Algy's Demise - On Saying The Final Goodbye.
Somewhere here I have blogged some prattle about people's reactions and actions
in dealing with a loved one who is dying, plus what I have witnessed in
hospitals, that did not quite fit in with the Elizabeth Kubler-Ross
model, or maybe they did. In any event I unwittingly did Ms Kubler-Ross a
bit of a disservice.
This entry is going to be about the 'D'
word again so be warned. It's not going to be terribly cheerful as again
it will be stuffed with emotion, some repetition and probably the
hardest thing for me to write with any degree of real honesty.
wonder how many of you have faced the loss of a loved one, in the fact
of being confronted with a diagnosis and prognosis that essentially says
"that's it, we can do no more."? How many of you are facing that now
with your own diagnosis? I have experienced the first both as a
professional and on a personal level but will be honest and tell you I
have tried hard not to think too much about the latter.
before in my career, I have been around death quite a bit (hopefully
not as a cause of!) from that horrible moment when a patient and their
loved ones are informed there is nothing more that can be done to the
point when death has occurred. And also again, I have considered taking
care of the dying a privilege as that is the last thing I can do for
that person and hope that at least there has been a semblance of dignity
before the final breath has been drawn. I have been there when a
machine has had to be switched off, when the 'line goes flat' after
thirty minutes or so of desperately trying to resuscitate a patient, or
offset some other life threatening condition, to the peaceful gently
holding a hand of a much loved elder person whose life was drawing to a
close after many years on this planet.
You would think after
all those experiences, I would be like one of those serene sorts who
would encompass a passing with the philosophical air, a comforting word
with a sigh. And yes, I have managed to keep my voice level, attend to
the needs of those who are left behind, being practical, not too overly
sentimental and I hope able to reassure people that a) it's ok to be sad
and to cry and b) those left behind (usually) have the best interests
and love for the deceased which can make letting go a tough deal, no
matter how expected the passing. I have been a source of strength and
comfort, so I have been told, but also have had my fare share of running
in to the sluice room or treatment room to shed a few tears myself.
What chokes me up is when I see others starting to cry or become upset,
especially when the news is sudden for example when a relative has been
informed their loved one has taken ill, to arrive and find that sadly
their loved one has died. The resulting shock is indescribable and for
all the best will in the world, there is never any 'easy' way of
delivering the news and dealing with the aftermath.
there has been a level of maturity that has developed over the years, of
experiences and helping my colleagues deal with the situation,
especially junior staff who are starting out on their career with the
hopes of being healers, but who have to also understand that death is a
part of life, that not everyone is going to make it, or peacefully or
otherwise pass from this life. They will have to learn about dealing
with the dread of phoning someone at 3am to break the bad news, or face
to face in a waiting room somewhere be it to inform someone of the death
of a spouse, relative of an older person or God forbid - and I have
been there to see this - being informed of the death of a child. Also
they have to learn there *is* a time to die, that none of us are built
to last forever and 'life saving' options are not always the most
appropriate options to seek.
But none of that has helped me
deal with this terribly well in my personal life. It is true when you
have professional face, it can shield you to a certain extent as often
there isn't the time to contemplate the full impact of what has happened
as there is more to be done with the living who also need you. That's
not to say there are no feelings, but just the fact there isn't time to
express or contemplate them.
There has been the time, too much
time to contemplate that someone close to me has a limited life span
left, and the feeling of helplessness that I have felt inside while
trying to be the good strong friend and bring comfort to those who are
dying. I am known to be quite honest in conversation as those I have
talked to often have told me things they would not want to anyone else
to hear, and on one occasion, who needed to hear I acknowledged they
knew they were dying.
One of the very first entries to this
blog, I wrote about my friend Veronica who died from a glioblastoma
multiform brain tumour and a conversation we had a couple of months
before she died, but I think that conversation was rather one sided as I
remember now I did a lot of the talking. But I hoped, and still hope it
brought her some comfort.
I had a similar conversation
recently with another very dear friend I have known nearly all my adult
life and had worked with over the years. And now it's hitting me she has
finally gone as I write.
Linda was a fellow nurse, cheeky,
stubborn, brooked no nonsense from senior staff, knew her stuff and had a
wicked sense of humour. Two years ago she survived breast cancer but in
late summer of this year (2013), died from peritoneal cancer which had
spread over the lining of her abdomen. No one really knows but this
could have been a metastasis from the small cancerous cells found in the
lymph nodes of right breast that were successfully treated by surgery,
backup radiotherapy and chemotherapy. No one can always foresee if the
cells have fired off into other areas of the body or not, except through
Lin herself retired from nursing through ill
health as she also had arthritis, but I felt she retired from life
itself a bit as she was a glass half empty sort of person, whereas I
tend to be a half glass full. She spent the remainder of her life
sitting at home with her iPad, tobacco and cups of tea close to her
side. When Lin had the energy, she would visit her favorite pub close by
and enjoyed a lot of Gold Label. At first, her husband tried
everything to get Lin to join in other activities but given her energy
state and stubbornness, Lin decided otherwise.
But of late,
she began to take to her bed, surrounded by her cats whom she loved and
stopped eating and only when she began to suffer crippling pain and
weakness, Lin allowed herself to be admitted to a local hospital, where
she was found to have acities, a condition where fluid builds up in the
abdominal cavity for various reasons, one being the presence of a tumour
Cutting a very long story short, Lin was found to
have multiple cancer nodules across her abdomen and needed up to 3 to 4
litres of fluid drained from her stomach daily as there was no real way
to reduce the cancer, which was the cause of the fluid build up. Lin had
left her treatment too late I guess, not fully realising what was
happening at first but also deep down on realising the extent of her
illness, was not prepared to live through another bout of chemotherapy
and what have you. She was always straight forward and honest with those
around her. Not one to beat about the bush, she wanted to remain in
control of her own destiny.
I visited Lin who was in inpatient
at Treliske not long before leaving for London to start my radiotherapy,
and had a feeling I wouldn't be seeing her again. We chatted about her
cancer and Lin was very definite about getting her affairs in order and
trying to reassure her husband as well but and I think she knew she was
dying at this point. I certainly knew at any rate her condition was too
far advanced for any real effective cure. We have both been experienced
enough with this type of cancer, to realise after a certain point
treatment was usually only palliative.
Mentally, I said goodbye
then, but have only just completed that journey earlier today. I wanted
to see her one more time before leaving for London but she didn't want
to receive any more visitors, so I asked her husband to pass on a
message to Lin that I was thinking of her. After two days in London, I
got the message to say Lin had been admitted to a local hospice for 'end
of life' care as it is known now, and had slipped into unconsciousness.
A day after that, I had texted her husband to ask how Lin was, and he
had text back to say she had just died.
A part of me was
relieved and a bit distant, another part just burst into tears. I am an
emotional person and am not capable of doing the 'stuff upper lift'
thing, and find as I get older, I am not so able to control my emotions
like I used to, not that I was ever very good at that anyway. Lin was
the complete opposite I think, taking charge of her situation by making
sure a will was completed, wanting and arranging to be baptised, setting
her affairs in order and making sure she said goodbye to her husband
who was faced with her dying. She wanted no fuss and wished for
cremation and to be buried with two cats of theirs who had died in
previous years. There is a small pet crematorium and cemetery outside of
Penzance, where animals and their human companions can be buried
I wish I could have returned to Penzance for her
funeral but it would have been a disservice to Lin's memory if I
interrupted my radiotherapy and I often joke that if I did, Lin would
come back to haunt me. So finally after a long while, Dave and I went to
the cemetery at Chyenhall Farm earlier today, had a bit of a domestic
over parking and where I planted (not very well) some crocus bulbs on
one edge of her grave. I didn't feel too emotional then, but am feeling
it now and as always, hate the fact I had to say goodbye and am not very
good at accepting it.
My own death? I have a strong faith, but
yet I am scared of death, probably the method of it and the separation
from those I know and the planet I have inhabited. I have no particular
thoughts about the 'salvation of my soul' as I feel the judgement of
that lies with the deity I call Heavenly Father. To me an afterlife
does exist but that does not make the fact of passing into it any easier
to contemplate. I am afraid to die, I don't want to leave, I don't want
to be without David, I don't want to be alone. If there is no
afterlife, I don't want to become nothing more except a bunch of protons
and electrons - but that is an immortality in itself I guess. I don't
want to cease to exist and I don't want to miss out on all that will
I have had to think about these things
though. My parents and David's are at an age where their time will be
done soon and I would like to think the two of us will be able to deal
with that well, but whether in your 50's or five, when a parent dies it
can hurt just as much at any age. When you have to deal with the fact a
loved one, or indeed your own life span is going to be restricted in
some way, that's also lot to deal with. I like to think when my time
comes I will have dignity and will be brave, not to dissolve into tears
at the thought of my passing, but that is something I cannot guarantee.
But I know even more so now - especially after the discovery of Algy
and the fact he or a cousin could still suddenly rise up to put the boot
in - I have to start looking at my mortality and accept that I have a
lot less years ahead than I have had behind me, and deal with the fact
one day I really will have to finally say 'goodbye'.