Monthly Archives: February 2014

Full Circle: Regrets Regarding Life, Death and Dying

In writing about promises and regrets as I age, the one experience that I count as a challenge in regret was the death of my mother.  I count it as a challenge because I could not have changed the outcome.  Whether she had lived to a ripe old age or died as she did at a young 66, I regret her death even as I recognize the inevitability of it.  Losing a loved one to death is one of the most difficult challenges that one must face.  Until my mother died, the reality of death had never affected my life as her death did.  Other members of my family had died; an aunt, a cousin, my grandfather, whom I had only met once when he came here from Texas to visit us.  My mother was my best friend.  We talked by phone almost every day, sometimes for just a short time, while on other days long, lingering conversations were a smooth flow of easy laughter, natural understanding and quiet joy.  Some days, after work, no matter how tired I was, I would stop by my parent’s nearby home just to share a hug with Mom.  I was Dad’s “Baby Girl,” and he knew how much I loved him; however, I splashed and floated in the quiet waters of the love I shared with Mom.

Sunday dinners at my parents’ home was an invitation that all of our friends coveted.  Not only was the food cooked with love, that special ingredient that Mom said she put in every pot, but she, with that affectionate smile, welcomed all those who came to partake in our Sunday rituals of   church, then home for Dad’s prayer, food, and laughter.  The food was simple, nourishing and delicious.  We, invited friends to enjoy those large bubbling pots of beans, greens, black-eyed peas, rice, large pans of corn bread, candied yams, and mac and cheese.  A couple of chickens, cut into small pieces and fried were bone-in nuggets long before the colonel ever thought of such, completed those Sunday plates that fed everyone to satisfaction.  There was a desserts of peach cobbler, banana pudding or butter cake.  A certain warmth and kindness exuded from her that is indescribable.  Love poured from her like a Caribbean rain, lush and life giving.

In the summer of 1986 when she complained of a pain that moved around in her chest I thought that she had pulled a muscle while working in the yard.  Upon being x-rayed, examined and a four-day hospital stay for tests, we were given an appointment for the test results.

It was early August when Mom and I drove to Kaiser Hospital in Oakland.  The doctor saw almost immediately.  He told us it was cancer and it had spread to most of her vital organs; it was in her lungs, around her stomach and there was a shadow on her liver.  A sudden dizziness and lurching in my stomach caused me to feign an ordinary trip to the ladies’ room where I splashed water on my face and tried to focus so that the pained expression didn’t reveal itself in my eyes.  When I returned to the doctor’s office, I asked if anything could be done, the doctor thumbed through Mom’s chart and said that the surgery performed over a year ago had been the only surgery that could be performed; this time the cancer had spread too far.  In hazy recollection, I realized that Mom’s previous surgery, the hysterectomy, was not for the fibroid tumors as she had informed the family and me.  Having had that same surgery myself, I had recovered quite quickly from it and Mom had seemed to recover just as well.  My head was spinning.  This meant that Mom had known that she had cancer for over a year; had gone through surgery for it, and had said nothing to me or anyone else in the family about the seriousness of her condition.

The doctor said that chemotherapy would only delay the inevitable for a short while, and that the illness associated with the treatments would weaken her already precarious physical condition.  “Less than a year” was his response to my question of how much time?  She decided against the chemotherapy treatments with no prompting from me. Secretly, I was glad.  A few years previously, I had watched another colleague, Mrs. Southlan go through days of violent illness after each chemotherapy treatment for her diagnosed cancer. To me, her last days seemed additionally chaotic and pain filled because of the chemotherapy.

Years later, in 2000, while, concentrating on getting my degree, a class assignment to read Doctor Elisabeth Kubler-Ross’ book “On Death and Dying” was a revelation to me and I wish I had read it before or even during my mother’s illness and death.  I know Dr. Kubler-Ross’ words would have provided comfort and understanding at a time when I needed somewhere to turn when prayer seemed not to provide the logic I needed.  The subtitle of her book, “What the dying have to teach doctors, nurses, clergy and their own families”, expressed the buried, but not forgotten feelings that remained thirteen years after her death.  The five stages of death and dying described by Doctor Kubler-Ross are: Denial and Isolation (First Stage,) Anger (Second Stage), Bargaining (Third Stage), Depression (Fourth Stage), and Acceptance (Fifth Stage).

The denial and isolation stage, completely described Mom.  When the two of us arrived back at her home after the doctor’s fatal prognosis, my three brothers and my dad were waiting to hear the test results.  To my amazement, Mom announced that she was just fine, that the doctor had found a “tiny shadow behind her liver, but that was all.”  Of course, my brothers and father were visibly relieved to hear that everything was fine.   Later, when I could get my father alone to explain to him what the doctor had actually said, he took the news very calmly and never returned to the subject with me.  He too was in denial.

Mom stopped talking with me and I did not understand.  Her silence was overwhelming.  Dr. Kubler-Ross says “Denial is usually a temporary defense and will soon be replaced by partial acceptance” (Kubler-Ross, 53).  One of the only statements that Mom repeated during her illness was “ I am at peace with my Lord.” Not temporary, her silence lasted from August until November 18, 1986 when she died.  No matter how I approached the difficult subject of her silence in my one-sided conversations with her, she would not respond.  I loved her dearly, but I did not understand why she wouldn’t help me prepare for the carrying on after she was gone.  My mother carried the family.  My dad didn’t know how to write a check.  My brothers depended on her for all their business transactions.  I was the only girl and only child with a separate home and family (with my two sons). I didn’t know where to begin with the business of her household.

In retrospect, through my own faith and expanding wisdom, I understand my mom better now than I did at the time.  She enjoyed a strong religious belief in the power of God in her life.  Now I know that she had turned her life over in the faith that had fueled her life and justified her existence.  She had been a good wife, mother and grandmother.   She worked in her church and community.  She saw to it that her four children and my two sons attended Sunday school, church and were grounded in the basic Baptist/Methodist Bible training all our lives. Her words regarding being at peace may have been her immediate entrance into what Doctor Kubler-Ross describes as the third stage of “Bargaining”, and I did not recognize it.

As Mom’s health quickly deteriorated, I lived in a whirlwind of daily issues concerning terminally ill health care, medications, hospice and social services.  Day care, special diets and finally Ensure, as a dietary supplement to offset her lack of appetite, became part of my everyday existence.  My brothers and Dad were afraid to perform personal care for her.  The malicious evil of cancer stealthy attacked the once robust woman of five feet eight inches, weighing 175 pounds, and we watched as she shrank into a gaunt birdlike figure before our eyes.

The major difficulties were the denial, the pain and the morphine.  Mom said she was at peace; however, the household was not.  My brothers were devastated.  My father (her husband of 49 years) was scared and confused; he never entered her sickroom.  He would peek around the corner in the doorway shielding his body with the doorframe as if to protect it from harm, in a shaky voice, he would inquire as to how things were going.  I instinctively knew that he really didn’t want any truthfulness from me.  In all my own confusion, I was confronted with the realization that these two stalwarts of my life, who had been my rocks of support, were both “only human” in dealing with the reality of this dreaded disease.  Mom had always recognized my dad as the head of the household; however, she was the glue that held everything together.  She was the air that we breathed.  She was our bread of life.  She was love.  None of us wanted to believe this was happening to us.  I spent many long hours in the emergency room for one reason or another-sometimes for infusions to “plump her up” as she would call it.  She couldn’t eat.  Shopping for Ensure became the order of the day.   A hospital bed, adult diapers, gowns that are easily removed, bedpans and morphine were everyday occurrences.  Hiding the morphine from my eldest brother, and dealing with all the lovingly concerned friends, family and church members was overwhelming.  Fortunately, at work, I had an understanding supervisor, even though my coworkers were not, and my absences and tardiness’ were forgiven.

As I watched Mom shrink into a small shadow of herself that I could lift, turn and easily handle, she became ever more silent, a surreal quality seemed to engulf the house and her sick room in particular.  In an almost dream-like state on the evening of October 18, 1986 I walked down the hall toward her room and it became a tunnel.  I could actually hear water splashing under my feet as I approached her room.   When I looked in on her, there seemed to be a soft yellow light surrounding her bed.  It seemed important for me to bath and change her again, even though I had performed that task lovingly only hours earlier.  She hadn’t spoken in days or rang the bell we given her to get our attention.  After I finished changing the bed and bathing her, I held her in my arms and was giving her water by dropping it into her mouth, as one would feed a baby who couldn’t suckle.

As I held her, I could feel the rhythm of her heartbeat.  It seemed strangely strong and healthy as it beat against my breast.  She moaned in pain, I gave her morphine and gently held her.  The yellow glow surrounded us both now and I felt a peacefulness that I had not felt during her illness.  It seemed that we had come full circle; through birth, she had given life to me; now, in death, I was protecting and caring for her as she traveled this mysterious, unsolicited journey. I felt the last heartbeat – it stopped, suddenly.

I have been reluctant to speak of that last night with my mom; however, Dr. Kubler-Ross helped me understand that what happened was not unusual:

Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening nor painful, but a peaceful cessation of the functioning of the body.  Watching a peaceful death of a human being reminds us of a falling star; one of a million lights in a vast sky that flares up for a brief moment only to disappear into the endless night forever.  To be therapist to a dying patient makes us aware of the uniqueness of each individual in this vast sea of humanity.  It makes us aware of our finiteness, our limited lifespan.  Few of us live beyond our three score and ten years and yet in the brief time most of us create and live a unique biography and weave ourselves into the fabric of human history (Kubler-Ross, 276).

If caring for a dying loved one was difficult, preparing for the funeral was beyond comprehension. At the wake, (viewing of the body by family and friends), I watched as they came forward to look at her as she lay in the bronze casket, appearing somewhat as she had looked before the devastation.  Her once warmth had become cold and hard skin with body fluids drained and replaced by the cough inducing fluid of death.  Some came forward in humility and love; others in gazing curiosity.

The next day’s church service, then going to he grave site and watching the coffin lowered into the ground was devastating.  Afterwards, there was the repast, where the consumption of food provides family and friends with a familiar ritual for saying the last goodbye.  After the feast in the family service center at the church, followed by family and friends accompanying me home for talk and further commensuration, I was kept busy into the late hours of the evening.  However, by far the loneliest night of my life was that night of the day that I buried my mom.  With the rituals complete and all the well-wishers retuning to their homes and families, an emptiness absorbed the air around me and I was enveloped into a realm of aloneness that I had never experienced before. Prayer helped me through that night.

My father died a seemingly peaceful death in October 1992 on an early fall morning as my brother prepared his breakfast. After Mom’s death, he had lived his life sitting at the kitchen table listening to talk radio, punctuated by his visits to the doctor to get more medication.  He loved to take pills, always had.  My brothers were much more helpful in caring for him in his illness and death. He died quietly of a heart condition. They told me they felt more comfortable caring for my dad. I guess there is a certain kind of intimacy that remains off limits even in sickness and death because I could not fathom, taking my father to the toilet.

Over the years, I had become accustomed to taking her place as the chief bill payer and grocery shopper. I was more prepared for his death and although it was difficult, his funeral and the rest of the rituals were much easier to bear.  My sons poured out their abundant love for him as they eulogized him in a quiet memorial service.  The repast was held at my home and I’m sure I didn’t have the “too busy to deal with nervous breakdown” that I know I had during my mother’s illness and death.  It’s the kind of nervous breakdown where you know that you are crazy, your actions prove it, but you have to keep functioning because so much and so many depend on you, so you do keep moving forward until you finally work your way through the crazy, taking one day at a time.

I’ve learned valuable lessons through the deaths of both my parents, my mother in particular:  the value of a strong religious belief, the value of prayer, of family, friends and church as an invaluable part of the mystery of life.  The cycle is inevitable. It’s a sweeping, never-ending circle of birth, hopes, disappointments, dreams, and realities, then, finally that last heartbeat of life.  Doctor Kubler-Ross’ final stage of “Acceptance” is the key.  Acceptance by both the dying and the loved ones who live on who may not always understand those you love, but realize and accept the reality of death as an integral part of life itself.

WORKS CITED

Kubler-Ross, Elisabeth.  On Death and Dying.  New York: Macmillan Publishing Company, 1969