In Memorium

Over two years ago, a close family member, MC, was diagnosed with leukemia. Just before her diagnosis, she visited us. A lifelong dog lover, she played with and loved Myra and Sally. Myra got excited that she jumped up to attempt to kiss MC and, in the process, scratched MC on the arm. MC's scratch bled for almost two hours. We cleaned and bandaged it, only for it to bleed through within a few minutes. A few weeks later, when she'd been diagnosed, Patrick and I thought back to that and felt that we should have known.

MC had many brushes with severe illness and the hospital since her diagnosis. She spent an entire month in the ICU one time, and we all thought that it would be the end. But she pulled through and even went into remission for a time. But, as leukemia often does, she relapsed, had several more bouts of illness and hospital stays, and finally, inevitably passed away last week.

Everyone in the world could tell a story like this, maybe many stories like this. The story that I want to tell is how she died. One of my biggest stumbling blocks in medical school is how do people actually die? How does a disease actually end a person's life? What happens to make the body shut down? My interest has thus far been intellectual and I always felt pity for the patient and survivors, but knowing the circumstances of MC's death showed me the other side of death. The side that is peaceful and liberating.

MC had been in the hospital for a little more than a week and, along with her doctors, had made the decision to stop treatment. For more than two years, she'd been preparing for this time and it had finally arrived: MC knew that she was going to die. Soon. People came out of the woodwork to see her. One of the blessings and curses about a condition like hers is that she was completely sound mentally. It was her body that was failing, but her mind was as sharp as it had ever been. For her friends and family, this meant that she could talk to them, thank them, tell them that she loved them, and that they could do the same for her. It was exquisitely comforting for everyone, though among the hardest things that any of us have ever done or will ever do.

I was not present at the time of her death, but in my conversations with the people who were, I cannot think of a more beautiful way to move out of this world. In the words of our friend, "Everyone should die surrounded by old women who love you." MC's breathing had slowed to almost nothing. Eight of MC's closest friends and relatives surrounded her and tended to her. One combed her hair. Another massaged her legs and feet. Two held her hands. MC was nearly gone, but her friends made sure she was as comfortable and loved as possible. MC breathed a last, sighing breath; the eight women continued their tasks with reverence. Several minutes passed without a change in activity. Finally, unanimously, and without direction, the eight joined hands in a circle with MC and said a prayer of thanks and hope.

And then, says our friend, the eight "went about doing what old women do - take care of what needed to be done." They tidied up, called the nurses, made the appropriate telephone calls, began the arduous process of arranging for a memorial service. And everything was done beautifully, perfectly, as if it were an art.

I am so grateful to have known MC in life and I am so humbled to know the circumstances of her death. I hope that I can provide that kind of comfort to my friends, family, and patients, as everyone deserves to be honored by such a peaceful passing.