I was honored to be part of a beautiful experience in late January of 2011. It was the death of my mother-in-law at the direction of Trinity Hospice in Aiken, SC. Having never thought I would describe death as beautiful the word choice comes as a surprise even to me, a Sagittarius and straight shooter, and in combination with mother-in-law, I would also guess, very suspect. However, sharing in her passing alongside her loving husband, sons, daughters and grandchildren, I found hospice to be a brilliant choice made by Shirley and all so dear to her.
Having worked in and around healthcare since 1998, I quickly learned that medicine is anything but a perfect science. The first time I walked through an ICU I was taken by the silence and the lack of life in the hushed hallways. Patients were housed in their individual rooms, hooked to ventilators, tubing and softly beeping machines. Not one room had a visitor or loved one sitting nearby on this day. Not one patients’ hand was reassuringly being held extending the one universal source of healing—touch.
A few years later I was in another ICU. I was talking with a nurse who shared with me a study they were working on. Family members do not understand just exactly what “do whatever you can” for their loved one means, she shared. Cracking ribs to resuscitate someone who has days or even weeks to live is useless for many, yet familial guilt or duty or feeling the need to do something, forces healthcare providers to perform actions they know in their heart are so far from the best interest of the patient. This particular study was allowing family members in patient rooms to witness the truth behind “do whatever you can” in hope that painful, costly procedures inflicted upon patients could be avoided.
When hospice came that unseasonably cold January evening in Aiken, a wonderful nurse who was unafraid of truth, or of death, told us all that it wouldn’t be too long before Shirley left us. She had lost the ability to communicate because, as the nurse explained, those who are dying become dehydrated from their inability to take in liquid or food making their vocal cords useless. When the nurse left, we sat vigil waiting for death to come. We Googled “stages of death” to better understand what we and Shirley were facing, and found both relief and comfort online in an outline of the bodies’ universal deterioration. We talked to Shirley, held her hand as she lay in her enclosed backporch, surrounded by windows that gave view to a golf course — the game she loved so very much. Photos of family and familiarity surrounded her until her final breath.
I encouraged my husband, his sister and my father-in-law to continue to talk to her when their own grief, fear and concern left the room silent. I could only put myself in her place and know that I would crave constant touch and a voice nearby saying, “It’s okay,” because dying is indeed just that. Sometimes better than okay, and for a woman who at 83 had battled the cancer that had first attacked her breast, then lungs, then back, then bones, since her 40s in the process of raising four children, a husband, three grandchildren and was loved and admired by many friends—her death was now a blessing. An avid socialite and athlete, all who knew Shirley knew that being confined to a bed for over six months was killing her spirit—a fate much worse than death.
A few hours before her death, my husband recalled to his mother memories of vacations they had taken over the years. Shirley tried to communicate something as he spoke. An unintelligible syllable here—a grumble there. We believe she heard him and was trying to join the conversation. We will never know what she was feeling or trying to say, if anything. But what I do now know is that the best way to die is at home if at all possible, with family around recalling trips to England, a soapbox derby 2nd place finish, or the hope that maybe the daughter she buried from the same cancer fifteen years earlier would be waiting to greet her in heaven. Perception and belief create our reality—I choose this one over the sterile, cold, often intrusive, unnecessary, loss of control that occurs when you surrender the care of your loved one to a healthcare system that tries but often falls short in this life passage.
Watching someone you care about suffer is hard work. Many shy away from it and give this gift to a stranger or healthcare provider. But being present for this transition is a gift—like birth, like graduation, like marriage. Dying is something we all must do and to miss this life passage of those you love most seems like the ultimate instance of not being there when someone most needs you. Shirley had those she loved most at her bedside that early January morning, and even if she couldn’t acknowledge us with intention, I know she felt our presence when it mattered to her most.
Tracy Granzyk is a health care writer and filmmaker.
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