The Last Day and a Good Death

I’m Nic. I have been a close friend of Deb’s for fifteen years. For the last four, I have been one of the crew members on the Nostromo, if you will. I accompanied the protagonist as she lived with (don’t say ‘battled’; she hated that) her personal Alien, anal cancer.

I am a poor substitute for Not Quite Ripley. I don’t have her wit nor her way with words nor a shred of her courage. She would have definitely blogged her last day though had she been able. Sharing in her death was an awful and awesome privilege. It’s a further privilege to be able to blog the final chapter of this story.

Although we knew that the end was very near, it was very difficult to accept that the time had come to witness the final transition for Deb from life to death. On the Friday, she had had such a happy and productive day. I don’t know where she found the time or the energy to have all the conversations she had with so many people who were important to her. She had also found time to write her final instructions for her funeral, to brief an amazing non-denominational celebrant about conducting the service and to change her mind about her outfit! Typical Deb on a good day.

But the morning of Saturday 30 May came and it was obvious that we had to prepare ourselves to say goodbye and make the very most of an incredibly short time left with her. ’Team Dolly’ closed ranks. Geography played a huge part. Some journeys would be longer than others. Flights were hurriedly booked.

Thank goodness that Deb had developed a loving friendship with her next-door neighbour who was a huge support and her first point of call often including, critically, on that day. After the call came, some of us were able to be with Deb at the Little Yellow House in person. Others, in spirit. All were united in love for her and support for each other.

I won’t lie. Deb told it like it was and she would not forgive me for not doing the same. The morning was horrendous. Deb was reliant on high doses of morphine as well as anti-sickness meds etc. but she had reached the stage where she could no longer take her medication orally. This meant that no-one could control her pain or emotional distress until the relevant meds could be administered intravenously. Apparently, there should have been injectable drugs at the Little Yellow House in a locked box ready for this moment. There weren’t. So there was a regrettable delay. Deb would have been furious but I don’t think she was aware of it.

We did have a brilliant team though. Both of Deb’s beloved… she called them her ‘helpers’ but they were so much more than that, were on hand. One of these wonderful women specialises in hospice care during the final days and hours of life and she guided the rest of us every step of the way throughout the day and evening. One of the best doctors of the many we have encountered attended, sorted out the drugs and helped me to understand what was happening and what to expect. A lovely nurse came and cared for her, and for us. I don’t believe in omens but it seemed fitting that the nurse shared Deb’s cousin’s name.

Eventually, by early afternoon, a syringe driver was in place to continually supply the drugs Deb needed: pain killers, anti-emetics and sedatives. She became more peaceful. We had been told that some things would be more difficult for us than for her so we were prepared. The moaning she made we knew was either involuntary and/or positively comforting to her. Once the sedatives were in her system, we knew that the jerking of her arms was involuntary ‘terminal restlessness’. She was no longer ‘raging against the dying of the light’ as might have been the case earlier in the day. Deb would want me to share this tip for others in the distressing situation of worrying whether or not a dying loved one is in pain. The doctor showed me. You need to press your knuckles quite hard into the flesh at the centre of the top of the breast bone. If there is no physical flinch or grimace, there is no pain perception.

Deb’s big brother arrived. I was glad he hadn’t been there earlier. It was enough of a shock for him to see his little sis like that as it was. Our queen of words and wit could no longer speak to us and that was one of the hardest aspects of the situation to accept. But we knew that she was still aware and could hear us a lot of the time, although she would be almost certainly muddling dreams and reality now even more so than in previous weeks.

We continued to talk to Deb and to each other. Occasionally she smiled (although you would have had to know her really well to be able to tell that) and we knew that she had heard. We continued to make jokes to Deb and each other. Occasionally she smiled and we knew that she had got them. We felt, very keenly, however, the lack of Deb’s, usually superlative, contributions to our shared humour.

We took it in turns to make tea. There was a lot of tea. We’re British so what else?

We did everything we could to make her feel comfortable and loved. We held her hands and we looked into her eyes. We moved her to try to make her comfortable and we moistened her lips. We sprayed her favourite scents in the room and massaged fragrant oils into her dry skin. Deb drifted in and out of consciousness.

“I’m looking at you even though your eyes are shut.” I said that so many times. It was the comfort she demanded from me during difficult procedures, when she was scared.

We knew we had to say the most difficult words. We had to give Deb permission to die. “Stop fighting now, darling. It’s OK. Just rest now.”

“What music does she like? Perhaps we can put it on.” Actually Deb preferred to listen to the spoken word so BBC Radio 4 and 4 Extra drama it was. And more tea.

The signs that Debbie was making the transition from life to death were coming so quickly. The changes to her colour. The cooling of her skin. Her breath becoming more shallow and her moaning more quiet. It became clear that her darling best friend who was fulfilling a promise to try to get here was not going to make it across the Atlantic in time. We put the friendship bracelet they shared into Deb’s hand. A little while later, worried about the bracelet digging into Deb’s incredibly fragile skin, I took the bracelet out of her hand and put it on the bed cover nearby. Deb executed only one of only two movements that day that I could be sure were intentional; She picked up the bracelet.

Deb’s dad and step mum were at the end of the phone. They had made the very sensible decision to be at home rather than in the car. Lots of people were at the end of the phone. And on Facebook. And Twitter (as I learned later). Messaging by various means. There was an incredible outpouring of love and support for Deb and for the rest of us on Team Dolly. Over the hours, I passed on every word, gentle hug and kiss that was sent to Deb. People have asked me whether I think she knew she was dying. Yes, looking back now, I’m sure that she did. But, more importantly than that, she knew that she was loved very much and by very many and that she would be remembered.

The sun was going down and we could hear the birds singing through the open window. It was a beautiful day.

“Would you like a cuddle with your brother?” For only the second time, Deb made an obviously intentional movement and raised her arm towards him. And she made the only understandable utterance of the day, “Yes.” It was the most tender and loving of moments but I won’t intrude further on it now as we didn’t then.

It was later than I had realised. The sun and Deb were both fading very quickly now. The four of us gathered around her bed. Her brother held one hand and I the other, just as we had promised her many times that we would. Deb opened her eyes wide and looked right into mine for the first time that day. I can’t remember all of what I said. I know though that I told her that the love and memories that we all had created together would live on in our hearts and minds and would never die.

And then, at ten past ten, Deb died. There was no trace of stress or pain on her pale face. She was almost smiling. But she was gone.

It was simultaneously the most intensely real and the most surreal moment of my life.

It was a good death. It was the one that she wanted and planned.

It was Deb’s last day. We loved, we talked and we laughed. We drank an awful lot of tea. From near and far, we held Deb and we held each other. And we always will.

About dolly61

Bit stubborn - this has come in handy lately.
This entry was posted in anal cancer, Death, palliative care, Planning for your future care (Advance Care Planning), Preferred Priorities of Care, terminal cancer and tagged , , , . Bookmark the permalink.

5 Responses to The Last Day and a Good Death

  1. Serena says:

    thank you so much for this brave post. Sending much much love to Dolly’s family and friends xxx


  2. Gwendoline says:

    Nic….how you managed to find the strength and courage to write this whilst still so sad and grieving so deeply amazes me…..just as your devotion and love for our darling Dolly and the strength, joy and happiness you and the Bee always had for each other has always amazed me. I said two days ago to myself, no more tears, just happy memories but once again I have failed and the tears have fallen.


  3. Leonardo says:

    Beautiful…….written for a beautiful person by a beautiful person. Men are not supposed to cry…..sorry……then I am not a real man


  4. Bill Cottham says:

    Oh,Nic how tenderly and lovingly expressed:Almost unbearably poignant and achingly beautiful,


  5. Dec says:

    I’ve only just come across this, Nic – I’m Twitilliterate, mostly. I have no words whatever. Love to you and yours.

    Liked by 1 person

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