HAVING TIME TO SAY GOODBYE AND TO GRIEVE
When people are asked which they would prefer, a hasty death, or to have the time to anticipate and prepare for death, most of us, while we are still healthy, will state a preference for a hasty death. We wish to avoid all the stressful emotional encounters, the possibility of prolonged illness and physical discomfort or pain. But by missing that opportunity to bid farewell, we can find ourselves with an aching place, -- deep inside.
A parallel in life could be like waiting for a train at the station with a loved one who will be taking the very longest of all journeys. The whistle is heard miles away. This will be the train. There won’t be another. There are things you still need to say. There isn’t enough time to say it all, but at least you have had the time to say what was most important--that you really cared. More than you could ever say. You bid farewell, and you thank God that you had that opportunity. But when a sudden death occurs, the shock and grief can be acutely painful because of having missed that last chance for the parting embrace and loving farewell.
Lynn Rees Lambert graciously granted me the right to quote from her newspaper column in Kingston This Week,1996, in which she describes the deaths of both of her parents. “People ask me. Which is worse? To lose someone suddenly or watch them go, agonizingly, to certain demise? They know I have experienced both. I still cannot answer.”
“With my mother, it was the slow, tortuous route. We watched her waste away--. She and I planned her funeral since Dad wouldn’t hear of it. --He couldn’t speak of death, at least not in front of his wife of 32 years.--Right up until the end, she tried to keep it light, preferring instead to help me organize the forthcoming lunch I would be expected to provide. With Dad, it was completely different. At five o’clock, he was at my place, peeling carrots and potatoes. Couldn’t stay for supper. Eight months after Mom had died and he was completely lost. ‘Just stay, I pleaded, there’s pie, your favorite.’ But no, he was going home. He never came back. The call came at 1:30 in the morning, the kind that no one ever wants to receive-- --something about Dad and an ambulance.” The column ends: “We never got to say goodbye.”
One of the most poignant scenes in the All In The Family television series was the one after the death of Archie’s wife, Edith. She had died suddenly of a heart attack. Some of Edith’s friends had come and removed her clothes and personal effects. The house seemed so empty. Archie looks under the bed and finds a remaining single slipper and he cries out in anguish, “Damn you, Edith, I never got to say Goodbye.” The shock of the news of a sudden death, with no farewell, leaves a huge empty space and, in our experience, a long-lasting grief for the missed opportunity of saying words of love in parting.
James Martineau has words of wisdom: “You cannot destroy the anguish unless you forbid the joy. A morality that rebukes sorrow rebukes love. When tears of bereavement have had their natural flow, they lead us again to life and love’s generous joy.” It is important for those of us who minister to the dying and the bereaved to remember the words of St. Paul, “Rejoice with them that do rejoice and weep with them that weep.” In so doing, we enrich our own lives.
Author and lecturer, Leo Buscaglia, once talked about a contest he was asked to judge. The purpose of the contest was to find the most caring child. The winner of the contest was a four year old child whose next door neighbor was an elderly gentleman who had recently lost his wife. Upon seeing the man cry, the little boy went into the old gentleman’s yard, climbed onto his lap and just sat there. When his mother asked him what he had said to the neighbor, the little boy said, “Nothing, I just helped him cry.” Sometimes there can be nothing to equal the simple compassion of a child.
The family living with the diagnosis of advanced disease in one of its members is a family in limbo--afraid to hope or plan for the future, struggling with the prospect of death or loss, not only the loss of the family member, but the loss of family life as it has been and never will be the same again. Underneath this grief is the poignant sense that death awaits each of us. During the time the patient is in treatment, family members may ride an emotional roller-coaster, alternating between hope and despair, with glimpses of possible recovery and “life as usual” again. If the illness is prolonged, mourning begins and some of the grief work may be done while the patient still lives. Often the patient may feel like an anachronism and a burden. Family members may often feel guilt for accepting the inevitability of death, or guilt for experiencing relief when death has ended the stress and the suffering.
The following is a story of a family that I knew well, in which it was very uncommon for anyone to express feelings of love or affection, or sadness and grief. Especially so with the men. They did love their Mother, but they spent little time with her at the last and expressed little emotion when they were with her or even after her death. June and I had come to know their mother, Maud, very well over the years and we were privileged to verbally and tangibly express that love during her lifetime. Thus, when we recognized her impending death, our sense of pain and loss had become lessened.
At the time Maud fell and broke her hip, both June and I each had several years of experience as palliative care volunteers. For that, we are thankful, for it gave us a heightened awareness and an added appreciation for what was transpiring. It was a priceless gift for we were given the opportunity of sharing our feelings, thoughts and concerns during those precious last few days and hours with her. Maud's final days were a wonderful example of gracious living and dying. It was the culmination of a life of courage and love for her God and her family. Her religion was radical in its emphasis on certain requirements as a means to salvation. While she accepted the teachings intellectually, in her real faith during her life, she had demonstrated an inclusive love that went beyond the restrictive boundaries of her religion. Hers was the essence of true spirituality.
Maud had lived till the age of 96 and her mind was clear, with only minimal short-term memory loss. Her husband had preceded her in death 11 years earlier. He had been domineering, and in the years when his family was at home, he often had been verbally abusive. She raised nine children and they were all born at home in the old farmhouse. During those years she lived in virtual poverty, though her husband was relatively wealthy. She had incredible strength that enabled her to endure it all. After his death, her personality blossomed.
For some time, Maud had been living with her daughter, as she had become too frail to live alone. Just before Christmas, she fell and broke her hip and was admitted to the hospital. Both June and I had become familiar with spending nights with patients in palliative care. June volunteered to spend the first night with her. Maud had helped to fill a space in June’s life that her own mother had been unable to fill.
June and I each took turns spending the fourteen last nights with Maud and we considered it a gift to be with her. The last night it was my privilege. She was too weak to say much above a whisper. In palliative care we had learned the value of taking a patient on a journey down Memory Lane. That was how, on that last night, we visited the farm where in years gone by she had raised her children. We described different events in the life of her family. We visited the church where her family had worshipped. It had been a central part of her life. We talked about her two children, who had preceded her in death, and I held her hand.
Sunday morning, June and I went to church and then came back to the hospital. It had become evident that Maud was near death. (Palliative care and hospice volunteers learn to recognize the signs.) She had no single critical problem, her body was just getting ready to shut down. For some time, she had been saying that she was ready to go, and indeed she was. Her family had been concerned as to how she could be cared for during her convalescence. It was hard for us, too, to accept the thought of her in a nursing home. She must have known that intuitively and provided the best solution on her own. When we saw her, we knew that the end was near. We called her family members and told them that her death was imminent. Her two daughters were already there. Maud appeared to be sleeping lightly, and then she became alert. She called her deceased daughter, Judy, by name, as if she were speaking to her directly. I then asked, “Maud, is your son, John, there too?” She answered “Yes.” We left shortly to go home to rest. About two hours later and just before sundown, Maud breathed her last. Hers was a good death. We truly loved her for who she was, and we have a continuing sense of her presence.
I wrote to Maud’s granddaughter, Charlotte, and described to her how it seemed that her Grandmother had spoken to her Mother, Judy, and to her Uncle John shortly before her death. In that family tradition, expressions of grief as well as love are largely suppressed. Charlotte had been carrying a burden of unexpressed grief over the pain from the two unfortunate marriages her Mother had endured during her lifetime. Her grief had been compounded by her Mother’s early death from breast cancer. My letter helped to alleviate her grief and provide hope that her Mother, whom she loved so dearly, had just been waiting to greet Grandma. She told me that when she read my letter, she was so relieved that she cried for hours.
Grief can be for a lifetime, especially if it remains bottled up. With sudden death, there is no opportunity for helpful, healing “anticipatory grief.” The grieving one does before, during, and after visits with a person who is terminally ill,--the crying and sadness one feels at those times, --that is what constitutes “anticipatory grieving.” “Grief is the price we pay for loving,” it has been said. So, if you are privileged to accompany a loved one closer to the time of his or her death, be grateful that there is not only “time to say goodbye,” but time to say how much that person will be missed, and how much that individual will always be loved! Further, by this sharing, you will enable your loved one to accomplish his or her own grief work, saying goodbye to one’s own life. Your standing by firmly and lovingly, in the midst of sorrow and distress, is the great gift you now have to give: What John Cardinal Newman has termed, “Peace at the last.”
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