 “No Day Shall Erase You From the Memory of Time” This quote by the poet Virgil is displayed upon the entry of the 9/11 Memorial Museum in New York City. It is an arresting thing to see, should you ever find yourself in Manhattan. It also reminds me of a story surrounding the passing of the mother of my good friend Janine. Janine is a registered nurse, and an excellent one at that. She is skilled at making split second decisions for her patients, which often requires that she checks her emotions at the door when she arrives at work each morning. Good healthcare workers are known for this separation of personal attachment from people they are treating, especially in an emergency. It is for this reason that it typically isn’t advisable for nurses and doctors to treat family members. Because emotions will always obscure our interactions with loved ones.
At this time, Annette developed significant trouble with her breathing. Janine was concerned for her mother, and often went and stayed overnight in the hospital rooms where her mother wound up. But as soon as Annette’s health worsened, she would rally and go back home to host Rummikub parties for her girlfriends. There was a spark within her that refused to be put out. It wasn’t until Easter of the following year and Annette was in the hospital again, when a nurse pulled her daughter Janine into the hallway to talk. “It is really time to consider hospice for your Mom. At this rate, she will likely die within a week, but it won’t be comfortable and she will be gasping for air.” Janine was torn. The nurse within her knew that hospice was the best idea. But the daughter within feared losing her mother. Janine returned to her mother’s hospital bed and brought up the idea of hospice. Annette’s reply tore at Janine’s own ribcage: “Are you saying that you just want to erase me?” I know Janine pretty well and she is a very quick thinker on her feet. “It isn’t that I want to erase you, Mom. But I think it would be a good experience for you to try hospice. If you don’t like the place, you can always leave.”
Janine and Dr. Buttles had a huddle between themselves. They were both on the same page. They wanted Annette to feel calm and at peace and they wanted the process to go quickly. “May I spend some time talking to your mother?” The good doctor asked Janine. Janine agreed and went out for Italian food with her husband at a local restaurant. Dr. Buttles spent two hours talking to his patient Annette. At the end of the two hours, several things were accomplished. First, Dr. Buttles discovered every single detail of Annette’s life, including why she named her daughter Janine (it was because she loved flying to Paris and adored French culture). Second, Annette made it abundantly clear to Dr. Buttles and the priest on staff at this hospice place that she didn’t want others to pray or engage in any religious practices for her benefit. And thirdly, Dr. Buttles was so persuasive and kind that Annette agreed fully to hospice and even stated, “If we are going to do this, let’s DO THIS! Let’s get started!” Janine returned from dinner with her husband to find a very relaxed mother. After all, Dr. Buttles knew what he was doing: he gave his patient morphine pills frequently to gently slow her breathing and Annette opened her mouth readily for this medication. She no longer gasped for air, either. As the night wore on, Janine and her husband and several family friends knew they had to go home and get some rest. Janine was exhausted, as the hospice decision and transfer had occurred during the past 24 hours. As she sat at the edge of her mother’s bed, Janine asked her mother if there was anything that she could do for her before leaving for the night. “Yes, you can do something for me,” Annette replied, her countenance tranquil and sublime. “I want you to go home and fv#k your husband.” The daughter within Janine was appalled. Annette had never used the F word as a verb, and certainly not to her daughter in a room full of family and friends! But shortly after the initial shock, the nurse within Janine remembered the awesome power of morphine. Janine knew better than anyone what this drug was capable of. For end of life matters and to suppress breathing, morphine is the drug par excellence. It can also loosen lips, as it did in this case. Janine awoke the next morning and made pastina to bring to the hospice house for her Mom. Yet she got a phone call from a worker there who said, “Your Mom isn’t waking up.” Janine arrived and her mother was peacefully sleeping. Still alive, but unable to open her eyes and converse. A throng of family and friends were within the room, enveloping Annette with their love and support. Janine had a family member who was a monsignor of the Catholic church. He suggested performing Last Rites, so the group gathered in a circle while the monsignor read aloud what is called the Commendation of the Dying. In the middle of this officiation, a black crow flew into the window above Annette’s hospital bed and fell to the ground. It was at this moment that the crowd realized they had violated Annette’s request that no religion be offered to send her on her way. “That crow made a very loud thud and it scared us a little,” Janine told me. “We stopped praying at that point. But that crow eventually got up and flew away a few hours later. Just as my mother finally stopped breathing for good.” As ‘end of life’ stories go, the story of Annette tops the list as one of my personal favorites. I have never met Annette, but in listening to Janine and writing this, I feel almost certain that I have. It all goes back to that quote by Virgil: “No day shall erase you from the memory of time.” Annette had feared the idea of hospice and asked her daughter if she would be erased. From her young beginnings of sunbathing and flying across the Atlantic Ocean, to raising her daughter who would become a nurse, to riding on her “yacht”, Annette had a wonderful life of parties and joy. And her departure from this world was equally as dramatic as her life had been, when she instructed Janine to “go home and fv#k your husband”, after which a black crow flew into a window to put the kibosh on the monsignor’s prayers. This is a working theory which suggests that Annette was not erased after all. None of us are. That dude Virgil was onto something. We are not erased from the world on the day that we leave it. We matter. The next time I go boating, I will look out on the shimmering water for a woman on a pontoon with a broad smile and an open laugh. She will appear in streaks of brilliant color, just on the periphery of my vision. Never to be erased. 
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 I am a pelvic floor physical therapist who works in Assisted Living Facilities in Florida. I used to treat men on an outpatient basis for prostate cancer. I loved that job, but something tugged at me to help people at another stage in life. I wanted to work with those who couldn't get to such a setting; I wanted to bring a unique perspective to those who might not be able to go out into the community as readily as their younger counterparts.
I treated a man today who is 95 years old. I looked in his medical chart and saw that he'd had his prostate removed due to cancer about five years ago. I entered his room and asked him what had brought him to the place where I was working. "I lost my darling two years ago," he told me. "My wife died and she was my everything." My heart dropped into my pelvis. My brother died several weeks ago, so I knew something about loss. But I still have my husband. I asked more of my patient. He had been leaking urine ever since his wife died. But he hadn't suffered full-on incontinence until now. This made me think. I walked with my patient to the bathroom and asked him to sit on the toilet. He needed help lowering his pull-ups and shorts. Yet as he sat there and we spoke of the long, dull and awful stuff of grief, I heard a stream of urine. It was a full stream, a stream which I believe released his bladder completely. When he was finished, and his shorts were up, we walked to the Dining Hall. This patient seemed different during our walk. This man stood taller, he spoke with more vigor, and we laughed and met other people along the way. I encouraged this man to sit with two other men who live at the Assisted Living Facility for lunch. One had been in Alcoholics Anonymous for 35 years. Another man I am treating for urinary incontinence due to bladder cancer. They embraced my new patient with the kind of masculine energy that makes me smile. I sat with these three men as they acclimated themselves to eachother. All of them are in their eighties or older. All of them have suffered loss of some kind. And yet they know the secret to survival that is lost to many people. They know shame. They know the depravity of age. They know what it is to relinquish all that they once were as people. But they know the peace that accompanies all of such things. Cancer, age, and addiction is something that will find all of us. But the victory of sitting at lunch with fellow comrades? There is no way to gauge the price on that. I know this now. Because I have sat with these men. And they know the kind of strength that will stay with me until I am in an Assisted Living Facility and need some people to sit with. I am sure I will find my people because I have already met them. Forty years from now, if we have the great fortune to be alive, we will sit together. We might have trouble using a fork to bring meat to our mouths. We may leak urine. None of these small details will matter. What matters is that we will be together.  My brother died in January. He and I had been closest as children and into early adulthood. He was my “first person” in the world and I couldn’t have picked a better boy with whom to explore this planet. His death was like an axe which broke my frozen heart. I happen to be working in an Assisted Living Facility these days. I immediately went back to work after hearing that my brother had died. I needed distraction. But I found so much more than that. I found three people who reside in one building: they each helped me to release the pent-up stoic tears that refused to fall. The first person is a Jewish female with large eyes that look like wells of ink. She is 86 and has traveled the world. Her apartment is full of exotic art from Asia. When I told her about my brother, she told me that her brother had also died. And that she stayed in bed eating very buttery popcorn for a month thereafter. But she also told me this: “I was married to a man who left me for another man in the 1970’s. This may not seem like a big deal these days, but it was back then. My daughter was ruined by this. I later met another man, who was a great match. But I never married him because I was too afraid to hurt my daughter.” This woman had lost a brother, a marriage and was carrying the pain of her grown child. The second person is an Italian woman with the skinniest legs you have ever seen. She is 96, has a theatrical presence and also has the kind of dementia where she flits from this world to another in a span of seconds. This woman wears a sea captain’s hat and large movie star sunglasses. I took her on a walk outside in the sun and told her about my brother. She paused and as she was speaking to me, her forgetfulness vanished. “My sister Louise killed herself. I tried to kill myself years ago, and failed. I realized that planning your own death is a lot of work and I didn’t want to go through with that again.” She wasn’t able to recall the details of her suicide attempt or when it occurred. But she finished the conversation with these words: “Your mother must be so distraught. I can feel her pain. She lost her son. But don’t lose sight of the fact that she still has you!” The third person is a tall and elegant gentleman who is 87. He’d been quite successful in life and wears a red cardigan every day, even in the Florida heat. I knew his wife had recently died, but she had been nonverbal and bedbound for the last five years preceding her death. “I used to visit her every day and spoon feed her lunch. It was incredibly hard to watch someone you love suffer for years on end,” he told me. My brother had suffered from mental illness and I knew what this man meant about prolonged pain. He and I hadn’t spoken during the last five years because there was too much rage between us.  I asked this man how he got through what he had. “I used to play golf. It was great for business, but I also loved the sport. I learned something that made my game improve. You’ve got to surround yourself with players who are better than you. When you do this, in any arena in life, you will find that you will push yourself to be better, stronger and you will be the kind of person who tackles problems with more courage because of it.”
In ruminating about loss, which I am quite prone to doing, I now catch myself before the thoughts begin to control me. I can grieve better because of these three people who I met at just the right time. They are all different, these three, but they all are better players at the game of loss. I can think of no better way to heal than this kind of interconnectedness. (Although lying in bed for a month eating buttery popcorn helps with healing too). Whether you are faced with a cancer diagnosis, death of a loved one or even losing a job that you adored, it is important to surround yourself with better players at grief. Seek them out and they will appear. Because these players want to help you and they know that perhaps the only way they can is to tell you, “I know what you are feeling. This pain is very real. Let’s carry it together.” |
