When the End is Near

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In two impersonal, sterile hospital rooms two separate families gather to keep vigil, to say good-bye.

Previously the doctors have had the hard conversations - the loved one is no longer responding to treatment and the prognosis is grim.

The patient and his or her family too have difficult decisions to make, hard conversations to hold. Words must make their way past a lump that forms in the throat, around sadness that breaks the heart, through tears that glisten in eyes and spill down cheeks, and finally formulate in a brain dazed by shock. These conversations require great courage.

The two families keeping vigil had these hard conversations. One family chose to deny the reality of their loved one's situation. The other family chose to let go. The patient chose to let go of this life and his family chose to let him go.

Letting go of this life and of a loved one is a heart-wrenching decision and it can also be an immense gift of love.

The family who denied reality and rejected the option of palliative care, of hospice care watched their mother, wife, and grandmother die painfully. Her death was a traumatic event both for her and for her family.

The family who chose to let go also chose hospice care. Hospice focuses on palliative care--keeping the person comfortable through the dying process. Hospice is not about heroic efforts to extend life, but about helping a person to die peacefully and helping a family to cope with the heart-rending loss of their loved one.

For many there comes a point when the doctors and other medical professionals have exhausted their options, when the treatments have failed. At this difficult moment in life, the choice becomes how to let go, how to face death. Hospice care, palliative care can help families make this difficult transition with support, care, and comfort.

News of Beginnings and Endings

At one end of the 3rd floor is maternity; at the other end is the hospice unit. Between them a short hallway, the dash between birth and death. Life.

The maternity unit is most often filled with wonderful news, with hope, with the anticipation of a life to be lived, of dreams to be developed, of potential to be realized. 

The hospice floor is a place of endings, of letting go, of saying goodbye, of memories of a life lived, of sad news. 

Between them is life, where dreams are realized or lost, where love is found and lost and found again, where families are built, where memories are made. 

I read a book recently about a man who was diagnosed with terminal lung cancer in his late thirties, a brilliant surgeon with a bright future. As he adjusted to his diagnosis, to chemo, to the loss of dreams, to the loss of the life he and his wife had planned, his oncologist challenged him to determine what he valued and to expend his energy, the energy and time he had remaining on what he valued.

If I was given the news I had 10 years or 5 years or 3 years or 6 months or 3 months to live, where would I want to expend my energy and time? What would I want to do? Who would I want to be with? What legacy would I want to leave behind? 

The man in the book chose to finish his residency, create a daughter with his wife, write the book I read, and love his family and friends. The journey for each of us will be different. Identifying what we value, where we want to spend our remaining energy and time is a deeply personal process. 

I haven't received news about how much longer I have to live, still I want to live a life of meaning, of focus, of value. I want to leave a legacy that matters. Pondering these questions, determining values, is an important part of the journey to leaving a legacy that matters. 

Lessons My Father Taught Me About Living . . . and Dying

I learned many lessons from my dad by the way he lived his life.

I learned that hard work is a good thing. My dad didn't work in a faraway office. When I was a child, my father owned a dairy farm - a business where the work never seems to end. He took me on the tractor to the fields and let me "drive" it even as a young girl. When he was building on an addition to the barn, he hung a swing from the rafters for me so that I could play while he worked. When I was older and the farm had been sold and he ran a sawmill, I went with him into the woods while he cut down trees. As a thirty-something adult, I finally came face to face with the realization that this was not the way most kids grew up. For many Dad left in the morning and came home again in the evening and in between they didn't see him. I learned about work by working side-by-side with my dad doing things that little girl hands could do. I don't ever remember him asking me to do something that was beyond my ability and I remember him protecting me from the things that could harm me in the hazardous work he did. He seemed to know what I could and couldn't do and asked me to do what I could, but didn't ask more.

I learned not to complain in the face of pain and difficulty, but to keep going, pace yourself, and do the best you can. When I was an infant, just 6 months old, my father had his second back surgery. As long as I can remember, he lived with chronic pain and significant health issues, yet he rarely complained. Sometimes in his sleep you could tell how bad the pain was because in those unguarded moments he would moan, but in his waking hours he rarely complained. And, despite the pain he built two successful businesses - the family farm and then a rough cut lumber business. His lumber business grew mostly by word of mouth. Customers would come back again and again because of the quality of the product they received. He did his best. And he paced himself, resting when needed, taking family vacations, and weekend getaways with my mom. Then he would return to work hard and do his best.

He was a man of few words, yet when he spoke his words carried weight and had impact. When he said he would do something, you could count on it.

I also learned about love. He was a quiet man and words of love didn't come easily to him. Yet his love for his wife and family was deep. He loved to have his children, grandchildren, and great grandchildren in his home. He always seemed to know that people were more important than things and that family were most important of all people. As long as he was able, each year he would drive the many hours to visit my sisters who lived far away to spend time with his daughters and their families. He made many gifts in his wood-shop for his children and grandchildren. He helped remodel houses, build potato bins, play games, hike, pick berries, and visit historical sites for and with his family. All of these expressions of his love.

He also taught me lessons in his dying. I had the privilege of helping to care for him the last 10 days of his life. The hospice workers warned us that it is normal for people to do things that we're not accustomed to them doing - like swearing a blue streak. My father, although in incredible pain those last days, didn't cry out, didn't get cranky and didn't swear. I don't think I ever heard him utter a swear word during my lifetime and that habit, I believe, was so deeply ingrained that even in death those words were not a part of who he was.

I knew that he loved Christ and had served Him faithfully for many years. It was his custom to spend time reading his Bible each day. As he lay in the hospital bed, the toxins building up in his system, I read to him from his Bible. One day I asked him if there was anything special that he would like me to read. His response was, "No, it's all good."

He died on a Sunday - Mother's Day - and the night before he uttered the last words I would ever hear him say on this earth. He had been basically in a coma for the few days before that, talking little, sleeping much. On that Saturday night, he spoke in a clear strong voice and said, "Thank you, Jesus!" I knew that he could see and was experiencing something very real and profound in the spiritual realm. In that moment, I felt closer to God than I had in a long time.

I am thankful for the lessons my father taught me in life and in death. He lived well and he died with dignity and honor.