The end of the end

A white t-shirt hung from his bony shoulders. A baby blue diaper was taped around his scrawny hips. His toenails were thick and yellow, sticking our repulsively from swollen feet. Once strong and bronzed by the equatorial sun, this body used to swim breaststroke through salty oceans towing a scared toddler over dark waves.

He sat that day as he always did, smack in the middle of the couch with legs outstretched over the sisal rug. But his familiar positioning was not reassuring. He ought to have had one arm casually draped around my neck, a cold Pilsner in hand. He ought to have been instructing me on useful topics like the price of grain in Sub Saharan Africa. Instead, with furrowed brow, he slurred concern over the dinosaurs in the room.

Kathleen, my dad’s hospice nurse, came for her scheduled visit that afternoon. I don’t recall anything telling in her expression that day. Or if she said anything directly about where my father lined up in the cue of the dying. But knowing what I know now she must have.

He walked painstakingly from the couch to the bedroom. He somehow got into bed, without assistance. He looked out of place lying there in a four-posted bed - a cowboy of a man who had once travelled across Afghanistan and used latrines in the bush of Africa. But his unmatched adoration for my red hair stepmother came with an embrace of rose print curtains and antique beds. I was invited by Kathleen to sit alone with him for a while. I was panicked. I know I told him I loved him. But at 20 years old how could I really understand this was it?

Later, we gathered around the foot of the bed. My stepmother, my sister and I. Kathleen spoke gently as she taught us how to change my father’s diapers. She didn’t get much teaching in other than something about rolling him from side to side when my father just up and died.

The man was fiercely private and pragmatic. He did not shed a tear over his mortality in my presence. He turned his disease into an education session about cell division and cell death. He talked about his bone marrow, held in safe keeping in a hospital in London, as though it was a project of interest to all. Through his daze that day he must have heard the lesson of the hour. There was just no way this man was going to let his daughters wipe his backside. He’d rather die.

After he died, I finished college and went off into the world, as young people do. Trying to find my way. Nursing was nowhere in my direct or even peripheral vision until, contemplating how to claim my spot in the coveted world of international aid, it occurred to me that nursing was a very fine, concrete profession that would give me a leg up over the development brats out there. But my global pursuits were repeatedly usurped by relationships and my pulsating uterus. And of all the choices I could have made, I found myself choosing oncology and end of life nursing over the avenues that would have better positioned me to land in Sudan or Syria.

The choice was as transparent as a dragonfly’s wing in the sun…

The years passed as a hospice nurse. I both loved this niche that I felt uncannily natural in and hated it. For so many reasons. I wanted to leave it almost as soon as I entered it. But it’s now been over 12 years (give or take a couple of babies). Sometimes at the bedside. Sometimes doing marketing and education. Sometimes full time. Sometimes part time. Feeling the profound rewards of caring for the patients who will never leave my memory, who are woven in my heart. Feeling the drain of holding sick bodies and supporting their anxious and grieving loved ones. Fascinated by the human stories I was privy to by entering patients’ homes - mansions and crack houses alike. Honing my ability to calm a family with my words when there was nothing else to fix. But the job has been crippled, in my eyes, from the bureaucracy and complexity of health care. And the more I know, the more I realize how little I know and how little I want to know about medicine. I’ve never been a textbook nurse. I’d rather photograph a dying patient than answer questions about the fucking spleen. I’d rather arrange flowers than read up on how antiemetics work.

Regardless of the reasons why, I just feel satiated. Done.

When my mother died last May she was progressively demented. In the early days post diagnosis she used to beg me to take her to Switzerland so she could be done in before her dementia got bad. Physician assisted suicide laws don’t work in favor of the demented. One day she fell and broke her hip. Now a shell of a life, with a broken hip and a cachectic body, I knew I couldn’t put her through medical management to keep her alive despite the occasional sunshine in her smile or the pleasure of stroking her beautiful hands. She had a sweet hospice nurse who let me do my thing and chart the course of pain management. My sister and I tucked flowers into her hair as her lungs marched painstakingly forward despite the opioids and failing kidneys. We curled up in bed, spooning this breathing corpse of a mother. Then she died, 10 days after the fall.

It was over due to exist stage left when I handed in my resignation. But while I will surely still find myself at the bedsides of men and women approaching the ends of their lives, it will be on my own terms.

Today is it. I trust I won’t look back.