A Lesson in Dying

By Pat Schwiebert, R.N.
pat@tearsoup.com

My friend died last week.  59 years old is too young to die.  Not being able to see her almost-13-year-old son grow up is also unfair.  But she died anyway.  There was no stopping death.   She had held ovarian cancer at bay for five years with chemotherapy, radiation, meditation and by becoming friends with what some call the enemy. There had been a sigh of relief when the doctors claimed her cancer was in remission after almost two years of treatment. She joined the worried well club assuming it was only a matter of time before she’d be thrown into rounds of chemo again.  But she always appeared cheerful never showing any concern or regret for what lay ahead.

I was in awe of how she danced her way through the unchartered territory of dying, considering foremost how this would affect her son and vowing to live each day with as much joy as she could pack into it.  She knew this was the final lesson she would teach him and she didn’t want him to be afraid of this part of life.

She was the primary parent, though she had never planned to raise a child.  But from the moment he was put into her arms minutes after birth she was hooked, and fell in love with him, and never gave her intentions for a childfree lifestyle a second thought. 

Fast forward to the most recent two months.  One final round of chemotherapy helped relieve her growing belly and the associated discomfort, but the constant nausea and vomiting continued to diminish her quality of life.   TPN (total parental nutrition) helped give her some nourishment but because of an inoperable bowel obstruction that prevented any bowel movements for almost two months, vomiting was her only way of emptying her GI tract. 

She had been in the hospital for three weeks with only a few days during that time when she was able to return home.  She called me from the hospital to report that there was no more that could be done to stop the cancer.  Her oncologist suggested hospice to assist her in her final days.  She appeared gravely ill as she lay in her hospital bed while we talked about what might come next.

Upon returning home she looked like the energizer bunny making her way around the house getting things in order, showing her partner how to manage their finances that she had always handled.  She looked different from the person who lay in the hospital only a few days before.  Her spirits were high.  Her color was improved.  Her vomiting only interrupted her activity once or twice a day.  She was a woman with a mission.  One could guess there might have been some divine intervention going on here.

There were still a few things she wanted to do before she died.  She made plans to celebrate their son’s 13^th birthday a few weeks early.   She knew that if she were still alive on his actual birthday, she would be too weak to enjoy it so she moved it up, with his permission, so that she could be part of the fun.   

She wanted to officially marry her lover of 22 years and she wanted the two of them to take a road trip to Port Townsend. Washington.

She knew it was important for her son to see his two moms officially married now that same gender marriages were legal in Oregon, even though the two of them had shared a holy union many years previously.  A handful of close friends gathered ten days before she died to witness her son escort her to her waiting partner so that the two of them could repeat the same vows they had spoken to each other many years before.

And that road trip was just for the two of them so they could look back and remember and say thank you to each other for the lives they shared. 

She was very clear about what she was doing and why. With great effort she paced herself so she could be totally present during the few hours a day she was awake.

When she got home from the 1 ½ day road trip she said, “I have only one more thing I need to do.  I need to die.  “

She had told me a few weeks before that she wanted to die soon because she wanted to give her son time to grieve before returning to school.  I laughed with her as we tried to imagine him getting all of his grieving done in a little over a month.  All I could think was that this was the most loving thing a mother could want to do—to set aside her fading life so that her son could get on with his.  She was always so pragmatic in the rest of her life, why not now also?

She had decided to stop the TPN even before the hospice nurse suggested it was doing her more harm than good.  When I asked how long she might live without that nourishment the nurse offered a guesstimate of about a week.  A deep sigh came from my friend.  I asked what the sigh meant.  She replied.  “A week seems like a long time.”  I had assumed she was going to say, “A week seems like a short time.”

What she knew was that she didn’t want to just hang on.  That was not her style.   She was already tired of being too tired to do anything.  She no longer had the stamina to keep up with her family. “No way to live”, she would say.  And she didn’t want her son to see her linger. 

10 days after getting married, 7 days after a fabulous 13^th birthday party, five days after taking a road trip to say I love you, and four grace-filled days after stopping TPN, she died.

We sang to her and prayed for her and wished her well on her next journey.  Her son came and kissed her goodbye and I saw her mouth the words, “I love you.” 

We watched her breathing.  And then it stopped.  Where she was going, she no longer needed breath.  And she gave birth to her soul.

After we bathed her and dressed her in the clothes she had worn on her wedding day just 10 days earlier, we sat without speaking, grateful for her journey that she shared with us that removed any fear of death from us.  And we were given the most precious gift.  The silence in the room was unlike any quiet moment you could experience in a different time. This silence that filled the space was full of life.  Was it a gift from her or were we sitting in the presence of the Holy One.  Whatever it was, it was PEACE.