The Drawer is Open!

I have been struggling for a few weeks now.  A very close friend was diagnosed with Stage 4 esophageal cancer that had metastasized in his liver, lungs and lymph nodes.   It was a very bleak diagnosis without much hope of any curative procedures addressing it.  One night around 9pm he called me and said he just got a call from his doctor with the results of his blood work and the doctor told him he was severely anemic and he should get to an ER immediately.  He said he was going to wait til the next day to go and I said, “Like Hell” and ran over, picked him up and off we went to Northern Dutchess Hospital ER.  They admitted him right away and gave him the first of 2 blood transfusions.  The first one didn’t work but the second one took hold.  With his symptoms and concerns they decided he couldn’t leave until they performed a colonoscopy and an endoscopy.  The endoscopy procedure identified the cancer and set all this into motion. From the very diagnosis he pretty much decided this was his death notice and began getting his affairs in order, accepting the truth, and trying to decide how to protect himself from the pain that more than likely would be associated with the end of his life.  His friends, myself included, weren’t quite as ready to accept his impending demise as he was.  With the help of his doctors and his loyal friends we encouraged him to begin chemo treatments and immunotherapy  treatments in the hope of slowing the process down and giving him some hope of survival.  There are new wonder drugs out  now and hope springs eternal….but not in Sal’s case.  I took him down to Sloan Kettering in Westchester County for one of his first chemo treatments.  Things went well, the treatment was relatively easy and painless, giving us both hope.  I was shown how to remove the chemo needle from the port two days after treatment and with great trepidation I agreed to be the official needle remover from the port in his chest.  He went through 4 chemo treatments before his next scan only to  discover the chemo did absolutely nothing to shrink any of the tumors or lesions,  In fact the number of lesions in his liver increased considerably. After much conversation, debate, and disbelief Sal and his doctors decided to end treatment and allow it to take its course.  That was in mid January…..By the second week in May he had passed

I have lost a lot of people in my life.  Both parents, my brother, aunts, uncles and friends have all passed in previous years as well as another dear friend also with esophageal cancer.  I miss them all terribly and there are empty spots all through me where their life forces once filled the holes.  But they all died at times and places where I was not present.  Sal is the first human I actually watched deteriorate, decompose and die in front of my very eyes.  Stepping back a moment, Sal and I met 8 years ago when I returned to NY after selling my inn.  We were both freshly out of relationships, had 2 adult children each, living alone for the first time in a long time, we were around the same age and similar in a lot of other ways as well.  The friendship developed quickly and mutually.  We shared many of the same friends and traveled in the same circles.  So our friendship grew very strong.  10pm calls were common to complain about our kids, the crazy state of American politics, ask advice, give advice and plan things to do.  It was very comforting especially because we both were newly out of relationships where all of that was build in. Now, once again we had someone to commiserate with, to complain to, to be encouraged by or made fun of for stupid remarks.  We each filled a need in the other’s life and things were good.

Sal’s disease struck suddenly, and the progression of it was so swift none of us was prepared for it with the exception of Sal, thank goodness.  But Sal had a group of loyal friends who in combination with his two sons, came together and started providing all the services and care he needed.  Grocery shopping, witnessing wills, driving him to appointments and the most important of all, visiting and talking with him during this terrible time. That was the most difficult part for me was just trying to be with him and comfort him.  What could I possibly say, what do we talk about, how do I make him feel better.  One day in a meager attempt at humor myself and another friend were sitting on his bed while he was laying down, and he pointed to his dresser and asked me if I would close the bottom drawer which was open about a half an inch.  Sal always was a little compulsive, but something just came over me and in a loud incredulous voice I said, “That’s what you are upset over?  The drawer is open a quarter of an inch while you can’t even get up out of bed?”  We laughed but driving home that night I felt terrible that I was that insensitive.  That Sunday, Sal threw his own 74th birthday party to give him the opportunity to say good bye to all his friends.  That was the last good day he had.  It was a great party and many of his friends came from all around the area.  It was truly joyous. That week things went down hill suddenly.  He called me to come over midweek cause his lawyer was coming and he needed a witness to update his will and trust. He had trouble sitting up that day but got through all the legal stuff and he was obviously relieved to have all that taken care of.  This was after he arranged for a priest to come to give him last rites, which actually never occurred.   That Friday his son called and asked if I could come over and sit with Dad while they went to temple on Saturday.  I got there around 10, he was still in bed and I came in the room and we chatted.  He slept for a little while and then asked if I could help him into the living room.  He was lying on his side and I lifted him upright which he couldn’t do for himself.  I helped him stand and put his wheeled walker in front of him and he asked me to walk in front cause the wheels sometimes went too fast for him.  We crept into the living room and got him set up on the couch.  He was a little hungry so i got him some fruit and yogurt and he ate a tiny bit of it only to regurgitate moments after.  We were talking and he fell asleep, moaning from the pain in his stomach. This went on and off for about 2 hours and I realized he probably didn’t even know I was there.  He was a shell of his former self having lost about 40 lbs in 2 months.  I realized he was dying right before my eyes.  When his son got home I made it to the car just before I broke down.  Sal passed two days later.

Since then I have been having a lot of difficulty.  That hole that is left that Sal filled hurts.  Politically we were in synch so when something happens that I know he would like I want to call and talk to him about it.  When 10 pm comes I expect the phone to ring but it doesn’t.  I was telling my doctor about it this week and he said that being privileged to witness the death of a loved one is one of the most intimate moments two people can share, probably the most painful but also the most intimate.  Something a person never gets over but works through.  It exaggerates my loneliness, the issues I was dealing with (or not) since my relationship ended and am alone.  He and I were simpatico, in synch, shared much in common and now that person is gone.  Knowing you are in the last chapter of life makes all of this more poignant.  I want to go out laughing and living life regularly, not morphined up and counting the seconds til relief finally comes.

Connections

George is grieving his friend: it is difficult and exhausting. It’s said that grief is a process, but I wonder if we emerge whole at the far end of that process. As individuals, we make sense of the world by establishing a sense of continuity. Death exposes the vulnerability of that proposition. 

George’s piece evoked a number of feelings and it’s hard to know how to respond. He was given the most substantial gift a dying person can bequeath: a seat on the last train leaving the station – the opportunity to be a companion on the final journey. This speaks to the connection between George and Sal. Knowing George, he brought compassion, concern and humor to the situation; an ideal traveling companion.

But now that Sal has gone on to parts unknown, the lost connection has become tangible. When the brain loses connections between synapses, we call it Alzheimer’s disease. Currently, there is no cure. How do we treat the loss of connections in the heart? Many of us have lost numbers of connections in our social fabric – and the losses mount as we age. We rely on this network of loved ones as opportunities to transmit our feelings and affections, as well as to receive love and feedback. Loss of these connections can shrink our world.

It is easy to say that the obvious solution is to simply make new connections. And that certainly is good advice. After all, the brain repairs itself: new experiences establish new connections. If the analogy holds, so can the heart establish new emotional bonds. But perhaps, we are not ready to leave behind the strong ties we have just lost.

So, George has taken a first step: that is, to honor his friend in his writing – to keep the connection alive. Highlighting those experiences, he shared with Sal reinforces the significance of that person in your own life as well.  Our friends shape us. 

At times like this, I think it is important to celebrate those connections with other friends. It reinforces the connections that remain and acknowledges the temporary condition we all face together. 

A stanza from When We Two Parted, by Lord George Gordon Byron

They name thee before me,

A knell in mine ear;

A shudder come o’er me –

Why wert thou so dear?

They know not I knew thee,

Who knew thee too well –

Long, long shall I rue thee,

Too deeply to tell.

Celebration and Acceptance

George shared his grief and sense of loss and found solace in doing so.  What he feels, what it triggers, and how it impacts his emotional well being, is only known to him.  Despite his openness, his conscious vulnerability, and his choice of words, we can never really understand what he is going through.  It is indeed a solo and lonely experience, whether we live alone or with a large family.  In the final analysis, when we move into our thoughts all that follows is ours alone to endure.

One of the many gifts I receive from speaking with these two other “old guys” every week is the ability to openly express my feelings and ask direct questions about death, dying, and living in our waning years.  An otherwise, taboo topic or at least one that is more often avoided rather than encouraged, the mystery and power of knowing I will eventually die is gratefully diminished as a result of this ongoing banter.  The more we dig deep to respond to each other’s thoughtful questions the more comfortable I become with the inevitable.  The more I recognize our overlapping fears and thoughts and hopes, the more I realize that I am part of a common and universal journey which affects all of humanity.  I feel less afraid, more prepared, and clearly motivated to make the most of what time I have left.  I wonder what it would be like if these kinds of conversations became more commonplace, especially among families.  Would we not fear less?  Might we make more time to forgive, accept, and live with more compassion and love?

Funerals, memorials, and wakes loom larger, for men of our vintage, than weddings, births, and other light-hearted gatherings.  Yet all are celebrations of life.  All bring friends and families together.  The passing of a loved one brings us in touch with others who not only share the loss but with the possibility of reconnection.  And doesn’t reconnecting with distant family and friends provide the potential for establishing deeper relationships than was possible before?

Each age has its benefits and its challenges.  The secret, I believe, is to create a mindset that recognizes and celebrates the benefits and accepts the challenges regardless of the decade in which we reside.

“It is not death that a man should fear, but he should fear never beginning to live.”

Marcus Aureliu