i.
My neighbor died, abruptly, while I was away at college. The girl across the street told me what happened: it was sudden, totally unexpected.
I didn't even know she was sick, I said.
No one did, not even her, she said.
She simply collapsed; alive one second, dead by the time she hit the floor. No warning, no symptoms. It was like she-and her family-got blindsided by a truck called cancer. It had been inside her, everywhere, engulfing her from the inside out.
ii.
After just about everything had been done, every last resort explored and found insufficient, after five years my mother finally knew (this was before the pain, the real pain, commenced). Even while we were still lying to her, she ultimately could no longer lie to herself. Her body told her, and her grandchildren-who didn't yet know how to lie-told her. The kids could sense it, and when she saw she was boring her granddaughter, that was a sign. When her granddaughter-the one she helped raise, the one whose diapers she'd changed, the one for whom she could not buy enough toys or treats, the one she secretly (and not so secretly) loved as much as her own children-made it obvious, in ways only very young children can, that grandma was no longer as much fun, she knew.
iii.
Generally speaking, illness is cathartic. Even the worst stomach flu is tolerable because we know that however awful it feels, it's temporary. In fact, as the worst symptoms ensue, you can take a curious comfort, knowing it can't get worse. It follows patterns, borders, and you can almost predict the course it will take. Then, as you gradually begin to improve, it becomes slightly intoxicating: the nasal drip that made it hard to swallow and difficult to sleep now congealed and coughed up, expired demons exorcised from your system. Your vitality stumbles back, like an eager baby learning to walk, and eventually, you're yourself again.
With terminal cancer there's no improvement, and each time you confront the worst possible symptoms, more are always on offer, a never-ending supply promising agonies you could not have previously imagined.
iv.
To hear some people tell it, angels are all around us. Lincoln spoke about the better angels of our nature, but these people believe actual angels are guiding our lives, their handiwork resulting in what we can only call miracles.
It's certainly an enchanting notion: our departed loved ones-or unknowable spiritual beings-looking down from heaven, intervening on God's orders, helping us do what we can't do for ourselves.
We see evidence each day of the ways our fellow human beings make concepts like angels, heaven, and even hell seem like the only sensible remedy for the evils we inflict. Even if, guided by angels or their influence over our natures, we established a better way to exist, we would still have inexorable setbacks like illness and death-the sorts of circumstances that practically compel divine exegesis.
v.
Question: What would you have done differently?
Answer: I would have brought in hospice much sooner.
Question: Why didn't you?
Answer: I didn't realize it was an option.
vi.
Listen: for a country that prides itself on doing so many things so well, America doesn't handle dying with any particular aplomb. In fact, we are decidedly inadequate when it comes to confronting death, much less embracing dying as a natural process, an opportunity to heal the living.
For more than five years, my family fought cancer. We faced multiple turning points and uncompromised choices. When we finally realized that hospice was an option-and despite the gratitude we collectively feel, in hindsight-the decision to take that step was far from uncomplicated. It obliged us to acknowledge a reality we could no longer elude: the woman we loved was increasingly close to death, and we could do increasingly little about it.
We brought in hospice. We did the research, made the choices, placed the calls, faced our fears.
The hospice nurse who visited us that first morning was calm and kind as my mother sat in the bedroom unable to control her shaking limbs, looking like a child who had been caught shoplifting. Within minutes, the nurse established a bond with my mother. Within hours, she managed to become all things to everyone involved, talking and listening to the rest of us as we sat around the kitchen table, a benevolent vessel who received-and seemingly resolved-every concern about medications, how to communicate (with my mother, amongst ourselves), how to navigate the unfathomable process of helping someone die with as much dignity and peace as possible.
Our nurse was the only hospice worker who visited us-for some families, a hospice doctor will visit as well, or a social worker, or a home health aide-and she was a miracle worker. She managed to console and reassure us at a time when we needed it most: You are doing right by your mother; you are bringing love and serenity to an impossible situation. The contrast between her and the overworked, anonymous nurses we'd dealt with to date had a profound, soothing effect. The seemingly simple, heretofore unthinkable access to a consistent, reliable advocate made a difference we could not have articulated only weeks earlier.
That's what they do, I thought. This is what they do, I say now to anyone who will listen. Hospice helps you help yourself: it's that simple, that extraordinary.
Hospice workers are angels of death. They help us see dying as natural; they help us to see it as holy. When we're faced with an impossible situation, we can't afford to rely on angels we're unable to see. No divine miracles are necessary, since beings are amongst us who provide the support, comfort, and grace many of us would pray for.
When you or someone you love is confronting a death that will be neither quick nor painless, these ordinary angels can become the embodiment of what God's envoys usually get credit for. When even the most compassionate doctors and priests are unable to offer more than kind words and empty promises, hospice workers are waiting to step in. And that is as close to a real miracle as we can expect to encounter in this world.
vii.
My mother came into contact with several dozen medical professionals between 1997 and 2002. Her hospice nurse was the only one who came to her funeral. This is what hospice does. This is what hospice is.
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Non-FictionQuestion: How do you get over it? Answer: You don't. You don't want to. It makes you who you are. Sean Murphy lost his mother days after her fifty-ninth birthday, following a five-year battle with cancer. In this eloquent memoir, he explores his f...