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Date: SUN 09/16/01
Page: 4
Edition: 2 STAR

The gift of Mary's last days

By Melissa England

My parents died before I was ready. Maybe everyone's parents die before they are ready, but I was 6. Part of me used to think I was lucky - at least their dying was something I didn't have to fear; it was over. The other part of me felt lost. I had unfinished business with death.

I grew up searching, pointing like a 2-year-old in a grocery store, not sure what I needed, only that the need was great.

Thirty-nine years after losing my parents, I answered an ad for the Visiting Nurse Association hospice in Houston. I took a 30-hour course and made a 12-month commitment to become a patient liaison. I was to meet once or twice a week with a dying patient. I would help with day-to-day problems, funeral arrangements and medication. I would be the person the patient could talk to about anything, including death.

The class included the "death game." Write down 12 things you value in life, then tear up the sheets as you lose: possessions, accomplishments, family and finally yourself. Lousy game. It reminded me of being orphaned. I left the class with an overwhelming need to call my kids. I added a note to my will, thanking them for coming into my life.

The technical class covered the stages of death. Doctors and nurses shared the signs of a deteriorating body. Pastors, nuns and a social worker handled the emotional issues. The technical aspect covered pain. Drugs, we were told, would eliminate 90 percent of pain.

Her name was Mary, my mother's name. She was too close to my age and too close to my circumstance - her children aligned with mine in age and gender. And she was dying. That's the deal with hospices; everyone is dying.

When I met her, she was in pain (damn, it didn't occur to me to ask about the other 10 percent). She twisted on the bed, twisting against whatever tore at her insides. She was so polite. I wouldn't have been. I would have thrown me out. I told her I was brand new. She nodded. I told her my name and how old I was, hoping years somehow added to my validation. I asked her if she would do her best not to die. She stopped moving. She repeated my words.

"Yes, that's what I said. I'm not very good at this."

She smiled and then laughed. I liked her. I like women with big smiles, especially smiles hard won. It was the beginning of our friendship.

Her drugs were adjusted, and on my next visit I found her eating fried chicken. I was so curious about her. How did a woman named Mary get to this part about dying so soon?

She married young; she had known him for only weeks. When she was forbidden to see him, she sneaked away in the night and became Mrs. him. Three weeks later she was resigned to the fact she had made a mistake, but there was no going back. She was determined to make her marriage work. Her father had made one thing clear: "You made your own bed."

First came a daughter, then a son, the children who filled her lonely marriage. She went to work, was well thought of and stayed in the same position for more than 20 years. She liked her sisters and friends, but she was sad.

I wanted to save her. I asked her if she wanted to set this "cancer thing" aside and get divorced. Rolling laughter. I really wasn't trying to be funny. Maybe she was dying herself out of a hopeless situation. She fell asleep with a smile on her face, patting my hand, asking me how I got into hospice.

The next visit was a bad one. It came at a hospital. She had panicked and called for an ambulance. It's not normally what patients do in hospice, but they still have that option. Her leg was bruised all the way up the side, and she was staring vacantly at the wall when I arrived. They had taken her for X-rays and told her to get on a table. In her weakened condition she fell. She didn't need X-rays. She had wet the bed, and she was lying in it. The nurses hadn't gotten around to her yet. That was almost three hours earlier. Anger rose in me. I banged on every buzzer in the room. I yelled at the nurses' desk. I told Mary it was all right to be mad. She told me it wasn't, that someone had told her anger made cancer worse.

It's one of those blame-the-victim sentences. It makes other people feel safe. I wanted to gag. "But aren't you angry, Mary? Just hoping not to be doesn't really work, does it?" Tears dropped on her cheeks as she turned from me.

"I'm sorry, Mary. I don't know anything, but I'm mad. Is it OK if I'm mad for you?" She nodded, wiping the tears. It was all the permission I needed. I screamed at everyone. Using my best truck-driver vocabulary, I sprayed the halls with hateful words. And I did hate them. I hated them all, for their incompetence, for their indifference, even for being foreigners. If I'm going to swear, I don't want to have to explain the meaning.

Thankfully, one nurse decided to take me on. I unloaded 40 years of rage into her face. The nurse asked me who I thought I was. Then she asked if I were "even" family. Ah, my Achilles heel: No, an orphan is never "really" family. Before I could speak, Mary whispered, "Yes, yes, she's my family." The nurse decided just to change the bed.

Mary closed her eyes, and I helped roll her from side to side as fresh sheets were tucked into place. I wondered at my own anger. Maybe some of it was for her, but most of it came from a place deeper inside me. But I wanted her to fight; I needed her to hold on.

The next visit was at her home, and Mary seemed peaceful. She said she felt chilled, a chill she couldn't shake. Pulling up blankets, I noticed one of her legs was icy cold. She said it was the cancer. She said cancer was killing her one part at a time. I wanted to fix it. I have always wanted to fix "it." I asked if I could give her a massage. It wasn't part of the class; it was just what one human being would do for another. She was hesitant. I told her if it made her uncomfortable I would stop. With lotion I began at her foot. I prayed with all my heart that the heat inside me would come through my hands. She talked for a while, saying it was nothing she expected me to do, but I felt the moment she relaxed into my touch. She didn't talk after that. I just moved my hands over her, thinking about how grateful I was to have come to know her.

I was loving her; I didn't mean to; I was going to keep my distance. What was the point of loving someone who was going to die? She had said I was family, and in my heart I was. I watched her face. I could see her younger, healthier. I thought she had fallen asleep, so I tucked the blankets around her and gathered my things. She opened her eyes, blue eyes, and smiled at me, one of those really wonderful smiles.

She thanked me. She said thank you especially for the laughter.

My last visit found her tired, more tired than I had known her. I was the one who was supposed to help her talk about death. I was the one who was supposed to ask all the inane questions like what songs she would like sung at her funeral. I never asked any of those questions. Who really cared? I dared God to have a choir of angels waiting. It was his part, I decided. Mine was to be on this side.

Her breathing was ragged, and the pain had come and gone, but something called Vicodan was doing its work in her. I pulled the covers up and noted how cool she was again. Under the blanket she slipped her hand into mine.

"Mary." I said her name softly, because I liked the sound of it. "Mary, what can I do for you? What do you need?" With a slight smile she said, "Nothing."


"Nothing" made me feel helpless. I toyed with her fingers, trying to bring heat back into them. That's when she started talking. "I'm tired now." I felt my heart beating harder, and every part of me wanted to interrupt, but I remained still. She had an agenda. It started with her son. He was angry about her dying, she sighed. Her daughter was silent, pretending everything was normal. And her husband raged. It was not his plan to have a dying wife. She had already told me these things. I didn't know why she was repeating them now. Still, I was silent. She continued. "I'm tired, but I think they will all be fine. I do love them. Sometimes the words just get messed up." Then her question: "Do you think they will all be fine?" I wanted to tell the voices in my head to shut up. One said, stop her, stop her from letting go. Another voice said, this is her life; I am here to help. Stay focused.

I squeezed her fingers gently when I answered. "Mary, I don't think they could have missed your love." She relaxed and breathed in deeper. My throat was hurting from keeping the emotion inside. I leaned against her bed and was thinking random thoughts about life and love when she asked what she could do for me. The question startled me. "For me?" I repeated. She was looking straight into me, past my eyes into my heart.

"Mary, I'm so scared. I'm so afraid of death. I feel like such a fake. Who am I to help anyone? Who am I to pretend strength? Under Melissa is Missy, the child who still cries for the mother who never came back. My mother, my Mary." The tears started. I warred inside, trying not to be the child I am.

"It's all right," she whispered. "I've got your hand." I felt her love spread through me. Mary, the one I had come to help, the one I had come to comfort, was holding my hand, and my tears just flowed. I stayed a long time that night. In fact, she was the one who helped me go, reminding me that two children were waiting for me.

At her bedroom door I turned to smile. She smiled too, adding, "I'm glad it was you."

"I know," I answered. "I'm so very glad it was you."

I got the call the next morning. I still replay her words, the ones that reshaped my heart, the first ones that touched me - "Yes, yes she is my family" - and the lesson, the one about letting go.