When I see the date, “14 February” I think of three things:
- Obviously, St Valentine, the Roman priest who secretly married Christian couples to avoid the young men going to war, and who was martyred and killed because of it.
- I also think of Oscar Pistorius and the way we woke up on Valentine morning 2013 with a soap opera drama unfolding before us ” the SA hero who killed the beautiful blonde” And in the weeks and months that followed, South Africans were like hyenas drooling over every intimate detail of their violent love story, and the fall of the para-olympian we so desperately wanted to succeed.
- And thirdly, of how, on this day in 2021, we almost accidentally, stumbled into end-of-life care.
Before that time, we focused solely on sub-acute and step-down care. Post hip-replacement care was pretty standard for us, but, there was nothing “standard” about Gwyneth, who checked in with us after her surgery. She was 97, had spent weeks in a sub-acute facility after her surgery, during a COVID outbreak, and was basically ignored by the staff and left to deteriorate terribly. (I will spare you the details as there are sensitive readers here, but suffice it to say, if there were a lawsuit, the facility would have had to close its doors). Dear Gwyneth was also an enthusiastic smoker, which makes everything worse during recovery.
She arrived here, and was delighted to see the sun for the first time in weeks. We let her sit outside in the garden before making her comfortable in bed. Her granddaughters and great-granddaughters arrived from the UK, and her only daughter never left her side. She was so frail, but she simply oozed character. She made it clear that she did not want to see any more doctors, that she did not want her family to wear masks, and she certainly had had enough of the mask she was forced to wear at the sub-acute. We honoured her wishes, her granddaughters and daughter arranged sleep-overs in her room and we had lovely dinners with her, where she just sat and watched. I am not sure I ever realised that she was an end-of-life patient. I think I assumed that if the doctors thought she was well enough to recover from a serious surgery like a full hip replacement, she would surely recover. But she didn’t.
Early on Valentine’s morning, I got a message from her daughter: “Mommy gracefully slipped away while cuddled between her two granddaughters on your king-sized bed.” I rushed over, totally panicked and found the family, outside, watching the sun come up, sipping on cappuccinos. I was convinced they were going to be angry and disappointed, but they were simply filled with gratitude that we gave them a beautiful and gentle space to say goodbye. I joined the huddle of women outside, and we chatted about Gwyneth, listened to her favourite music and even had a glass of sparkling wine to toast her life. It was an utterly beautiful occassion, and was completely different from what I envisioned death would be like.
This got me thinking today, about what we assume the last days and moments are like, and what I’ve experienced to the contrary.
The first myth I think we need to debunk is hat death is upsetting, scary, dark and awful. My experience has always been that it is gentle, serene and full of grace.
I’ve often heard that people at the end of their lives see religious figures, angels or family members who have passed on. I am not sure what people see, but what we do notice is that patients often stare intensely right past you, almost as if they are listening or seeing someone standing next to you.
Many people talk about being bubble-wrapped in fervent, beautiful love. Kate Bowler describes it like this: “I was blown away by the fact that the closer I felt to death, the more I felt intensely loved, and not just by other people, but just a supreme and beautiful peace.” I agree that we sense this too, and that is one of the many reasons our work is fulfilling rather than draining.
I have often heard that before people die their life flashes before their eyes, or a “life review” takes place. Maybe this does happen, but I’ve never had any reason to believe it does.
Then there are other myths like, “dying is painful,” or “hospice care hastens death,” “living is always preferable to death,” and “palliative care is just for cancer patients.” All of this is nonsense, so much so, that I will not waste words on it.
Some other myths are that when people stop eating, they die of starvation, and that when they don’t drink, they die of dehydration. Almost weekly, we get loved ones demanding that PEG feeding should be introduced or IV’s be put up. This is not necessary at the end of life. Just like we know how to live – as babies we take those first breaths and cry – so too, our bodies know how to die. Our bodies know how to shut down, and how to gently slip into another realm. We seldom need to put up tubes or take other invasive action. .
I’ve always, maybe ignorantly so, thought that people exit this world with profound wisdom and leave their loved ones with wise words. This does happen, but usually, it does not. We’ve had people whose last words were; “Can I have a Coke?” or once, a dad told his sons, in no uncertain terms, to get out of his life. We’ve even had the f-word as a last word just before death. I have learned that our most profound moments do not take place in moments… they happen over time in extended relationships and fellowship. Our lives are not like the movies.
Another common belief is that death is obvious and happens in one single moment. It is often so delicate, that you don’t even notice. It is not as if people take a last dramatic breath. It is usually quite serene and almost, dare I say, courteous. Often we are not quite sure it has happened, and we check and double check to make sure the person has passed away.
When you read obituaries and newspapers, they often says, he/she was surrounded by their loved ones. In our experience, most people die alone, in the quiet moments when the family members might be just outside, their spouse is busy on the phone, or the carer has just left the room. It is almost like the person dying chooses to depart alone, when others are sleeping or busy with their lives, possibly as if they know the next journey is to be entered in solitude.
On the other hand, we have seen that some people wait for loved ones to arrive before they die, or for important conversations to have taken place, forgiveness to have been asked or given, and gratitude to be expressed, but sometimes, nothing makes sense. People simply die too soon or hang on too long.
Every journey is unique and befitting of the person who is transitioning to another world. The more I learn about death, the more mystical it gets, and the more I realise how profoundly sacred it is.