Friday, December 28, 2007

A Time to Die

During my years of working in the hospital, I found it odd that some people seemed to be able choose the day they were going to die, and it happened, while others kept choosing to no avail. It made me wonder why people desperate to leave the misery of their illnesses often hung on for months, sometimes even years, unlike a few who seemed able to bypass the waiting by sheer determination.

Such was the case of one woman who was diagnosed with liver cancer. Her cancer was stage three – certainly worth a bit of a fight for some people – but she opted not to have treatment.

Her family was distressed at this decision, and I was called in during one particularly emotional moment when her son was begging her to reconsider. I have to admit that I didn’t agree with the woman’s decision. She was only in her early 70’s, healthy, and had a large, loving family. Given her circumstances, and the prognosis of several more good years, I thought she should give it a shot.

But that wasn’t my call. Nor was it her son’s. It was hers. So I had to help the family accept the decision.

Once they came to terms with that, she threw them another curve ball. She did not want to go home to die. She didn’t want to put them through the experience of having to care for her 24/7.

Again, I didn’t agree with that decision. Some beautiful things happen in families when they share a death journey, and I thought she was being thoughtless in denying her children something they obviously wanted. Besides all that, her cancer was not that far advanced. The oncologist thought she could live 6 months to a year.

But again, this was not my call. It was her decision, and as long as her insurance would pay for long-term care in our nursing home facility, she could go there. Our medical social worker arranged for her transfer, but indicated the woman only had coverage for 60 days.

Over the next two months, I visited the woman two or three times a week, and she continued to pray for a swift death. As the end of those 60 days drew near, she seemed unconcerned about possibly having to go home and finally told me that she was confident God would take her before that. The fact that medically she was no where near that moment didn’t deter her from that belief.

On the 61st day we had our discharge rounds in the Oncology Department and were informed that the woman had died shortly before midnight the night before.

We were shocked. No way should that woman have died. But once we recovered from the initial surprise, we realized it would be fruitless to try to figure out how that could have happened. We had all simply experienced too many mysteries to worry about one more.

And obviously she had some kind of pull somewhere.

Friday, December 21, 2007

Christmas Is

In this time of global interaction and political correctness, I know that focusing on a Christian holiday can be considered a social blunder, but would it be any different if I was Jewish and sharing my sentiments about Hanukkah? Or Muslim and wrote about the Hajj?

So in the spirit of that ecumenical thought, I share my Christmas reflection, and my wish for all of us, Christian or not,is peace and the blessings of good health and joyful lives in this Holiday season and the New Year.

Christmas is a time like no other in the lives of most people. From the wistful old lady who sits alone remembering Christmases past, to the starry-eyed kid who bounces around the house singing his own rendition of Silent Night, there is a place for each of us.

Sometimes for me, Christmas is the desperate race to get everything done in time. Every year I tell myself to start early. Make use of those lazy summer days to at least do the shopping, but somehow I don't often find my summer days all that lazy. Not to mention how hard it is to think "Christmas" when it's a hundred and five in the shade.

So invariably, I'll be running around the week before Christmas, trying to find something for Aunt Lucy and trying to balance the number of packages each of our kids will receive. (They will count them no matter how old they are.)

What bothers me most about last minute shopping isn't the mile long walk to get to the store from the parking lot. It isn't the lady who runs over my foot with her shopping cart. It isn't the clerk who can't possibly tell me where to find the ‘must have’ toy for this year. What bothers me most is wondering whether I'll make it through the check-out line before the kid I bought the tricycle for is ready for a car.

Sometimes I'd like to forget all about the Christmas Season and just spend two weeks in a rest home. Especially when the excitement starts to build in my kids, and I wish they'd just sit still and be quiet so I'd be more in the mood to be nice to them. It's hard to think kindly of a kid who's followed you around the house for a week reading his Christmas list.

Sometimes Christmas is the frustration of cookie crumbs mashed in the carpeting, candy canes stuck on the sofa cushions and the eighteen truckloads of trash strewn around the living room on Christmas morning. Sometimes it is a sense of futility as I wonder if we'll ever overcome our kids' basic selfishness and teach them the concept of giving as well as receiving. And sometimes it is a feeling of anxiety over whether we've maintained the proper balance between Santa Claus and Bethlehem.

But that's only sometimes.

Other times Christmas is a warm feeling of closeness when I share my daughter's wide-eyed wonder at the concept of Santa and all his magic. Or when I share my son's pride in the surprise he created for his dad out of a chaos of construction paper and glitter. Or when I share my daughter's satisfaction when she transforms our living room into a wonderland of tinsel and holly. Or when my other son asks me for the umpteenth time to get my guitar and play the Little Drummer Boy, and it reminds me mistily of another time, another place.

Somehow my dad could never refuse either.

And other times I think my heart will burst when I watch one of my kids spend their last dollar on a present for the brother I was sure they hated. Or when I find something totally impractical under the tree for me, and I look up to see my husband smiling in delight.

And other times I have a sense of awe when one of the kids wants to bake Jesus a Birthday cake and sing Happy Birthday. Other times I'm filled with an incredible sense of tenderness and love when I watch my oldest daughter set up the nativity scene and explain to the younger kids what happened that magical night two thousand years ago.

Yes indeed, CHRISTMAS IS a time like no other in my life!

Saturday, December 15, 2007

Missing You

There is no good time to lose someone you love, but close to the holidays, grief has a sharper edge. Excitement is in the air like electricity as people bustle around preparing for visits by relatives and warm, family times, and for some there is a huge hole in the gathering.

People deal with that fact of life and death in different ways,. For us, the year that Mom Miller died just before Christmas, we all put on a smiling face and carried on with the normal family traditions. We tried to soothe our aching hearts with the knowledge that she had lived a long, wonderful life, and she had been more than ready to go to heaven for ten years. And surely she would want us all to enjoy our holidays and not let sadness over her death put a damper on that.

Mom sure loved a party.

That thinking worked just fine for a while, but the next summer when we took a trip, the grief took another stab at us. Mom had left us a little bit of money, so my husband and I used it to make a road trip from Texas to Michigan, and then take my mother to Makinaw Island for lunch at the Grand Hotel. My mother, sister and I had made several trips to the island in years past, and Mother would sit outside the hotel and say how much she wished she could afford to go inside. (Our meager vacation funds would never cover the admission charge for going on the grounds of the hotel.)

So I talked my husband into splurging part of our inheritance on lunch for my mother, my sister, and the two of us. I told him it would be one of the finest gifts we could give my mother, so he agreed.

When we were seated at an exquisitely set table with fine linen, silver and crystal, we raised a glass in toast to Mom, thanking her for the gift of this wonderful experience, and it was a bittersweet moment. I was thrilled for my mother who was actually flirting with her personal waiter and loving every moment of being treated like royalty, but I was also experiencing an overwhelming sense of loss. I had started to think of how much Mom would enjoy something like this and had to remind myself that it was an experience we would never share.

Having to remind ourselves that someone is really gone is a normal part of the grieving process, but knowing that didn’t make it hurt any less. At least not then. It took a few years for the pain to subside, and today, it hurts a little less when I remind myself that I won’t be buying a Christmas gift for Mom again this year.

Friday, December 7, 2007

We Should Not Die Alone

One of my specialties when I was working as a chaplain was dealing with crisis situations in ER or ICU. I have always been cool under pressure, which was an asset when dealing with grieving families or families facing tough choices.

Sometimes I would have to try to contain the wild, demonstrative grief that had people flailing over gurneys and falling to the floor. Other times, it would be standing quietly while someone died with no family present.

That happened often when family members had been keeping vigil for days and days, and just stepped out for a short break. Almost as if the dying person wanted to do it alone.

But on rare occasions it was because family members did not care to be present for whatever reason.

One of the ICU nurses had a particularly hard time dealing with that kind of situation and called me one day in tears. A patient, who had been on a ventilator for several weeks with no hope of ever breathing without it, wanted the vent removed. She had two sons, who had seldom visited in those weeks, and they had different reactions when the nurse called to tell them what their mother wanted.

The first son said that was fine, and no, he did not want to come to the hospital when the vent was removed.

The second son said that was not fine, and he would come to the hospital with a lawyer if need be to prevent his mother’s wishes from being carried out.

The woman was conscious and able to communicate and had already signed a Do Not Resuscitate (DNR) order. The legal department from the hospital drew up another document outlining her most recent request and that was read to her before she signed it.

Then there was another conference call to the second son in which the doctor again explained that there was no hope of recovery for his mother, and we now had a document signed by her that she wanted the vent removed.

Legally, there was nothing else the son could do, but as the nurse said, if he cared that much about his mother to fight the removal of the vent, he could have cared enough to come and be with her when she died.

Everything was done to make the woman comfortable and before the vent was removed, I had a little service for her that she had requested. Then she nodded and the respiratory therapist turned off the machine.

The nurse cried. The therapist cried. And I cried. Not for the fact the woman died. But for the fact that she had to die with strangers around her bed.