Tuesday, April 21, 2009

A Good Death.

When I heard the news over the phone, I thought it came too soon. The doctors said you had 3 to 6 more months.

We were only at 2, and you were going so strong, smiling and laughing always whenever we saw you. We agreed you'd come to my graduation ceremony in 2 years time (and joked that we couldn't agree about my wedding because realistically it may be toooo far away) because I think a part of me wanted to believe you would outlive the cancer. That somehow your laughter and strength and dignity in those few months would put the cancer to shame and make it go away.

But it didn't.

After your stay at our home and the interminably long stay at the hospital, they sent you back to your hometown across the border in an ambulance because the plane couldn't take you. I told myself I'd go to visit you in June on my next break. We agreed you'd listen to me play the flute when I was better at it. We agreed you'd show me around your new home. We agreed you would come for my convocation.

Then I got the news and they told me you left. In a coma. They said there was no pain, just a lot of screaming and crying and trying to wake you up. Four twenty-six pm. That's what they said. I got a phonecall over supper in the foodcourt at hospital and that's what they said. Four twenty-six.

The day you left, I was in the emergency department watching people die of heart attacks etc. I told myself I wouldn't choose emergency medicine as a field of choice because I don't like seeing people die that way, sprawled on a table, blue from failed resusitation attempts, suddenly. People who should have been left to leave the world in peace being pushed into the resusitation room, having their shirts ripped off and breasts hanging out and chests zapped with electricity only to die anyway. I like medicine, but I find myself needing time-outs ever so often in the emergency room.

But you died in dignity- in a way I've never seen anyone die. And that gives me comfort. You knew all about the tennis-ball sized monster pressing on your lungs and frustrating your liver, but till the very end, you still wore a smile every day, and I would watch you putting on your ear-rings and fake hair every morning when you stayed with us. You never lost hope.

Perhaps my best memories of you will always be those mornings when I had breakfast with you, reading you bits of scripture and feeding you oatmeal. The last time I saw you I was so happy feeding you and you gave me a smile I knew I would never, ever forget.

The day we found out about the monster in your liver I was doing my attachment on palliative care. We learnt what it meant to die a good death- pain-free, in a place of choice, in the warmth of familiarity, with finished business, in dignity. You died a good death.

So many people would have given up by then. But you refused to. You ate when you had no appetite, you put on those jade ear-rings when you were bedbound and even though people put you in diapers and put a urinary catheter into you, you held fast to your dignity and you wanted to walk, still. If I were in your position, I don't know if I could have done the same. We see so many patients at hospital succumb to depression. You would have none of it.

And so we flew up for the funeral and all I packed was Black. I wore a black dress with the crystal ear-rings you gave me because you always liked me in a dress. When I was asked to read your eulogy on behalf of everybody yesterday, did you know how privileged I felt? It was in mandarin. Did you hear it? We said you poured out your life for us.

People were crying during the reading but I wasn't. I was stoic because I wanted to read the eulogy properly. And so now my grief lingers on though I try to be cheerful because it's hard for other people to understand unless they've had someone ill live with them and leave. The grief comes in bits and pieces like bad snot, just before I go to bed ( how come you're not in the room next door anymore) and when I'm milling about at the hospital-because of all the complaining and murmurring I had had in my heart when I felt inconvenienced during your stay with us. I was self-centred and resentful and stupid and hadn't the maturity to understand how love overlooks inconvenience. Still, you forgave me. I'm so sorry.

I'll always remember that smile you had, and that sweet, sweet smile you had on your face when I fed you noodles the last time I ever saw you. And I'll always remember what it means to die a good death. They always tell us at medical school that patients are our best teachers- I think I finally understand now, because you taught me so much about dying well. I don't believe the cancer won. I think you did. Because you taught us so much in those last months, invited us into the depths of life to understand love, compassion, will and dignity. I'm not sure if I could have died that way. You were such a strong woman.

You chose the way you wanted to live, and because you did, you also chose the way you died. In dignity and in love.

It was a good death, not least because you fought. But at the end, you won, still.




Death be not proud, though some have called thee

Mighty and dreadfull, for, thou art not so,

For, those, whom thou think'st, thou dost overthrow,

Die not, poore death, nor yet canst thou kill me.

From rest and sleepe, which but thy pictures bee,

Much pleasure, then from thee, much more must flow,

And soonest our best men with thee doe goe,

Rest of their bones, and soules deliverie.

Thou art slave to Fate, Chance, kings, and desperate men,

And dost with poyson, warre, and sicknesse dwell,

And poppie, or charmes can make us sleepe as well,

And better then thy stroake; why swell'st thou then;

One short sleepe past, wee wake eternally,

And death shall be no more; death, thou shalt die.

-Holy Sonnets by John Donne

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