Our encounters with death shape us:
they show us the reality of life,
teach us the lessons of love and loss,
enable us to reflect on what is important,
provide an opportunity to stop and change direction,
and give us a glimpse into our future.
For this, I am grateful.
Month: July 2020
August 2006.
I am in my final year of my nursing degree, and on my final clinical placement with HITH. I have learned to cannulate, take blood, give intravenous antibiotics and blood transfusions. I am learning a lot about infections, wounds and dressings.
I am looking forward to graduating.
I have just found out that I have a full time place in the new graduate program for 2007. I am hoping to work in oncology – my dream job.
I am completing my final assignment, checking my references, counting the words.
The phone rings, my husband answers it.
I sense, rather than hear, that this is not good news.
He is too quiet.
Listening.
He hangs up, and turns to me.
I see the look in his eyes, and my heart feels like it has been grabbed in a vice.
Dad, he says. In hospital.
We’ve been down this path before.
Non-Hodgkins lymphoma.
Diagnosed after many months of night sweats, cough, and weight loss – after returning from Kosovo, where he had been helping to rebuild after the war.
Precious engineering skills, generous heart.
Depleted uranium.
A botched biopsy resulted in a damaged diaphragm and collapsed lung, with a stint in intensive care. The surgeon did not instill hope.
We watched and waited, holding our breath.
Expected the worst.
He recovered. Eventually.
Chemotherapy. Months and months.
Beardless for the first time in his adult life.
Another intensive care scare, and a call to come quickly. He is struggling.
Cardiomyopathy.
Again, we watch and wait.
He pulls through.
Finally, a reprieve.
Remission.
Boxing Day 2004.
Tsunami.
Sri Lanka is dvastated.
His pull towards his country of birth is great.
He answers Word Vision’s call for volunteer engineers.
Goes to assess the damage.
Is too traumatised to tell us the whole truth of what he has witnessed.
He comes home, and starts fundraising.
Operation Hope.
Raises enough money to rebuild a village, and goes back to teach the locals how to build their own houses.
Fast forward to 2016.
The project is drawing to a close.
25 families have new homes, a chance to start again.
He has not told anyone, but the night sweats have started again.
The cough has returned.
Time is running out.
He finishes the last house, says goodbye to the locals, and flies to Switzerland. He wants to see his daughter and grandchildren before returning home to Canberra.
Perhaps he knows.
Two days later, and he is in hospital in Geneva.
DVT, they think.
Something is not right. He is struggling. The doctors are worried.
Heart failure.
The chemotherapy that extended his life so he could do good work has damaged his heart so badly.
He wants to come home.
Our phone rings.
Our world stops.
The french doctors have stabilised him.
A window of opportunity.
A chance to come home.
Pre-existing condition, the insurance company says.
It will cost more than $20,000 for a medical evacuation to Australia.
All of a sudden the flights are booked and I am at the airport.
I have never travelled alone.
I am terrified.
The weight of the world is on my shoulders.
I make it to Geneva.
Rush to the hospital.
He is so sick.
Take me home, he says.
I need to see my family.
Clinique Grangettes, Geneva.
Doctors and nurses in white scrub.
Beautiful. Sterile.
Terrifying.
The french doctors brief me.
They give me cannulas, fluids, instructions.
Wait, I say.
I am only a student nurse.
I can’t do this.
Yes you can, they say.
The airline has cleared him for flight, but we need to leave immediately.
No time to waste.
I call his haematologist in Canberra. He tells me to come straight from the airport to ED. He will accept care.
Good luck, he says.
Business class.
I am too frightened to notice it.
I spend the entire flight watching, waiting, monitoring.
Blood pressure.
Temperature.
Resps.
Scared that I will have to cnanulate and give fluids mid-air.
The air hostesses are kind. They can see the fear in my eyes.
He struggles.
We land at the airport.
My family are waiting.
He wants to go home to his house one last time, but there is no time to lose.
I can see him deteriorating by the minute.
Straight to hospital.
Fast-track through ED.
The haematologist is waiting.
He is kind.
We watch, and we wait.
I am exhausted.
A family meeting in Intensive Care.
I have watched this man that I love as a father suffer.
His family are suffering.
No more, he whispers.
Enough.
We gather round his bed.
Hand and foot massages, words of love.
A brief moment alone, just the two of us.
You have to do this, he says.
What?
Look after the dying. This is your calling.
I know in my heart he is right.
I have so much to learn, so many plans.
This man has taught me so much.
He has given me direction.
I know that one day, when I am ready, and have learned enough…
I will be a palliative care nurse.
She is more yellow than the winter morning sun.
The hosptial discharge summary is blunt. ‘Large tumour. Biliary obstruction. Discussed with family. Return for comfort measures.’
His grief overwhelms him.
He sobs, loudly at first, his whole body shaking, then his head falls quietly into his hands.
His pain is palpable.
“We’ve been married 64 years” he says, “but she has been my love for 67 years”.
I want to put my arms around him, but I sense that this would be his complete undoing. In his culture, men do not show emotion. They are sturdy, steadfast, stoic. And then, there’s COVID. I sit on my hands.
His heart is breaking and his life is crumbling.
He is alone.
“How long?”
I wish I could tell him. Like so many others before him, he wants a finite number. Would it help to know?
Perhaps.
Would it help to have a minute by minute plan of all the things to say and do before the end? How do you fit the love and emotion of 67 years into hours, a day or two at most?
“Have you told your children?” I ask.
He tells me his daughter is on her way. His shoulders start to shake again.
“My son…”
I give him a moment to breathe.
“Where is your son?”
“Melbourne”.
My heart sinks. Bloody COVID.
“Keep talking to her”, I say, “she can still hear you”.
He sits by the bed and lays his head on the pillow next to hers.
“I love you”, he says, then continues to quietly speak in his own language.
I see her stir, ever so gently. A flicker of the eyes. A twitch of the hand.
He moves his hand gently closer to hers, until they are touching.
Slowly, her fingers creep over his, and they start to interlace.
She cannot speak, but she still hears, and feels.
His sobs grow louder.
This is his last moment with her, it is so private it hurts my eyes and heart.
I quietly back out of the room and gently shut the door.
As the sun started to set he drew his last breath, exhaled, and was gone.
The first time I meet him, I am 17 years old.
We pull into the driveway, and I am introduced to the family.
He is quiet, but welcoming. He invites me into his home.
He is a teacher, a father, a husband, and uncle.
His ties to his community are strong, as are the ties to his old school and family in his home country. He works hard to maintain friendships and keep in touch with everyone.
I begin to learn words from a different language.
He is Thathi to his children.
He is Punchimama to my father-in-law.
He is Uncle to my husband, to me, and to our children.
To many he is their teacher, or friend.
Over the next few years, I grow into this family, and they accept me.
We have different skin colours, different cultures, different backgrounds.
He always makes me feel welcome, and I have a sense of belonging.
He is especially kind. A true gentleman.
Over the years I come to know him well.
I watch as he cares for his wife who has Alzheimer’s.
He lovingly cooks for her, bathes her, reads to her.
Even after she moves to a nursng home, he continues his care and cooks for her every day, takes the meals and lovingly feeds her.
He sits with her in her last hours.
I see his heart break when she dies, and the light go out of his eyes.
His world is upside down. He has lost the woman he eloped with, moved continents with, travelled with, raised a family with.
He is wounded, but not broken.
He is grateful for everything.
He begins to rebuild his life, devotes himself to his children and grandchildren. He meets with friends, goes for walks, talks to everyone in his community.
Everyone calls him Uncle.
He cooks for others, for temple, for family.
His wadi, fish cutlets and sambal surpass all others.
His curries are amazing.
He loves to entertain, to talk about cricket, politics and travel.
In the 2003 bushfires, he drives into the heart of the crisis to try to protect his daughter’s family home. He is devastated to learn it is gone, along with many treasured possessions. He supports her and her family as they rebuild their lives.
Eventally living at home alone becomes difficult.
He is lonely and tired.
He chooses a care home, moves himself in,
and decides to make the best of it.
He starts ‘happy hour’ and shares his whisky with anyone who will join him. They debate politics, talk about the cricket, shake their heads at the state of the world.
He begins a scrabble club and beats everyone else, every time.
He participates in playgroup, activities, sing-a-longs.
He flourishes. The care staff all love him. He becomes Uncle to them all.
He mourns as one by one the members of his friendship group drink their last whisky, or play their last scrabble game.
When his daughter is dying from cancer, he sits by her side. He hangs his head in sorrow, quietly watches her struggle, and wishes it was him instead.
When she dies, another part of him dies too.
He and his son comfort each other, lost in a world of grief.
He calls me and asks me to visit him.
He wants to write his advance care plan.
He makes me promise I will look after him,
the way I looked after his daughter.
We make a pact, he signs the paperwork, we agree it is not yet his time,
and we enjoy regular visits and chats.
Bit by bit, his body begins to fail and slow him down, but his mind is as sharp as a tack and he hears everything. He knows he is getting closer to the end of his life, and he is tired. Walking becomes a struggle. Eating is difficult. He has lost his sense of taste, and appetite.
The chest pain grips him in the middle of the night.
It is fleeting, but unbearable.
He is terrified of a repeat episode and asks if I can stop it.
When it returns the next night, he uses the spray, which takes the pain away, but the experience leaves him exhuasted.
His nurses call me the next morning, worried that he is “refusing” to take his regular medicines, and is struggling to get to the bathroom.
We sit side by side, and I hold his hand as he tells me the time has come.
The things that gave him pleasure no longer bring a smile to his face.
The struggle is too great.
The medicines are an unwanted burden.
“What’s the point?” he asks.
I tell him he is control, and can stop whenever he wants to.
His biggest fear is the pain, and that he will be aware of people watching him die. After sharing his home, his heart, his love, he wants the end to be private and dignified.
It is time for me to deliver on my promise.
I reassure him I will do my best to keep him comfortable.
I talk with his doctor and geratrician, both respect his wishes to gently head down this final path in life.
His only wish is that it be a short journey.
I tell him that only he and his body can determine the length of the path.
After years of sitting in his chair in the sun he stays in bed.
This, above everything else, tells me he is truly ready.
He is comfortable, awake, and able to talk with each of his grandchildren and loving family members.
He begins to dream, and takes them with him to the old country.
They appear on the path to Galle Fort, and walk beside him.
His wife is waiting patiently at the top of the hill for him to join her.
One more promise to be kept.
A date for an evening glass of whisky with his nephew. One last happy hour.
After being in bed for six days, he is determined to drink the whisky while sitting in his chair. He demands a wash, fresh pyjamas for the occassion, and walks across the room.
He gives instructions on how he likes his whisky.
Two cubes of ice and a generous nip.
He lifts the glass to his lips.
I watch his hand and the glass shake with each sip.
We reminisce, look at photos, enjoy his company.
The whisky finished, he is ready to go back to bed.
It is the last time he will sit in his chair, or walk.
I see him every day, and make sure he is comfortable.
He opens his eyes when I gently kiss him on top of the head for the last time, and tell him how much I love him.
As the sun starts to set he draws his last breath, exhales, and is gone.
A piece of my heart goes with him.