It is common in creative writing classes to begin an assignment by giving students constraints. Write a story in which a lemon, a large body of water, and a gas station all appear. Write a poem where each line starts with the letter J. Write a scene where a man on a job interview accidentally locks himself in a bathroom. One gift of constraints is they keep my analytical mind occupied so something more creative and serendipitous can sneak in the side door.
Life gives us constraints. Some unique to us or to our community and many shared. A dependency on fuel sources that are destroying human habitat. A new variant when everyone is weary. The fact that each of us will die though we don’t know how or when.
My mom lived her life as though her constraints were challenges giving her the opportunity to engage her creative acumen. When she gained weight after quitting smoking, I remember laughing with her on the phone when she said, “It finally occurred to me I could buy bigger clothes!” That was classic Jane. More than positive thinking–though there was that–Mom found her own way through things by looking for where she had choices.
The end game was always for her to be happy in her life so she could continue to be a positive force in the world. She was a giver who did not believe in martyrdom. Which means she found ways to want to do a lot of things that were good for her community and her family and the world.
The hardest thing for me to accept about my mom’s diagnosis of Alzheimer’s was that she would not be able to finish her own story. Towards the end of her life the constraints grew exponentially, and her cognitive skills diminished just as quickly making it hard for her to see her way through. Still, she continued to look.
Given the expansiveness of my mom’s life as a teacher and peace activist and poet and gardener and friend, watching her work so hard to find purchase was heartbreaking. Often when my dad would offer her a wedge of pineapple, she would receive it with glee. Once, when she was more pensive I asked her, “What are you thinking, mom?” And she looked up with a small smile said, “I’m thinking how lucky I am that I can swallow.”
Seeing her Jane-ness emerge from around the constraint of Alzheimer’s, that was painful, and also, gold. “These things happen…” Jane Kenyon writes, “the soul’s bliss / and suffering are bound together / like grasses.”
One of the things that has occurred to me while writing a blog called Tending to Endings is that we often don’t know during a health crises (or any other hard time) whether we are near the end or enduring a very hard middle, or on the cusp of a comeback. I look at those two photos of my mom only seven months apart and see that what felt like an era in the life of our family was really one half of a year.
During that last visit to Idaho, my mom’s health wasn’t good. She suffered from radiation wounds from cancer therapy and the Alzheimer’s was wreaking havoc on her short-term memory. But she could still play a mean game of Scrabble; and she knew the mechanics of getting in and out of the car; and when she was picking up her prescription of Aricept and the pharmacist would ask for her birthdate, Mom could still recite it before adding, “You know this is for my memory, right?”
That she would not see another summer? I did not know that. The pandemic has already lasted far longer my mom’s final bout with cancer.
As I’ve listened to more and more friends, family, colleagues, students who are walking through serious health events with their parents or spouses, I’ve realized that they often think the truth they need to accept or get others to accept is that the end is near. But what has often been truer for me is that I don’t know where I am in the story, that the future is uncertain, and the decisions need to be made in unfamiliar and shifting terrain. Sometimes they need to be made on someone else’s behalf which can feel nearly impossible to get right.
Last year I had the privilege of interviewing Chaplain Norm Shrumm about talking to our families about end-of-life wishes, ours and theirs. The holidays seems a good time to revisit the conversation. The whole interview is full of compassionate wisdom, and these words in particular have continued to help me:
And to the point you bring up about dementia like in the case of your mom, it can help to remind ourselves what that role of health surrogate entails. You are being asked to make decisions on a pretty high level emotionally and ethically. There isn’t any trickery there. I think that is what we sign on for: In the event I cannot make decisions for myself because I’m unconscious or because I no longer understand the complexity of the situation or its implications—my health surrogate will make those decisions.
I don’t argue against the guilt because I don’t think that helps. We have guilt because we are in moral distress and there is ambiguity. It is not a slam dunk decision. So, we just need to do this alongside of the guilt.
And what you are being asked to do is to draw on all your love for this person to make the decision on behalf of this person that she is unable to make. You landed in this role for this very reason. And so the moral weight of deciding on her behalf what would be the best death—remembering there is no option available to not have a death—rests with you. You’re being asked to clear the path towards the gentlest death, a soft landing.
Sometimes we get to help people finish their stories. I won’t have all the information I need any more than I know all the variables in my own life.
There was a time after my mom was on hospice care. This was after she had lost the ability to know how to sit down in a chair and had stopped using the whiteboard to find out what day it was and instead would just look to me or my dad for reassurance that all was well. She was no longer the first one up every morning, the way she had been for most of my life. Except on that morning, I woke up before dawn and came into the kitchen to find my mom studying the calendar.
“Would you like coffee, Mom?”
“That would be wonderful,” she answered, and her voice sounded like her old self. I inhaled deeply, noticed she was wearing her robe and glasses. She looked up and her blue eyes met mine.
“Laura, I woke up knowing that I haven’t been right. It’s as though I’m suddenly aware that it has been me who is crazy and not everyone else. I don’t know if this will last, but right now, it feels so good to understand. It’s like I’ve been gone and I am back.”
She was back, and I wanted to crawl in her arms and beg her to stay.
We sat on the couch each holding our mugs. She took long sips from the cup she often requested but, these days, usually let sit before her growing cold. We talked like we had on so many dark mornings throughout my life.
“I am here,” she said, “I am in Maui having a good conversation with my oldest daughter, Laura. I wish I could write it all down. I don’t know how long this will last.” Then she said, “If I wrote a book you know what it would be called?”
“What?”
“Choices. My life really started once I knew I had choices,” and she looked up at the ceiling like she so often would when thinking, and then to me. “It wasn’t which choices, or that I had choices. It was me knowing I had them.”
I too, wished I could write it all down. Wished I had brought my phone into the living room so I could turn on the recorder. Wished she could stay.
That was the last time we were in our rightful roles: mother, daughter. By the time the pastel glow of morning revealed a daytime moon, the fog of Alzheimer’s returned. But the living continued and we made our ways somehow through those final months together. And my mom, Jane Stavoe, shapes my story, still.
More Resources
While teaching the community college course this semester, I put together a list for my students. These are the books and podcasts and films that I find myself returning to often. You can now find that in-progress list at the Laura Library link on my website.
Three recent podcast episodes that I loved and may be of interest are “70 Sounds Young To Me,” a 70 over 70 interview with Diane Meier, a pioneer in palliative care medicine; “The Fullness of Things,” an On Being episode with poet and Zen monk, Jane Hirshfield; and George Saunder’s on Longform, which may be slightly off topic for this blog, but he has been one of the people who have helped me stay more grounded, hopeful, and (I think) kinder during the pandemic. He is a fiction writer, writing teacher, and wise soul.
If you would like to receive Tending to Endings when it publishes, please leave your name and email below. I plan to continue to post once or twice each month in 2022, though not necessarily on a regular schedule. I hope you’ll continue to find it useful. May your last days of 2021 be restorative and full of love.