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

About Paul – About Us

On February 12, 2018, I took my husband, Paul, to the hospital with severe abdominal pain. Three days later he was diagnosed with stage 4 adenocarcinoma. Cancer. Rare and aggressive, and on March 18, he passed away. He was brave and strong and faithful to the end.

When I met Paul, I had just turned 18. He had just turned 30. Now, I know what you are thinking because it’s what everyone thought. But thirty years later, our relationship had endured and born fruit, real fruit in our precious son and spiritual fruit in our own lives, and, hopefully, also in the lives of others. So, in that way, one of the first things he taught me, or tried to teach me, was not to be sooooo concerned with what everyone else thought and to chart my own course, our own course. That lesson has served me well. When I met Paul, I had never been west of Atlanta. That was the second lesson. Get out there! Learn new things, have new experiences, enjoy the world! He certainly did. Whether it was gardening in his own back yard or exploring new places, we always enjoyed it more when we were together. He was interested in and fascinated by the world…nature, science, history, people, how things worked. One of our first great adventures together was white water rafting. It was a beautiful summer day in Tennessee. I was excited but also nervous, and by the time we were in the raft and heading for the rapids, I was more than nervous. I was scared. He looked over at me, and it must have been written all over my face because he nudged me and said “Hey, you’re ok. It’s fun!”, and it wasn’t long before I was having the time of my life. When I was with Paul, I was always having the time of my life. That’s how he was. He made everything more fun. He lit up the room. He had the easiest smile, and holy smokes, those dimples! One day during our hospital stay, a nurse asked how we met. We were telling her how our story began, and she turned to me and said, “You must have been helpless!” and the truth is, I was helplessly in love with him. He was the best thing that ever happened to me. His family took me in, and loved me as their own. His friends took me in, and loved me as their own.

Paul had a generosity of spirit that belied the personal struggles he had endured. He was always so quick to offer encouragement to others. He encouraged me in everything. He gave himself to others so completely. He loved working with kids. He was patient and understanding and lifted others up. He even offered encouragement to his doctors particularly students and young residents. He was intuitive and perceptive, and he had a powerful gift for changing others’ perception of themselves. He had that ability, that amazing ability to make people feel better about themselves. WOW!

He had a quick wit. Cancer took everything from him, his very life, but it could not take his sense of humor. He retained that until the end. He often had his doctors and nurses smiling and laughing. He drew people to him. Doctors, nurses, and technicians came to his room “just to visit”. He was always so easy to be around. Near the end, he woke only briefly from time to time. It was on one of these occasions that he asked for our son, but he had gone home for just a little while to shower and change clothes. I told Paul that he wasn’t there, but he would be back soon and that he was “stuck with me” in the meantime. Paul said, “It could be worse.” I replied, “Yes, I suppose it could be worse.” Not missing a beat, he responded, “There could be two of you”, and smirked. That was Paul, flattering but always reeling you back in.

Paul was not afraid of dying. He was tired of the struggle, and he was ready. He was sad about leaving us. He was worried about how we would manage without him. His last piece of advice to me, the last thing he had to teach me was this… “Now, Malia, you’re going to have to make some friends.”

Fred Rogers said, “The greatest thing that we can do is to help somebody know that they are loved and capable of loving.” And Paul certainly did that. Scott Hamilton, four time cancer survivor, said “We are designed for struggle. We’re better off. We are more in touch with who we are as individuals in the struggle much more than we are in our good fortune.” I have discovered that true healing has occurred when you can be thankful for the suffering, and I am thankful!