What do you say to a dying person?

Heather and her husband, Joe

I don't know how to process this other than to just start thinking out loud, so hopefully you'll bear with me as I put my thoughts down in the best way I know how...it's been a week since I made a whirlwind, unplanned trip. My sweet son in law, Caleb, was my escort. He called last week and asked if I would like to come out to Texas and visit with his wife (my daughter), Erin, and the grandchildren. He said he'd be more than happy to drive up to Georgia to get me. At first I was shocked and couldn't believe what I was hearing...he was going to drive from Texas to Georgia to get me and then take me back home again...all in the span of one week...that's insane! But he wanted to do it. His heart was so filled with love that it was overflowing and he wanted to give of his time...to me. So in an instant, I accepted the invitation and immediately  began packing for the trip.

On the way to Texas, We planned to stop and visit our friend, Heather. I've written about her recently in several other blog posts. She is a young mother of 4 and is fighting for her life. She's dying of cancer. Originally, she was diagnosed with breast cancer about 4 1/2 years ago. The cancer has metastasized and moved into her brain, her liver, and other areas of her body. To put it bluntly, she's in really bad shape. She's been moved into the palliative care section of a large cancer hospital in Texas. She'd been moved there to receive the very best cancer treatment available.

When my son in law arrived late that night, he was so tired. My heart hurt for him. He'd driven all day to get here. It was 802 miles and I knew he was exhausted. I encouraged him to go to bed early and he did, but those few hours of sleep wouldn't be enough to rejuvenate him fully.

We started out on our journey to Texas in the wee hours of the next morning. It was dark, quiet, and chilly. We drove for several hours before the sun came up and were so thankful when it did. Traffic was light and we made good time, but the miles stretched on and on. Our plan was to stop at the hospital and visit Heather before going on my daughter's home.

When we arrived at the hospital, I was overwhelmed. This hospital was ginormous! I don't know how many floors or buildings it had but it seemed the hospital took up several city blocks. We walked and walked to find the elevators. Once inside the hospital, we traveled through a maze of hallways and floors to find Heather's room. When we finally reached it, we stood outside her door with trepidation in our hearts.

A sign on the door read "all visitors must wash their hands before entering." We turned to see a little sink and some hand soap just to the left. Both Caleb and I washed and dried our hands before gingerly knocking on the door.

An older woman greeted us and introduced herself as Heather's mother. A few seconds later, an elderly gentleman appeared and said he was Heather's grandfather. We said our hellos, shook hands, and watched as Heather's mom gently shook Heather's arm to wake her. The room was dimly lit but the curtains were open and sunlight streamed through illuminating Heather's face. Everything was silent except for the sound of the machine pumping pain medication into Heather's arm. Her relatives said they were going to leave for a little while and give us some privacy.

After they left, Caleb and I stood on either side of the bed just watching Heather for a few minutes. We didn't quite know what to say or do. Heather was still swollen and very jaundiced. She looked so sick and so weak.

Caleb was the first to speak and greeted her with fondness. Since Heather and I had never met in person, He introduced me to her. She thanked me for writing her over the past few months and for the knitted hats and shawl I'd made for her. We made small talk for a few minutes and then she asked me to hand her the remote control for the bed. She pressed the button to raise her head up so she could see better. I was surprised she felt well enough to do that.

We continued to talk and then, Heather cut to the chase. She asked us some really hard questions. She wanted to know why she'd been brought to M. D. Anderson. She said she felt like she'd just been brought there to die. She didn't want to be there. She wanted to be home. She was adamant about her feelings and very coherent in her thoughts. She told us the doctors had said if she went home, she'd have to have a hospital bed and she told us she didn't understand why...said she didn't want one and didn't think it would fit in the house anyway. We didn't know how to respond, so we just listened.

I chose my words carefully as I spoke to her. I knew she wanted answers to her questions but I didn't feel it was my place to give them. I could empathize with her because I too had been diagnosed with breast cancer. I tried to put myself in her place and thought about how I'd feel if I were going through the things she was going through right now. Yes, the doctors and medical staff knew she was entering the last stages of her illness and yes, more than likely, she'd been brought there to die but I couldn't tell her that. All I could tell her was that her family loved her and wanted her to get the best care possible. That's why they'd allowed her to be moved to the palliative care unit. (Palliative care focuses on symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping and depression. It also helps you gain the strength to carry on with daily life. It improves your ability to tolerate medical treatments. And it helps you have more control over your care by improving your understanding of your choices for treatment. Palliative care helps to make the patient comfortable and that was just what Heather needed.)

While Heather was focused on negative things, we tried to turn them into positives but how do you do that when someone is expressing such anger over dying? There were no words to say. All we could do was just be there...just show up...just give our love and support. We couldn't fix it or make it better and that wasn't what we were supposed to do. We had just come as friends to show we cared.

We were shocked at her anger but were glad she felt she had the freedom to express it. We couldn't judge her for that, after all...who's to say we wouldn't feel the same way if we were in her shoes...if we knew our time was short, wouldn't we be angry?! As I listened to Heather speak, I noticed her words were slow and deliberate. She was weak and tired. Her body was wearing out but she was determined to share her heart. I felt so sorry for her and wanted to comfort her but she didn't want that...didn't need that, she just wanted to have her voice heard, so we continued to listen as she talked about what she did and did not want. The more I heard, the more I realized she was in the 2nd stage of grief - ANGER. I'd studied the five stages of grief many years ago and had witnessed various stages of it throughout my time as a lay counselor. My heart went out to Heather as she continued to talk.

Heather looked so uncomfortable as she lay there in the hospital bed. I asked if the doctors were being able to manage her pain and she told me they weren't. She was hurting A LOT. As soon as she said that, she asked me to hand her the call button and she rang for the nurse. When the nurse answered, Heather told her she need pain medication immediately.

The nurse came and administered Dilaudid and  Hydromorphone, two extremely strong opiates used for severe pain management. It took a few minutes for the meds to kick in and for Heather to slowly begin to doze off.

Other friends arrived and we felt it was time for us to leave. We hadn't done anything to really help Heather other than to listen to her as she talked. We realized as we walked down the corridor toward the elevator that sometimes, all we're supposed to do is show up and that's just what we did. We were there. Heather knew we cared and that we loved her.

What do you say to a dying person? With an ill person, you can say "I hope you feel better soon," or "Is there anything I do to make you more comfortable?" or things like that. With a terminally ill person, the only thing I could think of to say is "I'm praying for you." Offering words of love and encouragement seemed so trite but necessary.

On the ride through Houston toward my daughter's house, I was quiet. I was trying to make sense of everything. It was hard to understand why God would allow such a young woman to die when she'd barely experienced life. Why had she been given a death sentence and why had I been blessed to receive life? We both had breast cancer...I didn't have the answers. I'm not God and I don't know why He has allowed this hard into her life. I am thankful that Heather knows Him. She told me she did and that gives me hope that she will have faith to trust Him even in the very difficult days ahead.

I couldn't help but think of Heather that evening as I went to sleep. I prayed for her and asked God to comfort her and to ease her pain. I also prayed for her husband and her children asking God to give them the strength to face their uncertain future. I know He will, but it will be extremely challenging for all of them.

It's been a week since I was in Texas. I'm back home now and every day I expect to get the phone call that Heather's gone home to be with Jesus. Since my return, she's been moved to another hospital into hospice care. Her family is staying in a hotel nearby so they can be close to her.

Heather's story is just one of the millions of women with breast cancer and I'm sure hers is similar to many of them. I'd be lying if I didn't tell you how scared I was as I stood beside her bed last week. All I could think was will that be me one day? I felt deep sadness as I watched her resting. Her skin a dull yellow color from the effects of a liver barely working, her smooth, round head lacking the lovely locks that once lived there, her swollen body curled underneath the sheets just wasting away, and the IVs providing medication to help her...all signs that cancer was winning.

Maybe I didn't do a good job of ministering love to her that day, but I sure hope I did. I tried. I did the best I could, but I really just didn't know what to say. All I could do was show up and that's what I did. I hope she knows I cared and I hope she knows I'll never forget her. God bless her heart. I take comfort in knowing when she gets to glory she'll have a completely healed and restored body...a new body that won't ever suffer any pain ever again and she will forever be in the presence of Jesus. That's what will allow me to be okay and get through this. It's so hard to watch one more woman succumb to the devastation of cancer. Oh how I wish we could find a cure. Maybe one day....

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