Okay, so on a scale from one to ten, this blog’s sadness level is around six. So, if you need to, go into your closet and put on your big girl panties. (If you are already in the closet, please come out? I can assure you the right people love you anyway).


I am probably asked on a weekly basis about which type of death is better: a quick one, or a long one. I think mostly this is because we all want a quick exit for ourselves, but are not convinced that we would want to lose someone else suddenly. I have pondered this for a long time and decided to put pen to paper (or fingertips to keyboard) and share what I think. However, I believe there are three options, not just two.


The Long-ride


In the last year of my dad’s life, people often asked me what the point of his life was. They would look at the man he had become: fragile and confused, totally reliant on others and imagined him like he was: strong, able and full of life, BUT, I also believe that they imagined themselves in his situation, dependent on others, disorientated and with no control. People think that a life like that is undignified, pointless and not worth living. I disagree so strongly that I want to shout it from rooftops. I see the indescribable beauty of this daily. I know, this is not the case for everyone, and people do often suffer terribly during their final months on earth, but I also know, that you do not need to suffer for a second. If you have the right team, the right pain control, and the proper management of the fear that encompasses end of life, this journey is as beautiful as a birth. When I am asked what the point is of the drawn-out months of wearing nappies, receiving meds and being checked for bedsores, I can honestly say that it’s for healing, not of your body, but of what happens around you. I am dumbfounded at the level of reconciliation that happens over beds of dying people. Bitter family feuds are put to rest when people are confronted with their own finite existence. There is a humility in this space of suffering which our fast-paced lives often choose to exclude. It is a world where your money and your power and your connections do not help. All that matters is the love. The fourteen months I had with my dad before his passing was the most precious gift he ever gave me.


Fast and final.


I apologise here as I have limited experience in this type of death. Heart attacks, aneurisms, accidents, and other trauma’s which end a life suddenly are fast, quick and abrupt (and therefore, obviously not the kind of deaths we deal with at the Recovery Lodge). It leaves us reeling no doubt, but the person who is dead did not suffer, or if they suffered, it was not drawn out. I asked my friend Deline how it felt for her when her mom, who raised her single handedly, suddenly dropped dead without a hint of an ailment. Just like that. At the age of 65. One minute she was there, living her life in full colour, and the next minute she was ripped out of everyone’s hearts. Deline says she is glad for her mom as she would have hated the suffering. She was efficient, like my friend, and she got things done. Maybe your death reflects your life? She did not suffer, but Deline describes her loss like an elephant that tries to sit on you. Some days the mere shock and distress of it all feels like you are being squashed by the weight of the elephant and other days he moves away and lets you breathe, but you always share the same space. The death might very well be quick, but the mourning and the grief for the ones left behind is the same, but with the addition of trauma.



The decision.


I am acutely aware that our role is to support and to be the scaffolding that holds up our people on whatever journey it is they travel. We do not give opinions or make judgements. We are simply the soft landing that envelops you with care. Full stop. Life and death decisions are never easy – especially at the end of life.


Ella was in her 80’s and in ICU. She was already frail and weak when she ended up there. There was a slim chance that she could recover after a ten-hour surgery she needed to prolong her life, in which the stents that needed to be placed would cost  over a million Rand, the recovery would be brutal, and that would be if she survived the surgery. She was given the option to have the surgery and embraced it. She felt she had to give it a chance, to fight the battle, for her kids and her grandchildren. I think our society has conditioned us to believe that we must, at all costs, take on every opportunity NOT to die, regardless of how the prevention of death will also prevent living life. Ella’s daughter had a medical background and as much as she was not ready to lose her mom, she loved her enough to have the hard conversations, to challenge the doctors, to look at the facts and the outcomes. Instead of the invasive, expensive and possibly fatal surgery, Ella was discharged and came to us. She was lucid, pain free and surrounded by her family for twelve precious days. A time which could have been harrowing gently transformed into a time of grace, because the right decisions were made by the right people, which served Ella and all her loved ones.



Recently I was next to the bed of a precious friend in Morningside Medi-clinic’s ER. Victoria had a twisted intestine and was in excruciating pain. She was my friend’s mom, but her strength in character simply extended into a mothering role for us all. She had ice blue eyes, and easy laugh, super-fast wit and she was regal, like her name. She reminded me of a big tree in the forest that could just not be shaken, where people could find rest in her shadow and others could belong and build nests in her branches. She was hugely significant but never overbearing. In that ER, it was the first time I had ever seen her afraid. My last words to her were, “Aunty Vic, you are strong like Russia. You’ve got this.” And she did, on her terms. For many years she has walked a road with a brilliant specialist that she trusted. She knew that he would guide the rest of the way, looking after her as a whole person. She knew that her doctor would treat not just symptoms, not just prolong a life and suffering for his own ego, would not insist on heroics, but would do all he medically could, bearing the bigger picture in mind. Finding this balance is not something you can learn in med-school. It is a wisdom you only obtain by walking right to the abyss of being really human, daring to face the limit of your own powers and respecting life above all else. I am sad to say dear Aunty Victoria survived the first of what would have been many surgeries, but passed away gently a week later. Her doctor put her in the same ICU bed where she said goodbye to her husband seven years earlier where he also had a dignified death. I am so grateful for the fact that the doctor allowed no suffering whatsoever and communicated and explained every step of the way to her family that adored her. The void she has left in our lives is huge and we battle to comprehend a future of which she is not a part, but when we think of what she was spared and how she remained in control right to the end, it makes it slightly easier to endure.


We have seen the wonders of modern medicine, but we need to remember when it is time to stop, contemplate, think and make wise decisions about this fragile, finite thing we call life. We are often there when the excruciating damage of chemo runs through bodies like wildfires, and more often than not, the person is going through the treatment to satisfy a loved one, because they don’t know what else to do, or they are clinging to hope when there was no hope to begin with. This type of death, when decisions need to be made, is probably the hardest on the families. It often has financial implications and is regularly a final straw on already strained relationships. Victoria’s case reminds us however that all this can be avoided by choosing your people right, by living your life so that when you need your tribe, they will rise up and serve you like you served them throughout your whole life. Or like Ella, who raised a daughter that would stand up and say no, now we stop. Sometimes love looks like saying “enough” and being willing to let go. Sometimes  it looks like fighting against all odds with everything you’ve got – and then you’ll need your tribe to prop you up and carry through it like never before.

In the end, it always comes down to love and relationships, like it always does – in death, in life, in the beginning, the middle and the end.