Tag: Cancer

Serendipity, A South Dakotan Stranger, and me…

rick holm

I believe in serendipity, I do.  I believe that people join us in our walk for reasons designed by someone other than ourselves. Or so it has seemed in my life.

Nearly four years ago, I found myself impotently trying to punch my way out of the stubborn paper bag of depression.  The mounting losses had rendered me unrecognizable to myself.

Serendipity came then in the form of a powerful woman.  I met Maggie Callanan in my driveway. She was a new neighbor, but it was not until she told me she was a Hospice nurse that the familiarity of her name hit me over the head.  Maggie could not know then that seven years before someone had given me Maggie’s best-selling book “Final Gifts.” It was a gift given while my mother lay ravaged with stage four cancer.  Nor could Maggie know that three years later her second book, “Final journeys,” would join “Final Gifts” on my nightstand as my father lay dying. 

I leaned on Maggie when my elderly uncle moved to be near me for the final eighteen months of his life.  She patiently counseled me as Uncle Bobby’s health faded, all the while encouraging my writing. Maggie was the only soul who came to sit with me in the dark of-of a July night as I said my final goodbye to my beloved bachelor uncle.

Serendipity brought me an unforgettable friendship with a woman who helped me find myself again.

Today I want to introduce Dr. Rick Holm, a South Dakotan physician who has committed a significant part of his professional life to care of the aging.  He is also known as “Prairie Doc,” as host of a weekly, one hour, live medical questions program on South Dakota Public Radio and a 30-minute live radio call-in show.

You might wonder how a fledgling writer from Connecticut comes to know a Prairie-born, Doctor of Geriatrics of significant renown.  Serendipity, of course!

Rick and Maggie have known each other as distant colleagues in the business of death and dying. In the midst of writing a book about aging and end of life care, Rick was diagnosed with cancer. In an unexpected moment in time, his writing took on deeper personal meaning.  

Rick reached to Maggie for review of his manuscript.  Maggie suggested to Rick that she had a friend who might be valuable in tweaking portions of the book to inject some lyrical prose.  Two medical powerhouses and this neophyte writer? Humbled seems too mild a word.

These past six months I have come to know Rick Holm through his manuscript.  I wish it had been released in time to join Maggie’s books on my bedside table while I cared for the dying loved ones in my life.    I now consider Rick Holm a friend.

Please Welcome Dr. Rick Holm to my blog space.  If you are, or suspect you will someday be, given the gift of sharing the end of life journey with a loved one, I encourage you to purchase Rick’s book which can be found on Amazon: 

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Life’s More Rich as It Nears Its End    Dr. Richard P. Holm M.D.

I’ve lived a life formulated to live long: eating right, exercising daily and savoring friendships and family. Despite this, I still came down with cancer two years ago. I’ve been treated with chemo, radiation, major surgery and now, with spread to the liver, I’m back on chemo. I’m still here and truly feel blessed and thankful for every day, but you can understand why, lately, I’ve been thinking about death.

Loving my enemies has made this easier. As our kids were growing up, I would find myself saying to them ”I will always love you unconditionally, but sometimes I don’t like what you are doing.” We should say that to our enemies, too. Here is the lesson: hate is poisonous, especially to the one who harbors it. Remember what Jesus said (as did Mohammed and Buddha), “Love your enemy.” I believe hating others, even when justified, only destroys us. When angry, we should point the anger at what he or she is doing, not at the person. Use it as propulsion to fight to the tooth for the cause . . . but let go of hate. How is this related to death, you ask?

When people ask me how I contend with the prospect of my dying sooner than I’d like, I go right to the opposite of hate which is love. I know it sounds clichéd and unoriginal but the word love embraces the spiritual, inner-warmth I feel when I value the other person (even if he or she is my enemy). Truly valuing others gives more meaning to my time limited life and helps take away the fear of my own death . . . but there is something more.

Some say, “One day, you’ll be just a memory for some people.  Do your best to be a good one.” That’s not bad advice, but I think the measure of our worth after we die, has less to do with being remembered and more to do with the reflection of our actions in others. It’s that Pay it Forward or that Jimmy Stewart Wonderful Life sort of thing. I believe meaning and purpose comes with the good that we do and how that moves others forward (whether they’re aware of it or not).

Our lives are all like a book that becomes more precious as it nears the end, especially by savoring friendships and family, by letting go of hate and by paying good deeds forward. Why waste any time fearing death?

Of Mothers and Memories…

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My mother passed away 11 years ago on Thanksgiving night.  I struggle to remember the exact date of her death.  The anniversary of it is inextricably attached to Thanksgiving.

She was diagnosed with Adrenal Cortical Cancer in late September. The following nine weeks are a confabulation of disturbed memory and racing recollections of traveling to and from Rhode Island.  Weekends were spent with my dying mother and distraught father, and weekdays trying to refocus on my family.  My children were so young that my daughter has little memory of a grandmother who loved her in a special way. She was the only granddaughter in the mix of boys. Grace was 6 years old on Thanksgiving night 2005.

When I cleaned my mom’s closet out weeks after her death, I found a stockpile of beautiful, expensive dresses, sweaters, and coats that would see Grace through several years of special occasions.  A corner of the closet was filled with precious items which surely cost too much.  My daughter was something of a life-size doll for both my mom and me.  Grace knew indulgence in fashion from the moment she was born.

After the whirlwind of wake and funeral, as I tried to settle into a life absent my mother, I received cards on a daily basis for weeks.  My father, in his heartbreak and with a slow shake of his bald head, would repeat this mantra in response to the outpouring of condolence, “People are awfully good.”

There was one such card that affected me more than any other.  I thought I had saved it, but could not find it, as I sifted through special things this week.  It doesn’t matter. While the words may be imprecise, the message is indelible.
My friend, Betsy, who lost her mom as a young woman, shared this sentiment (now paraphrased):

“When your mother dies, you lose your North Star; your guiding light.  For some time, you will find yourself imbalanced, your navigation will be off.  Regardless of your age, it changes your world.  It is only understood by those who are motherless.”

 
That beautiful letter moved into my soul the moment I read it on a cold, quiet December afternoon.  I was 43 when I lost my mom and Betsy’s letter was like a gift. Even in my incalculable grief, I understood that the death of one’s mother is an equalizing human experience.  In the natural course of living, parents pass before their children.  All of my friends and cousins who still had their mom’s, who sympathized, but could not empathize with the depth of my loss, would someday experience the same.  To be sure, I was imbalanced for quite some time when my mother left this earth.

In the last two years, I have attended too many funerals, watched too many friends and cousins say goodbye to too many mothers.  It feels like time to take a cue from Betsy.

My mother’s greatest gift to me was her example of faith.  She was an epic church goer, a Catholic from the tips of her toes to the top of her head.  I am not any of those things, but there is a moment I call upon when my own struggle is mighty.  My mom might say this moment was the work of The Holy Spirit.

Despite the fact that I had philosophical issues with the “Big C” Catholic Church, my local parish had been home to me.  I was a catechist and you could find my family, 6th row left of center, each Sunday morning at 9 am.  I loved the ritual of the Catholic mass. The predictability and familiarity of the liturgy were like meditation for me. Once my mother passed, church became impossible; the smell of incense or a single organ note undid me.  I vividly remember that first Christmas Eve, entering the church with my family, finding our pew and, as the congregation settled in, the choir led with “Oh Come, All Ye Faithful.”  Grief grabbed me by the throat and I let go of my 6-year-old daughter’s plump, impossibly soft hand and made my way out of the church with as much dignity as I could muster. The cold night air was a welcome relief, and I wept as I walked the parking lot for the hour it took for mass to be over.  The strains of “O Little Town of Bethlehem” and my mother’s favorite Christmas Hymn, “O Holy Night”, wafted from the Church into the night air. Each note like a stab into my already broken heart. I knew then, that Church would never be the same for me again.

For two months following my mom’s death, night was my demon.  I battled through the daylight hours, but once my head hit the pillow, unsummoned tears would leak from my eyes and my mind raced around every detail of the previous months.  Exhaustion ushered me to sleep, but dreams of my mother woke me nearly each night.  I dreamt, not of my mother as I knew her, but of the diminished her, twisted with the pain of cancer that consumed her body.  It was as though I never knew her whole.  Her pain was a nightly visitor.

The first waking moments for those grieving are predictable.  It takes but a moment of consciousness to remember the pain that has been dreamt away in the deepness of sleep.  As consciousness nears, the ache rebuilds.  I woke most mornings of those two months willing fresh tears away.

As the world turned to a new year, a challenge I was not ready for presented itself.  My husband’s father had died the previous January.  He was a kind, benevolent, smart, wonderful soul.  A Mass of Memorium was scheduled on the anniversary of his death.  I could not fathom surviving it.  I wanted to summon the courage I knew I needed to do the thing I knew was right.  I spent the week before oddly “psyching myself up” to gut it out for him, to be an example for my children.  The night before, I crawled into bed and prayed that I could be relieved, Dear God, just once, of dreams of my sick mother.  I fell asleep that mid-January night, determined to rise to the occasion regardless of which visitors came to me in my sleep.

All I can remember of that night is that when I woke tears did not well, nor did bad dreams fly to my consciousness.  What did was this:

My mother and I walking the boardwalk of Weekapaug’s Fenway Beach, both of us carrying beach chairs in our hands.  The sun was high and the sand was soft and my mom looked lovely, in her skirted bathing suit and white cover-up.  We set our chairs down, side by side, and the waves were gentle and our toes massaged the sand.  That’s all I recall of my dream on that January night, and it is enough.

I believe that The Holy Spirit visited me that night.  That my mother sent me a message that went like this: “All is well with me, and you will be fine.  Go be who you need to be. Don’t worry anymore.”

And I did.  I went and honored my father-in-law in the way that he deserved.  Any tears I shed in the church were for the memory of him.

My grief did not end that January night; it remains in my soul.  My friend, Betsy, was right.  I lost my North Star when my mother passed.  I am not so sure, 11 years later, that my navigational ability has improved.  I remain a bit unsettled but feel as though I am finding my way.

I dedicate this writing to the women in my life whom I love.  Many of you have lost your North Stars.  Many of you have yet to.  In your grief or grief to come, I wish you peace and the surety that the Holy Spirit is present.  I have experienced him/her many times since that January night in 2006.  Listen for it in your sadness, be open to it in your grief.  What a lovely gift for a mother to a daughter. It is as precious as the perfectly smocked dresses my mother bought her grandchild 12 years ago. It is as perfect as a lovely, handwritten note from a friend that would resonate in my heart forever.

Food , Glorious Food

Several years ago I had the great fortune to direct a middle school production of “Oliver!”  Little did Charles Dickens know that this dark story of orphaned boys in early 19th century London would be brought to life with such grandeur.  Notably, The opening number, “Food, Glorious, Food!”  perfectly captures the yearning for comfort food.  So good is that opening that you can almost taste the morsels which make the sooty-faced orphans pine.  Do we eat to live or live to eat?

When my mom was diagnosed with stage 4 cancer in September of 2005, it took nearly 3 weeks for the doctors to make an accurate prognosis.  It was imperative that they find the source of the initial cancerous cells first. That wait was almost inhumane, but my mother bore it with remarkable stoicism.  I suppose she knew that the cause mattered not at all, the result would be the same regardless of where those insidious buggers began their destruction.  Of all the Irish luck,  the roulette wheel landed on the adrenal gland, giving her an extraordinarily rare cancer with little evidence of successful treatment, and no positive outcome at the stage 4 level.  The prognosis was 3 months to live.

My mother, father and I left that prognosis meeting in silence, each of us digesting the news which was delivered with compassion by an oncologist whose name I don’t even recall.  We drove the 10 miles from his office to my parent’s suburban colonial, each in our own stillness  Mom was exhausted when we got home and went directly upstairs.  Not knowing what else to do, I followed her and asked her what she would like for dinner.  Seems a silly question in light of the news, but dinner plans were important in my Irish Catholic home.  Throughout my life the day seem to start with the question, “What’s for dinner tonight?”

She sat on her bed,  thought carefully and said, “I think I’d like some meatloaf, mashed potatoes and green beans.”  Okay then, that was easy enough.  I ran out to the market and got the goods and prepared while she napped, while my poor dad sat in the den struggling to wrap his mind around the inevitable.  

Meatloaf is best made with your hands; it’s nearly impossible to meld the hamburger, onions, eggs and breadcrumbs properly with a spoon and my mom’s kitchen had no such modern convenience as the Kitchen Aid mixer.  The old fashioned way was best, and there was something cathartic in preparing that loaf and finally pressing it into a bread pan, topping it with a Heinz Ketchup glaze and setting it in the 350 degree oven.  Mashed potatoes are more work and in my mom’s kitchen the Foley ricer was the tool of mashed potatoes.  Once they were boiled, peeled and cut, the stainless steel contraption would do its magic, smoothing out the potatoes so that just the right amount of milk and butter would create a creamy, fluffy concoction.  Green beans take no effort at all.  A quick boil and shake of salt and there you are.

Mom had lost significant weight in the months before diagnosis and her appetite had dwindled significantly since the word Cancer had been introduced nearly a month before.  In a twist of Irony, she often mused that she wished she had eaten what she wanted during her middle years, rather than battle her weight.  Juicy hamburgers and creamy sauces on pasta were traded for white fish and chicken, chicken, chicken after a heart attack stopped her in her tracks in her early fifties.  She survived the heart scare and thought perhaps that might be enough medical complication for a lifetime. There is a hint in there somewhere that we ought to live a little more freely while we may.

I prepared her plate of food, which she wanted to eat in her room.  On the tray, I put a placemat, silverware and a cloth napkin with a sterling silver ring.  A small glass of whole milk was a bonus and I carried it up the stairs carefully.  She was awake, but lying down when I walked in.  Upon my entrance, she scooched up and rearranged her pillows.  In that moment, she may as well have been just battling a cold or the flu.  Regardless of the dire information of the day, her countenance was peaceful, tired, but she was, as always, receptive and polite.  You could almost forget in that moment that the number of nights in the home she lived for 45 years were nearly over;   that nights of peaceful sleep were now numbered.  She asked me to put the tray by her side in the empty space to her right.  

I sat on the floor next to her for thirty minutes or so, but we did not talk of cancer or doctors or what happens next.  As I remember it, we spoke of my children and how long I would stay this visit. We planned my return the following weekend.

Mom didn’t touch a morsel of that meal on that October night.  Nor did she eat a bite of the roast chicken, baked potato and broccoli I made a week later.  Same for the pork chops, applesauce and potato she requested subsequently.  Her appetite was long gone now, and her tastebuds were muddled with medication.  It took me some time to understand that it was the smell of those comfort foods she craved; the soothing effect that comes from the aroma of the foods we love.

Mom passed away not 7 weeks later on the greatest food day of all time: Thanksgiving.  I’ve grown to love the irony.  Her death was met with kindness to my dad from all corners, and that kindness came often in the form of food.  His freezer was filled for almost year with casseroles, lasagna, chicken parmesan, chili,  and creamy soups.  Not a soul worried for him about carbohydrates, salt or sugar intake.  Not one person prepared white fish for him in the year following my mother’s passing.  Food, high calorie, delicious food, was their show of love.

This musing of mine is brought on as I watch Uncle Bobby’s appetite dwindle to nothing.  His most notable activity each day is to go to breakfast and dinner at the assisted living home.  He gave up lunch months ago, and sustains himself midday with Oreo’s and Fig Newtowns.  He will occasionally slip in a wedge of apple in a nod to health.  I puzzle at the menu at “Maplewood”, as it reflects our generations obsession with healthy eating.  The menu is fancy and announces “farm to table freshness”.  It’s impressive in its breadth and attention to detail, but Uncle Bobby and his dining companions often comically remark on the offerings.  

“What’s this, Fra Diavolo with roasted red peppers?”

“”Sea Bass? Where’s the fish and chips?”

“Since when did brussel sprouts become popular?”

I get the marketing of assisted living.  I understand that the elegant presentation in the dining room is not really for the residents, but rather the families who are trying to come to peace with the fact that the comfort of home is gone now for these elderly loved ones.  So while I understand it, I wish I had the courage to march into that kitchen and meet the chef face to face and announce, “Meatloaf, mashed potatoes, gravy, hotdogs with mustard and relish, spaghetti and meatballs.  That’s what they want!”

But like Dicken’s orphans, they will push their fancified gruel around the plate, and fill their imaginations with the glorious food they loved throughout their lives.  If they are like Uncle Bobby, they will wish for the midday to come so they can inhale some Oreo’s or Fig Newtowns, or his other guilty pleasure: buttery Ritz Crackers.  Food, Glorious Food, Indeed!