My mother died on Saturday, August 18th, 2007 at 6:30 p.m.
She was in a combination of nursing and hospice care in Erie after a hospital stay in Pittsburgh where she was in and out of the ICU.
It all went very fast; in the first week in August she was away on vacation, and then when she got back she exercised at the YMCA with her friends, but complained that she must have eaten something that disagreed with her. She actually had metastatic cancer in her abdomen invading several organs and causing all kinds of damage. It is approximately two years since she was treated (apparently successfully) for breast cancer. The new cancer (which might have started as ovarian cancer, or perhaps was metastatic cancer from her breast cancer) was not treatable surgically.
Somewhere along the way her heart was also damaged, perhaps some by her earlier chemotherapy and/or radiation, and perhaps by a heart attack caused by a blood clot during her hospitalization. Fluid was accumulating around her kidneys and around her lungs. She developed a pneumothorax and pneumonia as well as a kidney infection. These things were successfully treated and she was removed from intensive care, but suffered further setbacks, and after the damage to her heart was discovered, it became clear that the cancer couldn't be treated, not even via palliative chemotherapy. According to her advanced directives and her verbal instructions she did not want aggressive and invasive treatments any longer. The remaining scheduled tests were canceled, and she was moved by ambulance to Manchester Presbyterian Lodge in Erie. I rode with her. The high-pressure oxygen face mask and multiple IVs were removed and she had only a nasal cannula for supplemental oxygen. Most of her medications were discontinued except for liquid morphine (Roxinol) and a drug for anxiety (Ativan). When she was no longer alert enough to swallow safely, on her last day or so of life, even food and drink were discontinued.
She was with family during her last days. My family and I traveled to Pittsburgh and then to Erie to support her. She had regular visits from my wife Grace and her grandchildren Isaac, Veronica, and Sam. Many other people shared this experience with her as well: she received comfort, advocacy on her behalf, and round-the-clock company from her husband Richard, her ex-husband (my father, also named Richard), her niece and nephew, her daughter-in-law Carolyn, her grandaughter-in-law Alicia, my brother Brian, and also from a number of her friends. The end was pretty much as peaceful and loving as these things can be. She received enough medication to keep her free from pain and needless anxiety while still allowing her to communicate as much as possible.
While she felt that she was too young to die like this, and would have preferred to live longer, my mother knew just what was happening to her and she was conscious and as awake as possible through most of her last days. We had the opportunity to hold some final, very emotional conversations with her, to tell her how much we loved and appreciated her, and to discuss the dying process, what she expected to experience after death, and her hopes and fears and concerns. We told her that we were all doing well with our own families and she had helped us get to that point but that there was nothing more that we needed from her and she should not worry about us. She was looking forward to reuniting with God and she died with no unfinished business or grudges. In particular she was very proud of her ability to forgive everyone for every hurt, intentional or unintentional. She told us all that she loved us and we told her about our love for her. It was a beautiful and graceful death and I hope that I will be able to live up to her example myself when the time comes for my own death.
The funeral will be held this coming Friday, August 25, 2007 at 3:00 p.m. in the First Presbyterian Church of North East, PA. Her body will be set up for viewing before the funeral service. Anyone who will be unable to attend the funeral but who wants to have something read aloud can contact my mother's pastor at (814) 725-8641.
I will write some more on this topic in the weeks ahead and my eulogy will be posted here.