can’t imagine Karen needs permission to go, do you?’ I said. ‘She always was the boss.’
At this we both laughed, surrendering our attempts to move the situation along.
A dog barked a few houses away. The room was quiet except for every so often when one of us said, ‘I love you.’ No other words made any sense.
Then the screen door banged against the side of the house and a rush of cold air pushed in on us. The wind had prised open the latch. We had opened the glass door earlier that afternoon so that Karen could feel the fresh air on her skin.
Tears flooded our eyes as we understood that the end was near. Ten seconds of stillness between breaths felt like forever. Another long exhalation, followed by silence – twenty seconds, thirty seconds. I knew to wait. Even after a minute there might be a final breath. And there it was. Karen breathed one more breath in and out, and then her life was over.
I didn’t want to move a muscle, as though the stillness in the room told me to wait, not to interfere with a cycle that was still completing in the room. My eyes were magnetised to the stand of poplars outside the window as they responded to a crescendo of wind and the sky that was turning deep pink as the sun dipped below the horizon. Then I noticed Karen’s face was softening in tiny increments, the frown line between her eyebrows slowly dissolving and the shape of her mouth shifting. My attention was pulled back and forth between these two happenings: to the elemental world outside the window and to Karen’s body, made up of elements too, which were shifting and dissolving in front of our eyes, in what seemed like a necessary dynamic interplay. About an hour later, the momentum in the room had ceased and I noticed a tiny smile had appeared on one side of Karen’s mouth, as if to say, ‘Yup, it’s just as I thought.’
2
DANIEL: Memory Box
Daniel stood in the doorway of my counselling room, hand-in-hand with his seven-year-old daughter, Emily.
‘Sorry for the surprise, Janie,’ he said, glancing towards his daughter. ‘Can Em entertain herself in the waiting room while I talk to you?’ He looked at me from inside dark circles of fatigue. ‘Lin came down with a migraine and stayed in bed this morning, and when Emily insisted on coming with me, I didn’t have the heart to say no.’
Preventing the little disappointments was something he could do. He had no control over the big loss that lay ahead for her.
‘My girls don’t know how sick I am,’ Daniel had told me on the phone the week before. ‘It’s better that way, don’t you think?’
He’d decided not to tell them the latest news from the doctor, that his cancer had come back with a vengeance and he likely had only a few more months to live. Being the father of two daughters aged seven and nine was Daniel’s proudest accomplishment.
‘We need to have a longer chat about this in person, don’t you think? Can you come in for a session?’ I had asked.
Two days later he knocked on my door, Emily in tow.
She looked me straight in the eye, with a big smile. She exuded self-confidence, a sign of resilience, a character trait that makes all the difference in the aftermath of a tragedy.
‘I’m so happy to finally meet you, Emily. I’ve heard lots about you.’ I stooped down to her height and held out my hand. She took it briefly.
Emily’s dark brown hair was cut into a bob with a fringe that fell shy of her wide hazel eyes. She was dressed in multiple shades of pink. Her sneakers were well-worn and the strobe lights in the heels flickered faintly as she headed for one of the comfy chairs. She pulled a colouring book and a zip-lock bag of crayons out of her backpack.
‘If you need us, just knock on this door, okay?’ I pointed to the door of my counselling room. ‘Your daddy and I will be in there talking.’
She nodded without looking up. She was already colouring the dress of Princess Aurora bright purple.
Daniel took his usual seat on the overstuffed couch with its back to the window. His baldness seemed to highlight the ashen complexion of a man losing his life force, and his baggy sweatsuit attempted to obscure his weight loss.
A large maple tree against a backdrop of blue sky filled my office window behind where Daniel sat. The tree steadied me for conversations that were not often easy.
‘My wife and her parents are relying on me to get better. When I talk about dying, they tell me to stop being so negative. They don’t want to talk about death and believe that talking about it will make it happen. There are beliefs in her culture which I don’t understand. Of course I want to live, but it’s not a reality any more, is it?’ Daniel held my gaze and I inhaled slowly.
In these moments, when someone directly asks if they are dying, there are choices to make in response. Slip beneath the words, shift my eyes away from the gaze, succumb to the instinct to protect, to avoid the pain, to say something else, anything else. You can beat this cancer. You’re too young to die. Miracles happen, they really do. I know lots of people who’ve defied their prognoses. Michael, the guy you met last time you were here, outlived the doctor’s prediction by two years. You want to echo a family’s plea that death is conquerable, that the sick person just has to find the strength to fight. But in the end, you have to be honest. Death was already present on the couch beside Daniel, coaxing me to speak, and Daniel needed me to respect his capacity to handle the truth. Without respect, there’s no dignity.
I exhaled slowly. ‘No, it’s not looking like you’re going to make it, Daniel.’
Daniel’s voice was urgent. ‘If I’m going to die, then I want it to be as easy as possible for Lin and the kids. They’ve got to be able to manage without me.’ He turned his wedding band around and around on his finger, loose from the weight loss.
‘Daniel, I can help you prepare for your death, without either of us giving up hope that surprising things can happen.’ Daniel’s shoulders dropped an inch or two as he relaxed, and his eyes gave way to tears of relief.
‘Thank God. I knew I couldn’t figure this out by myself. I just know that pretending I’m not going to die isn’t going to help anyone,’ he said.
The dawning reality that death cannot be avoided has its own rhythm, its own season, and fruitful conversations about dying happen in their right time. I used to think it was my duty as a healthcare professional to guide people towards the fact that death was approaching, even without an invitation into the conversation. I’d feel a sudden rush of heat in my body, an upwelling of responsibility. I believed my forthrightness would help the dying person and give them enough time to prepare for what was ahead. I had seen many people run out of time to say goodbye, which often precipitates years of regret for those left behind.
However, over time, I’ve learned that my agenda, my hurry to open up a conversation, can frighten a person who isn’t ready. I’ve had to cultivate patience, quell the impulse to jump in until the truth has caught up and the psyche has assimilated what the body already knows. Sometimes the mind never catches up, and I have had to learn to accept that, too.
I knew Daniel was ready to talk from the urgency in his voice and the way he leaned forward into our conversation.
‘Let’s start with the practical stuff,’ I said, an easier place to start than the emotional preparation. ‘Have you thought about where you might die?’ I asked.
‘I can’t imagine Lin and the kids coping if I die at home, in our bed. She’d be haunted after. What do you think?’ he asked.
‘Memories of death are not always gruesome. They can be gentle and afterwards people usually speak about the comfort of having the person die at home,’ I said.
Daniel’s face was softer. ‘My grandpa died in his own bed, now that I think of it, and Grandma seemed to be okay, but Lin believes death is unlucky so I think it would be easier for her if I died in a hospital, or a hospice,’