Life in all its wonderous magic….
Life is pleasant. Death is peaceful. It’s the transition that’s troublesome.
-Isaac Asimov
The day is going to be a hot one, so Waldo and I start out on our walk early, just after dawn. The sun is up, just a few fingers above the horizon. The day beckons.
But not for everyone.
As Waldo and I move through Mother Nature, passing through the oaks, the maples, the black walnuts, the trees of heaven, the sumacs, the elms, the sassafras, the white pines and all else that is now so very green, my mind is somewhere else. We are swaddled in a blanket of vibrant life with all its chirping, buzzing, swishing in the breeze, rustling in the leaves and effusing a gemish of wonderous odors that my poor olfactory organ can’t possibly sort out, but I’m not here. I’m thinking about Lee, Phyllis’s husband, who has died.
I never met the man, but I know a little about what his last years were like, from what Phyllis has shared me. He was 78 when he passed. Phyllis has been involved with Lee for about the past two years, married for the past six months. At the time of their meeting, she was seventy-three and he was three years older. Both had been married twice before. About three years ago, Lee’s last wife died of cancer. Two weeks later, he was diagnosed with terminal prostate cancer and was told he would live about another two or three years. Lee didn’t want to live out his final years alone and looked for a companion. Phyllis and Lee met each other on the internet and Lee was up front with Phyllis about his diagnosis and prognosis early on. Lee’s oncologist told Phyllis that Lee would be fairly healthy up until about two months before his death and then he would quickly deteriorate.
From the first, the two of them were very happy. They enjoyed the camaraderie and intimacy that couples share and the company that brightens the shadows of old-age loneliness. There were some points of friction — Phyllis is physically active, Lee not so much. Phyllis likes to travel, walk long distances, ride a bicycle and paddle board. Lee liked to stay at home and cuddle on the couch. Compromises were made, but Lee wasn’t in good enough shape to keep up with everything Phyllis wanted to do. After frank and open discussions, Lee decided to give Phyllis the space to do what she felt she needed to do. Phyllis cut back on her daily routine to spend more time with Lee on his terms. Phyllis truly enjoyed cuddling on the couch and Lee, although disappointed at having to let Phyllis go off on her own, never punished her afterward when she returned to him. Phyllis felt guilty at leaving Lee to pursue adventure, but enjoyed the time she spent with Lee. It was a balance that worked.
Over a year and a half, Lee’s strength and energy slowly diminished and he was able to do less and less. There were good days and bad days, but, gradually, it all too often became a problem for him to even walk the quarter mile from his house to his mailbox. And for a long time, there would be days when he could walk a couple of miles with Phyllis and even went biking with her. Buying electric bicycles helped somewhat, but, as the tomorrows crept at their petty pace, the days when Lee had the energy to do any of that became fewer and fewer.
Prostate cancer usually metastasizes to bone – which means that cancer cells are shed from the primary tumor in the prostate, then travel to bones. All kinds of bones. There, they become lodged and rapidly start reproducing. In the process, the bone gets eaten away and becomes weak and brittle. This also causes pain. As time went on, Lee started experiencing pain in his right arm, then his left leg and his pelvis. This also decreased his mobility and ability to get around. Metastases to his skull behind his right ear made him dizzy and nauseous. Radiation therapy slowed things down a little, for a little while, but it’s no cure. As time went on, one problem would be ameliorated to just be followed by another and with quicker and quicker succession. Pain became more and more a part of his everyday life.
Eventually, bones started breaking. Lee’s right humerus was broken in two places and needed surgery. He went into the hospital and within two weeks, he required surgery to his left femur for similar problems. These surgeries required not just the placement of rods, but the bone was so damaged that cement was also required for stabilization. For the last three months of his life, Lee was in and out of the hospital and in rehab, recovering from these surgeries.
Commensurate with all this, for about the past year, Lee became more and more uninterested in eating. Over his last five months, he lost a good fifty pounds. While recovering from the femur surgery, Lee became so disinterested in eating and drinking that he was given a choice. He would either agree to a feeding tube going into his stomach or he would be put on hospice at home. Lee decided to go on hospice and went home. When he got home, he was in excruciating pain whenever he was moved. He was given pain medication for comfort, but that was inadequate therapy and he suffered greatly.
Over the last three months of his life, he slept more and more. In the end, he was awake only about four hours a day. There were moments when he was lucid, but he became more and more confused as time went on. He would talk about his previous wife as if she was still alive and sometimes just made no sense at all. Eventually, he became unconscious and lay quietly in his bed, with Phyllis at his side, holding his hand. His respirations became shallow and more infrequent, then one halting breath led to a long pause, followed by another, then no more. He was gone. He was home for about a week when he died.
Over my Emergency Career, I have been witness to a lot of death. Death is an old friend who I’ve interacted with many times in many circumstances. I’ve argued with the grim reaper and done my best to beat him back, loose his grip, dissuade his intent and send him on his way. Sometimes I was successful, sometimes not. In the end, I came to see him, not as the enemy, but as an inexorable force that is as natural as birth. It wasn’t death that I disrespected, it was suffering. Suffering, too, can be difficult to avoid, but by focusing on that, I wasn’t fighting the laws of nature, just negotiating with them to be kinder.
Lee’s last few years were a slow deterioration that accelerated to a breathtaking rush in the end. He was so lucky to have found Phyllis. She provided him with companionship, intimacy, caring, physical and emotional support, and just plain old humanity. Even though he had other family, without Phyllis, he would have spent so very many of his last days suffering alone. Phyllis was a godsend.
But the benefit of the relationship wasn’t Lee’s alone. Phyllis also received the same gifts and had a few years of togetherness that many older people are bereft of, as they approach the end goal that is common to all of us. In addition to the wonders of love she shared with Lee, she gained the magical gift of making a profound difference in another person’s life, just by being there, at his bedside as he died, lovingly holding his hand. Loving kindness is the greatest gift there is in life and it is so simple in its execution, yet so profound in its impact. And each and every one of us has the power to give it every day, every hour of every day and minute to minute.
The moment is calling to me. Waldo is tugging at the leash, the magic of Mother Nature is tapping my shoulder, seeking my attention. I’m still alive and creeping in my own petty pace toward the inevitable. But, I have not yet been given an expiration date and, I believe, that is still some ways off. Meanwhile, I’m not alone. I have family, friends, Waldo and all the beauty and magic that surrounds me.
And that is so much more than enough.
…and in all its subtle depth.