenance man at a pair of hotels in Bentleyville. He did it to earn enough money to put his daughters through college. Ashley, he said, wants to be a nurse. Mr. Fisher wants that for her, too.
He began to have heart problems in 2012 while living in New York. In December 2012, he had to have heart surgery and he received a pacemaker. While in Bentleyville, he traveled to New York for checkups, but he never complained or let on that anything was wrong, said Kim Tiano, accounting and administration executive at the hotels. He always had a smile on his face, she said.
One day in December, Mr. Fisher pulled his manager aside and asked for a ride to the hospital. His pacemaker had been jolting him as his heart function deteriorated. He spent two weeks at Allegheny General Hospital, fading quickly, and was transferred to Forbes Hospice at West Penn Hospital for end-of-life care on New Year's Eve.
Mr. Fisher said he wanted to die. The next day, his employer, Tejas Gosai, set up a computer in his hospice room and dialed his wife on Skype.
"Fisher was so happy and he said, 'I'd love to see them one more time before I die,' " Mr. Gosai said.
That got the hospice staff thinking. It's not unusual for this group to conjure fantastic plans around their patients' dying wishes.
Within the past week, they've arranged for a young man to have a horse-drawn carriage ride when the patient, who was raised on a horse-farm, said he'd like to be close to the animals one last time. They got tickets for a sold-out production of "Wicked" for another hospice patient. A few years ago, a 90-year-old man in hospice care got the Purple Heart that had eluded him for decades.
In the fall, Forbes Hospice even hosted a wedding for a groom who died six hours later.
Ellen Freise-March, an intern in Forbes, took to the mission of granting Mr. Fisher's wish like a "dog with a bone," according to Keri Harmicar, a spokeswoman for the hospice.
"You could not be in the same room with him and know the depth of his feeling and do nothing," Ms. Freise-March said.
She made call after call after call to contacts at other hospitals and to embassies in the U.S. and in Jamaica, with patience honed during 27 years of teaching elementary school children.
On Tuesday, she arranged for documents for Mrs. Fisher and her two daughters to submit their visa applications in Kingston.
The next day, Ms. Freise-March told Mr. Fisher that his family would be getting their visas and Mr. Fisher cried. "I just kept telling him, please, just hang in there," she said. That night he spit up blood. The nurses got him under control, but Ms. Freise-March was racing against the clock. On Thursday, his family received their visas and Ms. Freise-March recruited a corporate travel agency, owned by a friend, to book tickets as soon as possible. Mr. Gosai paid for the airfare.
Mrs. Fisher and the girls arrived at Forbes on Saturday night and have been there ever since. Although Mr. Gosai has arranged for the family to stay at one of his other hotels in Monroeville, Mrs. Fisher said she's not leaving her husband's side.
Mrs. Fisher's mother lives in New York City, and plans are underway to transport Mr. Fisher to a hospice there if he survives long enough. Ms. Freise-March said she's faxing the final documents today to arrange the transfer. She has crossed two fingers on each hands.
"So far, fingers crossed has worked," she said.
Anya Litvak: firstname.lastname@example.org or 412-263-1455.