Carol died on Wednesday, October 4, 2017 shortly after my Dad left for lunch. Her last months are the story of advanced treatment for breast cancer, of targeted biologics and life extended another day, another month, another year. To every drug she said yes, to every radiation treatment to lessen the pain of the bone mets she assented, to another and another clinical trial my stepmother nodded and submitted.
I am in awe of her fortitude. I’ve read and discussed the best-selling treatises on end-of-life, the exhortations to consider the aggressiveness of treatment versus side effects, how one wants to live their last days, as if we have choice and determination in the conditions of our lives at the end. I bought into all that—we are our own masters, right? Make it known, have the conversation, and we will ease ourselves into death.
I never had that talk with Carol. I don’t believe my Dad did either. She was a one foot in front of the other person when it came to breast cancer treatment. She didn’t want to die. She wanted to have another day. It was that simple.
That same straightforward iron willpower directed her last month. Finally, Dad and Carol had their last visit to Duke and her oncologist. Finally, the doctor told them the last ditch drug was not working. They were out of options. She’d been hospitalized three times since April for infections. It was time to call in hospice. The goal was now comfort.
With the end of chemo came Dad and Carol’s hope that as the side effects lessened, her energy and appetite would return. Carol told me she wished only for one more dinner party out with friends and some good belly laughs (this as we joked about buying a bikini to match her medical equipment so she could lounge by the pool in style.) In her retirement she’d had perhaps hundreds, maybe a thousand such dinners—cute holiday themed and formal affairs, pig pickins and galas, by the ocean in Maine and Florida, in Italy and at home. With our large family and with her life-long work friends. With another couple and with a hundred Pinehurst friends. The Mah Jong group, the four girlfriends, the Wednesday golf group, the dance troupes, the neighborhood “girls.” And I swear she had a different outfit for every one. With matching jewelry. And makeup.
Was that the source of her fortitude? The belief that just around the corner would be another good day? A hope that she would overcome this latest setback?
Her body dictated her course, she slept more and more hours in the last few weeks, and she resisted all of my Dad’s efforts to keep her active. And yet, Monday, October 2nd, while my Dad was in the living room, she surprised him and got dressed, ready to be admitted to the inpatient hospice. They walked to the car. She walked into the hospice. She was determined that my Dad not have too much to bear, he was utterly exhausted from full-time caretaking.
It was her strength, I think, that fooled us, that had us all, especially my father, her husband of thirty-three years, believing that she would rally again, just as she always had. She said yes to another go every time. No one wanted to live more than my stepmother. One step, and then another, no complaints.
He spent Wednesday morning with her, and though she slept the entire time the nurse assured him that Carol knew Ralph was there. She was stable and he should take a break. Minutes after he left, Carol stopped breathing. He regrets he wasn’t with her, but Carol would say differently, I bet. She’d fought for every last breath she had on this earth, she’d borne more than any of us would willingly choose over eight years to stay alive one more day. She knew he was there, and she knew when he wasn’t, she wanted to spare him.
Walking into their house, her absence is palpable. I’ve been with David for 45 years, and I cannot fathom how my father is bearing the loss. His is the grief of losing half of himself. Half his heart muscle, half of his lungs, half of his flesh and bones.
And yet, he meets the guys for a drink before dinner as before, he goes to the gym every other day still, he puts the trash barrel out on Monday nights. One step and then another. At night when he wakens he’s still careful not to bump her foot as he rounds the bed. It’s hard to get to sleep. But once he does, he sleeps soundly.
Carol loved her life with an infectious vibrancy. She had no need to plan her death, it was not the point. Breast cancer treatment was about living; Oncology, she showed us, is the speciality of hope.
That I should have half the grace my stepmother did, an iota of her optimism for my next day. An unquestioning and unequivocal desire to be alive one more day, and the fortitude to bear anything.
One step. And then another.