"A Good Death"
a sermon by Colleen McDonald
from
The Unitarian Universalist Church
Rockford, Illinois
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"A Good Death" a sermon by Colleen McDonald from The Unitarian Universalist Church Rockford, Illinois |
Jean McDonald, mother of The Rev. Colleen McDonald, died on January 24, 2005. The following is a sermon about her mother's impending death that Colleen prepared for delivery on January 9th. She was called to her mother's bedside in Washington on January 7th, so the sermon was delivered for her by Karen Wells.
“Give sorrow words,” said Shakespeare. “The grief that does not speak whispers the o’erfraught heart, and bids it break.” And so I’ve been spreading the news that Mom’s dying.
When Dad died, I played things closer to the chest. But these days, I gladly and gratefully reach out to my network of support, which encompasses the church and my UU colleagues; my piano teacher; folks at the Y, and my opera group; my Christmas card list of friends scattered around the country; my mom’s friends; and my companions at Womanspace.
Not long ago, I was talking to one of the wise women of Womanspace, Lenora, who has been walking with me as I journey toward the end of my mother’s life and try to figure out how I can be of help to her. In situations of untreatable, terminal illness, Lenora said to me, “the Roman Catholic tradition advises that we pray for a ‘good death.’” Yes, I thought (not getting stuck on the word “pray”), a good death.” But what does that really mean? And what does it mean for Mom?
December 29, 2003
I just put Mom on the bus to O’Hare. It was good, and somewhat stressful, to have her around, but isn’t that the case with family visits?
I rely on her each year to help me wrap presents. (She started our family tradition of faking names on the “from” section of the gift tags, like: To Jack McDonald, From: Hugh Downs [Dad couldn’t stand Hugh Downs.] or, To Colleen, From: Beverly Sills.) And on Christmas, “Grandma” spoiled us all with her gifts, as usual. The last few holidays, she’s given me a framed picture of herself “the way I want you to remember me,” she says. This year’s photo has Mom wearing the Hope Diamond-- it had just been cleaned, and the volunteers at the Museum of Natural History got to try it on before it went back on display.
We all went to A Christmas Carol on Christmas Eve, and “just us girls” went to Chicago. Mom and Jerry talked politics, most nights, after I’d gone to bed. She keeps telling me how lucky I am to be married to him (like I don’t know that!). And she’s very interested in Cathy and Saundra. I’m glad we’ve been able to give her grandchildren... Now that I’m a mother, I think Mom sees me as less of a kid, and I’ve discovered she’s not simply my mother, she’s a person!
But I wish she and the girls connected easier. I’ve noticed “Grandma” can be impatient, critical, and sharp-tongued, with Cathy and Saundra. Things between her and one of the grandkids in particular have been especially tense, and I don’t like feeling caught in the middle.
When one of the girls was crying, the other day, about something “Grandma” had said, I waffled by blaming the situation rather than Mom. I explained that, when I was a child, my own grandmother– who lived a quiet life, alone, like Mom does-- also had difficulty adjusting to the hustle and bustle of our family’s household.
Mom’s visit went by quickly; I probably didn’t spend enough time alone with her. Last year she left with a cold. This year she’s complained about recurrent back pain that doesn’t go away for long. But she’s had problems with her back since she was a child...
So, another visit’s over. I hugged Mom, and waved goodby as the bus pulled away. I felt sad... but, also, somewhat relieved.
I hope she gets home safely.
August, 2004
It’s been a couple of weeks since Mom has e-mailed. I finally called her today.
Her back’s still bothering her. Her doctor suggested it’s just aches and pains from old age, which angered Mom. She’s been getting physical therapy, which helps some, but Mom doubts the exercises are curing her. She’s afraid she’s going to have to give up her volunteer work at the zoo, and she complained about missing one of her operas.
September 29, 2004
I just had my annual check-up, and it’s official. I’m in menopause. For the last year or so, I’ve been wrestling with mid-life crisis. It’s hit me that I’ve probably lived more than half of my life and that it’s time to be more intentional about the time I have left. I scan obituaries for people who’ve died in their 40's and 50's; then I try to find out what they died of. Of course I’ve “always” known that I’m going to die some day-- but the reality is starting to sink in in a different way.
I’ve known for years that I was never going to get pregnant and have a baby; but that reality is sinking in in a different way, now, too. My body’s starting to shut down-- but I’m still alive and healthy, my kids are almost grown, and that means another phase of my life’s about to begin. I want to mourn and celebrate and mark this passage in my life... but how?
October
Mom sees a surgeon at the end of this month. Kelly’s already suggested that Mom consult a chiropractor, but Mom’s not interested. Could she have bone cancer, I wonder (worse case).
Mom turns 75 next November. I’ve been thinking Kelly and I should go out there, then, and help her celebrate.
October 12, 2004
My class for the Center for Learning in Retirement met again today. It’s on ethical wills. An ethical (or “spiritual” will, as some people call it) has to do with the non-material gifts you want to leave behind... lessons you’ve learned in the school of hard knocks, values you’ve lived by, causes you’ve lived for, and memories and blessings you hope will comfort and sustain your loved ones when you’re gone. You can write this kind of document at any age, but I love sharing this experience with seniors.
Mom writes humor and non-fiction, but says she can’t write anything that’s truly “good,” because-- she tells me-- the best stuff would be too personal. I told her about my class, hoping she might write an ethical will. “Nobody would be interested,” she said. “I would.” “Alright,” she said finally. “If you ask me some questions, I’ll answer them.”
October 16, 2004
Mom had four hour-back surgery, last night. When I talked to her this morning, she sounded surprisingly good. We’re both relieved it’s over. Yesterday was the first time I could really imagine her dying-- like she had been sucked into a black hole; and I felt lonely and lost and groundless.
This has happened so fast. The surgeon was called in when Mom lost control of her leg. He diagnosed osteoporosis and said he’d remove the diseased bone and put in metal plates. Mom’s wanted to avoid surgery, but when I talked to her before the operation-- her friends finally insisted she call me-- she was resigned. “This is what needs to be done,” she said. “Sure,” I said. “At least it sounds like the doctors are telling you this is something that can be fixed.”
Mom told me again, this morning, that I don’t have to fly out to be with her. She has her friends, she said, and she’ll need me more, later, when she’s back home, recuperating.
I hate to think of Mom ending up in a wheelchair, but the doctor is pleased with the result of the surgery, and Mom’s already getting more feeling and movement in her leg.
November 4
Mom has washed out of rehab. She’s not making enough progress in physical therapy to satisfy Medicaid. So she’ll be going to a facility designated as subacute rehab, where she can continue healing and receive less taxing therapy.
Part of her problem, now, is mental-- she doesn’t remember instructions, from day to day, and she’s so anxious about her future she has trouble focusing. The doctor says she may have had a small stroke, and that worries me. Her physical problems are one thing, but it’s even worse seeing her as “not all there”; I don’t want to believe I may have already lost a part of her.
November 8
Today’s Mom’s 74th birthday. Some birthday. She’s at Arlington Manor Care. By coincidence, that’s where her mother, my grandma, died. Mom says the food’s horrible, and her friends are concerned by how miserable she is. Her caseworker’s hard to reach.
November 15
Mom still doesn’t seem to be getting better, and I’m depressed. I’m grateful for my morning routine. My exercise class at the Y usually gets me out of bed. And when I get to church, I practice. At the piano, I’m absorbed in a different world for an hour, and when I get up to go to my desk, I feel refreshed.
But today when I sat down to practice, I couldn’t concentrate. I went through the motions and played my pieces, but I never escaped and felt free.
Is Mom dying?
November 22
Suddenly I’m aware of the immensity of human loss. On any given day, I wonder how many people I interact with are grieving, in one way or another.
I couldn’t find my gloves tonight, and so I called Aunt Mary’s restaurant, thinking I might have left them there at lunch. The guy who answered the phone checked more than one place for me and didn’t find the gloves; but he was so nice about it. In my battered state, I was so grateful for his concern. I want to make more of an effort to be kinder to people, in small ways– who knows when it will make a difference to someone else who’s hurting.
November 24
She has metastatic cancer. I know I sounded calm when the doctor told me, but how could he have said it like I already knew, like it wouldn’t be a shock? Have I been missing something? No. A tumor was found yesterday, the surgeon removed it today, and it was cancerous.
I can’t imagine Mom having cancer. It’s as incongruous as though someone were expecting me to believe Mom just sprouted another head.
Kelly cried when I told her. Then she said the same thing I said to Dave, earlier: “I just don’t want her to suffer.”
I’ve never forgotten what one church member said after he watched his wife die of cancer: “What it comes down to it, you can either cut it, burn it, or poison it.”
December 1
People at are still asking about Mom and offering sympathy. Several have mentioned my helpfulness to them when they were dealing with a death. I know it’s true, but, what did I really know before all this happened with Mom?
I know what to do after someone dies-- well, I know lots about memorial services. But I don’t know much about being with a dying person. I’ve been with dying people, as a minister. And I was with Dad, a couple of months before he died of bladder cancer. But he didn’t want to talk about dying, and he was remarried, by then, and had Ruth to be with him and take care of him.
I’ve sat with a dying person for an hour or so. But then I’ve left and gone on to other things– not had to think of them constantly or feel responsible.
I leave for Washington tomorrow. What am I going to do with Mom, all day, when I’m there at the hospital?
December 2-4
I don’t think I’ve ever been happier at the thought of seeing Mom again.
Mom doesn’t look as bad as I’d feared. It’s amazing she still has so few grey hairs. I saw her naked, when the nurse was moving her, and felt like I was intruding– but Mom didn’t seem self-conscious. She’s not eating much, so I started feeding her, and that felt awkward, first, then wonderful.
We did have a bit of a heart to heart. She says she’s had a good life and has no regrets, though she wishes she could have gotten closer to dad and made the marriage work. (Though the divorce was her idea, I don’t think she’s ever really gotten over it.) When I asked her about unfinished business, she said she wants to get her paperwork in order, and maybe do a little writing-- maybe a humorous book about her experiences being laid up.
But then she said that first thing yesterday, her life sort of played itself back to her. And she’d already been thinking that a chapter in her life was closing and wondering what the next one would be...
I’d thought it would feel strange to stay in her apartment without her, and it did, at first. But that place is so full her. Stacks of the Smithsonian magazine and Opera News. Her piano and her own paintings. The family heirloom samovar. Souvenirs, albums, and scrapbooks from her travels. Dozens of photos of her family and friends and adventures. Someone who didn’t know her would walk into that apartment and say, “How interesting! I’d like to get to know the woman who lives her.”
When I lay down in her soft bed at night, I wrap her quilt around me; and so far, I’ve been sleeping well.
December 10
I’ve been trying to reach Mom on the phone, every day. She has little to say, doesn’t always make sense, and is often tired and ready for bed. Sometimes the phone just rings, and, in a way, I’m relieved.
Lenora tells me that, when people are very ill, sometimes all they can do is hold themselves in their bodies. That makes sense; and now I don’t take it so personally when Mom doesn’t seem to be getting much comfort from hearing from me.
December 15
Today I finally talked to the oncologist. She told me Mom has Stage 4 lung cancer. I guess I should watch those medical shows, because I had to ask her how many stages there are. (There are only 4.) When I pushed for a prognosis, she told me 5% survive 5 years. What kind of a statistic is that? “What about the other 95%?” I asked. The odds are that Mom has a year or less.
How is Mom’s going to be able to handle hard core rehab, again, after radiation? And I really don’t know about chemo, but Mom says she wants both. She’s acting compos enough that the treatment team seems to think she can make these decisions for herself. But I don’t think they’ve given her the prognosis.
Tonight I told Mom what I’ve learned from the oncologist, but she wants to stick with the plan. I’m thinking, hospice would be so much easier. We wouldn’t have to worry about finding a rehab place that can get her to chemo, for however long that lasts-- and it seems only half of patients respond to chemo, anyway.
I’m feeling angry about Mom’s decision.
December 18
Sometimes, the pain I feel when I think about Mom dying is so intense that I marvel at the human spirit. How do spouses get over the death of their soulmate, or parents get over a child’s death? What about murder and suicide? What about MIA’s? And how does someone cope with a series of major losses?
Today I took the girls to a pancake breakfast for Rory Zuba. Rory’s 13 and has a brain tumor. His mom died a few years ago, and his baby sister, some time before that. How does one family live through so much grief?
But the mood of the gathering was upbeat, and the true Christmas spirit of love and hope and giving was in the air. One of the most basic purposes of living became so clear to me: to form caring attachments with one another so that, whenever the time comes, we won’t have to face death alone.
December 20
When I get overwhelmed, I concentrate on my breathing and tell myself all I have to do, for the moment, is breathe in, and out, in, and out.
I wonder what it’s like to die-- when breathing can be very difficult... when the goal is not to keep breathing but to stop.
Lenora says dying is hard work, for most of us. And she told me she suspects that when the time comes, we will know how to die and that what we need will be there to help us.
December 22
The girls got into a big fight over putting up the Christmas tree. Underneath it all, I thought they were having trouble coping with the fact Grandma’s not with us this year; and so we talked. We talked about our sadness, and missing Grandma, despite her crankiness.
Finally, the girls got to work. The tree was so beautiful, I wished they had put it up sooner. Saundra put Mom’s Hope Diamond photo next to Mom’s stocking.
December 28
Someone said, today, that some day it may be possible for people to choose to live forever. The more I think about that, the more it horrifies me. I don’t want to be any different than the trees and the creatures and even the sun. I want to have my time on earth and then get out of the way for newer life to follow. I hope there’s something more, after death, but I like the sentiments of a colleague who said he was comforted by the thought that one day he’ll simply wear out-- he’ll be all used up.
December 29
Kelly’s back with Mom. I called her in the room this morning, and she was crying. Mom’s been in a lot of pain most of the day, and the staff is finally getting concerned at her level of confusion.
At least Mom’s finally said, quite clearly, that she doesn’t want rehab or chemo.
I feel like I’ve spent days lying on a bumpy mattress, trying to get comfortable. Exhausted, I finally drift off to sleep, but then I wake up with a start, and my whole body aches.
January 1
I spent part of today tackling the clutter in my office-- bringing some order to my life when things are so out of control right now.
Sorting through my in-box, I came across a card someone sent me after her husband died. “The last two months were particularly horrible,” she wrote. “Society does not let an animal linger like that. Some day we will be as humane with humans.”
January 2
I ground myself in the semblance of a normal life. But I almost look forward to the time the real crisis hits and knocks me down to the depths, to wallow for awhile, shouting in my ear that though I will return to my daily routine, something will have changed forever.
January 5
I’ve already called my colleague at the Arlington UU church, letting her know how sick Mom is. The part of me that wants to spring into action is planning Mom’s service.
I wonder if we could get a young singer from the Washington Opera... I’ve been saving some poems by Ellen Kort for just the right memorial service--
who’d have thought it could be Mom’s?
One blessing at having Mom die at this stage of her life is that she still has plenty of friends around to help us remember her. We’ll invite Lucy, Susan, Mary, and the others to meet with Kelly and me and the minister, to plan the eulogy. That’s the part in this process I’m looking forward to-- sharing our stories, finding out things about Mom I never knew, and understanding her from someone else’s perspective.
I hope her eulogy will be less saintly than Dad’s. We don’t need you to be perfect, Mom. We’ve loved you just the way you are.
January 5
Was it Christmas that I last talked to Mom? Before I go to sleep, I send her my love and hope to dream about her. I’m glad I can still hear her voice in my dreams.
January 6
Mom was paranoid and in pain two days ago, much improved and even “perky” yesterday, then worse again today. Someone suggested I’ll be riding a roller coaster for awhile, but I feel like I’m on a descending escalator. Every now and then it stops for a moment, and I climb up a few steps and get another perspective, before the escalator carries me down again.
The same woman who evaluated Mom yesterday and said she was not a candidate for Arlington Hospice was called back today. This time she said Mom’s condition is so erratic she can justify getting her a bed at their in-patient facility. The idea of hospice doesn’t scare me– I’m relieved. I want Mom to be in a place where the staff are knowledgeable about death and dying, can help us all through the end of Mom’s life, and, in the meantime, keep her as comfortable and pain-free as possible.
January 7
Back to the idea of a “good death.” Is death itself good? Probably it’s neither good nor bad, it just is, and it seems to be necessary. It certainly gives life more meaning, challenging us to negotiate that paradox of accepting the certainty of death, while at the same time, finding ways to transcend it.
Is Mom having a good death? Kelly sure didn’t think so, when she was ready to call in Dr. K. I agree with hospice, that when death seems inevitable, it’s time to turn off the technology and keep the dying person as comfortable and pain-free as possible.
So Mom’s been through the mill, physically, but she’s in good hands, at Hospice, and mentally, she’s at peace. She’d like more time– and fought a bit, when she had it in her-- but she’s grateful for the life she’s had and isn’t afraid of what’s to come. She’s had me and Kelly to help take care of her, and she can’t get over how much her friends have done for her these last months. All that is a part of a good death, too.
And maybe the concept of a “good death” also relates to one’s surviving loved ones. Perhaps the “good death” of a mother, at least, is something that empowers her children with a reminder of who they are, and where they have come from, and what they have been given that will help them meet life without her when that umbilical cord is cut for the final time.
How would I even know this, had it not been for these waning days of my mother’s life?
[Colleen wrote this sermon for delivery on January 9th. On the 7th, her mother’s condition had deteriorated to the degree that the doctor urged her to come at once. She asked Karen Wells to deliver the sermon for her. As of January 13th, Jean McDonald is peaceful, in good spirits, and failing.]