Gerrie is a wise and formidable lady, and truer words were never spoken. I thought of this maxim of hers over and over while my mother, Molly, was going through the process that ended in her death on January 22, 2017.
All this time I’ve been writing about the “dead” and the spirit world from a position of being in touch with that reality, but for the most part I was not down in the trenches with death itself and its gritty and messy biological details. It all became immediate and concrete when my mother had a stroke on January 12. I’m going to write about what I observed in hopes that it is useful to someone.
First, on December 30, 2016, our 20-year-old cat passed. She had done astonishingly well for a long time with her failing kidneys, but her body reached the end of what it could handle. Sheena had been velcroed to my mother constantly for a few years, and her death was a hard thing for my mother to get through. We nursed the old lady through to the last, very hands-on because she would not allow herself to be left alone and cried if we weren’t right with her every moment. We were left with her tiny body between us on the sofa, like a perfect sculpture of a cat down to every hair but somehow no longer a cat. My mother wondered what we should do with the body overnight, since it was late and we weren’t going to bury her till morning. “Well,” I said, “no matter where we put her body, she will probably be in your lap.” And at that moment I felt Sheena crawling into my own lap, a small warm weight that stayed till it was necessary for me to get up.
For a few days it was as if we still had two cats, only one was invisible. After that, it seemed that we only had one cat.
Shepherding Sheena through her journey, being the person who listened to see if her heart had stopped, arranging her little limbs for burial, gave me a kind of dry run or rehearsal to help me deal with what would happen with my mother. In Sheena’s case, there were no wrenching medical decisions to make, no questions about whether she might get better. We had known the end was coming and that there was no treatment possible. Things are more complicated with humans and hospitals.
On January 12 my mother suffered a major stroke, affecting areas on both sides of her brain. I think the emergency room doctor had the right instinct. She told us very gently, based on what she saw, that it was time to think about making end-of-life decisions. But within a few hours my mother was able to move her left side again, and within a couple of days she was speaking somewhat intelligibly and swallowing a bit. It looked like she might recover enough to at least sit up in a chair, communicate and feed herself. We exhorted her to rest so that her brain could heal as much as possible, but for a while she was using a lot of energy to make it clear that she wanted to get the hell out of the hospital and get rid of the IV and the other medical annoyances. Which was certainly understandable.
Two and a half days after the stroke, late on January 14, she was able to explain to my daughter that she was ready to go and had nothing else she needed to do. She had great difficulty speaking but was able to get a whole paragraph out and be completely clear. “I’m ready for the sky,” she said, and Lenore confirmed with her that this was really what she meant to say. We’d pretty much known that she felt that way, as she had been weak and had felt rotten most days for a long time, due to problems with her heart, but it was a great gift to hear it in so many words and be sure of it.
The hours and days had a way of running together, and I’m having trouble remembering exactly when various events occurred. It was probably the 16th when she suddenly pointed straight ahead, no trembling in her arm, and clearly called out, “Ann!” That’s her eldest sister, with whom she had had some previous dreamlike contacts. “Is she here?” I asked. My mother nodded. Since the other contacts had been extremely helpful and positive, I was glad to hear it. I couldn’t detect my aunt myself, but I knew that communication with deceased relatives was common near the end of life, and I took this very seriously. My husband and daughter were familiar with this phenomenon as well, and I think that was when we all knew she was turning the corner toward death.
I will spare you the details of the indignities and unpleasantnesses that my mother had to suffer over the next few days. We were told that most people in this kind of situation “just slip away,” but unfortunately she had to take a harder road. We had assumed that the severe agitation she was displaying so much of the time was an effect of the stroke and would likely improve, but if anything it got worse. By the time the palliative care team came to see her on the 17th, she had been through at least a day of hardly any rest or respite and the nurses and I were getting frantic trying to help her. As soon as the palliative care doctor saw her, he recognized what was going on as “terminal delirium.” I had never heard that term before, but apparently it happens a substantial percentage of the time.
The doctor said that we should stop bothering her right away, pull the IV, the heart monitor, and the other devices that could not possibly do her any good. Thankfully, we were moved to a private room where there was relative quiet. We still had a terrible night because the low doses of medications being given weren’t enough to stop the seizure-like agitation. I couldn’t imagine any of us going on like that. The palliative care people agreed and very quickly and efficiently put through an order to move to the inpatient hospice. Their nurse held me and let me weep all over her.
The Kaseman Presbyterian inpatient hospice was a revelation. Instead of a cramped, chaotic hospital room, we found ourselves in a space big enough to walk around easily, with home-like seating and nearly perfect calm, and an atmosphere that felt like it was filled wall to wall with angels and helpful beings. Soon after my mother was brought in and my daughter and husband and I gathered around her, a priest came in to give her the blessing for the sick. The moment Fr. Charles opened his mouth to pray, it was as if the ceiling opened and a thousand more angels dropped into the room. My mother had been stressed further by the ambulance trip there, and this uplifting interlude was soothing to her as well as to the rest of us. I had only once before had an experience like this with being prayed over. Not everyone has that kind of connection to the heavens, it seems.
We more or less lived at the hospice during the next few days. They had a miraculously comfortable place for a family member to sleep, such a contrast with the hospital, and I took advantage of that. The first night, Wednesday, I felt that I was embraced hour after hour by myriad beings of light, wrapped securely in grace and benediction. In that state it was easy to make a strong heart connection with my mother and feel her embrace as well. I was up often to respond to the nurses and check on things, but when I slept it was a wondrous and restorative sleep, and I dozed off and on far into the day, with the staff encouraging me to rest.
Despite that, Thursday night I felt ill and crashed at home. I intended to go back to the hospice in the middle of the night, but never made it. We all continued to limp along through the process, my mother still sedated most of the time and moving slowly toward the end, not really responsive anymore.
Friday morning there was some drama. Her body became extremely hot, not just to the touch physically, but radiating incredible energy all around. The nurse could also feel the heat and energy— I think anyone would have noticed it— and she and I assumed my mother must have had a raging infection by that time, but since they don’t take temperatures in hospice, we didn’t determine whether she had an actual fever. It was far more than that, though. I had never seen so much energetic activity around a person, and I’ve seen a lot. I wasn’t sure what to make of it, and wondered if it had anything to do with the nonphysical part of her moving away from the physical substrate. I haven’t found any information or opinions about this, but much later I did see a reference to a dying person’s skin becoming very hot at about the same stage.
I will describe my subjective perceptions of the next stages of the process. Friday night, as I was keeping watch from the sofa bed across the room, I saw what looked like a sudden opening in my mother’s chest, like a door or hatch being opened. Something that seemed whitish poured out. (This was a “mind’s-eye” vision— I was not looking directly at her.) This energy appeared to congeal into a mass near her body, with a sort of band still connected rather tenuously. It looked like a vague ribbon or stream to me, not the famous “silver cord,” though it must have been functioning in the same way as that.
Drifting through the hours in the middle-of-the night state of grace (not dreaming, mind you), I lost track of where that main concentration of energy was. Where is my mother? I kept asking myself. She didn’t seem to be close to her body anymore. Fryderyk was accessible, and I asked him what he could see and if there was anything he could explain to me about what was going on. I said something about wanting to be sure to be present when my mother actually passed and not wanting to miss the moment.
“If you wait to see it, you will already have missed it,” he told me in his usual aphoristic and slightly cryptic way. In images, he conveyed the idea that death is not a moment but a series of steps or distinct events.* I was already witnessing it, he said. And as usual, I realized that he was telling me something that should have been obvious to me already.
The next morning, Saturday, I found a distinct change. Her skin was still physically quite hot, but there was almost no feeling of energy near it at all. My mother’s body was still functioning, more or less the same as the night before, but she was somehow much less alive. She had already been mostly unresponsive, but now she seemed not to be “in there” in the same way anymore. I took this as a positive sign. It seemed much better for her not to have to experience too much of her body’s travails.
My understanding was that beneath the painkillers and sedatives, the body was still feeling some distress. I could detect a strong sense of disturbance in her heart, that is, the physical organ, and I felt pain in my palm when I held my hand near that part of her chest. I mentioned to the nurses that I was feeling pain in her chest, and no one seemed to think anything was strange about my statement. Hospice personnel hear and see all manner of things.
We began to feel like midwives, encouraging my mother to make the leap into the next birth. We talked to her and told her it was OK to go, which we figured she knew, but we thought we should say anyway. We started to wonder whether there was some unfinished business we didn’t know about. As I would with a regular patient, I poked around and looked for any emotions or issues that might show up, and worked to clear the minor things I found. (Mostly, she was concerned about leaving the mess of papers and paraphernalia in her bedroom for us to sort out.) We reassured her that we were fine and she didn’t need to worry about us.
I stayed over again Saturday night, afraid to leave, thinking that it would happen anytime. By mid-morning Sunday, I was wanting to get a change of clothes and clean up, and the nurses were gently pushing me to get out of there. (We know that often people wait to pass, not wanting to do it in front of their loved ones.) “Did your mother spend a lot of time alone?” they asked. (She did.) “Maybe she’d like some alone time now.” So I went home, and Bob went to replace me a little while after. Hardly an hour later, they called for Lenore and me to come back right away.
It was almost comically anticlimactic to rush back to the hospice only to sit there again just as before. But things were beginning to change more noticeably. An elderly friend who hadn’t been able to come sooner arrived with her daughter, and they confirmed, based on their experience, that it wouldn’t be long. Their perspective and wealth of experience were helpful, but a little disturbing and imposing too. When they came to my mother’s bedside, I moved to the foot of the bed so that they had space, and they immediately told me not to stand there. Huh? They explained that in their belief system, the soul exits the body through the feet, and they didn’t want me to block its passage. I was completely nonplussed by this thought— I’d been brought up Catholic too and had never heard such a thing— and taken aback that anyone would try to dictate anything to me at my own mother’s deathbed when she was so near the end. I moved over, though, mumbling something about having seen my mother’s chest open and her soul pour out that way already, which didn’t seem to get through to them.
Every so often the nurses checked on the color of my mother’s extremities and the sound of her breathing. There was nothing to do but wait as the death rattle set in. I sat very close, and the sound was terrible even though I knew it was normal and expected. I was insulated from the distressing events, though. What I mainly experienced was the warm, reassuring sensation of my mother embracing me as if I were a tiny child. It was an incredible gift. I knew that whatever her body was going through, she was fine, and so was I. I wished that my husband and daughter, and the staff too, could feel what I was feeling and know the same peace.
I was the one who probed for a pulse and announced that it was gone. The nurse confirmed the time of death, then left us to say our goodbyes. We weren’t quite sure how to react. I remember blurting out, “I’m so excited for her!” and really meaning it, since so many new possibilities had suddenly opened for my mother. She was vibrantly present in the room, so I kept talking to her. Her mouth was hanging open awkwardly, and I wanted to close it for a more dignified appearance, thinking that she would not appreciate being seen that way. I kept trying to reposition her head to make that possible, and it just didn’t work no matter what I tried. I apologized for my failure, laughing helplessly. The absurdity somehow seemed natural. We found ourselves engaging in some gallows humor, and I wondered how the other families in the facility were dealing with this kind of thing. It was surreal and bizarre as much as it was sad, and at that moment I was feeling relief more than anything.
I wistfully noted that the individual cells of the body, most of which were probably perfectly healthy, were now condemned, along with the billions of commensal organisms that ride along with us and make our human life possible. But that is the way of things.
My mother was around and available a great deal for the next few days, and others besides me experienced and enjoyed her company. I couldn’t really feel grief-stricken, since she wasn’t gone. She didn’t continue to hang around so much of the time, and I expect that she’s been doing more worthwhile things than watching us, but there is contact now and then. I still haven’t found her current will; I’d thought I knew where to look, but her papers were not arranged the way I expected. When I begged her for help in locating it, she pointed me in a definite direction in her bedroom— but what we found there was her will from 1963… this would be a great time for me to be a much better medium than I am… still no current will to be seen, unfortunately.
But that situation can be easily dealt with. I have no major complaints. My mother is dead but not lost, and I’m at peace with her and with the process of her life and death. I’m intensely grateful to have been privileged to observe and perceive so much of what went on. My only discomforts have been a few small lingering questions about the medical decisions we made. I’m comfortable that we did the best we could with the information we had at each moment, though.
I understand far more about death than I did before, but there are myriad questions remaining. For one, I have been wondering, if a person dies suddenly in an accident, by gunshot, etc., do they go through the same stages, only much more quickly? Or is it a very different process? I’m sure there must be some after-death accounts of sudden deaths out there.
Friends and patients have been telling me about their experiences of the deaths of their own parents and others close to them. I would love to hear anything you would care to share, either as a public comment or privately.
*Michael Tymn posted this on his blog at
‘In his 1998 book, Light & Death, Michael Sabom, an Atlanta cardiologist, cites an article by Dr. Linda Emanuel, who comments that life and death are viewed as non-overlapping, dichotomous states, whereas in reality there is no threshold event that defines death. “Several scientific observations support Emanuel’s argument that loss of biologic life, including death of the brain, is a process and does not occur at a single, definite moment,” Sabom writes.’