Guest author Gwen Tuinman contemplates that moment we must all dread, when the world slows on its axis and time seems to grind to a stop.
by Gwen Tuinman
The doctor reviewed my file while I waited on a plastic chair. Morning sun brightened the examination room. Illustrations of pretty pink uteruses and fallopian tubes hung from the opposing wall in a neat row. Click, click, click. The doctor toyed with his pen and adjusted his John Lennon glasses. I wondered idly if he shopped for his own shirts, or if his wife deserved the kudos.
He eventually laid the folder aside and wheeled his chair close to me so that our knees nearly touched. Only in retrospect would I recognize the foreshadowing of that moment. Not even his discerning expression raised the alarm. Bad things happen to other people.
No they don’t.
“We’ve discovered something in your ultrasound. I’m very concerned.” He leaned toward me, and in dulcet tones, described my tumour and the insidious nature of ovarian cancer.
Everything slowed down – my breath, my heartbeat.
“Is it early?” I asked.
“We don’t know yet,” he replied. “I’m very concerned.”
I remember later, resting my elbows on the reception counter while the nurse completed some paperwork. “I’m a yoga practicing vegetarian who exercises regularly.” I laughed nervously. “How did this happen?”
“It’s pure chance,” she said. “You’ve done nothing wrong.”
If only blame could have been laid on something I’d done, like ignoring the jumble of vitamin bottles in my cupboard or skipping the gym on the wrong day. I would have preferred shouldering responsibility to knowing death could target me by random chance.
Five months later — after major surgery, positive mantras, walks in the woods and follow up testing — I received a clean bill of health. But during those days of not knowing what the future held, I thought a lot about dying.
Along the way, I documented thoughts on a digital recorder. “The scariest thing,” I said, “is seeing people’s emotions mirrored back at me when I tell them I’m sick.” On another day, I said, “I feel optimistic. But if this thing is kicking me in the pants, I’ll keep it to myself. I’ll be brave and push forward and do my thing.” I remember hoping my husband and children would take their cue from me. I’d remain calm and hopeful to set the tone for everyone else. The cadence and tension in the recordings belied my fear. I was preparing for battle and establishing the mindset I thought, perhaps naively, would carry me through.
Sometimes, the possibility of death comes to us quietly like the rustle of leaves. Other times, it thrusts itself upon us with a crack of thunder. Three years after its first appearance, the possibility of death sideswiped me again. Pain sliced through me for five days before I was admitted to the hospital. Had I gone without medical treatment for one more day, I might have died. “Prepare yourself,” the surgeon warned. “It’s probably cancer.”
Before being rushed into emergency surgery, I laid a hand on my husband’s arm, “Don’t worry honey, it’s going to be alright. And even if it’s not alright, it’s going to be alright.” That’s my last memory before waking up post surgery to my husband’s assurances that all was fine. By fluke, wayward scar tissue from the first surgery had knotted itself around my insides much like the jute macramé craze of the seventies. A problem easily unravelled.
I had a brief window of time in which to contemplate squaring off against mortality again. The icy bubble of morphine gliding through veins relaxed me, but I believe my calm response to the situation can be attributed to the practice run from three years earlier. I’d pulled out the playbook and executed the positivity strategy already in print.
Still, this time was different. There’d been a physical suffering not encountered in the first event and, albeit briefly, I’d glimpsed the powers of pain management. How foolish that I’d focused entirely on emotional strength and neglected to consider the prospect of a painful ending.
The earliest conversation I remember about death took place at the First Baptist Church in my hometown. I was six years old when the reverend’s wife told my Sunday school class about heaven after death. “In our father’s house there are many rooms,” she said. Falling asleep in my own bed and waking-up in more opulent surroundings didn’t sound so frightening at that age.
My first loss came in the form of my great grandmother’s death. I remember at eleven years old, standing forlorn in the dark paneled hallway of the funeral parlour, watching her daughter — my paternal grandmother — in pleasant conversation with another mourner. She noticed me there and we both began to weep.
“Oh Gwen, don’t cry,” she said, wrapping her arms around me. “Old Grandma had a long life and she didn’t suffer.”
I could understand the merits of not suffering.
My maternal grandmother once told me a story about her sister, Clara, who died at home from influenza. Just before her passing, she extended a fevered arm to angels hovering above her bed. The image captivates my imagination.
Research of my ancestry has led me to discover stories told by death certificates. One of my great grandmother endured one surgery and three years of illness before succumbing to cancer of the lung and breast. She too died at home. So many questions come to mind about her pain and fear. What nature of medical care did she receive? I think about the loved ones who tended to her needs. Were they equipped to usher her through the last days? Or were they in a state of constant worry and uncertainty, overwhelmed by all that death entails?
One of my friends is a community nurse with several years of experience at a major Toronto hospital. Over her career, she’s supported many people through their final days. “It’s about helping a person along that journey,” she told me, “and making them comfortable so they can get the best from their remaining time.” We’ve talked about hospital beds in living rooms; IV pumps and pain medication; caregiver relief; and the virtues of home versus hospital. I’ve learned there is a host of expertise and programs to usher people through.
I recently told my husband I thought, should the need arise one day, that I would choose palliative care in a hospital. “It would be such a trying the experience for you and the children. Maybe it would be more fair if you could visit then go home to escape it all.”
“You’re entitled to think of yourself in your last days,” he replied without missing a beat. “I would want to make them as comfortable for you as possible. You would do he same for me.”
He was absolutely right. I would, without hesitation.
I don’t obsess about the possibility of death. But an awareness of mortality’s fragile nature nests just below the surface of my consciousness. It instills gratitude that I’m participating in the world. These experiences remind me how to live. I tell people I love them whenever the mood strikes. I share spontaneous hugs and gushy emails. I heed intuition and stop to savour a beautiful moment when it presents itself. I laugh at myself more often than I should admit to. When I’m too afraid to step outside the box, I do it anyway. I’m doing it right now.
Death and illness are difficult subjects. I rarely discuss my own experience or reflections at length. When I brave the topic, most people’s eyes tend to glaze over and they check their watches. They mentally back away from me, as if this random medical misfortune is a living thing looking for a new host. It might latch onto their sleeve, then they’ll be hauling it around.
Discussions about dying won’t cause death. Avoiding discussions about dying won’t prevent death. The timing is almost always out of our hands. My considerations on the matter are philosophical and hypothetical. For me, knowledge is empowering and preparedness is medicinal. But no two journeys are alike and no approach is wrong. After all, we are each the authors of our own story.
About the author:
Gwen Tuinman’s short fiction is included in The Renaissance Anthology and is currently featured in a text and photography exhibit at The Robert McLaughlin Gallery. She is a former member of the Board of Directors for the Writers’ Community of Durham Region and writes for The Word Weaver. She is currently at work on a novel. Research and reflections relative to her works in progress can be found at http://www.gwentuinman.com./
A riveting account by a narrator who, pushed twice to an emotional precipice, seeks to exchange uncertainty for certainty in every way available to her. She embraces the accoutrements of dying, writes her “positivity” playbook to protect those she loves, invokes gratitude, summons a steely courage, and exposes the fallacy that ducking the conversation will somehow make dying, or the prospect of dying, easier—when the opposite is far more likely to be true. Many moving thoughts and phrases stay with me: the chilling repetition of the words, “I’m very concerned.” Evoking nature through “the rustle of leaves” versus the “crack of thunder.” The “icy bubble of morphine gliding through veins…” The poignancy in “How foolish that I’d focused entirely on emotional strength…” The goblin that might “…latch onto their sleeve, then they’ll be hauling it around.” The reinforcing presence of the wonderful husband. The whole thing, beautifully expressed.
Discussions around dying are always difficult, but absolutely necessary. None of us will escape the heartache of losing someone dear, but the difference between people who are able to manage their grief and those who can’t is preparedness. Being prepared doesn’t have to grim or scary. It is just being real. Being prepared is never forgetting to appreciate loved ones, and as you say, Gwen, knowledge is empowering and preparedness is medicinal. Thank you for being brave enough to share your story and more importantly, brave enough to go through what you’ve experienced and come out the other side so amazing!
Hello Sharon. It really is difficult to talk about death, whether it is entertaining the possibility of your own or someone else’s. My own experience is a hick-up compared to what a lot of other folks have been through, but it certainly got my attention. Some of the conversations I’ve had since have bonded me to other friends with similar experiences and helped me understand how to support them through their time of worry. Thank you for taking time to comment, Sharon.
Heidi, thank you for the kind words. The exercise of reliving those days and selecting the words that would properly convey the experience of it all, led to some deep reflection on my part. I read recently that some writers of memoir don’t know what they think until they write it down. I can certainly appreciate that thinking now. With some more distance between myself and those days, I realized some things I didn’t before. I hope other people with similar experiences will write, journal and doodle, even if another living soul never sees it. The process really is comforting.
A beautiful piece of writing – I particularly noted a number of phrases, including this one: “By fluke, wayward scar tissue from the first surgery had knotted itself around my insides much like the jute macramé craze of the seventies. A problem easily unravelled.”
And a beautiful piece of writing about the possibility and the inevitability of death. This is such wise advice when we are facing supporting someone through their last journey: “It’s about helping a person along that journey,” she told me, “and making them comfortable so they can get the best from their remaining time.”
And I loved, in particular, this note about what an enhanced awareness of death can do for the way we live our lives: “I don’t obsess about the possibility of death. But an awareness of mortality’s fragile nature nests just below the surface of my consciousness. It instills gratitude that I’m participating in the world. These experiences remind me how to live.”
And what a lovely nod to the title of the upcoming book: “Discussions about dying won’t cause death. Avoiding discussions about dying won’t prevent death. The timing is almost always out of our hands.” May this book, and these pieces, promote these essential conversations.
Kudos to Gwen for this beautiful piece.
Sue, I appreciate your comments on the specific lines that reached out to you. It is so special that we are able to share these very human experiences here and to know that our words have been heard and felt. Thank you for that gift.