the right path

When I was 15 years old, and open heart surgery was still a relatively rare and risky operation, my father had a triple bypass. I remember sitting on our balcony with my cousin and a friend listening to the hushed adult conversations in the adjoining dining room. I hadn't even considered the possibility that my dad may not survive this event and that our lives may be thrown into a tailspin, tragically crash, and create a drastic change in all of our lives. The empathetic looks from our loved ones gathered that warm summer afternoon hadn't fully registered to me until my cousin whispered, "I hope he makes it."

Moment by moment, like the innocent anticipating a long awaited judgment, we listened for the phone call from the hospital. What would be the verdict? Would he make it? All of a sudden, I was overcome with emotions I was unprepared to fully understand and embarrassed to share. This intense experience, the realization that one of our team members, in fact our captain, could be cut, left me scrambling for a sound lifeline to my family, my roots, and the hope for my future. I gripped the railing and stared through my tears and into the glaring sunlight, praying for a peaceful outcome and that no one would see me cry.

Although he suffered a lifetime of pain and uncomfortable buzzing sensations in his right hand and arm due to a pinched nerve while he was strapped down for the 8 hour operation, the procedure was deemed a success. While my father was heavily sedated my family made the somber pilgrimage to see him. We all understood that he was certainly not out of the woods. Each successful hour of continued living we counted as a blessing, each day a victory.

Illustrations © Barbara J Holzapfel

When it was my turn to tip toe into his curtained ICU enclosure I felt the weight of the moment and flashed back to my naiveté only days earlier. Oh, how I wished I could have remained in blissful ignorance of the many dire possibilities this frightening situation could manifest. As I was watching his ashen face, totally devoid of any recognizable expression, he suddenly, desperately, clenched my hand as though I was his last lifeline and sole connection to his own destiny, and plead, "Take the right path. Just take the right path." As my heart thumped in my small chest, I promised my father I would be ever careful and determined to take the right path.





I've often wondered what he was speaking of that late summers day, tucked securely into Vancouver General's sterile, 24 hour intensive care unit. Was he consumed with the worry that he may not survive to share his wisdom and lovingly guide his four children through the perils of lives well lived? Or was he talking to himself? Was he facing the ultimate, profound choice.. live or die? What was the right path?

keats

Illustrations © Barbara J Holzapfel

Can death be sleep, when life is but a dream,
And scenes of bliss pass as a phantom by?
The transient pleasures as a vision seem,
And yet we think the greatest pain's to die.


How strange it is that man on earth should roam,
And lead a life of woe, but not forsake
His rugged path; nor dare he view alone
His future doom which is but to awake.

John Keats

quitter

Illustrations © Barbara J Holzapfel

 There are relentless chants echoing around death beds of the terminally ill all over the world. They go something like this..

" If you quit you lose. If you fight you survive. Be a fighter not a quitter. "

Many family and friends will have opinions regarding how you should live your life, as well as how you should end it: fight tooth and nail to be victorious, or lean gracefully back with reflection and gratitude.

With the myriad of emotional pressures one may face when dying, the shame of 'quitting' can be a challenging stigma to deflect during this tender and confusing time.

When and how do we gracefully shift our conversation from, "You can beat this", to "You have done well"?

home

One of the first differences I noticed when I moved to rural Saskatchewan from downtown Vancouver was the increased number of elderly folks still living in their family homes. Sure, most of them had some sort of family near by to help in times of need, but those without that benefit were surrounded by a community invested in the wellbeing of all segments of it's residents.

My experience in the city?
- As soon as your children graduate high school parents will downsize.
- Following retirement, another downsize; the goal to travel supersedes the desire and obligation to maintain a nice yard.
- Once the globe trotting desire has dwindled and housekeeping becomes too challenging, the next step is a minimal care home; they have less responsibility but still feel a sense of independence and privacy.
- The final chapter of an individual's long life in the big city is spent in a nursing home, most probably partnerless. By this time they have downsized away most of their possessions and are living in a room that someone else decorated and furnished to suit the special amenities necessary to ensure the resident's safety and wellbeing.

Illustrations © Barbara J Holzapfel

When my own mother reached this stage of her life and most of her living was confined to a small room, it was almost impossible to perceive who she had been all of her life and what factors had impacted who she had become. At first glance she was indistinguishable from any other elderly woman in the facility and one room was as bland as the next.

This is not to say effort isn't made to personalize the space, but by this time in ones life, it's more likely that your loved ones will be the ones choosing which items will represent to the world the life you've lived. Which means residents will have reflected back at them who it is their loved ones perceive them to be and be surrounded by what others believe they would enjoy.




My Grandmother, on the other hand, lived alone, in the house she shared with her sweetheart for so many years until the very end of her magnificent lifetime. Her kitchen sink was always ready for any task; her front porch a welcome beacon of hospitality.

When I walk into an elderly persons home in the small town in which I'm currently living I can look around and have an immediate impression of who they have been and, more importantly to me, who they are right now. I have had the privilege of getting to know many remarkable people, some who have lived in their homes for over 60 years.

They remember the day they planted that tree, the year the snow reached the kitchen window, how the tree fell over on Christmas Eve when the family cat just wouldn't leave it alone. They have every chore covered by loved ones, paid community helpers, or generous neighbours.

At the end stage of ones life, as the mind slips progressively sideways, the sanctuary of home comforts the soul, settles the bones, and provides a  familiar nest for reflection, acceptance and release.

enough

Illustrations © Barbara J Holzapfel

A young father was heard speaking of the tragic death of his two year old son...
"Even if my dying child hasn't had enough time to change the world, he's changed my world."

How does one determine how much living is enough. When is it okay to believe the common statement, "He's lived a good life, it's his time to go". Is it measured by the number of breaths taken,  friends loved, or celebrated accomplishments achieved? Is one deemed worthy of death by the quality of loving connections made during that life?

People speak about the impact certain folks have had on the evolution of creation and an individual may be able to identify the significant relationships which have contributed to the magnificence of who it is one has become. But what if there was not even enough time to take one breath before leaving this life? Would that be sufficient to justify a life? Perhaps the unseen value our living has had on the Universal Consciousness some may call God is all that is necessary for a lifetime to be complete.

fishing

Illustrations © Barbara J Holzapfel

Barry, facing a recurrence of skin cancer, had to make a choice - surgery plus radiation, or just surgery. His main objective with this decision was to be well enough to join the rest of his beloved family on their annual, northern Saskatchewan fishing trip. If they went in aggressively to ensure all of the cancer was removed, and included radiation in the plan, they faced the probability that he may not recover well enough to make the trip.

On the other hand, a more reserved approach would likely leave some of the cancer, increasing the probability for expansion of the existing tumour which, in all probability, would advance the progress of his decline, but increase the possibility of immediate wellbeing and of attending the family fishing trip. At the end of the day, Barry chose to be less aggressive with his treatment, which he felt would provide him a better quality of life longer.

Surgery was a success; they were able to get all of the cancer present. Radiation was not included in his preferred treatment plan. Now, a mere three weeks from his surgery, Barry is preparing himself for the challenging trip ahead. Next weekend he will be driven to his home town airport a couple of hours away by a family friend, while the rest of the clan begins the arduous, day-long drive up past La Ronge, Saskatchewan.

At the airport, a fellow pilot and fan of Barry's celebrated career as a spitfire pilot in WWII, will help him to board a small plane and fly him the four to five hours to the fishing camp, where his family will be anticipating his long awaited arrival.

In order to select the appropriate treatment plan during the end stage of life it is imperative that one considers realistic expectations with regards to side effects and estimated recovery time. For Barry to meet his goal of attending the cherished family outing, time and overall impact of each option required careful consideration.

one you

Illustrations © Barbara J Holzapfel

Barry served his country in WWII as a fighter pilot, and then later owned and operated a small town newspaper, which exposed him to his other passions.. writing and photography. Dedication to his country fuelled his first passion, commitment to his family fuelled his second. Throughout Barry's long lifetime he lived with singular devotion to every task at hand. This is a man who will fulfill his obligation to completely express his unique nature.

From a young age Martha was surrounded by music; she swam in it with her whole loving family. They played at community events and the instruments were always well within reach at every family gathering.

Illustrations © Barbara J Holzapfel

She was a dedicated mother and contributed to the running of the family business as the linotype machine operator, typesetting the stories her husband wrote. Once the children had grown Martha began a celebrated passion as a potter. The beautiful pieces she created over the decades are family treasures in homes scattered across the province.

Martha Graham, an American modern dancer and renowned choreographer, influenced dance as Picasso influenced modern visual arts. She pushed valiantly against society's definition of dance. This is her take on 'be true to oneself'...

"There is a vitality, a life force, an energy, a quickening that is translated through you into action. And because there is only one you in all time, this expression is unique. And if you block it, it will never exist through any other medium. The world will not have it. It is not your business to determine how good it is, nor how valuable, nor how it compares with other expressions. It is your business to keep it yours, clearly and directly, to keep the channel open."

Evidence of the integrity with which both Martha and Barry lived their life's passions will continue on in this world long after those very passions are abandoned. 

procrastination

Illustrations © Barbara J Holzapfel

There will always be reasons and excuses to put off doing what one feels the need, or want, to do. There is usually something we can find to deem more pressing and urgent to do than those wanted or unwanted obligations with which we feel burdened. Sometimes just sitting and watching tv feels more necessary in that particular hour of the day.

Why do today what you can put off until tomorrow?


When facing the end of a lifetime, the procrastination approach to living reveals itself as a massive time waster, and death becomes the immediate cure for procrastination and the ultimate lesson in purposeful living.

If this was your last day, what would you do?

This is not to say that every moment of every day requires task oriented achievements. Some moments truly deserve the sanctity of a comforting cup of tea and a good read.

attention

The physician known as the Father of Palliative Care, Dr. Balfour M. Mount, tells a story about his visit with a patient suffering from the common and understandable 'dark days' soon after becoming a quadriplegic. Dr. Mount asked her one simple question completely unrelated to her condition. What kind of music do you like? Her response, following her look of "What does this guy want", was Elvis.

When the good Doctor shared with her his memory of being at the 1957 Elvis concert in their home city, her face lit up, and a spirited conversation ensued. This short visit had an enormous impact on the woman's overall state of mind, which greatly improved her physical and emotional health.

Dr. Mount believes the reason for the drastic improvement in this woman's quality of life was due to her sudden flush of 'living fully in that moment'.

Our perception of what things mean tint our experience of this world and are the essence of our attachments to how things must look in order for us to be happy. Unfortunately, as A COURSE IN MIRACLES suggests, our attachment to what we believe things mean, whether they be feelings, objects, or ideas, is only that - our belief.

In fact, a mastermind plan to get to where you believe are going to be happy will take you from this moment of pure potentiality and your opportunity to feel the profound peace and happiness of this very moment. Elkhart Tolle says in his book, THE POWER OF NOW...

"Forget about your life situation for awhile and pay attention to your life."

It is in your life, including and most especially the dying moments of your life, that you will have the golden opportunity to simply allow and fully experience the eternal peace and happiness you seek.

equal measure

In every life there is a beginning, middle and end. The circumstances of birth begins ones epic story of life on earth. Spattered throughout childhood are the tales of mischief, and merriment, making friends and picking sides. Adolescence provides action and suspense as we navigate through the perilous waters of puberty and first loves. The middle of life is an ongoing process of discovery as ones self image is defined with confidence, while profound experiences of love and loss are woven throughout the years.

Illustrations © Barbara J Holzapfel

And then.. the end. Not a trivial aspect of life, nor the pinnacle, but an equal measure of importantance as every other moment in ones lifetime. Death isn't just the end of life, it's a part of ones life story.

pain

The most common fear of death and most probable reality of those dying due to serious illness, is the possibility of unmanageable pain. People think, "If this is the level of pain I have now, how bad will it get in the 'end'?

What is shown on television, and in other popular media, instilled in us this fear. As with most matters represented in social media, the reality is quite different.

As  Mike Harlos MD, CCFP, FCFP , a palliative focused Canadian physician writes:

Illustrations © Barbara J Holzapfel

"While it is true that pain is a common symptom in advanced illness and merits the full attention and expertise of health care providers, it tends to behave consistently for a person throughout an illness. If pain difficulties have not been present, they are unlikely to develop near end-of-life. If pain has been present but manageable, it will most likely continue to be manageable rather than escalate out of control in the final days."


One cancer study (Conill et al 1997), revealed that the majority of seriously ill palliative patient's level of pain actually decreased from 52% six weeks before death to 30% during the last week of life. The dying process is one of shutting down so it makes sense that, as death approaches, our energy decreases, our alertness decreases, and we tend to rest and sleep more.

outing

Illustrations © Barbara J Holzapfel

When launching end of life care, the all-consuming preparations often distract from enjoying precious time left for living. Outings planned with family and friends, gentle activities that require little physical effort, can uplift and infuse the palliative patient with joy and comfort.

For those anticipating the loss of their loved one, these shared experiences will provide cherished memories, available for reflection throughout the difficult grieving process.

regrets

Five most common regrets of people facing death, written by Grace Bluerock, hospice social worker:

1. They wish they had loved more deeply.

2. They wish they had lived their own dream.

3. They wish they had spent less time working.

4. They wish they had allowed themselves to enjoy life more.

5. They wish they had not been so afraid to take risks.

At the end of the article Grace adds,  "The most valuable lessons about life,  I learned from the dying -- and there is nothing I would trade for that experience."

Following her dire prognosis, Martha's husband asked her if there was anything she needed to do, anywhere she wanted to go, or something she longed to accomplish with her time left. She said, no. She felt quite complete, and satisfied to spend the rest of her time with loved ones. 

I believe that's one of the best gifts of a life well lived.

time

There is a rustic warmth to the family home in which I stay to spend time with Martha and Barry. When you enter the house, resting in the middle of the breathtaking Saskatchewan landscape, you will most likely be welcomed by one or more dog and one of a few cats.

Illustrations © Barbara J Holzapfel

On my first visit, as I stepped into the foyer, I found myself looking through a doorway with a simple homemade gate securing the room entryway, it's purpose being, I would soon learn, to control their young shepherd pup from interrupting the resting Barry or Martha. As I gazed through the doorway I noticed, curled up at the far end of the bed, frail and sleeping Martha.

This room in which Martha and Barry spend the majority of their time feels different than any of the other rooms. It feels as though there is an invisible energy field of 'there is no such thing as time' filtered throughout their room.

As Martha becomes more sensitive to light, electric light with appropriate shading is preferred, rather than the less manageable, ever changing sunlight. At any time of the day or night one may walk into the room and never know what time it is. The scheduled meal times help to identify what the clock may say, but even those loose there dependability as appetites evolve and wane.

In this sacred space it is most often not quiet or still. No, it would most likely be filled with the tv telling a long forgotten tale, the tapping of the computer keys, or easy conversation between these loving, lifelong partners. Everything is deemed okay in this sacred space - tearful realizations, recollections of precious memories, passionate debates and playful banter - whatever must happen is considered, accommodated for, and accepted.