Death as Transition

Some of life's transitions are more filled with sorrow than others. Recently, I lost my father after a three year battle with cancer. He died at his home peacefully with my mom and me by his side. I watched him exhale his last breath, just as he watched me inhale my first breath. It was circular, and meaningful, and as beautiful as a death could possibly be.

Still, I am sad to find myself in this passageway between life with my father and life without him. 

Death is a transition both for those dying and for those left behind.

I happen to believe there is life after life. I have no idea what it feels like or about any of the specifics, but I have learned that the amount of mater in the universe is fixed. It does not disappear, it breaks down and transmutes into a new form. So while whatever life he has found on the other side of this transition is beyond my comprehension, my belief that nothing truly ends has been of great comfort to me. 

Something else has been a comfort to me; my passion and interest in the art of transition. In my previous post on the birth of my son I broke down the three stages of transition as I conceptualize them; Preparation, Culminating Event, and Acclimation.

Sometimes the intellectualization of a life process helps us gain footing in an emotional sea. I would therefor like to take a second to breakdown my father's death into this same model. I can not know what it was like for him, and so I am not exploring his experience of the transition, but my own.

Preparation

Those of you who have experience with a terminal diagnosis know that it is very rare for doctors to give you any sort of solid prognosis. We live in a world very focused on keeping the terminally ill alive for as long as possible and no one wants to admit to a person that the time has come to say goodbye. In our case, multiple treatments were available and we started out fairly optimistic that one of them might cure his cancer entirely. However as time went on, it became clear that the treatments were making his quality of life much much worse. My dad, forever an entrepreneur, did not see it this way and kept on trying to heal. 

It was painful to watch his process. But in retrospect, it was a gift my father gave me...I was continually called to hope. It prepared me to practice hope even now, in the midst of despair. My dad never gave up. Even in those final hours on hospice care, he never said "goodbye". A large part of me wished he would, but now I realize it was simply not in his nature. He was not a quitter. 

However, in those years of fighting I was also quietly preparing for his death. I worked with death and dying as part of my graduate studies and I volunteered with hospice. I was getting ready to face the inevitable loss by moving towards and pushing myself to look deeply at my own beliefs. I also have to admit that I pulled away. I unknit my father from my daily life as a way of preparing for life without him. Although this is natural and I felt him simultaneously pull away from me, it is not something I am proud of. 

There was one other very important way in which I prepared. I had a baby. I wanted desperately for my father to feel his own importance and the continuation of his love. I would have wanted a baby anyway, but the desire for him to see his grandchild was deep and strong. His grandson, named after his family, was in his arms during his last lucid moments and that will forever be something I cherish. 

During the preparation phase of the transition my thoughts were on the future. I wondered "how long do we have?" and tried to make myself ready for what ever life might be like without my dad. It was about waiting and making the way for loss. Although it was a painful time, I am so grateful to have had it. So many people do not have long preparations when they experience loss.  

Culminating Event

The day he died I was present, in body and mind. I used techniques I had learned in my hospice work to make him more comfortable, I showed up in time to visit with him before he slipped into a comma, and I pushed back my fear so I could be with him in those not so pretty last moments. The whole time thinking "this is it", "wow...it is happening". 

Time stopped entirely and my mind was focused in the present moment, no where else

Acclimation

Here I am now...still getting used to the idea that he is gone. Kubler Ross's stages of grief abound and could probably applied to the acclimation period of any of life's transitions. (but that is another blog post).

As I move through my grief, I am caught off guard by tears now and then, but I am more surprised by my lack of tears. Life as a new mom is filled with distractions and even now I am cradling a sleeping baby as I write. 

Still, my theory of the stages of transition apply. My mind is in the past, I am overwhelmed with this new life, and my thoughts are "how do I do this...I am doing this". 

My life and my mother's life have transformed. My father has transformed, but in all of these stages I have felt his love. Even now that he is gone, the love he shared with me is not. That is a great gift, a great legacy of our relationship and throughout all the transitions in my life it will remain a constant. Love is the beating drum that drives us on through dark passageways to new life. 

An Invitation to Gratitude

Life is so full at Thanksgiving. There are visits to make, people to see, turkeys to battle, and for some people shopping to be done. It isn't all easy and it isn't all fun. Today is my father's birthday. He is very sick right now and I am very pregnant and so we won't be able to see each other. 

Thinking back, he is the start of my Thanksgiving memories. He is the cook in our little family and so every year on this day the kitchen was his. My dad is an experimenter, a tinkerer, and so his meals were never repetitions but rather little works of art that he proudly shared with the people he loved. 

Not being with him today is painful. Not because it is our first our only Thanksgiving apart, but rather because I fear it might be his last as I have every year since 2012 when he received a bleak diagnosis. Couple that with the small little life growing inside me longing to meet its grandfather and well, the pressure is on.

Yes, life is full and it isn't always easy to find gratitude when day to day existence drags us into worry, doubt, and the fog of holiday traffic. So what can we do? What can I do, to draw out Thanksgiving?

Starting at the beginning, we might notice that gratitude is the goal today. It is now and always should be. When gratitude comes, it is followed by joy, peace, compassion, enlightenment, and basically all the good stuff. Thankfulness is what we all really want on our plates this afternoon because nothing is more filling than settling into how provided for we are...how deeply loved. 

Thanksgiving invites us to the table of abundance. It invites us to pull up a chair and delve in to the richness of living. That invitation is not an invitation to ignore our sorrows, but rather to look deeper in to them. To find the gift of the grief. 

So as I look deeper at the fullness of my own life today I see a pretty lucky woman, about to be a mother. I see myself at the center of loving family in an act of creation and extenuation of that family. I see my dad living on through the lessons I teach my son and I see the beautiful patterns of love in my life. I see connection, and I am grateful for it. 

That gratitude is a resting place as I move through today, missing my father and longing for my child. The good is there...always just one deep breath away and followed by the gifts of a very full life.

So join me, friend, at this table. Sink in to Thanksgiving, push yourself towards the chaos and take a breath. Life, full and abundant with all it's mystery, awaits you on the other side of this meal. 

10 Lessons from Hospice

End of life and bereavement work is not something that gets a lot of focus. So often those who work in hospice and palliative care are wondered at. I frequently get asked why do I continue to volunteer for hospice and work with clients at end of life. Well, as hard and real as it might be working with death and dying is filled with joy, beauty, and life. Here is a list of some of the best little tidbits of wisdom uncovered in my recent hospice volunteer training. 

Focus on the Beauty

Often hospice work is filled with unpleasant sights, smells, and thoughts, but if you walk into each situation looking for the beauty you will be able to do what you need to do. Notice the person before you; their eyes, their smile, the flowers at the bedside. Pay attention to the beauty and it will grow.

Follow the Undercurrent

Instead of getting caught up in the details of the situation, try to see if you can hear what the emotional message is. For example, some one might say "my daughter is always complaining that I watch too much television". What are the unspoken messages of that comment? That is what we should respond to; the undercurrent of each communication. 

All Grief is Unique

Everyone grieves differently. There is no perfect pattern for healing. It looks different, feels different, sticks different, is DIFFERENT. So, all we can do is just observe and support people in their unique process.

Also, bereavement comes from a latin word that means "to be robbed". (just a neat fact)

Being Still is an Art

Seriously. Try to say nothing and be still. It isn't easy, but leaving space for the other person will be the greatest reward.

Validate Yourself

Never expect a thank you. Find the gratitude for your service in the service itself.

All Pain is Non-Physical

I could write a whole blog post about this one. Hospice and palliative care has a goal to lessen suffering, but it is not an easily obtained because suffering is a complex experience. The pain felt from a broken leg is not the injury, rather it is the perception of the injury in the brain. So pain, like grief, is a unique internal response to an outside stimulus. Once again, everyone's pain is different.

We Teach People How to Treat Us

Everyone who spoke to us in the training mentioned "good boundaries". It is important to be able to know where you stand, why you are there, and what the limits are of your service. We will treat people how to treat us by the way we treat ourselves. 

Ask your Self Hard Questions

 What would be the hardest things for me to have to give up in my life? How might I handle having to die? Who would I want to be my power of attorney? What is a risk I need to take, right now? By asking myself hard questions...all the hard questions I can think of...I am growing empathy, and understanding for others and myself.

Tears

Don't stop someone else's tears by saying "it will be okay" or giving a pat on the shoulder. See if you can lovingly hold a space in your heart for the other person while you witness tears. Tears comfort us by releasing chemicals and hormones. They are a necessary part of healing and sometimes the best thing to do is cry.

The Only Way Out is the Door

This was presented as a quote from Hellen Keller. It seems to sum up a lot of what goes on at end of life, and in all life transitions. Walking through that door can be terrifying, painful, lonely ...but at some point we simply can no longer stay where we are and we have to move on to what ever comes next.