The story of Paul’s last day.

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 a death that people did even 100 years ago. Death used to be common place in our homes due to wars, illnesses that now have common place 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 or a lock of hair or is actually a finger print or the imprint 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 we 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, we 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 Paul. Even unconscious, he 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. The palliative care team member 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 the dying process is. 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 that 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 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 I (is she) 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 grieving 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

The Keeping-it-Real Post: Part I

“How are you doing?” It should literally be the theme song, the catch phrase, of grief. The real answer to that question is complicated and unpalatable for most people, even those closest to me. There’s always a real response in my head followed by the more polite, socially acceptable response that comes out my mouth.

So, why can’t I tell people the real answer to that question?

Because some days the real answer to that question goes like this. “Well, I’m not thinking about driving my car into a tree anymore” and “I’m finally able to ride over bridges without thinking about jumping” or “I am seething with sinful jealousy because you are sitting next to your husband, and I’m not sitting next to mine”. There’s also, “My heart is breaking right now, because, as I am watching you spend time with your son, I am remembering those same moments between my son and his father. I ache for my own son who will spend so much of his life without his father. I’m in pain because I know the intense daily sadness of living so much of one’s life without a parent.” Like I said….keeping-it-real.

I realize these responses would startle folks. Most people expect the typical response, “Fine! How are you?” or “I’m doing ok”, and when they don’t get the response they are expecting, they are flummoxed and stammer for a way to respond appropriately. I don’t want to put my burden on others especially not in the middle of the day at work or in the store when I run into an acquaintance. I think most people who are grieving do this. They wear this mask because it’s the only way to get through the day. It’s not intended to be deceptive or untruthful. It’s just not practical or possible for me to tell people how I feel because we have to be able to get through the rest of the day, and if I told people how I really feel, none of us could. Believe me.

The bottom line here, the lesson for all of us, is that it’s really impossible for anyone who is grieving to be “ok” regardless of how they look, act, sound, or respond to the “How are you doing?” question.

I’ve run across this sentiment in two other contexts just this week. Here in John Pavlovitz’s blog and here in Michael Gerson’s sermon where he candidly discusses the ravages of depression. Apparently, Facebook knows I am grieving just as well as it knows when I’m shopping for shoes because recently my news feed is rife with articles about and references to the grief process. One of the pastors at my church also referenced the Gerson article. And it’s no wonder why because Gerson nails it when he says, “At some point, willed cheerfulness fails. Or we skim along the surface of our lives, afraid of what lies in the depths below. It is a way to cope, but no way to live.” Depression, grief, anxiety….willed cheerfulness is the mask we wear to get through the day. Pavlovitz’s article is more of a decidedly welcome, public service announcement regarding the grieving people who we come in contact with every day but don’t realize their pain. He says, “Everyone is grieving and worried and fearful, none of them wear the signs, none of them have the labels, and none of them come with written warnings reading, I’M STRUGGLING. GO EASY.” Speaking of his own grief after the death of his father, Pavlovitz goes on to say that if people did realize what pain is hidden beneath the mask “…it probably would have caused people around me to give me space or speak softer or move more carefully.” Honestly, it makes me long for the days when widows would wear black for up to a year, and people wore a black arm band for up to six months after the death of a parent or spouse. In that way, we could “wear the signs” to alert others to our fragile condition.

Surrounded by friends the day of Paul’s funeral.

It occurs to me that encountering death in everyday life used to be more commonplace. People just flat-out dealt with death more frequently in the past. High child mortality rates before the advent of vaccines and antibiotics, world wars, pandemics like the Spanish flu (50-100 million deaths in 1918). Death was, well, normal. Society had many ways to manage grief through traditions and expected behavioral responses. It wasn’t that long ago that a viewing or visitation was actually held in the home of the deceased not the funeral home as it typically happens today. The modern death experience has been sanitized particularly in the West. In my opinion, that has not served us, the bereaved, well. When did we, as a society, become so uncomfortable with others’ emotions that grieving is now something that is expected to be done in private? The isolation of grief does not aid the process. It, in fact, can delay healing and growth. But I’ve digressed.

So, how do we respond to the “How are you doing?” question in a way that is honest, healthy, and facilitates the grieving process?

Do this: Develop one or two standard answers that are truthful but don’t suck the air out of the room. Keep the response short and generalized, something that is honest but doesn’t require awkward, uncomfortable detail.

Some of my go-to responses are “I’m struggling, but I’m here” and “I’m having a tough time. I miss my husband.” You can always add, “Thank you for asking. I appreciate your concern.”

Come up with responses that work for you. Practice them out loud if you need to until you are confident and won’t be searching for the words when people ask because they will. They always do. Thankfully, they always do.

Take care of yourselves, Malia

Introduction

“Paul had a generosity of spirit. He drew people to him. He was always so easy to be around and had such a great, if a little wicked, sense of humor! Paul loved to cook and go fishing. He loved being out on the boat, rivers, and beaches of the Lowcountry where his soul shined. He loved music, all kinds of music, but what he loved more than anything was his family. He was a devoted father to Aaron and an adoring husband to his wife of 26 years, Malia.”

That’s an excerpt from my husband’s obituary, and this blog is about the resulting grief process, but a death and the subsequent grief can take many forms. My mother died when I was twelve years old. My husband died. Those are physical deaths, but there are other types of death. The death of a relationship, divorce or uncoupling. The death of a dream, a career, a beloved pet, and we grieve those losses in ways very similar to the physical loss of a loved one. This sharing so openly is not easy for me. I am by nature an introvert, not expressive. My friends and colleagues would tell you that I am a very private person, but writing this blog feels like a very necessary element of the grief and healing process. The transparency may be raw and painful at times, dear reader, but my hope is that something I write, something I share will somehow help someone else along the way.