Not only do we not “practice dying,” as Socrates advised his students, but most people in western culture know very little about the process of dying, and how to be with someone when that is what is transpiring. Of course, not all deaths can be accompanied, many happen suddenly and without warning from an accident or, unexpectedly, a person dies in their sleep or from a stroke or heart attack. The dying process then can be nearly instantaneous. As my beloved 83-year-old Auntie started across the room, she was making a joke about the piano playing pitcher for the Tigers who had just won the pennant. Before she got to the other side of the room, she had collapsed and was dead before her body reached the floor. That was the gift that she did not have to deal with serious disabilities before she died. But for those dying of diseases like some types of cancer, it can be a gift to be able to comfort and be comforted, to express appreciations, to say good-bye, and to live close to whatever you call the Ultimate Reality, in the liminal space and time referred to as “between the worlds.”
It’s been nearly 30 years since my friend Rose called from a hospital in Nebraska to say that “the cancer had spread everywhere” and that she was dying. Later she extended an invitation, “Come and be with me while I do this, and then I will be with you when it’s your turn.” “How could that work?’ I thought, but I didn’t say that. I flew to Nebraska from Texas, but not before calling my native American teacher and friend Glenda Taylor to engage her as my backup coach. I didn’t know much, but I knew I needed support for this caregiving/health advocate role.
In those days before you could google your questions, one of the things we don’t know was about the expected timing of the dying process. Along about the 4th or 5th day that we were together, Rose said, “This seems to be taking longer than I thought it would. How does it seem to you? I agreed with her perception, but I thought it might be like when life is coming in. My delivery nurse mother used to say, “No matter what the calendar or the numbers say, babies come when they’re ready to come.”
There is a limit to how long one can remain pregnant and there are limits and stages to the dying process as well. Medical experts say that for the 3 weeks or so of the pre-active dying phase, a person usually detaches from social activities and spends more time sleeping. This was true to some extent, but when Rose and I we were together in her hospital room, when my son Ken lay in the high-ceilinged living room of our home we’d turned into the dying room, and for our daughter Corinne, when her hospital bed occupied the den of her family’s home, there was a lot of life affirming social activity and insightful conversations.
Some people refer to the Ultimate Reality as Energy and the energy in those spaces was palpable. One woman delivering flowers commented, “It’s hard to leave this space, there is so much love here.” I suspect that it has to do with what Glenda refers to as “going into ceremonial time,” a time when past, present and future can be perceived simultaneously.
Things got done–like when Rose’s women friends visited the hospital in the evenings, and with her consultation completed a project she had started, planning an upcoming State-Wide Women’s Healthcare Conference. Ken experienced reunions with theater friends and celebrated his 31st birthday with a party that included dancing and singing in his hospital room, and his hairdresser friend Les teaching stepdad Rich how to shave his head. Corinne woke from a dream with the answer to a dilemma her husband’s family had been dealing with for years regarding his quite elderly grandmother. Her determination and clarity got the wheels turning to move Gam to a high-end assisted living facility. She didn’t want to go, but after seeing the place I called and told her, “You are gonna love it! You will think you’re in heaven and you didn’t have to die to get there.”
During the active stage of dying, which is generally thought to last 3 days, many things can influence the person’s readiness and ability to let go. “A major organ must fail for death to occur, “we were told when Kenneth was dying. “For young people, their organs are often in pretty good shape, despite whatever it is that is causing their death.”
Thirty to forty-five percent of people experience a period of agitation, during the dying process and here is where the arts of music, video, audio books, singing can be helpful to patients and their family members. At one point, Rose had trouble relaxing enough to go to sleep, so we secured a video of nature scenes set to music which played on a loop and helped her get through that rough patch. Ken played songs from his collection of Broadway shows, and I still remember the lines of reassurance from the musical Sound of Music that filled the room, as my blue latex gloved hands massaged Ken’s sore leg.
“…For here you are, standing there, loving me,
Whether or not you should
So somewhere in my youth or childhood
I must have done something good. “
The timing of the person’s letting go can be affected by many things, including who has arrived and who is still in transit. Rose waited for her daughter Jill’s visit, which got postponed a couple of times. When my daughter Corinne seemed to be hanging on longer than humanly possible given the numbers on the equipment attached to her, I feared she might be holding on for her father to arrive from Oregon. When I learned that he wasn’t coming, I did what hospice team members suggest, I told her that it was ok for her to leave and that I would say goodbye to him for her. Ken left only a few minutes after my sister had arrived just after midnight. That timing meant that I had support as he transitioned. When Corinne’s husband called me back into the room just as her spirit was leaving her body, I had a vision of streaming strings of light breaking their bonds with her body. I thought, if those strings were attached to all the people who wanted her to stay, no wonder it took her so long to leave.
Hearing is the last of the senses to go so music and song are valuable accompaniments to a person’s dying journey. A woman told me of the last hours of her mother’s life. She no longer had language, but she was a jazz aficionado, and as she lay peacefully on her death bed, her big toe tapped in perfect timing to the rhythm of the jazz music her son was playing for her.
Volunteer threshold choirs sing for people who are on that threshold between life and death, perhaps an example of what Ram Dass calls, “Singing one another home.” But I had never heard of this practice when I took Rose’s hand and sang to her one of the songs from Glenda’s spirituality group. I was singing “I am woman I grow out of the earth “but on the second verse, the words switched for me and became, “I am woman I go back to the earth, and at that moment, after 14 days of trying to die, Rose left.
