Impermanence, Inevitability and Dying with Dignity.

footsteps in sand

I haven’t posted since July 2020, but it is a new year and notwithstanding the recent outbreak of COVID19 in my local area, I am hoping 2021 will be better.

This is actually a reworking of a post from several years ago and if you read to the end, my choice of updating and reposting should make sense. (It’s not just laziness although it is an effort to overcome a lack of enthusiasm and feeling of irrelevance!)

The last six months have been the definition of hell for so many people despite some (including me) attempting to find the glass half full.

I’ve read of achievements, new hobbies, friendships, educational courses, diets and exercise regimes, technology,  books, films, music, imaginative recipes and discovery of  local environmental gems… there were also plenty of negative impacts from panic and fear, lockdowns, isolation, shortage of goods and services, lost jobs and homes, broken relationships and health issues.

The Virus not the Only Health Crisis

For me, health issues loomed large – my last post ended with the news of a stage 4 invasive melanoma diagnosed.  This shock of a recurrence of skin cancer (I had basil cell carcinomas removed when 30 years old) added to the news of breast cancer returning in December 2019, albeit a different and rarer, breast cancer.

A relieved thought (or unvoiced fear) was how lucky can one person be!

It wasn’t the immediate end of the world but I would be lying if I said thoughts of death didn’t loom large. I checked finances and discussed plans with my daughters for  ‘no funeral, just a big party’;  ensured my will, plus medical and financial power of attorney up-to-date.

In the last decade, many health scares, so déjà vu for the Neil household at this regular event!

yearly mammogram

However, the discovery of a brain tumour and the fear it was metastatic cancer shocked the GP who has cared for me for over 25 years. We both fought back tears, our trembling lips hidden by masks, social distancing forgotten as she squeezed my arm in sympathy and murmured about unfairness and not to lose hope because it could be a meningioma.

I’m 67 years old, ironically, the same age as my husband when he died in 2002, (John was 18 years older than me). Whether it is the Highland genes or just my Mother’s Irish superstition, this coincidence played on my mind and also worried my daughters.

Survival rates for cancer vary from person to person but the milestones of 5 and 10 years are always at the back of a patient’s mind when diagnosed. The longer you can go without a recurrence is something to celebrate.

However, survival rates for a tumour in the brain, poor and if an operation required the risk of stroke high.

I was disappointed when breast cancer returned after 9 years but my breast cancer surgeon inspires confidence and he acted quickly and decisively and this time it was a lumpectomy rather than mastectomy.

I don’t put off mammagrams no matter how uncomfortable they are and I follow his advice, even if data suggests most breast cancer is not picked up by mammagrams.

Plus, the shock of another breast cancer diagnosis soon eclipsed by COVID19 anxiety and declaration of the global pandemic.

The recovery from the melanoma and skin graft during severe lockdown, and in the middle of winter, took a little longer with travel permissions to worry about and more stringent rules for clinicians and patients. These restrictions lasted well into the next health surprise.

By the time I went through all the tests and consultations for the brain tumour, it took a lot of energy to even pretend to be positive about the future.  I thought back to the deaths of family and friends I’d witnessed or been involved with in the last stages of their life – hence revisiting this post about my friend Margaret.

Will I be calm and accepting? Do I want to prolong the inevitable? What are my priorities and is there any point in a bucket list?

I almost forgot to breathe when the neurologist decided it was a meningioma and not metastatic cancer. In the words of my breast surgeon on my annual visit in December, ‘You dodged another bullet, Mairi!’

How long I can keep dodging is a mystery but I’ve decided to turn the page on 2020 and try ‘business as usual’ along with my mantra ‘this too will pass’.

Digital Distraction

I spent July to December posting photographs and haiku on Instagram after joining at the suggestion of a dear friend in Japan who posts about Bonsai.

Naoko was a writing student of mine at Mordialloc Neighbourhood House, when she lived in Australia. She said I was an inspiration to her during a difficult time in her life and even wrote a poem about writing class which I published.

We have stayed connected and she returned any perceived favour by inspiring me to learn a new digital platform (with daughter Mary Jane’s help), indulge my love of photography and the environment, and write haiku, a favourite poetry form!

Naoko’s Instagram is #bonsai_sana and mine is #mairineil

Walking the dog each day around Mordialloc, I focused on everyday sights, let my imagination and thoughts wander and in the evening, inspired and guided by the demands of the form, I wrote haiku.

The anxiety, fear and dark thoughts about health and death receded as once again my passion for writing became therapeutic and a distraction. It gave me a focus and a project.

beautiful sunset creek

Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure — these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.

Steve Jobs

pathways

And for many, death comes too soon…

Farewell To A Friend

The telephone call came out of left field. Tragic news to wreck quality time with a dear friend, yet it  is also a dear friend on the other end of the mobile.  My eyes sting with welling tears, but remain focussed out of the window of the Malt cafe in Beaumaris.

I watch two young mums chat animatedly on the footpath. Relaxed and smiling they are probably enjoying the freedom of the first day of the school year; the little darlings who kept them busy all the summer holidays tucked into classrooms. Another couple on an outside table feed their Golden Retriever tidbits from their plates.

I’m surrounded by chatter; the cafe almost filled to capacity. The aroma of  fresh muffins, fruit toast, and homemade jam mingles with my skinny latte and Lesley’s extra strong cappuccino. However, normality dissipates as I absorb the details of the call.  Body trembling, I feel as if I’ve been punched in the stomach and as usual Tamoxifen blesses me with a hot flush as anxiety peaks and emotions rage.

The day takes its first lurch into the surreal.

I’m on my way to celebrate a friend’s retirement from decades of teaching. She’s treating several friends to lunch at Sierra Tango, Cheltenham instead of us paying and hosting the celebration for her! The generosity of the invitation indicative of her warm, supportive personality and the venue a tribute to her knowledge of gastronomy, appreciation of fine foods and wine, and a commitment to support local businesses.

Determined not to spoil Lisa’s day, I seal my tragic news into an emotional compartment to be dealt with later…

I remember a poster I had on my wall at Burgmann College in 1971, when I lived on campus at ANU; my first year away from home. A poster long since eaten by silver fish when it was consigned to the garden shed, but here’s graphics with the same message – a sightly more colourful way of describing “left field”:

il_570xN.594810779_2dtb

The telephone call from Canberra, from a friend from those university days. She can’t keep shock and horror from her shaky voice.  A mutual friend, someone I shared a flat with in the 70s, is dying. She  was the first non-family member I lived, worked, and studied with – we even shared the double bed that came with the one-bedroom apartment – and thought nothing of it!  She’s now on borrowed time.

How could this be?

A voice laced with tears explains that a late discovery of inoperable breast cancer, treated with letrozole, has metastasised to the groin and brain stem. The condition kept secret for two years, while Margaret spent time travelling overseas and going through her bucket list. Now, in palliative care, her lifespan numbered in weeks rather than months – or days, if she experiences a seizure or rapid deterioration of the brain.

A  picture of all of us at the Harmonie German Club in Canberra in 1973, was shared in a recent post.  Tall slim Margaret centre stage.

Mum's_Picture_of_Margaret_&_Jane

She can’t be dying – and not of breast cancer. This news, too confronting and scary. I think back to the apartment we shared, and shiver. That old house divided into three and this news means all of the women living there, including me, have breast cancer: one double mastectomy, two single mastectomies and now Margaret with metastatic breast cancer! Bad luck? Coincidence? A cancer cluster?

A problem for another day…

Bad News Travels Fast

During Lisa’s celebration lunch I receive another phone call with news that a European friend who had stayed with me early January had to have an emergency eye operation in Sydney because of a detached retina. There’s a danger she’ll lose her sight.

This super fit friend, a world-renowned marathon swimmer, came ninth in the Pier to Pub swim at Lorne this year. She’s supposed to be leaving Sydney for her home in Italy with a stop in one of Thailand’s resorts, but is now delayed in Australia until doctors allow her to fly.

The day has taken its second lurch into the surreal.

On my way home, I have the Serenity Prayer playing in my head as I try to put the sad news into perspective and decide on a course of action.

images

The next day I’m in Canberra and over four days catch up with many old friends from university, make some new ones, and spend hours with Margaret as she adjusts to the effects of radiotherapy and the news of having limited time.

She copes well with the steady stream of people who want to help in some way, as well as saying goodbye. The adage ‘bad news travels fast‘ proving true.

The busyness reminds me of husband, John’s last days – the irony of our busy vibrant house,  constant comings and goings, laughter and noise, feasts, and endless cups of tea and coffee surrounding someone dying.

We share meals with Margaret, laughs and stories. I spot photographs in an album – and snap copies with my camera.

 ‘Those indeed were the days my friend,’ I say,  ‘we had a lot of fun!’

Margaret agrees. I listen as she describes the highlights of her overseas trips and of her intention to travel again.

Deep down we both know another trip will never happen.

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Before I leave, I water the plants and pick flowers to brighten inside.   Margaret manages to negotiate back steps with some help and watches me water the garden, pointing out several special plants that came from other people’s gardens, or were received as gifts.

‘This can’t be happening,’ she whispers and I know she isn’t talking about my watering efforts. She alludes to her parents’ longevity, father ‘Digger’, dying a few years ago aged 93, her mother living into her 80s.

Her head shakes slightly, ‘I thought I had 23 years before I had to worry about all these decisions … what to do with things … ‘ Her voice trails off as her eyes drink in the beauty of flowers flourishing from the effect of an unusually cool Canberra summer providing higher than average rainfall.

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I help her back inside wondering if this will be the last time I will feel the weight of her arm. The last time I brush fallen hair from her shoulders as her scalp reacts to the radiotherapy.

Why is the sun still shining? The magpies trilling? Laughter drifting from nearby apartments…

I recall a speech from one of the many Aboriginal women in our friendship circle. She thanked Margaret for all the books she bought her children over the years, the encouragement to access education. ‘One son got his PhD last year, all my girls have tertiary qualifications – thank you from the bottom of my heart.’

Others repeat similar sentiments. ‘You may not have any children of your own, but what you have done for our children means they are yours too!’

The seeds we sow. A wonderful legacy indeed, but I wish Margaret had another 23 years to sort out her life…

I wanted the last few days with her to be surreal and someone to wake me up and say it was all a dream. But of course I faced the reality of saying goodbye and dealing with my grief.

Now, with the reality of declining health I’ll hopefully adjust with similar dignity as Margaret when the inevitable must be faced – with luck still in the distance.

Then again, 2021 may hold bigger surprises than 2020 and they could be good!

That (wo)man is successful who has lived well, laughed often, and loved much, who has gained the respect of the intelligent men (and women) and the love of children; who has filled his(her) niche and accomplished his (her) task; who leaves the world better than he (she) found it, whether by an improved poppy, a perfect poem, or a rescued soul; who never lacked appreciation of earth’s beauty or failed to express it; who looked for the best in others and gave the best he(she) had.

Robert Louis Stevenson

 

3 thoughts on “Impermanence, Inevitability and Dying with Dignity.

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