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Monday, January 15, 2007

Saying Goodbye

F.D. and I don’t take “getaway” vacations, not in recent history. We take "visiting" vacations, which are a real mixed bag. We visit my parents, we visit our children and grandchildren. There are many cities to choose from and many combinations of people to see.

When my parents first bought in Miami many years ago I would visit them for a couple of days then slip back to Chicago, my absence virtually undetected by my patients. At some point F.D. would see the sun on my face and think to himself, What a dolt I’ve been. I could go, too..

So he’s been joining me for a few years now, and since two of his elderly aunts had lived only a few hours north of Miami, we would take the opportunity to visit them, too.

Well, this time we hoped to visit Aunt Sherry. F.D.'s cousin told us that she wasn’t doing very well. At 95 that’s not uncommon.

On the day we had planned to visit her up in Lake Worth, F.D.’s cousin Kenny called to say that she was doing really badly. In fact, she was nearing the end.

“Well at least we’ll say goodbye,” was our thinking.

Except that when we got there Aunt Sherry was in a coma.

She was lying peacefully in her bed. We approached slowly. F.D. took her hand and checked her vital signs, asked his cousin Rita about things like "oxygenation." He tried to ask Aunt Sherry things, too. Aunt Sherry, do you hear me? Can you open your eyes?

She didn't respond.

I felt very uncomfortable. I didn’t know if I should talk to her or not, and certainly didn’t know what I’d say if I did open my mouth. Being quiet in serious situations is a good thing, I always tell myself, but I was fond of Aunt Sherry. I wanted to somehow “say goodbye.”

At some point I blurted, “Hi Aunt Sherry, it’s me, Linda.”

Joanie, another cousin, gently corrected me. “Even if she hears you, she won’t know who you are. She hasn’t recognized any of us for a week.”

“Oh.”

We all slipped out of the room except for Rita, Aunt Sherry's daughter, and tip-toed around things to talk about. Rita joined us and wept for a second, squeaking out, “Who am I going to talk to now? Who’s going to listen to my complaining? Who will help me with my problems?”

Pretty impressive, isn’t it, that Aunt Sherry was still the person her daughter talked to every day for support, turned to for advice about life all the way to the end?

We left that one rhetorical and looked at pictures, took some digitals of old ones, commented on family resemblances. F.D. continued to check on Aunt Sherry. He never lost his “serious look.”

When you know someone for over thirty years you know their “looks” and their “faces.” I particularly like F.D.’s piano face, the one he makes when he’s working hard to get a piece right.

Anyway, I got a little worried that we were actually waiting for her to pass away. I was willing to wait, of course, if that was what F.D. wanted, if he thought that he would be helpful somehow.

But the more information he collected, the more convinced he was that this family was well prepared for whenever the worst would happen. At some point he said for all to hear, I guess we better be getting back before the traffic gets too heavy.

We went over the obligatory turnpike directions (had already had a great time on the 95 coming up from Miami) and took off.

In the car F.D. turned to me and asked, “When are you going to blog about death and dying?”

“Do you mean end of life when it’s expected, like this one?”

“Uh huh.”

“Oh, I don’t really have much experience in that,” I said.

“Really?”

“No. It’s funny. Personally I’ve never seen anyone quite this close to death before, in a coma like this.

And professionally, although I’ve certainly talked to people who’ve gone through this, it hasn’t made it into my secondary trauma registry. It’s not like the unexpected deaths, the gunshots, the stabbings, the overdoses, the hangings.

A peaceful death like this one has never registered distress. I mean, I empathize for sure, but my personal experience falls short, makes me feel a little shallow, honestly. I don't have hospital privileges or it might have been different, maybe. But I haven't got a real fix on this, you know?"

“So you’re saying you’ve never seen anyone in a coma?”

“Not near death.”

“Hmm.” He paused. “So what did you think?”

“It’s very sad. Are they all like that? Do people generally close their eyes really tight like she did today, as if they’re retreating from the light, running away from this world, saying, Just Go Away?”

“There are many different presentations. But this is one of the more common ways of dying, yes.”

“I found it so natural. I don’t know. It did seem right to me. Anyway, I still don’t feel I know enough about this to write about it.”

“Okay.”

“You should though, F.D.,” I told him. "You've seen it so often."

“Yeah, but I write about bunk on health. That’s the only thing I’m going to write about right now. The dumb things people think are true about medicine drive me crazy.”

“Okay.”

We drove back to Miami and took a walk on the beach, got back early enough to get ready for dinner with some close friends. F.D. got the call that Aunt Sherry had passed away. He had warned me in the car that he was sure it would be today, that it she was hours, if not minutes away from expiring. He’s rarely if ever wrong about anything medical so I wasn't surprised when he gave me the news.

The next day he was leaving for Chicago and I was staying on another day. I drove him to the airport early in the morning. As many times as I’ve been to Fort Lauderdale International, I always worry that I’ll make a wrong turn, get lost, and that someone will miss a plane (usually me). It took only minutes to get there and before I knew it we successfully accomplished Kiss and Fly.

After he slammed the car door I zipped into airport traffic on my way back to Miami. I wanted to get back on the beach to walk and take some pics while the sun was low in the sky. But as soon as I zipped into traffic I started to feel really badly. The saying goodbye thing made me cry. Probably like most people, I appreciate people more as soon as they're not with me. And to make matters worse, I realized that I hadn’t done my look back thing. I hadn't watched him as he walked away, watched until he disappeared into the airport

Usually when someone that I love is leaving me I wait and watch. I wait for that person to disappear into the school, or the house, or in this case, the airport terminal. I get that one last look.. I create the snapshot picture of the person walking away.

It's just what I do. A lot of people do this, I'm sure.

When we left Israel following our Sabbatical I burned images into my brain, my own images. I could have looked at photographs of the kotel, the "Wall,” or bought postcards of the beach in Tel Aviv or referred back to my own photos. But I wanted the images in my head and stared at the wall and the ocean long and hard enough to create them in my head.

So I kicked myself for not getting that last one of F.D. as he left me in Fort Lauderdale. It just didn’t seem right at the time that I neglected to do that, silly though it may sound.

So I took a few pictures of the ocean (like 70) and watched the terns for quite awhile. It's a long winter in Chicago. Here's one.



Copyright 2007, TherapyDoc

15 comments:

J said...

Weird. I too had a big good-bye today. My older sister is leaving for a year and may or may not be back to visit during the time.

My parents and I definitely waited to get that one last glimpse as her bus left for O'Hare; we were able to see some waving movement through the heavily tinted windows.

You know what though? It still didn't feel right. Some good-byes are like that I guess.

bjurstrom said...

Dear Doc,
Death as a natural consequence did not stay with me. The natural order of things kind of trumped the loss....I took care of both my maternal grandmother and my mother ...they both died at my home (hospice patients). my grandmother had a similiar kind of vigil as your husband's aunt. Taking care of both my Grandmother and Mom gave me a kind of wisdom....probably about my own mortality. I was glad that I was able to take care of them...it was kind like returning the favor for the care that I received.... You did just fine writing about saying good-bye...when you get the chance......

TherapyDoc said...

J--I try to stay scientific and tell myself that so much of this emotional overlay is physical, meaning accept it because it a few minute, maybe hours, I'll be in a different place altogether.

But as BJ so elegantly writes, the "natural" order of things doesn't always feel natural.

Mark said...
This comment has been removed by a blog administrator.
TherapyDoc said...

Thanks Mark, but I'm mostly talk, honest.

You're right about death, that's for sure.

local girl said...

I think it's great that you try and make the most of every moment. Time passes too quickly and we sometimes forget to stop and take a look around.

Thank you for sharing this with the Carnival of Family Life.

TherapyDoc said...

Thanks, Local Girl. Readers should follow the link on the side of my blog to the Carnival of Family Life for more.

Lisa said...

Big good byes are hard, it really makes us appreciate those who are in our life in a big way.

Here via the carnival of family life.

Kerri said...

I do that "last look" thing, too. I was with my mom and my dad when my dad died after a long illness. It was hard to believe that the "last look" that time was truly a last look. Nothing about his dying really felt natural, I don't think, but I'm thankful that I could experience with my family.

Here via CoFL

TherapyDoc said...

I'm wondering if it can only seem natural as you get a little older, like over 50. Thanks Kerri.

Aldana said...

Hey Doc (Name? I'm new in here, sorry)
I really liked the last look at someone as I do that my self too. For some reason it makes me feel like I've spent every available second with the people I care for and love, even if they didn't know I was taking one last look them... I feel so nostalgic when I have to say goodbye!!

Aldana

TherapyDoc said...

Thanks Aldana. Did I already ask, does anyone out there remember that song "With One More Look at You" from A Star is Born.

DigitalRich said...

Thank you for participating in the 4th edition of Carnival of the Storytellers!

DigitalRich

SeaSpray said...

What a thought provoking post! I also love your pic-very pretty. :)

I hate good-byes...probably more than the average person because of the loss in my young life.

Anyway, I have been around people at the end and it is upsetting to know something is so wrong and you can't do anything to help and you can't even say one last thing.

The most positive death and dying experience was with my uncle Jim.

He was set up as a hospice patient in my cousin's house. My mom and I made the 4 hour trip up to the Adirondacks and didn't get there until 9 at night. I had been ill earlier in the day but it passed...thank God! So we left as soon as we could. i was praying all the way up the NY state throughway that we would get to say good bye.

He was awake and I got some quality time with him. He had a marvelous sense of humor and even though he could hardly speak he managed to get out a well timed joke in response to someone else's statement. He also said that the most important thing is to know that your kids are doing alright for themselves.

I did most of the talking and am so glad I got to say I love him again. Life is so weird sometimes. Because here we had a cherished family member dying in one room and yet we cousins were heartily laughing at family stories. Life goes on. I know that warmed his heart. He wanted to know his daughters were alright.

Anyway, the next day his fever spiked and he could no longer communicate. At the end of the day we had to leave for home and so my mom went in to say goodbye to her brother. Then I went in but I stayed so my mother came to get me but I started to cry and said I didn't want to leave and then tears ran down his face...just a couple.

They say the hearing is the last to go and so I believe he could hear us.

He took his last breath just after he heard his grandson come home form preschool.

I have total peace about that experience.

Regarding comas...I read something interesting from a commenter over at Surgeonsblog fairly recently. She stated that she had been a coma patient and that she remembers being able to pic up the moods in the room. She went on to say something like keeping negativity out of the room or negative people. I am sorry but don't remember exactly. Very interesting.

I am sorry this went on so long. Your post moved me. Please delete if you wish. :)

Mark said...

therapydoc,
You are soulful. I love how you "burn" into your mind the images that you hold dear to you.
I think it's wonderful that you cried when you realized that you missed your opportunity to "burn" an image of your husband as he went into the airport.
Death, represents loss and the mystery of the unknown, it is no small wonder that it plays havoc on our emotions.