Friends, this post will be difficult for all of us. If you’ve had a very recent loss, it’s probably not the best time to read this one. Save it for later when you’re stronger. I am not even sure I should be sharing this. I don’t know who it will help. Maybe you, but maybe just me. I do know that I feel called to share it, and I am very sure that it is a necessary part of the healing process.
Modern medicine has essentially removed death from our everyday lives. People today don’t experience the number of personal losses to death that people did even 100 years ago. Death used to be common place in our homes due to wars, illnesses that now have readily available treatments and cures, accidents, and the prevalence of livestock in people’s everyday lives. We had so many rituals and social structures around death that supported and ushered people through the process. Mourning jewelry that contained images and remains were prevalent. People do still wear mourning or remembrance type jewelry, but it is typically disguised as regular jewelry so that no one but the wearer knows that it contains ashes, a lock of hair, or is actually a finger print or the impression of the electrical impulse of a heart beat from an electrocardiogram. Death has become something to be handled discreetly, privately. I believe that has made it more difficult for those who are grieving, and we are all grieving. We need to talk about it! Candidly. But we don’t. People don’t talk about it when they have been witness to the final moments of life. It’s painful. It’s intensely personal. It’s packed with conflicting emotions that are difficult to describe in words. Perhaps it’s not considered polite to share the contents of that experience. Honestly, manners—superficial, defined social structures—don’t matter that much to me anymore. People, feelings, experiences, being totally present, deeply listening, understanding, and questioning are the things that I care about and pour myself into these days. Transparency, vulnerability, truth. These are the conduits to healing.
The last two weeks leading up to Paul’s last day had been a constant effort to keep him comfortable. The cancer was pervasive. It was everywhere, lungs, brain, abdomen, colon, liver, intestines, everywhere. Our chief concern was, of course, managing pain. We soon arrived at a crossroads where, in order to manage the pain and keep him comfortable, we would have to relinquish his ability to remain conscious. This was an insanely difficult decision-making process for us to navigate. We knew every choice we made about the medications that were being used could mean that we were interacting with the essence of what made Paul Paul for the last time. Some of the drugs being used to manage pain could, in fact, lead to his death. During this time, Paul would have what we described as long pauses. There would be periods of time when he would just stop breathing. We would all huddle close to him thinking that the moment had come. Then, after up to two or three minutes (an eternity!), he would start breathing again. These long pauses happened multiple times a day for days on end. It was traumatizing. Because our son and I would frequently take turns going home to sleep, shower, changes clothes, and walk dogs, there were several times when a period of long pauses occurred when one of us was not at the hospital. When this happened, we would call the one who was not there and stay on the phone while we hurried to get back to the hospital terrified that we might miss Paul’s final moment. Like I said, traumatizing.
He had not been conscious in over a week. The Paul we knew was gone, but his body remained. It was hard to understand what was keeping him tethered. A member of the palliative care team explained that sometimes the dying have a need for privacy in their final moments. So, our son and I left the room for several hours at a stretch, both of us, for the first time since Paul was admitted to the hospital, but it only seemed to agitate him. Even unconscious, Paul rested more comfortably when we were in the room. I asked a member of our palliative care team why Paul was lingering when it was so difficult. I just didn’t understand how his body could possibly be enduring. I think what I was really asking was why Paul had to suffer. I know now that to be human is to suffer. We are human. Suffering is the human condition. For the rest of my life, no matter what happens to me, no matter who I love or who loves me, in my last breaths, I will be in that hospital room with Paul in his last moments. I will see what I saw. I will hear what I heard. I will feel what I felt, and as brutal as that was, it was a privilege.
The palliative care team member I was speaking to was an older doctor, and he gently explained to me, in the most beautiful way, something that had never occurred to me before. He said that, in his career, he had been present at countless deaths and countless births. He said that not all people arrive easily. For some, the birth process is difficult, a struggle, and that the same is true of the death process. For some, it is difficult. It is a struggle. I’m not sure why that had never occurred to me. Again, I think it might be because we as a society do not talk and share enough about the ubiquitous human experience that is the dying process. It makes sense, though, right? Birthing is called labor. There is pain. Then, so, too, dying is also a labor, and some labor more than others just as in the birthing process. Paul was in labor, struggling to be born into the next life, and we were witnesses, but after talking with the doctor, I saw myself as a coach as well and began to think about what Paul needed from me, how I could come alongside him as his partner in the process instead of merely his care-giver and advocate.
On morning of the last day, I arrived at the hospital early. Our son had been with Paul through the night and headed home for a little while. Shortly after our son left, Paul’s breathing became labored and noisy, loud. It was difficult to be in the room. It was brutal.
I sent this message out to family and friends. “We are on our knees this morning. This road is very, very difficult. But we are not alone. We feel the love and prayers of family and friends near and far. Any strength you perceive in us, I have to tell you is not us, but Him. I am running on His Grace alone. There is nothing left but His Grace. Everything else has been stripped away. We are laid bare in the pain and struggle of it. I have honestly never experienced anything worse than this, and yet I rest in the comfort of my Savior’s embrace. We love you all.”
In desperation, I cried out to God to be merciful. This was my prayer that day, “Please, Lord God, have mercy on your servant, Paul. He belongs to You. He has always belonged to you, Lord, and now I am begging you to have mercy. I am thankful for the days you have given us. I am sorry for the many ways I have fallen short. Please, Lord, be merciful.” Then, I had a heart-to-heart talk with Paul, the way a wife talks with a husband. I told him that we were trying everything we knew to keep him comfortable, but we were failing. I told him that we could not heal him, but God could. After 30 years of complete and utter love and devotion, I told Paul for the last time that I loved him but God loved him more. Yes, God loved him more. That was an important realization for me. I had always thought that I loved Paul most and best, but that was actually never true. God always loved him more. I also talked to Paul about all the wonderful, fun, sad, difficult, normal, extraordinary things we had done together. We were always together, but this was different. He would have to do this last thing on his own, and I told him I knew he could do it. He had to go on ahead of me, and he had to do it by himself.
Our son arrived back at the hospital about noon, and the labored breathing continued throughout the day. In the evening, he was suddenly quiet. The three of us spent the rest of night together peacefully. I awoke at about 1:30 in the morning. I don’t know why because on the surface nothing had changed. Paul was still quiet and peaceful. So, I just sat there with him holding his hand. The pace of his breath quickened, and I spoke with the nurse about a medication change. She administered the medication, but his breathing continued to be erratic. I woke our son up. He and I surrounded his dad with love and joy and gratitude and saw him traverse the threshold from this world to his eternal home.
When it comes to cancer, everyone prays for a miracle. Well, we did have a miracle. It was not a happy ending in the traditional sense as in a cure, but it was a peaceful, dignified ending. The miracle is that, given what we were facing, Paul died peacefully and with dignity surrounded by family, friends, and so much love.
I have used this picture in a previous post, and you may have thought, as I did, Why am is she (am I) smiling? When I saw myself in this picture, that was my first thought. Why am I smiling? Initially, I didn’t have an answer for that question. Over time, I realized why. For me, the hardest part was watching Paul in pain, watching Paul die, and that part was thankfully, blessedly over. I could not even cry. I felt so ridiculous, not being able to cry, but I was so happy for Paul, that the pain and suffering was over. My grief was delayed by relief. I recently saw a picture of another young widow, an acquaintance of mine from high school. Her husband died of cancer, 49 years old. In the picture, the day of her husband’s funeral, she is smiling, just like me. I know why.
Be blessed, Malia
Party of One, or Life after Death 