5 Days in Hospice

Being asked to help someone die is both a great honor and an overwhelming responsibility.

Over the course of 30 years, my stepfather and I had many conversations about death and dying. You see, he was a physician well versed in the process of human demise. And he wanted to avoid the loss of independence and dignity that often comes with dying. Death due to long and lingering diseases was in his control.  When his time came, he would stop eating and drinking and drift off. He had lived a good life.

May 2019 brought the moment for him to test his resolve. At 80 years of age, he was diagnosed with metastasized prostate cancer. 

The cancer had spread and was blocking his ureters. A simple surgery rerouted his urine output directly from his kidneys to tubes strapped to his legs and bags that hugged his calves. For a while, it seemed the cancer would progress slowly, as prostate cancer is wont to do, and he could still live an active life. 

“Up to 10 years,” predicted one doctor. 

“Great!” said the 80-year-old man. After all, cancer or not, 10 years was a good outlook. 

But cancer cares nothing for the predictions of doctors or the wishes of families.  The cancer was in his abdomen. His bones. Possibly in his brain. 

“This is it,” he told his family. And some of us supported him. We knew. We understood. We had talked to him about this. We had sat together and helped my mother to die. He set a very simple goal – to live until his birthday in October. Then he’d stop eating and drinking and quietly ease into death.

Letting go of life is not a simple choice. Some people choose to hold on to every last breath. Try every treatment. Endure all pain. Fight for every last second of life. My stepfather’s family of origin was of this mindset.

After my mother died two years ago, my stepfather made a pilgrimage back to his birthplace, a land he had left far behind him when he set off to college, and never looked back. But there is something about aging – about losing the woman he had wed, and loved, and mourned, that perhaps encourages one to reexamine their roots. Six months after my mom’s death, my stepfather sold the house, loaded his pickup truck, and moved home.

And for a while, it was great. He came from a very small town. The residents were happy to welcome the return of the prodigal son. He volunteered. He joined the library board. He thought about running for the city council. Before the pain took over.

The doctors said radiation might be the answer – not as a cure but to reduce the pain. My stepdad was skeptical. He was a physician. On some level he knew. But he has always been a person easily swayed when it came to keeping others happy. He had only just returned, his family of origin said. They wanted him around a bit longer. He said yes.

But the radiation never really helped, and his pain increased. He could no longer live alone in his home. He moved in with his sister. He gave up on the city council. He no longer went to the library. His birthday came and went. Just a bit longer, his family of origin encouraged. And he did his best.

I got the call on New Year’s Eve. In a frantic tone I had rarely heard from my unflappable stepfather, he said, “I want to shoot myself in the head.  I want your support.”

He was done. Done with the pain. Done with trying to meet other people’s needs. Done with the loss of control over his body.

“Don’t do that,” I said. “Wait.  I’m coming.”

“I need you to be my advocate,” he said. And I said I would.

I caught the earliest flight the next morning. I rented a car and drove to the hospice where he’d checked in the night before. We sat with the doctor, holding hands, while he said in a clear, competent voice that he wanted to stop eating and drinking. The doctor nodded and asked questions. The nurse stood by as witness. And it was done.

My stepdad is a healthy guy. He is of the “eat little and exercise daily” frame of mind. He is thin. He has muscle tone. He has a strong body. Even when that body is laced with cancer, it fights on.

It’s been five days and my stepfather is still breathing. It may be hours, or days, or even another week. Nobody can predict. 

There has been family conflict over his decision, but his children – both his biological son and his chosen daughters – support him. And there is something strangely peaceful sitting here alone with him as he breathes, eyes closed, pain finally dulled, while his body comes to terms with the end. 

Through it all, he has given me both a gift and a great responsibility. Asking someone to help you die is no small thing. Trusting them to follow through is a great leap of faith.  In the end, I know my stepfather loved me, deeply and without reserve. Who else could you ask to help you die but someone you truly loved?

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EPILOGUE:
My stepfather died on the early morning of the sixth day. I was by his side. Perhaps in a moment that shows the interconnectedness of the universe, he died to the same song as my mother two years ago – Time to Say Goodbye by Andrea Bocelli. Truth is stranger than fiction. May you both relax in each other’s love.

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I would like to recognize and thank Iowa River Hospice in Marshalltown, Iowa. Helping people while they take their last breaths is an extraordinary calling and requires special people. Those special people are here – supporting both patients and families with all the compassion and caring of angels. Give to your local hospices. Death with dignity is a precious gift.

Jenny Lang is an Author currently working on a novel inspired by the life of Sarah Winchester, builder of the Winchester Mystery House in San Jose, California. If you would like to be notified when the book is available, please sign up here.