Dying Alone
2005 Networking with other healthcare advisors (I am second from right)
I’ve always had a comfortable relationship with time.
When asked to name a positive attribute about myself, this typically comes to mind. However, I don’t always say it.
Instead, I give another answer that is true but fits more neatly into the expected answer box.
My good relationship with time has boded well for me in both mental and physical well-being. I have never dreaded a birthday or looked in a mirror longing for the past, while unhappy in the present. Regardless of my aging body, a new day is nothing short of a gift and a chance at a new adventure. And the past? A fun ride to be savored with the memories.
Part of my comfort with time isn’t just in aging but in my acceptance of dying. Although, as humans, we are quick to point out our differences, the commonality that always exists is our inevitable death. No matter the amount of power, money, or good intentions, we will all die-and never with the foresight of a predetermined date.
Now that I am well into my fifties, the reality of an expiration date has become more apparent. In my thirties, a death in my circle of friends was either rare or unexpected. It is now a frequent occurrence to send condolences for the death of a parent or family member. A life-threatening diagnosis received by a peer was once a shock but is now common.
. . .
Spending over twenty years in the public accounting profession, death was a frequent subject in client conferences. And for the most part, my clients hated these conversations.
Estate tax, the dreaded death tax, was an agenda item at annual tax meetings. Succession planning was on the checklist for business owners. A medical power of attorney and beneficiaries at the time of death were on the legal paperwork punch list.
My clients would wiggle in their seats and avoid eye contact when these subjects came up. Few wanted to talk about aging, and no one wanted to die, let alone discuss its inevitable prospect.
. . .
During my public accounting years, I ran the healthcare department. In 2005, I was selected to serve as a Community Healthcare Intern. The idea was to allow local professionals, advisors from the outside, to get a real look at the inside of the healthcare profession. This group included politicians, bankers, attorneys, and accountants who worked in the industry.
I was happy to be selected as part of this elite group; more excited about networking than the actual work. I hadn’t a clue that this brief tenure in the bowels of healthcare delivery would include my holding a stranger’s hand while she died.
At her side, I ultimately spared her dying alone. That moment in time has stayed with me. Back then, I thought it was a lesson in never allowing someone to die alone.
It has taken twenty years for me to understand that the lesson was much more than that.
. . .
As a Healthcare Community Intern, I was assigned four posts at various medical facilities. Spending half a day at each, I shadowed physicians through their normal day. Although I had experienced similar office settings as a patient and as an advisor, walking alongside the many doctors, nurses, and workers from the inside gave me a new perspective.
I listened to conversations around charts where diagnoses were hypothesized, and labs were read. After shadowing an OBGYN, the doctor later apologized when no babies chose to be delivered during my time there. No apology was necessary, noting that I had already given birth to three babies-an experience from a different angle.
What I did experience at the OBGYN office that day served its purpose of opening my eyes to things I was not aware of. I sat in on a conversation with a young pregnant girl who had decided to give her baby up for adoption. She cried and held the doctor’s hand as advice was given on adoption options.
A menopausal fifty-something-year-old woman broke down in tears as she explained to the doctor how taxing it was for her to be the primary caretaker of her ailing and aging mother. Still not over her divorce, the woman felt alone and depressed. Medicine and therapy were discussed and prescribed.
A consent form needed to be signed to allow me into the patient rooms. I wondered how it was explained to that patient that a stranger, an accountant, would be watching their exam from a corner of the room. Surprisingly, all allowed me in. Not a single patient declined the request.
Another shadowing assignment took me to a low-income pediatric clinic. Much of the day included diagnosing head lice and ear infections while working through language barriers.
My recollection of shadowing at a privately owned eye surgery office is of the physician arguing with the office manager over the thermometer setting and its impact on a higher utility bill. The office was frigid in both temperature and atmosphere.
. . .
My shadowing assignment in a hospital emergency room impacted me for years to come. I was there on a Friday night, and just like on the TV shows, the place was hopping.
The head ER doctor was a kind, personable man. Young and handsome, he was big in personality but soft in his words. Although he constantly directed staff and made decisions on the fly, he always took the time to include me. While running down hallways, he explained every new admission and gave orders to the awaiting nurses, never forgetting a please or thank you.
There was a great deal of shared respect in the ER that night. EMTs brought in patients on the many ambulance arrivals to awaiting staff, working together to move the patients while providing ease and assurance throughout the process. A high level of camaraderie was strong among many triaging nurses and residents.
I watched the compassionate doctor perform a physical exam on a young woman in great pain. Doubled over, her parents sat next to her, explaining the ongoing abdominal suffering that riddled their daughter. He assured the frightened parents that he would return once the test results came in.
Following him into the hallway, I watched his expression drop, reading a file handed to him. As he moved on to the chaos of the nursing station with a quick update from the lead nurse, he gave me my orders.
“That young woman has a bad diagnosis. I am going to go in by myself and talk to her and her parents privately. I need for you to go down to Room 12. They just brought in an elderly woman from the County Home. She has advanced dementia and is dying. There is nothing we can do but keep her comfortable. Can you go in there and just hold her hand? I will come in as soon as I can.”
Hesitant on this request, I wondered if this was an appropriate job for an intern trained only in numbers. I chose to trust the kind doctor as I made my way to Room 12. Walking into the room with no expectation, what I saw took my breath away.
In the dark room was a solitary hospital bed with an old and frail woman moaning incoherently. Hooked to an IV, she was tossing and turning, exposing all parts of her wrinkled and withered body that weren’t covered by the scant hospital gown, adult diaper, and fuzzy socks. The noises coming out of her mouth didn’t sound like pain but confusion.
I immediately sat by her side and held her hand.
The moaning continued but settled into a lower rhythmic cadence as I rubbed her arm. I told her things in a soothing tone that I no longer remember. Her eyes remained closed, with unkept grey hair matted onto her crumbled face. Although I felt like I was in that room forever, the time spent likely spanned no more than thirty minutes when she took her last breath. Her body gently released out of a fetal position as the moaning stopped.
Holding her limp hand, I said a simple prayer and carefully placed the lifeless hand onto her body as I straightened the gown. Going back into the hallway, I found a nurse to medically confirm the death I just experienced. I regret not asking her name.
Later in the evening, when the ER settled down, the doctor thanked me for my deathbed work. He then gave me some advice, friend to a friend.
“I’m glad they brought her here, and you were able to be with her. That place she came from is terrible. It should be shut down. Don’t ever let anyone you love live there.”
His words stayed with me. Added to my list of life lessons came two from the ER:
1 – Don’t die alone.
2 – Don’t let anyone I know live at that nursing home.
. . .
Twenty years have passed, and I haven’t returned to an ER as a patient or an intern. I have also not sat at another deathbed. The only thing that has changed since my ER experience has been my takeaways.
With lesson #2 on the bad nursing home, I now wish I had expanded my scope to not letting anyone live there at all. Efforts should have been made directly to shut that shithole down.
As for lesson #1, I no longer think the goal is not to die alone. The key isn’t how you die; it’s how you live.
Although I am grateful to have soothed an elderly stranger in her last moments, my wish for her now is more focused on her life. I hope her earlier years were filled with joy and loved ones, creating fond memories before the dementia set in. Everyone deserves happiness throughout all stages of life.
A good life is one enjoyed with others. The moment of dying is not the critical point of being loved. The years leading up to death are when no one should feel alone.
Movie death scenes often create award-winning moments, but it’s the years of living that create an epic and memorable story. Whenever I watch a wonderful tribute video or read kind words pulled together at a celebration of life, I hope the person who died was able to enjoy these same tributes while living.
I used to share my funeral preferences with my middle son. Although my husband would do a great job on the technical details of death, my sentimental son was the better pick at remembering my favored songs and remembrances. I would tell him my ceremony needed to be a fun party.
As time has passed, I have found this celebration of life planning unnecessary. I have opted instead to enjoy my favored songs and people in real-time. Other than the technical details involving physical belongings and legal paperwork, no post-life arrangements are necessary. Instead, I will continue enjoying my daily celebration of life. And why have a party that I will miss out on?
Death is simply the end, the closing act.
The joyful celebration from beginning to end is our ongoing act of living.
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Photos included in my ongoing celebration of life video reel…
