FINAL GIFTS – Negotiating Life’s Ultimate Transition

Charlotte’s sister had been contending with cancer for some time. Sally and I would ask about her whenever we ran into Charlotte in the neighborhood. After several of those updates—reports of points made and lost—we learned that, after all, she’d lost the argument.

Soon after Charlotte returned from the funeral in Michigan, she gave us a book called Final Gifts. She explained that a friend had given it to her, and that it had helped her and her family get through those last painful months. The book was a blessing, she said, one she wanted to pay forward.

Final Gifts was written by Maggie Callanan and Patricia Kelley, two veteran hospice nurses who not only care for the medical and emotional needs of patients who are dying, but help them and their families understand and grow from the end-of-life experience.

What makes this so relevant to the theme of One Man’s Wonder is that these wishes often aren’t immediately apparent on the surface.

NEARING-DEATH AWARENESS
A Kirkus review of the book says, “The ‘final gifts’ of the title are the comfort and enlightenment offered by the dying to those attending them, and in return, the peace and reassurance offered to the dying by those who hear their needs.”

In one example after another, the authors describe how the fear and grief associated with death are buffered by the dying person’s deep-seated need to reconcile relationships, settle accounts, spare loved ones’ feelings and leave a meaningful legacy.

What makes this so relevant to the theme of One Man’s Wonder is that these wishes often aren’t immediately apparent on the surface. Understanding them involves curiosity and open-mindedness.

Instead of using conventional words or actions, a dying person, especially when they’ve entered the stage the authors call “Nearing Death Awareness,” may describe what they’re going through or ask for things they need using apparently inane symbolism.

THRESHOLD OF FOREVER
A reference to a map or packing a suitcase, for example, might indicate the patient’s fear of the unknown or of not being prepared for death. Talk of a balance sheet or I.O.U. might represent scores to settle or amends to be made. Or the mention of having received an invitation might signal the patient’s peaceful acceptance of death.

In all their cases, Kelley and Callanan help families of the dying to do emotionally and spiritually what many of us already know how to do with our physical sensing: to appreciate the wonder of life, discover new ways of looking and seeing, give voice to deeply-held faith and, ultimately, to embrace the unfathomable.

Like all of Nature, death has more to teach us when we appreciate its many layers. For one dying person it might be the opportunity for caretakers and loved ones to look under the surface of spoken words to discover his or her ultimate needs.

It might compel another patient to reach back through layers of time, asking someone long estranged to come back and share the letting go of resentment, hurt or blame—often for a disagreement whose reasons have long since been forgotten. In many cases, patients are able to hold on just long enough to reconcile with that person before passing away.

Suddenly, he sat bolt upright in his bed, his gaze fixed on a point somewhere
well beyond the upper corner of the room.

WELCOME TO HEAVEN
Sometimes the end of life even enables a dying person to reach across death’s threshold and sense the welcoming spirits of previously-departed loved ones.

Sally and I had no way of knowing how soon the things we learned from reading Final Gifts would apply to our own lives. But within months after Sally finished the book, her friend, Mary, after decades living with recurring cancer, finally was succumbing.

One evening near the end, Sally was sitting with her. Mary’s eyes seemed to drift away from Sally to something in the empty corner of her bedroom. “Who are they?” Mary asked.

Sally admitted later that her normal reaction would have been to try talking Mary out of her “confusion.” But, having read about this behavior in the book, she was able to embrace Mary’s experience and help her make sense of it. “Tell me more about them,” she prompted.

That simple acknowledgment helped Mary realize that the figures were those of her long-departed sister and uncle, and that joining them might not be as fearful as she’d imagined.

THE RAPTURE
Those who experience Nearing Death Awareness often talk about seeing an indescribably beautiful place, one that moves them to wonder and awe. When my dad was dying (at the age of 91), we knew death was imminent. After being knocked to the floor several times by jolts from his defibrillator, he’d decided to have it turned off.

The doctor advised us he’d almost surely die within a couple of days. My brother, Dan, and I decided to keep vigil with him for whatever time remained. We let him know of our sadness and our hope that he’d change his mind. Ultimately, all we could do was to support him, talk with him, advocate for him, and make sure he was comfortable.

It was my shift. Dad was in deep sleep, his breathing so thin that I feared each time his chest rose and fell might be the last. Suddenly, he sat bolt upright in his bed, his eyes wide open, his gaze turned upward, fixed on a point somewhere well beyond the upper corner of the room.

His expression was one of pure rapture. It was as if he were witnessing something stunningly beautiful. Even though the wonder, whatever it was, was visible to me only in his eyes, I too was struck dumb. After about 20 seconds, he lay back down, closed his eyes and resumed his sporadic breathing.

He died the next morning.

SPIRITUAL TRANSFORMATION
Does all of this mean that death’s a wonderful thing? It depends. For my dad, I think it was. He was ready. On the other hand, I can barely imagine what it must be like to lose a child. Or a young family’s loss of a parent. Or anyone dying alone and scared…just the thought brings tears to my eyes.

Nonetheless, Final Gifts reminded me that the pain, fear and grief surrounding death are not evil; they’re part of the human condition, part of the Creator’s plan. When I view death in that context, through eyes unclouded by all the value judgments and taboos our culture imposes on it, I can’t help feeling that, somewhere under those folds, there’s the potential for it to be an awesome, even beautiful, thing.

The patients and families depicted in the book struggled with the apparent contradiction between that possibility and the stark reality of their own loss.

                                              ~     •        ~     •        ~         
PASS IT ON!
I’ve given away that copy of the Final Gifts that Charlotte gave us, as well as several others I’ve bought. The initial reaction I’ve gotten from some recipients, especially those under 40—from whom thoughts of death and dying are still far removed—has fallen a bit short of gratitude: “What a downer!” “Why such a creepy gift?” “Are you dying?”

Most, nonetheless, have dutifully read it. Everyone who’s done so has thanked me for the discoveries and the comfort it’s brought them. I hope you’ll read it too—and then continue the sequence by passing it forward.

Final Gifts – link to Amazon

(Final Gifts and a few other books and articles I’ve read about death and dying have led me to become a hospice volunteer—with Health Partners Hospice—which has deepened my understanding and appreciation of the end-of-life experience.)

A BREATH’S BLESSING – My Intimate Encounter With a Dying Baby Squirrel

A heartbreaking little drama played out this afternoon while I was walking along the beautiful, peaceful trail that flanks the Mississippi River just below our house.

Right in the middle of the asphalt path, right where people walk and ride bikes, lay a little pink lump not much bigger than my thumb. As I got closer I saw that it was a baby squirrel. It must have been just days old, since its eyes looked as if they’d not yet opened. 

I saw no sign of injury, but its bare skin looked to be a bit sunburned. My first thought was, the poor thing, it might well have succumbed to the heat of that searing pavement.

And then it moved. At first it was barely noticeable, but its precious little feet and tail were definitely moving. Oh, my God, I thought, it’s still alive!

     I prayed somehow my intervention, my touch,
     might be a vehicle for Creation’s mercy.

A shot of adrenaline coursed through me as my thoughts turned from finding a decent resting place for the kit, to actually saving its life. First, I had to get it out of the sun and see if it would take some water.

I listened for any sound of an agitated squirrel parent from the adjacent woods. (I didn’t want to be one of those well-meaning folks who might intervene when it’s not necessary.) Not a peep.

So I wrapped the little thing in a grape leaf and hurried down to the river’s edge. As I did so, I prayed somehow my intervention, my touch, might be a vehicle for Creation’s mercy. Please, please let it live!

Dipping a small stick in the river, I was able to transfer a few drops of water to the tiny animal’s partially open mouth. But there was no reaction.

In fact, now there was no more movement at all. The sweet little creature had died in my hand. I stroked its soft, wrinkled side, hoping it might respond.

I sat down on a log and wept, fully present with that precious departed soul. I was grateful to have made its acquaintance, and hoped I’d offered some small recognition of its life.

There was just one thing left to do. I made a sheltered little bower on the forest floor and lay the sweet baby to rest, its last fleeting breaths having blessed me in ways I’ll not soon forget.

MY BAD – Taking the Rap for Hope

The last month or so here has been laden with what seems like more than its share of death and dying. I’ve lost a former hospice patient and dear friend (He “graduated” from the program five years ago.) and a member of my 40-years-and-running men’s group. Another, current hospice patient is fading. And my long-time shrink has cancer.

What if the outcome I pray for is different from that being invoked by the patient?

WHOSE PRAYER IS IT?
When someone—especially a loved one—is facing a scary diagnosis, naturally I want to do something. I guess we all do.

So, besides the usual nuts-and-bolts support—visiting, offering respite to the care-givers, perhaps dropping off a nice pie or casserole, I put my fondest wishes for the person out there into the Universe to assimilate and perhaps factor into its next rendering of The Big Picture.

In other words, I pray. But for what, exactly? Do I pray for the dying person’s ability to gracefully let go of life and pass away in peace and comfort? Or do I pray for them to beat the odds, kick cancer’s ass and get back to a normal life? It’s a real dilemma. And what if the outcome I’m praying for is different from that being invoked by the patient?

Well, for the hospice patients I volunteer with, the answer’s usually easy. Typically, they’ve lived good, long lives, suffer any number of discomforts and indignities, and in many cases are quite ready to die. It’s when the patient’s younger— chronologically and/or in their attitude—that I’m conflicted.

PROFESSIONAL DETACHMENT
Right now I’m channeling all the positive energy I can marshal into the prospects of the man who’s been my “behavioral health” counselor (I’ll call him Bob). For the past five-plus years Bob’s been the only person in my life whose time I’ve felt I could commandeer to just sit there and listen to my personal problems. He’s helped me cope and hope and grow into a better man.

A couple of months ago, the day after my last appointment with him, Bob had a sudden seizure. Next day, they operated on his brain and confirmed the worst: glioblastoma, the most aggressive form of brain cancer. He was admitted to hospice.

Maybe it’s not typical of such patient-provider relationships, but I love Bob. Though I’m sure any reciprocity on his part has been unintentional, let’s say we’ve come to know each other pretty well. He’s a kind, gentle, compassionate man.

And now, though I want desperately to see him and help him as a friend and supporter, a veil of confidentiality imposed by his employer separates me not just from offering that help, but from even the most basic information about his condition or whereabouts.

So, for Bob, it’s come down to praying. But I’m facing that give-up or give-‘em-hell dilemma. What if what I’m praying for isn’t what he’s praying for? What if he’s decided to commit himself fully to dying with grace?

          I picture every single cancer cell in
          his body as turning a bright, Day-Glo
          red, no longer able to hide.

EXPANSIVE THOUGHTS FOR A SHRINK
I thought about it for several days, simply wishing him peace and comfort. And then it hit me. So what if I wish for a recovery he can no longer envision? Could that be any worse than cheering for an athlete who’s resigned to losing a race, or for that matter any underdog who doesn’t believe they can beat the odds?

So I’ve taken part of my daily meditation—the one visualizing my own body as healthy and pain free—and turned that biofeedback toward Bob. Maybe I’ll call it tele-biofeedback.

I picture every single cancer cell in his body as turning a bright, Day-Glo red, no longer able to hide from his body’s natural defenses and the search-and-destroy raids of chemo drugs. I see all those pinpoints of red getting zapped, darkening to burgundy, then dark gray, and finally blowing away as so much lifeless ash.

There’s a chance I’ll never, ever know what happens to Bob. But whatever it is, at least I’ll know I did my best by him. I think that’s what I would want from my friends and loved ones. Cheer for me even if I cannot cheer for myself. Even if it turned out to be an outcome I couldn’t have, I think I’d forgive them for their misplaced hope. Wouldn’t you?

And Bob? What if he just happens to end up among the five percent of patients who survive this cancer…do you think he’ll blame me?

A HOLE IN TOMORROW – Seeing Right Through Mortality

You may have noticed the gradually increasing frequency of my posts touching on aging, death and dying. This is partly due to my perspective, which I can no longer pretend is anything but that of a senior citizen. It’s also inspired by my experiences as a hospice volunteer. (I spend a few hours every week with people whose days are numbered.)

Despite my long predisposition to the present moment, the older I get, the more often I seem to stray to thoughts of the ever-more-precious future. Like imagining how, when the time comes for me to face my own life’s end, I might do so with half as much grace as my patients do.

       In just the past couple of years, five of my 
       family members and friends have faced a 
       cancer diagnosis.

TOMORROW…AND TOMORROW
I know, I know…worrying about tomorrow is pointless. While it’s probably more useful than worrying about the past, either way there’s little any of us can do to affect the consequences of time.

But there’s tomorrow…and then there’s TOMORROW. For someone simply living out their last days or one facing a grave health crisis, the term could mean, literally, the next day; one might not dare look ahead much further.

But for those of us still fortunate enough to still gaze out on an indeterminate horizon, the view is quite different.

Yes, there’s still that sense—especially if gratitude is part of your daily spiritual practice—of each tomorrow being a precious gift, one you should appreciate as if it were your last. But even that self-imposed filter doesn’t keep those of us in reasonably good health from fully expecting another tomorrow after that…and another…and another...

How cruelly that expectation must change when one receives, say, a cancer diagnosis. These days, I find myself thinking about that all the time, because in just the past couple of years five of my family members and friends have faced that reality.
        It’s an opportunity to introduce ourselves 
        to our faith—or at least an aspect of that 
        faith we may never have been in the same 
        room with before.

CLOSER STILL TO HOME 
Even as I’ve been writing this post, one of those loved ones dealing with cancer—a dear old friend—has experienced a dramatic change in his condition. Steve had been responding quite well to cutting-edge treatment which aimed to seek out and destroy cancer cells no matter where in his body they lurked.

But now, quite suddenly, the cancer has gained the upper hand throughout his body. There’s nothing left to do for him—at least in terms of cure-oriented medical treatment. He’s entered hospice, and doctors advise him and his family not to think in terms of months, but weeks…or maybe even days.

What a fickle friend hope can be. I can only imagine what he and his family must be going through, given that initial ebbing of the disease’s leaden horizon and then its abrupt rushing in and imminently crashing over them.

PERMEABLE PERMANENCE
I guess this is one positive effect of death—a silver lining, if one thinks broadly enough—in the whole human scheme of things. It causes those left behind to confront the reality of our own mortality.

It’s also an opportunity to introduce ourselves to our faith—or at least an aspect of that faith we may never have been in the same room with before.

It’s that faith that renders the dreadful, absolute finality of death somewhat more forgiving. As if that barrier to yet another tomorrow becomes, rather than a dark, impenetrable, tombstone-granite wall, perhaps more like a fine-mesh screen which, while it certainly inhibits our free, physical movement from one dimension to the other, at least allows the free flow of air and sunshine and spirit between the two.

As death becomes an ever-more-frequent visitor to my aging circle of loved ones, I’m asking myself if my faith is up to the task. Can I, as with any other aspect of wonder, learn to be fully present with my mortality? Might I, if faced with a terminal diagnosis, be able somehow to see beyond—if not right through—death’s dark curtain?

Could you?

THIN SPOTS – Close Encounters With Eternity

Recently, the mother of my dear old friend, Charlie, died. She was an incredible woman, smart, civically engaged and, at 97, still living independently. As a minister—ordained when she was in her sixties—and someone with a life-long passion for music, it came as no surprise that she’d orchestrated much of her own beautiful memorial service.

Some time before her death, while discussing that eventuality with her minister,
she had noted some of the most important aspects of her own, personal spirituality. Among them was her belief that human beings—at least those of us open to the possibility—regularly encounter “thin spots” in the self-made barrier between our largely-mundane daily busy-ness and other, more transcendental realities.

She felt it was her job, as a minister, to encourage people’s awareness of those convergences, because, among other reasons, they are good places to find God.

          If I could choose between this state and 
          deep sleep, I’m not sure I could tell you 
          which I’d pick.

BLISSFULLY AWAKE
The other night, perhaps facilitated by that posthumous sermonette, I encountered one of those thin spots in my consciousness.

I’d already had a unique and memorable night. Unable to sleep for some reason—
I seldom have that problem—I’d been lying there, resting quite nicely, though acutely aware of my surroundings, my body, my thoughts. It wasn’t that anything in particular was on my mind, nor even that I was unable to turn off my thoughts;
I truly wasn’t thinking of much more than how amazingly comfortable I was, both physically and mentally.

Instead of any sense of urgency or frustration with not being able to sleep, I just felt utterly at peace. I remember thinking, If I could choose between this state and deep sleep, I’m not sure I could tell you which I’d pick.

Now, to be honest, I can’t say I might not have drifted briefly off to sleep now and then during the night, but it sure didn’t seem that way.

            A tear—a real, cool, liquid tear—
            rolled down my cheek.

THROUGH THE MEMBRANE
Then, some time in the wee hours, I was suddenly aware of a presence. Not a flesh-and-blood presence, but a presence nonetheless. It was my dad. (In the 20 years since he died, I’ve had just one other significant connection with him, so I knew right away this was something special.)

We talked. I don’t remember saying anything out loud, but we talked. My “voice” felt real and true, and his…well, it seemed completely spontaneous, by all ap-
pearances his true voice, not one of my own creation.

So I asked Dad some of the questions I, because of both my reserve and his, had never thought to bring up while he was alive. “What were some of the high points of your life?” I asked. Without hesitation, he said, “You and your brother.” A tear—a real, cool, liquid tear—rolled down my cheek.

“Were you happy as an old man?” I asked. “You and mom seemed pretty detached by then, if not downright fed up with each other.” He replied, “Oh, you should have seen us when we were younger! When we got married, we were happy…and we were in love. Back then, we could talk, we laughed, we were affectionate...or as affectionate as conservative, German Americans could be (he winked)—we shared dreams…”

“Yeah, but were you happy during your final years, after you sold your homes and business?” I pushed. He thought for a few seconds. “I guess it was a different kind of happiness, the kind that comes from fulfilling a responsibility. Once I got your mom situated where I knew she’d be looked after, and sewed up some financial matters, I figured I’d fulfilled my purpose. I kind of let go.”

     In a kind of role reversal, I felt I’d taken 
     on the role of parent, and he was the child.

Dad and I talked for quite a while. I filled him in on my life since he passed away—during much of which he smiled and nodded knowingly, as if he already knew. I had to catch myself a couple of times running on about myself and tried to turn the conversation back to him. After all, I told him, this was about him.

He disagreed, but I guess that’s one reason this encounter was so amazingly special; in a kind of role reversal, I felt I’d taken on the role of parent, and he was the child.

I told him how proud of him I was…and am, and how much I love him. And how sorry I am that I wasn’t able to express that pride and love more overtly while he was still alive. In one of Dad’s patented responses—usually issued when the rare mention of love came up—he said simply, with that familiar, twinkly-eyed smile of his, “Ditto!”

Finally—I don’t know if I eventually did drift off to sleep or if it happened consciously—we said our good-byes. But not before I made him promise that he’d come back. He promised…and I’m waiting...

THE FLAVORS OF FATE

In my continuing efforts to demystify the spirituality of awareness, I often find myself at what might be described as the back door of Buddhism. That is, I embrace ideas associated with Buddhism, but without paying the price of constant study and discipline.

One such theft is of the idea that happiness hinges on detaching oneself from expectations—those uniquely human constructs built on the past and future, but having nothing to do with the present moment.

That said, detachment does imply faith. Yes, you most certainly have plans and goals; yes, you apply yourself to the task at hand. But beyond that you believe the universe will steer you to exactly the outcome it—and you for that matter—needs.

MM-M-M-M, MENINGITIS!
An old friend of mine applied this tenet in his encounter, many years ago now, with cocci meningitis, a fungal infection of the lining of the brain. It was thought at the time to be a terminal diagnosis.

Walter—an aspiring Buddhist by the way—tried just about every alternative, new-age treatment you can think of. He meditated. He hung out with crystals. He traveled afar and dug deep within for answers. (The first thing one spiritual/medical guru, in Texas, asked him was, “So, Walter, why did you decide to get sick?”)

I’ll never forget when Walter announced to our men’s group that he’d come to a place of peace with the disease, come what may. As he put it, “It’s like ice cream; if having cocci meningitis is vanilla, then not having it is chocolate. Either way, life is delicious.”

Walter, twenty-plus years later, is still with us.

The trick is to handle these events the best we can, not let them handle us.

A GREATER REALITY
We all face events and decisions every day in which we vest the outcome with a value—from how the barista makes our latte in the morning, to whether the house we just bought is really as good a deal as we think it is, to coping with illness, even death.

And we always have the choice between seeing unexpected consequences as failings or misfortune, and seeing them as simply parts of a greater reality which can be labeled as neither good nor bad. It just is.

The trick is to handle these events the best we can, but not let them handle us. And, once we know we’re doing our best, as Walter did, we let go of the outcome.

It’s incredible how liberating this attitude can be. For it does not suffer fools gladly; useless emotions like disappointment, regret and fear are dismissed before they can utter a word.

This is how I want to live my life. But it’s not easy. Ever since I was three or four, nearly every lesson I’ve been taught, every message absorbed from the culture, every example held up to me, has been about investing all you’ve got in an outcome and never letting go of that expectation.

   It may be an outcome we could never have 
   imagined, one understood only by the boundless 
   wisdom of the universe.

JUJU BEINGS
Perhaps it’s the luxury of being an older, more independent man, but my instincts have been quarreling with all those do-or-die lessons. They're arguing—when they can get a word in edgewise—that the outward pursuit of success, happiness, faith…whatever…is a fool's quest.

Human beings are hard-wired for happiness. So, instead of looking outside ourselves for a certain result or to acquire some special juju, the real answer is to look within. It is a process not of acquisition, but of divesture, shedding all the garbage that has piled up on top of the perfect juju we already have.

So Walter's point—made, admirably, under the direst of circumstances—is well taken. Except that I'd add one thing. If the outcome we would have liked (before our conversion to quasi-Buddhism, of course) is chocolate, and the one we wouldn't is vanilla, there's a third option: a result that is neither—an outcome we could never have imagined, one understood only by the boundless wisdom of the universe.

As I ponder the deliciousness of all three of these possibilities, an odd thought sidles into my consciousness—a craving for ice cream. Not vanilla; not chocolate. Neapolitan.

                                 

FROZEN IN TIME – Death By Degrees

My hearty fellow winter wonderers: I know you must marvel, as do I, at the hard truth of a frozen lake—this once lively, liquid pool, now captive, groaning, its huddled molecules tired of such close quarters. Where, just four months past or hence, you're in it, one with it, now you're shut out, settling for but a skin-deep appreciation with boot or blade.

Unless you're an ice fisher, chances are that's where your attention ends, your curious juices freezing the instant they hit the surface. But, as with all surfaces, there's more to see if you can look deeper.

Occasionally, a surreal image will catch your eye: a fish frozen into the ice. Sometimes they've died before freezing, floating horizontal to the bottom of the top, there but for ice's shield against beak and talon.

Sometimes they've died before freezing, floating horizontal to the bottom of the top

But, once in a great while, you find one caught alive, vertical, flash-frozen in mid tail stroke. You stop and ponder how it could possibly have not been able to swim away as the water, passing from 33 to 32 degrees, started to set around it.

What went through its little mind as heart kept beating, blood kept flowing awhile, till that too eventually thickened and set.

And I wonder, is there memory in death by degrees?

MOMENT OF DEATH – A Ghostly Etching

What was the pigeon's last conscious thought at the instant captured here so hauntingly on glass?
 
There was nothing tentative about this swoop down the open atrium, no hint of trouble—wing beat is frozen just as down-stroke began; head forward, dead on. 

Even the feet felt the impact…or did they, striking as they did a split second after the head?

Did the bird mistake the dark, inner space of the stairwell as refuge— perhaps from grasping talons?

Might death have been swifter, kinder this way than by a hundred tearing bites of falcon beak?

(The medium that renders such a white, ghostly impression is fine dust accrued from the natural abrasion of the pigeon's finest feathers—called powder feathers.)

Snapshots from Zihuatanejo - The Colors of Death

The ghost of a young tuna haunts a few feet of Playa La Ropa sand; the camera lens ventures closer than human hands or feet dare.

What was the last thing this creature set lucid eyes on? The glint of a fisherman's knife? Or worse, the dull blade of suffocation?

There's beauty here, even in death. Air tarnishes life's quicksilver gleam to dull gray; but this head, returned to the sea, has steeped to translucent shades of pink and almost lavender.

And that one wide, worried eye still pleads—as if I could spare it those final, terrible sights. Could it be that cold stare that's kept these remains from hungry mouths and beaks, in a realm where nothing is supposed to go to waste?