Editor’s Pick
APRIL 4, 2011 12:18PM

Dying with John

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Dying with John was such an unbelievable honor that I feel I should write it down so that I can hold onto it forever. I didn’t die too, just John died, but I helped him. And no, I didn’t kill him either. Cancer killed him, but I helped him die by telling him what to expect, how to protect his functional independence for as long as possible, reframing and contextualizing the whole beautiful and awful business, giving him drugs, calling cancer a bitch, and holding John’s hand.
I was a hospice nurse for two years, and in that capacity, I helped many people die. People die all the time. Everyone does it. And for some reason, I am excellent at helping people die. Call it a quirk. I don’t know. Some people play a mean guitar. Others rollerblade. Me? I’m an angel of death. It’s my niche I guess. Everyone thinks being a hospice nurse is depressing, but it is not at all depressing. It’s not a party, but it is life-affirming, bittersweet, painfully precious, and being with someone when they die is nothing less than a gift.
When most people die, family and friends begin batting around canned phrases. I hate canned phrases and refuse to take part in them. Inauthentic speech is exhausting. But I don’t begrudge people their inauthentic speech when the C word or the D word comes up: “Things happen for a reason,” “God has a plan,” “I believe in miracles and the power of prayer,” etc., because even though death happens to every single person in the world, when it strikes, human beings are shocked stupid. They will repeat anything they’ve heard before or they’ve seen in movies because a strange vacuum forms in the wake of terminal illness that sucks words away and renders them inadequate. So more and more words are added, and grieving people often lean on stock answers for support. So, while they attempt to stuff full the void with inauthentic speech, I speak authentically and honestly and these types of words are always a little sturdier. I firmly believe that truth gives more peace than dancing around subjects and pretending. I also leave God out of it because I can’t keep up with all the different versions and adaptations. We did have a priest on our grim reaper team, and he talked about God all the time. But in his gentle way, he would always assure the dying that they knew every bit as much about God as he did.
There is no great wisdom that occurs when people age that prepares them wholly for death and nonexistence. The advice and kind words the healthy say over their dying friends are now being whispered to them, and the words sound small, hackneyed, pathetic. The process of dying, though similar for every human body, always feels so uniquely unique that the fact that the world continues to turn and Big Macs continue to be sold and there is a line at the DMV all feels like a great betrayal. But the world doesn’t stop for death, even when it’s our turn. And it’s a surprise to everyone and it is sad every time, even at age 95. As a patient recently said to me, “No one wants to leave the party.”
But John was different. John didn’t believe in God, so he didn’t use any canned phrases from church. He didn’t engage in inauthentic speech of any sort. John was fearless. John was an inspiration. Within minutes of meeting him, I felt I had known him forever.  He was hilarious and somehow managed to laugh at cancer. He made me laugh at cancer. John said he wouldn’t even believe he had cancer but for the fact that he looked like Lurch. Then he would take his shirt off and try to look creepy. And he was great at looking creepy. About death, John said, “You just keep going until you don’t,” and then he would smile. And when you think about it, that’s really all there is to say. Except he also said, “cancer sucks.” And I guess that’s a valid statement too. “Cancer’s a bitch,” I would say. “Yeah,” he would say, “fuck cancer!” Then we would laugh.
“So how does this dying thing work? What’s going to happen?” he asked. He wanted the truth and I obliged. “You are going to begin taking more naps during the day. You will sleep for longer periods and eventually you will sleep more than you are awake. You will lose your appetite gradually, and you do not have to force yourself to eat. Try to eat calorically dense foods, or just eat ice cream if you want. Walk if you feel like it, rest if you feel like it. You will get weak, you may need a walker and a shower chair. And when you can’t do that, we will bathe you in bed. There may or may not be pain. If there is pain, we have medicine for it. If there is agitation, we have medicine for that too. We have medicine to fix everything, except for the death part of course. Eventually you will develop secretions in your lungs and mouth, otherwise known as the ‘death rattle,’ and we have medicine for that too. But regardless, there is nothing at all to fear, because we have something for everything and I will be right next to you.”
He seemed to find this answer acceptable … though I suppose he had little choice. But we didn’t always talk about death. His house was like a museum of souvenirs. He and his wife were world travelers, and both had written and published several successful novels. They had also kept a log of their travels, and for every odd mask, picture, statue, or shoe, there was a corresponding story scrawled in pencil from thirty years prior. What treasures these notebooks were! After one particular visit, as John walked me to the door, he asked if I would make my next visit when his wife was away, as my visits tended to make her sad (that angel of death thing). I assured him I would.
When I arrived, his first question was, “So who keeps that medicine?” “What medicine?” I asked. “All the medicine that fixes everything.” “Oh, that medicine. Well, when you begin to show signs of decline, I will stick it in the fridge. That way, you guys can call me, and I can walk you through which med is for what and how much, while I’m en route.” But what John really wanted to know and was bold enough to proposition was would I administer enough medicine to kill him, and he would pay me for it. Dr. Kevorkian style. Of all the people I have helped die, not a single one of them had ever asked me this. I was offended, not because he wanted to check out a little early or because he asked me to assist him, but because he thought I would take money for it. Of course I declined to assist him, but I also tried to talk him into wanting to live. I told him it was time to start his bucket list, I reminded him that he loved working in his garden, and when all else is gone, there is still that warm bit of sunshine, and joy can be found there. There is ice cream! There is music! There is so much to live for, I argued. To die now would be to say that all life is meaningless, because what do any of us have other than moments, small delights, ice cream, and bright bits of sunshine.
“Molly, I don’t find joy in these things anymore. The sun gives me no joy, my garden gives me no joy, and I’ve never cared much for ice cream. My wife is sad, and I hate dragging this out for her. I don’t want to be dependent on others to bathe, I don’t want to use a walker. I’ve already hit every single thing on my bucket list. I lived my life. I lived it well and fully and wrote it all down. And I enjoyed every minute of it, and I had the most wonderful woman in the world to share it with. And as a gift to her, I want to make this as quick and painless as possible.”
Something about John’s strength, his honesty, his kindness, his willingness to look at and name things that are scary, and just the thought of any creature living without joy made me weep. This made him laugh heartily. He grabbed me some tissue and called me sweetheart and hugged me. “You’re not supposed to be taking care of me,” I said through tears. “I’m supposed to be taking care of you hoo hoo hoo,” I sobbed. This made him laugh even more, which made me laugh too.
Then he gave me some shark teeth. He had collected hundreds of shark teeth from beaches all over the world, and he gave me some to take to my kids. So I did, and the kids were impressed. And John died. His wife called me and said simply, “I think we’re losing him.” John had slipped into a coma. He never weakened or had pain or used a walker or had to be bathed, he just went to sleep. He was nonresponsive, and we watched and held his hand when he took his last breath and his heart stopped beating. And he was gone. And it was sad. And the funeral home men in suits came and said canned phrases about being sorry for the loss, and that the Father had called him home, and then they took his body away. He was cremated and had no service, just as he had requested. His wife and I looked at old pictures of their “adventures” together. And we both cried.
We have moved since then, and in the move and in a chaotic and busy house with kids, the shark teeth have been scattered about. Sometimes I think about putting them in a designated spot or in a little jewelry box or something, but I never do. I found one of the shark teeth on top of the microwave this morning. I rather like them scattered about. The kids pick one up occasionally and marvel at how sharp it is before throwing it down (or on top of the microwave apparently) before moving on to something else. Occasionally I’ll find one, and what a happy surprise it is for me. I am reminded of dying with John. I am reminded of the importance of living authentically, speaking authentically, dying authentically, and trying always to be grateful for each precious moment, ice cream, and the sunshine.

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open call, spring cleaning

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Straight up, direct, honest and beautiful.
Heartfelt and moving. Thank you.
I hope my loved ones, and eventually I,
have someone as refreshingly honest and honorable
around
when i kick off..."so what's this death thing like??"(ha!)

You hit on something I have felt intensely when
I have dealt with death in my own life:
the sense of " a great betrayal. ..(that)the world doesn’t stop for death..."
That must be why we have funerals & wakes & calling hours , etc.
Thank you for sharing John with us.
Love your writing! John seems like a wonderful person to have known.
I'm in awe of the service you provide your patients. Beautifully written.
Beautifully written. thank you for sharing.
John's way is the way I want to go. No doctors bossing me around and pushing more more more of their crap on me, and stealing my remaining time in their soul sucking waiting rooms.
I have been reading and writing here for several years and this is one of the most eloquent and fascinating and touching pieces I've ever read. Ever. I often think of maybe volunteering at a hospice center when I retire (next five yrs). I thank you for sharing this.
Being a hospice nurse is not easy and I admire you for being one of them. I'm not afraid to die but I'm afraid to leave my loved one's. I hope everyone will make most of their time while they're still alive..
Being a hospice nurse is not easy and I admire you for being one of them. I'm not afraid to die but I'm afraid to leave my loved one's. I hope everyone will make most of their time while they're still alive..
Being a hospice nurse is not easy and I admire you for being one of them. I'm not afraid to die but I'm afraid to leave my loved one's. I hope everyone will make most of their time while they're still alive..
You have found your niche and what a gift to your patients. I believe at least in health care, everyone has one, that they love, that they excel at. This was beautifully written, and I agree with your authentic approach as opposed to false assurances.
Great story, really honored the passing of this man. I have a mom dying of Alzheimer's and I know what you mean about about canned phrases, but sometimes it's all we have to cling to.
Best, Erica
Wow, what a voice you have!
I loved your approach in such a difficult time and hope when the time comes for his wife that she will also have a peaceful exit.
You have a gift with your actions and words.
~r~ for authenticity and sharks teeth (one of my favorite things!)
You're a gifted writer as well as an angel--your story brought tears to my eyes. Think about writing a book about death and dying; it may help many more people. AR
I helped my dad die. I've written a lot about the experience because it was so satisfying. I was able to help him have the simple death at home he wanted. Luckily he died in the summer when I wasn't teaching and I could leave my family and spend the last two months helping. Our first hospice nurse tried to convert him. Our second was wonderful--straightforward, reassuring, and he became very attached to her. I think she has left hospice nursing but I still think of her fondly. We shared something important. I bet John's wife still thinks of you.
Oh my. That's heartbreaking. I'm sure you'v seen a lot and have had to adjust yourself (a lot) based upon what people in the throes of crisis need to hear. You're a jewel for giving in - giving them what they need to hear - rather than falling back on what you believe.
Very moving writing. I admire your work more than I can say, having been through a long protracted death with my mother. As for the canned phrases, yeah, I hear you! I've heard quite enough of those to last a lifetime and then some.