Posted by: Peadar Ban | October 27, 2012

Depart In Peace

I have known an other one.
We danced beneath a star filled sky
Watching rivers rolling to the sea.
She lifted me, when I fell
And carried me, though hurt as well.
I swam the crest of joy with her
And walked the shores of grief.

peg
March 23, 2004

I remember the last day and the last minute, as clearly as if it was today, this minute, but it does not often take me as forcefully as now, nor as vividly for as long.  This time of year is different, though.  The weather, the glow of light in the early afternoon, the scent of change on the air, all bring that day and the ones leading to it to mind. More than any other this is the season of change, loss, goodbye.  Now I notice how dawn takes longer getting here.  How evening arrives much earlier.  The changing leaves and their windy flights.  The school bus going by my window in the morning.  In their own way they speak of loss, change, time passing.  Things I might never have given a second thought proclaim themselves here when I would not have noticed them.  Except that they open a door on memory.

It was a warm morning that would become a sunny day, a day of slight breezes and a few puffy clouds in a soft sky.  I was awake early, rising from the sofa cushions on the floor in front of the fire place, picking them up and putting them behind the easy chair.  I would spend the day there as I had spent several months of days since the last visit, the last time we had been out together in July.  I had had a lot of time to think about that hour or so in my life; a kind of pivot for the whole thing.

That was the day we had our last appointment. We were in Dr. Baker’s office, and Sheila said, “I think I will end the chemo treatments, Doctor.”  It had always been quiet in Dr. Baker’s office.  He wasn’t much for chatter. I suppose Oncology isn’t a specialty which provides much opportunity for light talk.   Well, neither was Sheila a “chatterer”.  She spoke with those with whom she must speak.  She said what she had to say in those times for those reasons, and then she stopped.  There was no chatter.  “Life,” she once told me, ” is not a run on sentence.”  She saved her considerable intelligence and bright wit for me, her few close friends and her children.  Otherwise, she let her actions speak.

She sat on the little examination table.  Dr. Baker, his back to the door, faced us both, standing, looking as he always looked, serious, sober, slightly sad.  Not for the first time I thought, “Cancer is no day at the beach.”

“How do you feel about this, Peter,” he asked.  I might have thought the question odd if he had not been Sheila’s oncologist for several years now; our oncologist I could say with some truth.  She had never seen him without me there.  No word had passed between them that I did not hear, no course of treatment suggested, medication offered, that I was not involved in considering.  So, naturally, he would ask.  besides, I had gotten used to his quiet and very gently way of including the other person in the room.  In light of that though, my answer, when I heard myself say it, was very strange sounding, I suspect, “I do not have cancer.”

His eyes, big enough already, grew just that much larger when I said it.

Sheila smiled slightly.  We were both New Yorkers, and it was a New Yorker’s answer.  The doctor from the small Pennsylvania town perhaps did not hear everything I’d said in those few words.  We had had years of talking about, thinking about, planning for this moment if it ever came.  And, now it had.

So, I stood on the pier, while she began her voyage.

That was the thought that crossed my mind as we sat in silence in the little room after I had given my answer.  Other words were spoken that I do not remember.  Dr. Baker offered any help we might need in the weeks or months to come — we did not know — and we left to go home.  It was late July. And, we drove home.  On the way home we stopped at the Rectory and saw Father Karl, our pastor.  Sheila told him of her decision.  We made arrangements for him to come to the house to anoint her had hear her confession.  Then, errands done, we finished our trip.

Father showed up about a week later.  I stayed in another room and read a book, one of the many strewn about, until I was called.  It was done, I thought, her passport issued, her visa stamped, and father left.  I would not see him again until the night Sheila died.

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There was no great change in Sheila after our visit to the doctor’s office.  The next morning was the same as the morning before.  She was, if anything, more at peace that she had spoken what was on her mind, had made her decision known and, now, she could rest and wait.  I think I was more at peace myself.  I didn’t want anymore to watch her come home from her chemo treatments sickened for days, and know that her chance of benefiting at all from it was only one in five.  Years ago, during her first experiences with cancer treatments, she had said that in the future scientists and historians would look back on this age and say that what passed for cancer medicine was little more than torture and guesses.  It had been fourteen years, I thought.  We had both talked about this.  It was time.

It was a good thing that I had retired in January, little figuring that our time and our world would shrink down to what it had essentially become about three months into the year; just the two of us together in our house, in one room, really, 24/7.

The routine was simple.  Several weeks before Sheila had become too weak from her chemo treatments to climb the stairs to our bedroom to sleep.  So, she moved onto the couch in the family room and passed her time there for the most part.  In those days I still slept upstairs alone, and we were connected by an intercom at night.  The same one which had been used for our children and grandchildren when they were little babies.

I usually awakened at about 6:00am and went downstairs to see how she was, how she had passed the night. Most often she was awake, waiting.  We had the conversation spouses in the morning always have.  Who remembers what was said.  We heard each others voices, we breathed the same air.

Sometimes, not often, she was still sleeping.  I let her sleep.  It would not be long though before I would need to wake her and give her the morning pills.  She took her last dose of pain meds at about ten pm.  The next one she’d need at six.  But sometimes she’d call me during the night.  Then I’d go downstairs and take care of what needed taking care of.  On those nights I’d spend the rest of the night in one of the easy chairs we had in the room while Sheila tried to sleep.

She had metastasis of the bones, the cancer in her spine and elsewhere throughout her body, so pain management was an important part of her care.  Finding a position where she could be comfortable and free of pain became for me a consuming passion.  I wanted to make it possible for gravity to disappear for her, to arrange things so that she neither lay down nor sat, but rather floated.  It took a while, but it worked.  She would smile and say something quiet, like, “Find me a “big shoulders” movie.”  That was her way of describing something from the 1930s or 1940s when shoulder pads were all the rage, and hats and gloves and nylons.

Breakfast wasn’t much.  A cup of tea.  A piece of toast.  And, those bare essentials grew cold waiting.  So would lunch.  So would supper.  A sip of this.  A nibble of that.

There were the protein packed drinks that I bought by the case, opened a can for her and brought it to her like a feast for the Queen of Sheba.  She’d smile and take it, gently put it down and look at me.  I’d wait and she would say, “Thank you.”  Several hours later I’d pour the feast down the drain.  I knew better than to say something like, “You have to eat to keep your strength up.”  I knew better but I said it anyway.  Sheila would not answer me except to say, “Maybe next time.”

A few times I’d talk about next year, and a trip to Ireland again.  She let me dream, but then she put a stop to it.  She was bringing me to heel, making me face up to things that she knew and I knew I really didn’t want to face up to.  “*I’m not going to Ireland next year,” she said, only slightly annoyed that I’d mentioned it again.  This was around the time that she had involved us both in my learning all about the running of the house and the operation of all of its machinery: stove and oven, dishwasher, washing machine, freezer and refrigerator, and where the pots and pans, linens and dishes were and should be.

She even had her eye out for my future spouse, a story for another day which still continues.

And, I thought I was taking care of her.

I did try.  As the weeks went by, much too quickly I began to think, Sheila began to fail.  It was her lungs, first.  A doctor could give you a name.  The first time I took her to the hospital for help in that area I thought we would not come home.  She could not breathe because her chest had filled with fluid.  It needed draining.  In a darkened room in the basement somewhere along the corridor labelled X-Ray, she sat on a stool while a technician stuck a needle in her back and removed about a half gallon of yellow fatty liquid.  No one said a word.

She felt better on the way home, and even ate a half a slice of toast.

Maybe it was Labor Day, I can’t remember.  But, someone, perhaps a doctor or a nurse, had mentioned that Sheila might benefit from going to a pool.  I booked us into the nearest hotel with a pool, a Marriott just across Route 3 and only a mile away as the crow flies, perhaps less.  We got a nice room just a few yards from the pool.  It was painful for her to move at all by then, and the trip took a while, but she loved being in the pool.  Twice, for a couple of hours each time I held her and walked around in the water with her.  I remember holding my children in much the same way when they were infants and being bathed.  It was that kind of an experience.

Back in our room I arranged pillows on the hanger deck of a bed.  She had a martini.  I had a beer. We celebrated feeling almost normal.  That was our last trip but one out of the house together.

Sheila had had her lungs drained at least twice more after the first experience.  A week or two after our trip to the pool things were getting worse.  She labored for every breath, like someone might at high altitude.  Morphine did not ease or open up any airways.  Late one evening I called Dr. Baker and told him.  He sent an ambulance and admitted her .  Once there she was placed in a room and put on a morphine drip.  I fixed her pillows and stayed for a while until she seemed to be breathing easily, normally if slowly.

“Go home,” the nurse said.  “She will rest.”  I called the doctor when I got home.  It was late.  “Peter,” he said, “I will do whatever you want me to do.”  Get behind me, I thought, before I said, “What I want you to do, you can’t.”  I was crying.  In the morning I was there very early.  When I walked into her room I was shocked.  I thought she had died!  But she breathed.  The morphine made her unresponsive.  Everything, especially her breathing was low, slow, shallow.  I told them to take her off the drip.  After they had called the doctor and I had spoken to him once again, they removed the IV, and I stayed.  As I sat by her side on the edge of the bed I thought that even this would be enough, and I would be happy.  Even this. It was several hours before she came to herself, and another two hours or so before I could take her home.

She was so much more alert, alive and herself that I wondered just what had taken place, and hoped.

Hope faded over the next two weeks.

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I do remember the day as if it was today.  After “making my bed” I made tea for us both and sat holding her hand in mine.  I drank my tea and watched her cup grow cold.  I brought her a glass of water so she could have a sip, and wondered about St. Catherine of Siena who only ate the consecrated host for so long.  I caught myself wondering how many were gathered in the room now with us.

A week or so ago I had given up thinking that Sheila’s “rally” would take her to Christmas, and perhaps into the new millennium.  I had even mentioned it to her, and she smiled, wryly.  “Not if I feel this way,” she said.  We did not joke about her death, but we knew it was near.  We were waiting.

Even so, I sometimes thought, things can change.  But as the day drew on Sheila grew more and more weak, her breathing more labored, she more uncomfortable.  In line with my instructions I gave her some morphine to relax her, and she settled back on her wall of pillows for some little while.  Strange as it may seem I wasn’t sad.  Perhaps, looking back on the day and the end to which it came, I was a little bit numbed by the situation.  That was a grace, a gift.  Without that perhaps nothing would have gotten done.

I even cleaned the house and did some wash.

When Sheila awoke in the early afternoon I gave a few sips of water and tea.  She waved off anything else, and I took my usual seat in the chair across the room while she watched her “big shoulders” movie on Channel 38.  Then, a short while later, I told her I was just going to go out to get the mail and some fresh air.  “Don’t get lost,” she said in her dry whisper.

Our neighbor Ann, a nurse, was outside with her children.  She asked about Sheila, and I brought her up to date. She had been helpful from time to time and she, and our friend Margie were the only two people not family members who had visited with Sheila for months.  She had no desire to see anyone.  When Margie had visited, only a day or so before, Sheila had dressed and served tea and chatted for the better part of an hour.  When it was over and Margie had gone she simply said, “No more.”

In a way, I felt very privileged to be allowed myself to be there.  I should have known, though, that privilege granted can be revoked.

I can’t remember how long we were talking by the mailbox, perhaps ten minutes, but it was long enough.  “Peter,” came the raw voiced call from the front door.  I looked over and saw Sheila standing there.  Hurriedly I said so long, and ran up the walk to Sheila.  As I helped her back to her place on the couch we had our very last argument.  She took a while to calm down, but not after letting me know how angry she was, and determined, if necessary, to go off and die in some Hospice care facility.  I apologized and satisfied her anger.  After she had calmed down I offered her another cup of tea, and joked that she could let it cool on the end table behind her so I would have another dish to wash.  She smiled, and the storm passed.

There was a knock on our garage door.  Ann had come to see how Sheila was ee how she was.  Sheila let her know all was well.  Ann did some nurse stuff and left, telling me on the way out that she thought Sheila’s time was short.  Quietly, the last bit of hope drained away and I began looking at another way of life.

It had become our practice over the past few months for me to fix Sheila a martini in the afternoon.  I did so now.  I put her in the wheel chair, wheeling her down the hall to the front door so she could have a few gulps, smoke a cigarette and watch what she could see of the world go by.  It was a little bit of urbane sanity we agreed in the kind of insane world our had become.  We “exchanged pleasantries”.  I held her ash tray.  She sometimes referred to me by my surname, as if I was the butler.  We did the same today, only she had trouble holding her cigarette and holding her drink.  She kept drifting into a semi-conscious state.

After a short while I suggested we go back to the couch, and no objection coming, I turned her around.  Back in the family room, we made ready to receive the Hospice Nurse who came by daily to check on Sheila and give me any instructions that might be necessary, or communicate with the doctor if that needed doing.  Her visit was routine, more or less.  She did tell me, as had Ann, that Sheila had not much more time left.  She suggested that it might be more comfortable if I could find a way for Sheila to sit upright with her head tilted back.  Sitting might ease pressure on her lings from fluid buildup and tilting her head back would open up her air way a bit more.

It was quiet in the house after she left.  The day was ending, dusk overtaking the light.  Our windows were open, but as it cooled I closed them, and came back to find Sheila wakeful.  She needed to go to the bathroom.  I helped her a few feet to our small downstairs bathroom, placed her on the commode and turned around to get something from the medicine cabinet.  Thus I heard, but did not see her fall off the commode.  I turned and caught her as she was crumpling to the floor between the toilet and the wall.  Picking her up — she was so light–I carried her to the couch and laid her down.  As I covered her I said, “Don’t you go until the kids get here.”  She opened her eyes, fully conscious now, and said as clearly as if nothing was wrong, “You bet!”  Those were the last words she spoke.

I realize now two things, her ferocity in an emergency, and her strength of will.

Next I called Ann, who was there almost before the call ended.  She checked out Sheila and said that nothing much had changed.  I called the Hospice office and they said they would send someone right over.  Then I called our son, Andrew who was at work.  Our daughter Jeanne Marie who had been coming by regularly to sit with her mother and I, give me a break to rest and freshen up for some time now, was there.  Ann left, saying she was just next door if needed.  I thanked her and waited for the Hospice nurse and Jeanne and Andy.

Andy soo arrived but the nurse was not long after.  She checked Sheila more thoroughly than before, and then she spoke to us.  “She will die sometime tonight,” she said.  “She is dying now.”  She paused.  It was very, very quiet in the house, the only sound the everlasting hum of the oxygen machine two rooms away pushing air into Sheila whom I could never get to keep the tube in her nose for long.

She went on to explain that her hands and feet were already cold.  “We die from the extremities in,” she explained.  “Our bodies conserve heat, and shut things down to keep our core warm.  When that begins to grow cold we are not far from the end.”  It was so calmly said, so matter-of-factly explained.  She reminded me about getting Sheila into a sitting position for her own comfort and ease of breathing, and then she said goodbye.  “I’ll pray for you,” she said on the way out the door, adding a suggestion to call those who would need to know.

That could wait, I thought.  Who needed to know were all here; the ones I could see, and the ones I could not see, the One whom I asked to keep watch with me.

Back in the room I explained to Jeanne and Andy what we should do and we went about moving Mom, rearranging pillows and cushions.  Then I sat next to her and rested her head on my left arm.  I can still feel where her head rested.  And we began our vigil.  It was at just about the time of day I am writing these words, 6:00PM, that we started.

We kept the TV on, tuning into Sheila’s favorite programs as the evening advanced.  The Hospice nurse had told us that our hearing is the last of our senses to fail.  Perhaps it sounds strange, but I wanted to keep things to their established routine.  Even so, I prayed through the hours, while I held her, while I sponged her mouth and lips which were dry and must have been uncomfortable, while I wondered who else was with us waiting.

From time to time Sheila lifted her right arm and seemed to be pointing, her eyes were closed, her breath slow and gradually growing fainter.  The nurse had told me that when it became soft and shallow it would signal the end for us.  Too soon, I thought, though more than five hours had passed, Sheila began to breath softly and clearly.

The kids noticed, too.  Andrew sat on her left side and took her hand.  Jeanne moved to the floor in front of us and took her right hand.  My right hand was on her arm, so cold to my touch. I whispered, “It’s all right, Sweetheart.  You can go.  You can go.” I began counting her ever more shallow breaths, and when I reached five, there were no more. She had gone.  So peacefully leaving was she that I waited for the length of a breath again, before speaking those words, “Mom has gone.”

Taking my arm from behind her head I stood, gathered the two children and held them.  “The best part of us is gone,” I told them standing there in the deep stillness.  I didn’t realize that someone had turned off the TV.  There was no sound at all in the room, in the house, perhaps in the world except the sound of the oxygen generator two rooms away.  We prayed a Hail Mary and simply stood there for some moments.  Then we eased our wife and mother down on her pillows and her cushions.  And began making phone calls.

And yet, she hasn’t left at all.   It isn’t a haunting.  It isn’t a flashback.  And there are times I wish it could be more.  I will be honest and say that there are times I wish it was all that there ever was or would be.

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The two Tavener pieces capture in music how I feel this time of year.  If you have gotten this far you may wish to go a little further on:

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Responses

  1. Courage and love to you Mr. Gallaher. WE HAVE BOTH GONE THROUGH SUCH ENNOBLING TRAGEDIES. IT IS SO ODDTHAT WE LEARN ABOUT LIFE AND DEATH MOSTLY IN AND THROUGH LOSS AND PAIN; THE ETERNAL PARADOX THAT LIFTS US UP FROM THE MUNDANE FACTS OF LIFE. I SINCERELY HOPE THAT IN SOME DIMENSION BEYOND THIS EARTH, I WILL HAVE THE PRIVILEGE TO MEET SHEILA AND YOU CAN MEET MY LOST ONES.

    • Thank you, Dr. Mullan. Be careful of the word ennobling. The Other One, as I reverently call her, would probably treat that description with risible scorn. I can hear her now. But, I appreciate it. You will meet her, I am sure.


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