Now that Mary Ann is enrolled in a Hospice program, there is certainly a vivid awareness of death.  What exactly does that mean about what it is to be alive?  Is Mary Ann as alive as she was before she was enrolled in Hospice?  I will soon be 67 years old.  Statistically, I am closer to death than when I was 27.  Am I less alive now than I was then?

Marilyn, a Lead Staff member at the church I served as Senior Pastor for a dozen or so years has asked me to consider doing a presentation some time on funeral preparation and things that are associated with the process of dealing with a death in the days after it happens.

After forty years in the ministry, I have been through death with numbers of people.  In my job, I simply could not avoid thinking about and talking about death.  I remember when working on my doctorate, for a class on ministering to the older population (of which I am now a proud member), interviewing my Mother, who was in her seventies at the time (sounds young to me now).  I asked what she thought about death.  She said it is just a part of life.  It had been for her, having lost her first two children, one as an infant and the next as at the age of five.  People lay in state at home in the early years (she was born in 1907).

On occasion, when I had a cluster of funerals very close to one another (happened surprisingly often), I would wonder if I ought to find something to do that did not involve being immersed regularly in peoples’ lives at a time of such loss. I am convinced that the truth of the matter is unless and until we come to terms with death, with ours and others’ mortality, we can’t really live life to the full.

Fear of death seems to me to steal the joy from life.  Fear of dying is another thing entirely.  That fear is pretty rational.  None of us longs to have a long protracted process of dying.  Death is just the period at the end of the sentence that is the story of a person’s life.  Every day we are writing that story.  Accepting the reality of death frees us to give our full attention to the story we are writing each day, from the time we wake up to the time we go to sleep.

Making plans for the time when we die is just a normal task each of us needs to do, assuming we care at all about those who will be left behind. There is a peace and freedom that comes when all that is in order.  Today, Hospice Nurse Emily mentioned that her very healthy 87 year old Grandpa asked the Grandkids to go around his place and put their names on things for the time when he was gone.  At first the kids were reluctant, but he insisted.  For him it was comforting to know where his things would go.

The process of funeral preparation can be very life affirming.  While I do not recommend writing your own obituary with the expectation that it is the one that will be published, the exercise itself can be life changing.  Who do you want to have been when the period at the end of the sentence comes?  How do you want the story of your life to read?  Once you have gone through that exercise, it is time to actually do something to make that story a reality.

Mary Ann and I are no more or less alive than we were a month ago, a year ago, a decade ago, a half century ago.  Hospice or not, we are both alive.  There are limits on what we can do now as we continue to write the story of our lives, but there are limits of one sort or another on everyone.  The limits are not so confining as they are simply the setting for the story.  We write the story of our lives using the resources we have, not resources we used to have or wish we had, but the resources we have, thereby avoiding wasting time lamenting that we don’t have.

Mary Ann had a reasonably good day today.  It started with some fainting, but we got through that.  There was more conversation about dreams that seemed real to her.  Later in the morning Hospice Aide Sonya came to do Mary Ann’s shower, etc.  After a pretty full lunch, Nurse Emily came.  Again, it is good to have someone to report to and lean on when trying to determine how Mary Ann is doing medically.   I am happy to report that Mary Ann has gained back a couple of pounds, now at 114.5.

Former parishioners came by for a visit.  Randy and his Mom Leota came by for a while.  She is also suffering from some form of dementia, so her memory is not good.  Her husband was an avid fisherman, whose catch she would sometimes cook for us and call us to come and pick it up.  I did the funerals for one of their adult children, and her husband, as well as a couple of his fishing buddies.

Mary Ann ate a decent amount for supper and is now trying to settle down for the night.  The snow is falling at a rapid rate.  The first day of Spring tomorrow may include as  much as a foot of snow.

Since I seem unable to keep my eyes open, I think I will bring this to a close and head to be.  Here is hoping for a sleep-filled night.

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Warm gel is a good thing when having an echo-cardiogram and a carotid sonogram.  Yesterday was Mary Ann’s every six month check of the lesion in one of her carotid arteries (the ones in the neck that supply the brain with blood), and her every six month check of her heart, the valves and general condition.

The tests happen so regularly since at some time, should the lesion in her carotid artery grow past a certain point, the question of surgery will come up.  She has already had one stroke, probably caused by bits of plaque sloughed off from that lesion.  The most we can hope for is very little change in how much of that artery is blocked.  I will admit that neither Mary Ann nor I am much interested in a major surgery.  We would certainly discuss the option.  I would not presume to know for sure what Mary Ann might want to do if surgery is suggested.  Her Mom had it when she was in her 80’s, and she did very well.

What the echocardiogram shows could have some impact on medications.  It was interesting to watch the med tech do the test.  She had a student with her.  She described what she was looking at to the student as she pulled up each view of Mary Ann’s heart.  I had a great view of the screen during the entire test.  It was helpful to me to hear her point out and name the parts of the heart on the screen.  Having watched the screen for the last few echo-cardiograms, I am getting fairly familiar with the images on the screen.  It helped this time to have a running commentary on what I was seeing.

What was especially interesting was a little mini-drama, as the med tech was describing what she was seeing to the student.  At one point there is color added to the screen.  The red indicates blood coming toward the probe, the blue indicates blood moving away from the probe.  When the med tech was checking the valves using the color mode, her voice lowered as she spoke to the student.  I inferred that the movement of the colors was indicating leaking valves and she did not want to break protocol by revealing that within Mary Ann’s and my hearing.  I had been quiet (unusual for me) until then.  I decided to relieve her distress by mentioning Mary Ann’s problem with leaking heart valves. The med tech’s response indicated my assessment of her reaction had been correct.  Up to this point, the leaking is not severe enough to warrant raising the surgery option.

Both Mary Ann and I had blood tests a week ago.  Her orders came from our GP (thyroid and cholesterol check), mine came from our Cardiologist (cholesterol).  Mary Ann is the one with problems, right?  Her numbers were great!  Mine produced a message from the Cardiologist to double the dosage on my cholesterol lowering med.  Mary Ann’s annoying ability to stop eating when she is full, as well as her distaste for leftovers and much of what I cook, seems to be serving her well in the blood chemistry department.  My inability to stop eating until everything is gone on my plate and all the containers on the table, does not serve me so well in the blood chemistry department.  I suspect a program of improved diet, exercise and weight reduction is in my future — perhaps I should have a snack and lie down until that thought passes.

We got a copy of the written results of our blood work yesterday after the tests were done.  Mary Ann’s results revealed the continuing reduction in her kidney function.  The surface of her kidneys has hardened due to decades of high blood pressure.  If you have read earlier posts about her struggle with Orthostatic Hypotension (low blood pressure when standing, producing fainting spells) you will catch the irony.  She is now taking medicine to raise her base blood pressure to reduce the problem of her BP lowering too much when she is standing and walking.  If I am reading the lab report correctly, she has just moved into stage three of five in her Chronic Kidney Disease. The good news is that we all have so much kidney capacity that it could lower to 30% of full functioning without becoming dangerous. When I include that sort of information, remember that I am not a doctor.  Don’t take my word for it. A few years ago a very candid Nephrologist told us that Mary Ann would likely die with Chronic Kidney Disease, not of it.  At that time we all agreed not to treat the kidney disease since the treatment would make the fainting worse by lowering her blood pressure.

As the tests were going on, I thought about how scary all the test results can be.  When we first were told about each of the problems, there was that feeling in the pit of the stomach that the end might be nearing.  After years of monitoring the results of the tests, it is just more information confirming what we already know.  Even if there is something new, Mary Ann has faced down so many medical problems for so many years, we just take it in stride.  Mary Ann could die in ten minutes, ten months, ten years, or more.  So could I.  Death lives just on the other side of life.  Coming to terms with that provides a sense of peace, and affirms the sweetness of the life we have at any given moment.  Our spiritual foundation steals from death its ultimate power to destroy.  Neither of us longs for it.  We both recognize the pain that is left to those we leave behind.  At the same time, we recognize our mortality and have learned to live with it.

If you want to write a comment about this or any of the posts on this blog, look to the column on the right side of this page, titled “Recent Posts,”  click on the name of a post and you will find a box at the end of that article in which you can write a comment.  Clicking on the title of the post you are reading will accomplish the same thing.  Comments are appreciated.