Goodbyes

Tending the graves

Some people find cemeteries mysterious, even creepy. Others find them peaceful and inspiring. For David Shea of Butte, Montana, the local cemetery turned out to be a teacher.

After moving back home to help his father in the 1980s, Shea noticed a cache of coffee cans in the garage. On Memorial Day, he understood their purpose when his dad filled them with sand and silk flowers and decorated the grave sites of people who had helped him over the years -- and who had no survivors to honor them. Through this ritual of "doing the graves," Shea learned about his dad's life.

He recounted this experience in a wonderful piece on National Public Radio's StoryCorps this past Friday. You can read it -- or, better yet -- listen by clicking here.

For me, David Shea's tale shows the power of saying thank you to the people who have touched your life, whether by carrying on their work, recognizing their qualities in you or your kids, or performing the simple act of placing a can of flowers on a grave.

Respecting her husband's wishes

As Christine knows all too well, sometimes a person facing a life-threatening illness simply doesn't want to discuss death, dying, or goodbyes.

Christine's husband, Ed, was diagnosed with nonsmoker's lung cancer when he was in his early his 40s, and being a staunch optimist, Ed was sure he would beat the disease. During his 15 months of treatment, he continued working as a graphic designer and artist, coaching his daughters in sports, and living as fully as he could.

But about one month before Ed died, one of his lungs collapsed, and he became progressively ill and weak. Although they sensed that things were grim, the couple didn't discuss hospice, funeral arrangements, how to prepare taxes, or other responsibilities that Christine would have to eventually shoulder. "I had to believe in him, but I also had to prepare to lose him, and I couldn't really talk to him about it," she remembers. "It was his illness and body, and I wanted to respect his approach."

One day in January 2000, Ed could barely walk to the car to get his radiation treatments, and he was hospitalized in Boston. His doctor expected he would die within a few weeks, according to Christine, but things happened much more quickly. She and their two teenage daughters visited Ed that Saturday and planned to return the next morning, but he passed away in the middle of the night. He was 44.

"The last thing Ed said to me was, 'See you tomorrow,'" Christine recalls. Not being able to have a final conversation with her soul mate of 16 years "is probably one of the most painful things ever that I have to live with."

On the other hand, she is devoted to honoring Ed's memory by staying in touch with his family, helping organize an ongoing art exhibit at the hospital where he was treated, and marking the anniversary of his death with a quiet, reflective day off from her work as a writer.

"I have a kind of lifelong mission to include Ed in our family life as much as possible," she reflects. Her greatest comfort is seeing his traits -- like his slightly lopsided smile, passion for baseball, and sense of adventure -- in their children. When one daughter was itching to cycle across the country with some friends, the more-cautious Christine told her, "Daddy is letting you ride. He would let you go."

Christine and her new partner, who lost his wife to cancer, are comfortable talking about their late spouses and keeping them present in their lives. "I don't think I really want to say goodbye to Ed," Christine says. "It's more a matter of going forward with him."

Consider this . . .
Take your cues from the person who is dying. Some people don't want to exchange goodbyes.

Develop comforting rituals that continue your bond with the person, like marking anniversaries.

Camp memories

My friend Jill lost her only child, Elizabeth, more than 30 years ago to a rare and incurable cancer. She was 12 when she died. Saying goodbye to a child is "indescribable because it's so terrible, so really terrible," Jill told me. "There's nothing worse."

As hard as it was to watch her daughter go through the treatment and multiple hospital visits, Jill feels she made choices that allowed Elizabeth to be a kid as long as possible. This is how Jill -- a university professor in New York City –- described the experience:

"My daughter Elizabeth had a delicious personality. She was very bright and a lot of fun. It was sometime in the fall when she developed pains in her chest and a cough. The pediatrician thought it was pleurisy [an inflammation of the membranes surrounding the lungs]. Then, Elizabeth spiked a fever and was admitted to New York Hospital. They did some tests and found that she had cancer, and they moved her to Memorial Sloan-Kettering Cancer Center."

Elizabeth had reticulum cell sarcoma, and they didn't think she would survive a week. But she began chemotherapy and managed to stay in school and do everything normal, like seeing friends and playing piano. Her health improved after that, and she and Jill even took a weeklong vacation to Puerto Rico.

As summer approached, Elizabeth begged her mom and doctor to allow her to go back to her cherished Camp Normandie, on Lake Champlain in upstate New York. The summer of 1973 was going to be her third year. With the camp director's blessing, Elizabeth went and had a wonderful time, despite missing the first week and having to fly back and forth for medical appointments.

"Sending her to camp was the single best thing I've ever done in my life," Jill said. "It was so difficult for me when she was away, but it was so much the right thing to do. She just loved it there."

Shortly after camp, Elizabeth declared that she wanted to stop her cancer treatments; they were too awful. But Jill insisted that she continue the two-year regimen. Elizabeth put her own stamp on the ordeal. For example, she would change into dirty clothes or unlace her sneakers before going to the hospital for her chemo, saying, "I'm not going to look nice for those people." "The nurses really liked her because of it," Jill recalled. "She was willful, and she knew who she was."

During the first week in October, everything fell apart, according to Jill. One night, Elizabeth's doctor called with very bad news. The cancer had spread.

Elizabeth knew that she was dying, and she and Jill talked about what life would be like without her. "She wanted to know that I'd keep her things, like stuffed animals and clothes," Jill said. "She wanted to know who would remember her. I reminded her about her grandfather, who adored her. I said, 'You always think about grandpa Harold; you haven't forgotten him and all the times you went fishing with him on vacation. So everybody who has had time with you is going to remember you.'"

Jill also assured her daughter, "You are my heart and soul, but I will get through my life and be OK."

Elizabeth had emergency surgery in early February, and after that, the nurses allowed Jill to sleep in the hospital room for what turned out to be her last month. Jill's ex-husband (Elizabeth's father) would stay when Jill had to teach or go home to shower. At the very end, Elizabeth fell into a coma with Jill by her side, and she died on March 4.

As heartbreaking as the experience was, Jill believes she did many right things during Elizabeth's illness. She remembers a young resident who was on duty when Elizabeth was admitted to New York Hospital and who would periodically stop by to say hello. One afternoon he said, "I have something to ask you, Elizabeth. Was all the treatment worth it?" And she replied an unequivocal yes.

Afterward, Jill told the resident, "I don't know how I'll ever be able to thank you. I had wanted so much to know the answer, and I could not bring myself to ask her because I was afraid of the answer."

That resident's question was a gift to a grieving mom.

What were my last words?

Whenever my friend Carol leaves the house –- or when one of her family members leaves -– she makes sure she says "goodbye" and "I love you" to them, even if they have had a disagreement.

This habit was born from tragedy. When Carol was 8 years old, her mother took her own life after years of battling depression. Carol and her 12-year-old sister were home at the time and found their mother in the bathtub, with blood everywhere. She never came home from the hospital. Although Carol was left with numerous unanswered questions, she felt relieved that she had told her mom "I love you" before she died.

Carol is now a now a wife, mother of two, and financial services manager in her 40s with a fulfilling life. But that childhood experience is embedded in her soul, and the soul of her two siblings.

"I think all of us feel that every goodbye could be the last," she explained to me. "We don't embrace every conversation we have, but we don't like unresolved conflict. So we tell each other 'I love you' when we say goodbye, even if we're not always feeling it. It's a mechanism we have put into place to protect ourselves from ever having to wonder, 'What were my last words?'

After hearing Carol's story a few years ago, I began doing the same thing. You never know.

"Be kind"

Goodbye conversations can help a dying person put his or her life in perspective and transmit wishes for the future. This is what hospice professionals often call "life review." It can be done in an informal or structured way (by writing down or recording stories), but the bottom line is the same: the dying person has a chance to reflect on his or her life and its meaning.

That's what Anne, an oncology nurse in Boston, found out during the last year of her father's life as he faced the debilitating effects of chronic emphysema.

Traveling from the East Coast to St. Louis several times that year to spend time with him, Anne asked her dad to help flesh out some family history and answer a few nagging questions -- like whether he was disappointed that none of his daughters wanted to take over the family business, which sold commercial furnishings and textiles. He assured Anne that he wasn't let down.

"For me these conversations were a gift, and for him it was an opportunity to look back on things as he was wrapping up his life and impart what he wanted to say," Anne told me in a recent interview. "I was constantly aware of how lucky I was to be having those talks."

The two spoke a lot about his legacy. During one of their most memorable conversations, Anne asked her father what he expected of her after he was gone. He responded with one simple request: 'Be kind.'

"After he died, one of my sisters made little plaques embroidered with those words, and we all have them in our kitchens, above our sinks," Anne explained. "It's actually a tall order because he meant being kind in all ways, not just when people are watching you. It comes from the inside. That's how my father was: so simple in some ways, but so powerful."

And then Anne added half-jokingly, "In some ways, it would have been easier to take over his business."

Consider this:
You can help bring a person's life to a close through a life review.
Bring some photos or music to help someone reminisce about his or her life.
Give a dying person the gift of listening.

Looking back at a life

The current issue of Time magazine has a poignant essay by Nancy Gibbs about the peaceful death of her father six years ago, surrounded by love, prayer, and pies delivered by neighbors. It's called "The Light of Death," and Gibbs reflects on how so many of us distance ourselves from the concept of death that we forget to celebrate the lives of our loved ones on the anniversary of their passing.

Removing the fear and regret from death can leave us with peace, she says. I highly recommend taking a few minutes to read this beautiful piece.