Not right, nor orderly.

Breathing lightly.

I think that continued aphasia blocked any false hopes on Laura’s part.  As Avastin improved her functioning during December 2008, she was happy, but it was never enough.  Until she was back to her old self, she never thought she was recovered or even on the road to recovery.  We got the hard word from the oncologist in February 2009.  Laura’s level of functioning at that time might be the best it would ever be, even if the cancer were somehow stopped.  Certainly any improvement would come very slowly, if at all.  Laura was quite depressed about the news.  

Hope?  Was Laura going to get better?  Should we hope that she would get better?  Why would she keep going through everything if we didn't have that hope?  The fact of the matter is that Laura did put herself through treatment tortures for more than a year, and let me keep trying for a last chance clinical trial with no hope that she would get better.  Just sheer will that she would get her speech back and get back to work.  And when the probability of those outcomes faded, she was determined to live until she vested in the pension system for the sake of Anne Mei and me.  

Hope in a cure or remission was irrelevant, or a nuisance at times when others expressed wishful thinking in the face of the unrelenting facts.  In a recent episode of  "Downton Abbey," the Dowager Duchess of Grantham says something that expresses how Laura and I felt about hope.  "Hope is a tease designed to prevent us accepting reality."

During her last week Laura was on heavy doses of morphine and fentanyl to suppress the pain.  As sedated as she was, Laura was still aware of who was with her and what was going on.  Laura’s mother, father, brothers, and sister had all come to be with her.  When the hospice nurse left for the weekend on Friday afternoon, I said to her, “See you on Monday.”  The nurse, who had been through many deaths, said, “Probably not.”  No wonder Laura liked her.

When they put Laura on morphine, Anne Mei started sleeping on a small bed next to Laura’s hospital bed. I switched from that small bed to a couch at the foot of Laura’s bed.  It had helped Anne Mei to sleep with her mother when Laura was first diagnosed.  Sleeping near her now also comforted Anne Mei.  

About 4:30 am Saturday morning, I woke and checked on Laura.  It was time for her morphine dose, which she took orally by eyedropper.  She had stopped eating food and drinking liquids about a day before. I wet her lips.  Then I talked with her until about 6 am.  It seemed to me that she was breathing lightly, but I kept putting my ear close to check.  I don’t remember much of what I said to her that morning.  For the last two months, I had been getting up two or three times a night with her.  Sometimes she had wanted to watch TV.  Sometimes she wanted me to read to her.  Once she even wanted me to do taiji in the bedroom while she went back to sleep.  But that morning was the longest time I just talked.  Then I went back to sleep and woke up around 8 am.

Laura seemed to be sleeping the same as she had been around 6 am.  Her sister Julie came to check on her as I went out to make coffee and tea.  Julie came right back out and said that she didn’t think Laura was breathing.  I said she looked like she had earlier this morning.  Laura’s brother Paul, a physician, came in and confirmed that her heart had stopped.  Anne Mei woke up just as more adults started gathering around her Mom.  She heard what Paul said and started to cry.  I went over to hold her.

Was Laura alive during the 90 minutes I was speaking to her earlier that morning?  I’ll never know for sure.  I would like to believe that she was alive and that she felt my presence or even heard my words.  But, as Sister Aloysius says at the end of Doubt, “I have  doubts!  I have such doubts!”  My doubts about when Laura died are more wistful than the painful doubts of Sister Aloysius or mine over what Laura meant when she said “Sometimes.”

I just described the doubt I felt about whether Laura was alive as “wistful.”  That doubt actually was not a very pleasant feeling.  I wanted her to have been there and aware that I was with her in her dying moments.  Not to be sure hurt.  Not as much as “sometimes” did.  Both hurts were more about me than Laura.  

Deep down I don’t think I ever expected Laura to get better.  I just didn't think she would die. That's why at the end I was the only one who thought she was still breathing. During the time I spent with her in the early hours of that morning, I told her over and over that Anne Mei and I would be ok.  I said that we would miss her terribly, that she didn't have to worry about our physical or financial well-being.  I told her that she didn't have to hold on for us.  She could let go.  Nevertheless, I did not expect that she actually would. 

Or had.  I didn’t talk too loudly because Anne Mei was in the bed right next to me.  I held Laura’s arm and stroked it.  I even gave her a morphine dropper during that time.  Was she already dead?  Was that when she died?  We’ll never know. 

What did Laura experience as she died?  How did she experience it?  Joan Didion asked if her husband experienced “The ‘moment of terror’ the “eternal dark’?”  Did Laura feel fear, terror, sadness, regret, frustration, continued worry about Anne Mei and me?  Or nothing?  Was she too zonked out on morphine and fentanyl?  Are these skillful questions?  They certainly don’t alleviate her suffering.  I’ll never know the answers.  What difference would it make now if I did?  I was able to do something about her list of dying wishes.  I could not do anything that morning about her inability to express her feelings at the end, and most certainly I cannot now that she’s gone.