Dying as transition

Sandy and I used to talk about dying suddenly, instantaneously, and simultaneously. We talked about a massive tree branch crushing our car on Mt. Rainier, a plane crash, a fatal traffic accident. The goal was to die without suffering, and to not leave one of us a widow.

As it happened, Sandy's death was relatively quick for a cancer death, but far from instantaneous. She suffered considerably in the weeks and months that preceded her death. And she left me behind. But the experience of the last several days of her life, when her pain was under control, have changed my thinking about preferred methods of death.

New to my collection, this photo was taken by a friend in 2002.
She just found the photos from that day and sent them to me. A
wonderful gift and the rare kind of surprise I welcome.

In the last few weeks of her life, and especially the last few days, Sandy let go of plans and worldly concerns, found resolution in relationships, and prepared to move on. She communicated with people that others couldn't see, and she apparently had some out-of-body experiences, loosening the ties between the physical and the metaphysical aspects of herself.

As she went through these transitions, those who love her were engaged in our own processes. We grieved, celebrated memories, and came to terms with the reality that she was dying. I say "we," but each of us responded differently, and I was the least successful in facing her death. I've read that this final period is a time for the dying person to release attachments to others, and in turn, for those left behind to separate. I wasn't prepared to do that, but I did benefit from the natural death process.

I've just read Final Gifts, a book written by a couple of hospice nurses in 1993. They realized that the dying often communicate in ways that the living misidentify as hallucinations or confusion, so they decided to share their insights. The book is full of individual stories, many of which illustrate experiences I recognized from Sandy's process: interactions with people who have died previously; speaking in metaphors; needing to have certain matters dealt with before they can die peacefully. Some of what the authors say is speculation, and I think they make some unwarranted assumptions about the impulsive efforts to walk that sometimes occur just before death — they seem to think dying people are actually trying to make the journey physically, but from the conversations I've had and other things I've read, it seems much more likely to me that, that close to death, the body "forgets" its disabilities and makes one last effort to live — but many of their conclusions ring true.

I'd absolutely recommend the book to anyone who is caring for someone with a terminal illness. I wish I'd read it before Sandy died. I've been remembering Sandy's outbursts and puzzling statements from those weeks in hospice, attempting to evaluate which truly were paranoia from the steroids (the accusation that I wasn't human; the fear that her food had been poisoned; the belief that her sister was an imposter) and which were real (her delight in interacting with people we couldn't see; her emphasis to me that I should be grateful for our 15+ years together; her description of having just been in our bedroom and seen the cats on the bed).

There are some events that I'm not sure how to categorize, though.When she relived the time she nearly drowned over and over again, was that really hallucination brought on by the gurgling moisture in her throat or was she trying to communicate that she was being pulled under before she'd done all that she needed to do? (That first demanding cry, more of an order, "Help me!" as she looked straight into my eyes, glaring and stern, still haunts me. My immediate impulse was that she was angry that I'd stopped trying to save her life, but once the nurse arrived, we realized she thought she was drowning.) When she said we could still Skype, was she referring to the visitation dreams we'd have — or was she, as I thought at the time, believing we were talking about her traveling to France? After she'd been a total ham with her family one evening, throwing pills around the room, she got very serious and said we needed to talk about what I'd said, that I was breaking up with her and needed to move on. At the time, I told her I'd never break up with her; I thought I was reassuring her when I said I'd always stay with her. Now I wonder if she was telling me that she needed to know I could move on after her death, that I'd be okay. I think my initial interpretations were probably correct, because she relaxed after I reassured her I wasn't leaving, just as she relaxed another time when I told her that, no, I wasn't planning to kill her. So those probably were the product of steroid-induced paranoia. But I desperately want to know that I gave her what she needed as she was dying.

I still support our death with dignity law, and I even wish Sandy could have gotten the pills she was entitled to and determined to have. But I'm glad she had the slower dying process, the ability to make the transition, to straddle both worlds and know that she had nothing to fear. When I think about my own death, I now hope that I have just enough time between the onset of illness and my final breath to make the same transition and gain the same confidence and comfort. I imagine it must be rather shocking for a spirit to go from life to death so suddenly, and I've never cared for surprises. I'd rather ease into it. I especially hope that the person I get to talk with so happily in my hospice room, the person no one else can see, is Sandy.