My friend, Phil Dwyer has written a book on palliative care, called Conversations on Dying. It’s a remarkable book – part memoir, part research, part expose. In his words the book is: The story of the end-of-life experience of Larry Librach, a palliative care pioneer who helped thousands of patients to die well.

Part of Phil’s ongoing mission to bring this once taboo subject out of the dark is to publish fellow writers’ experiences of being with the dying. I was inspired to write about the deaths of three of my family members who passed away within eight years of each other.

You can find it on his site:

Here it is:

The day after I received the call that my father’s time was coming to an end, the Twin Towers crumbled. Not two years later, one week before Mothers’ Day, my mother’s legs buckled and froze. Before six years had passed, on a bright April morning, I knew as soon as my sister spoke my name that my brother was gone.

I sat with my father while he prepared, while he sat propped in the hospital bed they brought to the sweet little sea lodge overlooking the quiet Caribbean bay. My guru once advised that in order to truly know life, to be totally alive, one must become intimate with death, must embrace the knowledge of one’s own mortality. There were death meditations, such as imagining oneself in one’s own coffin, to help us get to that place of surrender to the living moment. Once, in India, I sat with a burning body at the ghats by the Mula River until nothing remained but bone.

But this was my father. When he was gone I would never be the apple of anyone’s eye. I watched the slow rise and fall of his chest. I breathed my own breath, aware that these specific breaths – mine and his – would never be breathed again. I’ve never considered myself very good at meditating, but there in that room, there was only my father, me, my sister, my brother, and my mother who timed her own breaths with his. I suspect she’d been doing that very thing for sixty years, even across four years and an ocean during the war.

We waited, my father with the least patience, glancing again and again at his watch which now hung loosely on his wrist, until finally, in exasperation he let his arm drop to his side and said, “Why is it taking so long?”

I touched his feet only to be told that my touch was painful. I had been to the grocery store frantically searching through the shelves for a morsel he might enjoy, and later in hopes of an offering he could tolerate. Consommé, his favorite when ill, chilled with a squeeze of lemon. Too spicy. Until at last, the turn of his head conveyed the truth that even a can of Ensure was unwelcome and pointless.

He called us all into his room, took out the oxygen plugs from his nose, had the four of us sit like a row of monkeys on the single bed my mother now slept in and told each one of in his whiskery voice that he loved us. Then he said, “I want you to take your mother across the lanai so I can see you, out the back door onto the beach, and around the house.” My mother jumped up. “No!” she said. “We agreed. Bill! We agreed, remember?” And she clung to him. My father looked out over her shoulder at the three of us and said, “Go. Wait for her in the living room.” Through the closed door we could hear her crying, hear his soft murmur in response. After a few moments, she emerged, her face a blur.

We held on to her, instructed as we were not to look into the bedroom as we passed in front of the lanai’s small pool. We held on tight – my brother on one side, me on the other, my sister holding open the door, opening her arms as if to catch my mother when she fell. Boats with their sails folded floated on the blue-green water, tiny as toys. The wide fronds of the young coconut palms held still as we passed. The soft sand buried her feet and we half lifted half dragged my mother between the condos to the front steps.

We stood, three grown children and a crumpled wife, in the small living room. I hadn’t yet discovered the trick of watching him through the lanai and through the bedroom window to the dresser mirror beside his bed. The door was closed. My mother looked from my brother to my sister to me, pleading, begging, imploring, What, what, do we do now?

I put my hands to my face, finding it stretched, the bones underneath sharp.

The palliative care nurse arrived before I could say, to hell with it, and open his door, hover my hand over his mouth, and close his eyes, if death had indeed come. She waved us back and went in, closing the door behind her. A few moments later, she came out and told us he was fine and to go back in.

“What just happened?” my father asked.

“I think you thought it was time and you wanted to do it alone, so you sent us out. But it didn’t work. You’re still here,” I said.

My father cast a weary look past the lanai, past the white silk beach, and past the small boats now bouncing a little on the blue-green water, and replied, “Yes. Yes, that’s exactly what happened.”

It was much later that I discovered what my mother had meant when she said that they’d agreed. My parents lived on the north side of Grand Cayman where hedges of Oleander line every driveway. The dark ‘tea’ she kept on the nightstand between them was to be the elixir to save her from grief. A week after the thinning filament that tethered my father to life finally withered completely, she had me pour its contents down the bathroom’s white enamel sink.

Just as my mother had predicted, after the first week the parade of fruit baskets and pies stopped arriving, as did the caring faces of my parents’ friends. “They think I’ll steal their husbands,” she said, blowing a hard stream of smoke into the warm moist air. “That’s why I won’t get invited to dinner or to parties.” She gave a harsh laugh. “As if any of them could hold a candle to my Bill.”

Six months later she swallowed all of her pills at once.

I found a beautiful retirement home close to my home in Ontario, flew to Cayman, closed up her condo and brought her north, where she hadn’t been in twenty years. After Christmas we moved her into a comfy room with a west facing window and went shopping for winter clothes. Her skin lost its year-round gold and one day after I kissed her goodbye and started down the stairs to my car, I came back up to retrieve my forgotten gloves to find her buckled over and sobbing, crooked fingers dug into the arms of her chair.

So when I went two months later to the hospital where she lay twisted and still, I wasn’t surprised that her eyes flashed wide when I told her they would put in an IV to keep her comfortable. “Not even that?” I asked, having spent an entire afternoon with her that relentless ice-bound winter filling out the details of her living will. Nothing. Nothing. Nothing. But surely, I thought, she would want some comfort. Her head didn’t actually move, but I saw her shake her head, no. She trusted me. “Okay,” I told her. “We won’t do anything at all. Nothing. Okay?” And her face relaxed. Her eyes slowly closed and opened again to meet my gaze. I wasn’t surprised. Only sad.

In that time with my mother, I drew very close. I put my face next to hers. Her breath was sweet, like burnt sugar. When I was a child I imagined that my parents were eons older. As an adult I began to see their faces in the mirror. But when my mother lay dying, I saw how close we really were; I recognized the shortness of the thread between us. How near were my own final breaths.

There is something in this waiting with the dying that is not like any other thing. It isn’t even really like waiting. It is time suspended. One sustained moment. It is only that. Between the second hands. It is only this.

My mother was thirsty only for the end. As one day bled into the next and she faded out of consciousness, it seemed a kindness to attempt to assist however we could. It was carefully suggested that a little extra morphine could be administered. After some deliberation among my sister and brother and the staff we agreed that it might help.

It didn’t. When the extra medication registered, her body spasmed and her mouth opened wide, her head thrown back. She gasped for air even though she never regained consciousness. It was awful to see her like that when she had been so calm. We stayed close until the drug faded and she rested again. I sang to her and promised we would wait with her. In the corner of one eye a single tear formed.

My father had ten years to prepare. My mother began her preparations the moment it was clear she was to lose him. My brother. I don’t know.

When my brother recognized through the fog of post-surgery coma the tubes and catheters and clips and IVs and beeping monitors for what they were, he tore at all those entrapments. His wife saw that wild face of his grow even more fierce as he ripped the mask from his face, the needles from his arms, and struggled to rise. The doctors swept his wife out while they filled his veins with deep sleep. His heart had survived surgery, but his body rejected someone else’s blood. That night, we all hung on tight, but it was as if we were holding on to a 747 with binder twine. His wife felt him straining for takeoff more acutely than we did. But we felt it, too; those of us left on the ground.

All the strands binding him to life snapped in the night and he broke free.

My father, mother and brother all were able to choose in their own ways, and each one, even though their loved ones were near, died when they were alone in their room. Death, it seems, is a private affair.

Not all of us are fortunate enough to have the opportunity to choose the way in which we will leave our bodies. I only hope that when my own tenuous filaments stretch taut I will have, as they did, the presence and the courage to let go without complaint or resistance.