Including Dying with Death
This article is an excerpt from the Vissell’s soon-to-be-released book, A Mother’s Final Gift: How One Woman’s Courageous Dying Transformed Her Family (available mid April).
Until I attended medical school, death was something I heard about, rather than witnessed. I remember playing in our back yard as a child when my mother came outside to tell me my grandma had just died. Although I loved my grandma, I didn’t see her very often, and hadn’t seen her sick with cancer. So it was just news. Bad news, but still news. It wasn’t up close and personal.
In medical school, death and dying were clinical phenomena, to be studied in a detached intellectual way. The human cadaver my small group of first-year students and I dissected was only a real person in rare moments of reflection. The rest of the time it was organs, muscles and bones. Even the patients who died during my clinical rotations through the hospitals were often stripped of their humanity in our feverish attempts to prolong their lives.
Friends have died along the way, some closer to me than others, some very young. I was never present in the extremely intimate day-to-day dying process.
Then there was my own dad. One moment he was hugging my mom before she went out to do some errands. The next moment he sagged against her, falling over on top of her. By the time the first emergency team came to their house, ten minutes had elapsed and, although they restored his breathing and heartbeat, his brain had suffered irreversible damage.
I caught the first flight I could and arrived in San Diego that evening. My mom and I visited Dad in the hospital. He was connected to a breathing machine, and his heart was beating regularly with the use of drugs, but it felt to me like my dad was not there. His body lay in the hospital bed, blood and oxygen keeping it alive, but something vital and essential was gone.
The next morning we arrived at the hospital and signed the forms to “unplug” his body, removing all machines and drugs. For the next hour, my mom and I watched his body gradually shut down as his breaths came with longer and longer intervals in between. My mom was stroking his head while she cried. I encouraged her to say good-bye, which she did. As he took his final breaths, I sang a song to him.
I distinctly remember I had no tears – until I called Joyce, minutes after his body was still. Then it felt like the floodgates opened, and the tears finally flowed.
Still, something was missing. It was death without dying. I missed the opportunity to say good-bye while my dad was still alive, to sit with him and integrate all the feelings of the dying process and, perhaps most of all, to listen to and feel his experience of dying.
Of course, over the years since his death I’ve had many conversations with my dad. I’ve said good-bye to him. I’ve expressed unfinished feelings and difficult realizations. And most importantly, I’ve expressed my love, which has given me the most peace. Still, it seems there will always be something missing around my dad’s death.
All this changed with the dying of Joyce’s mother, Louise. Having Joyce’s mom next door, seeing her every day, expressing my love to her, receiving her love, listening to her experiences, talking about death, all these things have changed my life for the better.
Louise gave me the gift of including dying with death. Death was no longer just news I received in the back yard of my childhood. It was a complex, dynamic, painful and joyful process, a life-changing experience. Death was part of living, not the end of living.
Dying is not neat; it’s messy. I thought I would dread changing diapers on an old woman, or taking care of bedsores. Instead, it was something that needed to be done, and in fact could be done with tenderness and patience. Even the feelings are messy. I remember one day helping to move her body to relieve pressure on one of her bed sores. Louise screamed out in pain and anger, “You’re torturing me.” I found a capacity for patience that the closeness to death seemed to bestow upon me. I calmly said, “No, Louise, it just feels that way. Your bed sores will get worse if we don’t move you.”
Dying is not a clinical experience; it’s extremely personal. I finally had the opportunity to turn off my “doctor mind,” to stop trying to find solutions to her medical problems, to stop trying to figure out ways to prolong her life. Sometimes I wouldn’t know how busy my mind was until I walked into Louise’s apartment. It was like walking into a place where time simply didn’t exist. The tranquility around her provided a stark contrast to my own lack of peace. It forced me to focus on my breathing, to calm myself down, so I could match her energy and connect heart to heart.
What an opportunity to silently look into Louise’s eyes without any hesitation or embarrassment, to see her great serenity reflected in those luminous pools of light. Her eyes were truly the windows of her soul, and her soul was nearly always content with her current journey – except, of course, when she was in pain.
It was nearly impossible to gaze into those clear, shining eyes and not see the reflection of my own death, however far into the future. When I was really present with Louise, her dying was my dying as well. When I was at peace looking into her eyes, exchanging words of love, I was at peace with my own dying.
Louise knew with clear certainty that death was not the end of life. She knew death as the beginning, as well as part of, an even greater adventure and journey. Her calm certainty allowed those of us around her to touch our own knowing of life beyond the confines of the body. The times she spoke with her beloved husband, Hank, and other friends and family who had passed on, the things she shared with us about the world on the other side of the veil of death, were too inspiring not to be believed.
I suppose it would be possible to hang on to the belief that there is no life after death. But after sitting day after day with Louise, watching her body gradually shut down while watching something deeper and more essential actually getting stronger and more alive, witnessing a birth during the process of a death, how could anyone doubt the immensity and continuity of this journey? It feels to me the only way I could doubt life after death would have been to keep myself from looking into Louise’s eyes, or listening to her wisdom and experience, or feeling the growing love in the room. I could only doubt the ongoing journey of her soul by refusing to see the birth happening in front of my own eyes.
Being with Louise’s dying has allowed me to be with my living. Being with Louise’s heart, her love and aliveness, has allowed me to be with my dying in a new way. When it is my time to die, I hope I am surrounded by the same love of family and friends, supporting me and helping me to launch into my next great adventure. I hope I can bring through wisdom from the next world to prepare the way for those after me. I hope I can inspire my family as much as Louise inspired all of us. I hope I can make my transition with the abundant expectancy I witnessed in Louise.