Contradictions; How can death be life?

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I sit here looking at this computer screen, thinking about the past few years of my life. They were years I wish had never happened. However, these same years not only taught me about myself, but of life and death.

I sit here remembering what being a caregiver was like and remembering all the fears, concerns, and insecurities. They spilled over one day as I told the Hospice nurse that I, a 28-year paramedic veteran, did not have the training or the strength to deliver chronic disease and hospice care. I remember her telling me she had faith in me, and I could do it. To her credit and my peace of mind, she was there when ever needed.

The patient; well she had faith in me as well. I had known her for 23 years, in good times and bad. I remember how she loved life and her "babies" at Children's Hospital in Dallas. She pushed me on and suggested I go to work there as well. I did and learned that hope comes in many forms.

Throughout the remaining five years of Penni's life, of OUR life dealing with Cancer, I was exposed to facets of medicine I had only heard about. I learned about oncology, palliative care, Hospice care, and chemotherapy, to name a few. I met some wonderful members of the nursing profession and patients that fought on. I received so much from them; I decided to become an RN as well. If I can give back a tenth of what I received, I will have accomplished so much.

To that end, I worked full time, until my acceptance to the local ADN program were we now live. I am raising my daughter, attending school, and moving on. This essay was written by me as a caregiver's perspective on my experiences with the "Edge of Life," and was picked up as part of a series of articles by the Dallas Morning News titled "At the Edge of Life." I intend to move forward as far as I can go, and am looking to specialize in Pediatrics and/or Cancer care. For in Death, Life continues on, and Hope moves forward. I hope you enjoy it.

Contradictions

David Bourque

June 14, 2008

"Are you strong enough to be my man?" asks Cheryl Crow in her popular song of 1995. As I drove home, listening to the lyrics and contemplating the past few years, I realized that I may not feel as if I am. However, I believe I can answer yes. Arriving at this answer has taken me on a journey few would want to venture. I certainly did not. And yet with a few fateful words, the journey began.

"Your wife has cancer." The rest was unimportant. I heard something about ovaries and grapefruit and stage III ovarian cancer. I remember telling Dr. Stringer that we have life insurance, as if the money could magically buy off the cancer. He continued explaining about the surgery. I heard none of it. It was like being shot. The pain was intense, searing through my consciousness, plunging me into despair.

"Cancer." To me, the word was synonymous with death. My wife of 15 years was going to die. I lost all rational thought. I felt numb. I felt rage. I felt weak. I so wanted him to lie to me, tell me that all was going to be all right. "Please tell me...." "I promise, I'll believe." Instead the cold facts sank in slowly.

I later told my wife, Penni, the diagnosis. We cried. I cried ...she slept on. We became travelers on a journey no one should have to take. The next day after surgery, Dr. Stringer came in and talked to us again. Even though we knew what he was saying, we really didn't know. This new reality was and is full of contradictions. Penni would start chemotherapy in a few weeks.

We learned about debulking - the act of removing as much of the cancer as a surgeon can. We learned about this gigantic experiment called chemotherapy - a chemical that kills the cancer and the good cells. Somehow this killing, and its many side effects, makes the cancer go away. We learned about steroids and anti-nausea medications. The map began to come together. We learned the rules as we went along. We learned that feeling like hell was good; another contradiction on our journey.

Our ability to deal with this killer improved. Through our research, her support group, and talks with Dr. Stringer, we developed more coping mechanisms and began to feel more comfortable with this reality. We persevered, enduring the almost financial devastation, the Emergency Room visits, and the endless days of her being sick.

As for me, I focused on what sanity I had left. For the longest time, I wanted to shoot something. The tears of rage and sorrow welled up but would not come. Feeling like hell became my reality. The contradictions piled up, and Penni began to look better. She went off the chemotherapy, and the world seemed well; yet the hush of fear hung over us. Fear that the cancer would return.

Once again I hoped Penni's doctor would lie to me. Again he didn't. We returned to our alternate reality in the Twilight Zone. For four years this was our life. We thought we were prepared for the worst. We weren't. How can anyone be prepared? After all, "It will never happen to me."

We had just finished a long drive from Dallas to Albuquerque. A drive made longer by the circumstances of her father's death from cancer. He was to be buried at the Memorial Cemetery in Santa Fe, New Mexico. No one really wants to go to a funeral, and yet, we needed to. Penni needed to. Her father was a big part of her life, and watching his death foreshadowed her own to come. The closure was needed. Once again the cancer struck, this time in an insidious and cruel manner.

Instead of her being able to go to her father's funeral, we spent a week in an Albuquerque hospital. Her doctor was kind and helpful. He spoke to me of staying with her. We spoke of the odds. Was this her time? It seemed to be close. The death bookies gave her 90 days.

A week later we all flew back to Dallas: Penni to Baylor via air ambulance, Michelle and I via commercial airline. From that point on we learned about TPN, pain, bowel obstructions, and radiation therapy, among other things. The orificenal was being whittled down; the cancer was winning. We persevered, the cancer making up new rules as it went about its cruel business. Spending my time with Penni began a new dance. a dance involving many miles and multiple partners: Penni, my daughter, my mother, her mother, the home, and work. My business was closed, and I took on a job. As my dreams and aspirations began to crumble down around me once again, I began to look closely at Penni. The more closely I watched and learned, the more I began to see that life is more than what I wanted.

It is something less tangible than a house, a car, a business. And yet, as cancer has taught us, it is a contradiction as well. Life is the small things and yet the big things. You don't care about the dishes being put in the dishwasher right then. You don't care about the guy that cuts you off. You just don't care. They are not important. But neither is the big vacation or the big promotion. What is important is the moment in time between the butterfly's wings as they move. What is important is the smell of the rose. What is important is the time you have today with the one you care about. And yet as this contradiction of little and big continues, you learn that the bigger picture is just as valuable as the smallest flower. This is the lesson of life.

A year after Albuquerque, once again I contemplate the reality of this existence. The cancer has progressed and introduced us to palliative care. Penni's life is coming to an end. Yet a new life is just beginning. For me and my daughter it will be one of sorrow, sadness, and coping. For her, it will be one of joy.

Penni once told me that she "missed the memo" dealing with bowel obstructions, swollen bellies, and the like. However, the cancer got it, and we learned about palliative care. Although you would think that palliative care and hospice are the same, it turns out this is not so. Palliative care teaches you ways to cope with death. For the first time we were truly faced with the dreaded "D" word.

Ecclesiastes 3:1-8, tells us that "For everything there is a season, and a time for every matter under heaven." As such, death is just another matter under heaven. As I become more of a visitor to Penni on her journey and less of a companion, I find her compassion growing. To quote The Tibetan Book of the Living and Dying: "...we start to have a burning, almost heartbreaking sense of the fragility and preciousness of each moment and each being, and from this can grow a deep, clear, limitless compassion for all beings." We learn that death is not some large figure in a black cape to be feared, but a new season under heaven. We both know what lies ahead. We both know the hardships will mount.

We both know the journey will surely end. Penni's journey will physically weaken her. We will continue on together, as long as we can. Despite the sadness and sorrow being left for the living, there is a moment of joy and peace that is stronger than all the sorrow we will feel. Penni will have attained a place in heaven we all hope for.

As for me, I watch Penni blossom as she approaches death; I can only hope that I am as selfless. I too have changed and grown stronger, but I can only hope to approach her level. Of all the people who have a right to complain. She does not. How can weakness beget such strength? How can cancer be life?

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Specializes in Rural Health.

This is so beautifully written. As I watch my Dad battle cancer I see my parents appreciating the little things and each other so much more. Wishing your family the best.

This was beautiful and expresses many of the same emotions I dealt with on my father in laws journey with cancer. We said our final Goodbyes May fifth and I will forever keep that moment in my mind when I leaned over and whispered "sleep well my friend. I love you" after holdings his head in my hands when he took his final breath. Best wishes to you and yours. I believe this experience has made me a better care provider. And I can tell it has done the same for you.

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