Circles and Doors

The first human death I experienced, was my great-grandfather, a man I always loved and remembered as fun and kind. I remember being sad I wouldn't get to go see him or his home in Oregon again, but in a very short amount of time, I was fine and remembered what I remembered of him without really being impacted by his death because he was so very far away.

The first death that hit a different chord was my that of my mother's best friend, Robin. Mom, Robin and I frequently met for girl's ice cream dates. I knew Robin. I loved Robin. I enjoyed Robin. I learned she died in a fire. One night during our bedtime prayers, my mom was crying. It was the first time I remember her crying as she shared the news that Robin had died in a house fire. I remember dreams and nightmares of burning and the understanding that there would be no more girl's ice cream dates. No more Robin. Something felt lost. Broken.

I was in my late twenties before I encountered death again. I remember being in awe of that fact when I was younger, hearing the stories of friends who had lost and lost and lost the people they loved. This death, the true first, was to be the worst kind of first loss. My grandmother, my friend and teacher and comfort. I learned as an adult that my grandmother was a survivor of child abuse and from the very great grandpa I loved who died when I was little. It changed my understanding of him, but it transformed my knowledge of her. My grandma, the sweetest human I think I've met, even now. She who lived in this world as a lover of people, a lover of jesus, a lover of life. How she became who she was from the barren soil in which she grew, that was one of life's greatest mysteries. The broken heart I felt when Robin died multiplied by ten thousand when my grandmother died. I remember falling to my knees when I was told the news. I remember the deluge of tears that could not stop, would slow to a trickle, but continue for days. I remember the guilt of not seeing her one more time, guilt I'd carry for many more years. If lost and broken followed Robin, the death of my grandmother was an apocalypse.

My family changed, the link that held us together severed. My life changed, the purpose I felt so sure of flickered and cooled. My grief so complete that I barely knew the me I was becoming from the one I knew in the world in which my grandmother lived. I left the home that was no more, not for the first time, but this time it felt like a door closing, that place where once she existed was no more. She walked through her door and I walked through mine. It was a door I never would have found if she had still lived.

Years later, my grandfather, never one to get sick or take a day off, ended up in the hospital. I stayed there with him overnight so my family could rest and the nurses, already stretched thin, could have one less patient to worry about beyond the usual rounds and meds. That night, watching my grandfathers fitful sleep, helping him adjust and readjust pillows, recognizing signs of discomfort and unease, I realized I could do this work. Gramps recovered and was released. The fear and concern we all had when he went in, temporarily subsiding as he moved back into his usual way of life, then returning as he began his slow decline, falls and weight-loss and his ever black hair silvering. I switched careers, becoming a caregiver, then quickly, a med tech, administering medication and making calls on the day to day care of the residents in the house I worked at. I loved the work. I loved the people I cared for every day, my grandmother and grandfather in every face, in every story. I threw myself into the work and was good at it. I moved onto night shifts. It was here that I experienced death in a professional capacity for the first time.

The first death was traumatic. I was covering a shift in a different building that I usually worked. Sandra's husband was in the room with her. I popped in at regular intervals to check on her and giver her a mix of morphine and Ativan for comfort measures. I'd never done this part of the job. She was the first person I worked with when I started the job. I regularly sat with her at meals, feeding her and giving her space to talk in her unintelligible way. Her death was very difficult her face tormented at the end and I was unprepared. It perpetuated my belief that death was a terrible ordeal. And then came, Margret, a woman who seemed she'd live forever, walking through the world in her silent steady way, walker in hand. She rarely spoke, but when she did, her thoughts were coherent, a rare gift with Alzheimer's victims. Not only were they coherent, they were precious and meaningful and often "Sarah. That's a beautiful name. It's one of my favorites." or the story of the painting she bought of a scene of the Italian coastline and a village she vacationed at with her long dead husband.

It was Margret's death in which I sat vigil for the first time. It was a surprise going in to work that night after a couple of days off. She was in normal health when I saw her last. The transition came quickly. Due to the comfort measures we took with all residents as they were actively dying, she was incoherent, her breathing shallow and inconsistently consistent. Her skin had changed, her facial features more shrunken. She was always a thin woman, but now she was gaunt, her skin stretched over the bone and yellowing. I had tears in my eyes as I came to stand over the hospital bed that now took up the sitting room of her suite. "Margret, it's Sarah." I told her. "I'm going to be here with you all night, until you're ready to go." I knew she couldn't respond, but according to trainings and reading about the death process, I knew she could likely still hear. I decided to spend the evening between rounds in her room, watching over her, watching the rise and fall of her chest, watching the o of her lips suck in and blow out as her breathing deepened, then stalled throughout the evening. I left only to do my rounds, checking on other residents and giving their meds as needed.

Her death was easy. It was the absence of breath where moments ago she was breathing. She looked at peace, unafraid. It was miles from the look of terror on Sandra's face. Margret was in many ways, the opposite of Sandra. Though they both lived in a world of incoherence most of the time, Sandra's felt pained, traumatic, sad eyed and scared. Margret had a radiance, a sparkle in her eyes and joy in her words, when she was interested in speaking. She died as she lived. She died with that same quiet sweetness, that same peaceful steadiness. It was one of the most powerful and honorable moments of my life. The lack of life in her body was palpable. I approached her bed, hand on her arm, asking "Margret? Are you still with us?" I waited a moment to see if the breathing would resume, it did not. Her slack face lacked all of the nuanced movement life brings, that we don't recognize until it is no longer there. As a tear slid down my cheek, hand on her arm I whispered "Thank you, for sharing your life with me. Thank you for your stories and for your love. Thank you for allowing me to be a part of this moment in your life". I went about calling her family, cleaning her body, writing the report of her final moments, understanding that my knowledge of death and dying before this moment was the thing that was broken.

Margret had a "good death". I think my grandmother had a good death, for her, though I was not at the time able to comprehend it, she had the one she wanted. Margret's was the first of many I'd sit vigil for. Her body, the first of many I would be privileged enough to perform their final washing, to honor with final words at a time it is believed they could still be heard, even after death. I created my own ritual around their final moments, my own way to say goodbye, thanking them for the gift of time with them, even at the end of their life. It became precious work, though at that point I still had much to learn before this could become my life's work. Two years after I started this work, my grandfather died. When I got the call that he was in the hospital, I still had two days left of work before my days off, so I decided to stick them out and head down after. That night I was dozing between rounds (I had been granted permission to do so if I could stay present enough to hear bed alarms or residents up and about). This dozing resulted in a lot of lucid dreaming. This particular night, I was sitting in a chair at a table in the center of the house where I was able to hear and see most of the rest of the house. In the dream, one of my residents was sitting at the table next to me. We chatted for a few moments before I realized I was dreaming. "I need to go back." I told her. She asked me to wait a moment. I felt the pull of my consciousness encouraging me to awaken, but I stayed with her as she asked. Her features began changing, her hair lightening, her body shifting until in her place my grandmother, several years dead, who I had dreamed of only once before, sat in front me. "There you are Sarah girl, I wondered when you would see me" She said. She told me she was there for my grandpa and it was time to drive the two hours to be with him in the hospital. I woke up, crying (you'll learn that I cry a lot). I immediately called my bosses both at this job and the coffee shop I worked at for a few hours every morning after caregiving at night. I went home and slept for a few hours after my shift, then drove to say my goodbyes to my grandpa.

Someday I'll tell the story of his death, but for now, I'll leave it at he was gone within a week, surrounded by his children and grand children and great-grand children. His death was hard and beautiful and difficult to watch and then unimaginably perfect. It so well suited the man he was in life. And there was so much love. His death was the full circle. I started the journey into this work because of him, unbeknownst to me then that this very work would be the thing that was needed at the end of his own life.

I didn't realize until some years after his death the impact the last years of his life would have on this work of learning to be present with death as a way of being present with life. Life and death are circles ever bound, they move together and apart as they guide us in and through and around and give breath and urgency to the lives we live. Death is many things. It's a paradox. It holds both endings and beginning in it's orbit. It both separates and binds together. It is both sorrow and joy and peace and war. Death is that one thing we will all experience but can never fully know. And even in its finality it is so entirely endless. Our very lives proof that the dead are never gone, at the very least, they live on in us. Another circle never ending, just as death is a door we will all walk through.