The Way To Go: Reflections On A Good Death

My mother died about a month ago, just shy of her 88th birthday. Her death was caused by metastatic lung cancer (for those who reflexively ask the question – no, she was not a smoker).  Her death was not the result of  COVID-19 but the pandemic’s emotional and medical toll has helped me put her death in perspective. And if I am honest with myself, I am engaging in some very public grieving here. This if the only time I ever shed tears while writing this blog.

Although my family and I are deeply saddened by the loss of our mother, her death has helped me understand the terms under which I want to prepare for and face my own – hopefully distant – death. My mother had several wishes about her death, all of which she managed to fulfill. Most importantly, she wanted to die before her children died. She often said that you know you’ve lived too long if you have outlived your children. Second, she wanted to remain independent. Which she did, in her cherished Brooklyn apartment overlooking the salt marshes of the Marine Park Nature Preserve until the last 2-3 weeks of her life, doing her own cooking, cleaning, shopping, and socializing. Third, she remained cognitively intact; a few days before her admission to the hospital, she was working a NY Times crossword puzzle. Miraculously, the metastases that punctuated her brain did not seriously impair her stubbornly strong cognition. Fourth, she did not have a long disease course; it was only a few weeks from diagnosis to death. Despite the advanced stage of her cancer, her breathing and overall functioning had not recently been deteriorating any more than one might expect in an 87 year old. This bomb more or less dropped out of the blue. Finally, she faced death with a dignity and acceptance I hope I will be able to emulate one day. She thoughtfully weighed her treatment options and firmly but politely declined any interventions. When she went into hospice care, she told the social worker that she had come there to die as peacefully as possible.

From a practical standpoint, my mother was very frank and organized about anticipating her death. Her savings and possessions did not amount to much but years ago she made sure that all four of her children were aware that every important bit of paper was neatly labeled and filed in one place. She even prepared a list of wishes – her Casket List, if you will – for her funeral and burial, including her choice of funeral home, cemetery (with my father), Catholic church for her funeral mass, and list of songs to be played at the service. Let me pass along one bit of advice – do the same, and do it now during your in-place sheltering. One day your grieving family will love you even more deeply for having done this.

Fortunately, my mother’s death occurred barely a week before the coronavirus pandemic hit New York City. This allowed me to spend two weeks in Brooklyn with my mother, visiting her in the hospital and in hospice, holding hands and comforting one another, and I was able to return for her funeral. Two of my sisters were with her through the agonal breathing up to the moment of her death; my mother died surrounded by love. My heart goes out to anyone who has been robbed by this cursed pandemic of the ability to be together as a family in the face of death and dying.

I was grateful too that my parents, a pair of  life-long office clerks, somehow managed to raise a medically sophisticated family. Two of my sisters are physicians, which, along with my own experience in the oncology world, made it much easier for us to grasp the medical issues at hand and allowed us focus on our grief and support for one another. We didn’t have to worry about trying to comprehend arcane medical terms, weigh the ins and out of  complex treatment options, or worry if my mother was getting good medical care (at Brooklyn Methodist Hospital – NY Presbyterian, ironically the very hospital she was born in, she received superb and compassionate care from bed pan cleaners to nurses to medical specialists).

My mother’s journey to death even had a darkly humorous moment that happened while I was staying in her apartment. After undergoing a diagnostic lung biopsy, my mother experienced the not uncommon fentanyl side of effect of severe hallucinations. Early one morning, while I was still sitting around in my pajamas and sipping a cup of tea, the doorbell rang. I opened the door to find a pair of police officers and a pair of EMTs. Apparently my mother called 911 from her hospital bed, claiming that she had been tied up by a bunch of doctors who were forcing her to stay in a locked closet in her apartment. I was met with a skeptical stare from the police officers when I said “Oh don’t worry. My mother is on fentanyl and she is just hallucinating again.” At that point, I figured I had to let them in and have a look around just so they could be sure about things.

My other expression of public grieving took place during her funeral service when I delivered her eulogy. Like my mother, it was short, sweet, and to the point. I have reproduced it here and hope that I have adequately captured the essence of her life in a few words:

My mother is in Heaven right now. Surely someone with so much love in her heart and in her life is guaranteed admission, no questions asked. St. Peter had those gates opened and he was waiting for her with an eternal welcome.

I suspect that the afterlife has not changed my mother much. So, even though it’s only been a few days, by now I am pretty sure that she knows the life stories of most of the saints, has prepared several meals and desserts for the angels, and right about now she is sitting down with God, and, over a cup of tea, giving him her thoughts on how things should be run around here. And when she listens to the Mets’ games in Heaven on her transistor radio – surely an omnipotent God can arrange this for her – she might even ask God to give the Mets a bit of a divine helping hand every now and then. They could sure use it.

The love that earned my mother her heavenly reward is the same love that formed the emotional center of our family’s universe and held us together in the face of our many wanderings around the country and the world. That love though did not die with my mother. She taught my sisters and I life’s most important lesson – how to love. In that way, my mother lives on in the love that my sisters and I share for one another. And she lives on in the next generations as our children and grandchildren form new families and new, widening circles of love. One could ask for no greater gift.

Goodbye Mom. We love you.