Beaches and the End of Life
“Where does a wise man hide a pebble? …”On the beach.
She came to see me because her pain was out of control. She had two serious, chronic illnesses. This was the last person in the world who could stand another blow. Yet here it was, clear as day, a severe case of rheumatoid arthritis that threatened to cripple her overnight.
Not that anyone deserves to get sick, but destiny could have chosen someone else to curse. She was in her early seventies; a sweet, kind, gentle woman who had worked hard all of her life. She had raised several wonderful kids. She had been widowed some time back. Her life consisted of doctor visits and being kind to her family.
Under ordinary circumstances her prognosis would have been excellent. Once I have to keep in mind the potential complications that my medicines can generate on an already compromised and elderly body my options significantly narrow. I was not looking forward to the next few months.
You have to take your medicine. Stick to your diet. Avoid all alcohol. Check your sugars four times a day. Get blood tests every two weeks. Report everything and anything unusual to me by e mail.
She gave me a blank stare. As if I wasn’t in the room.
Look: I think that I can help. It’s just that we’re not starting from square one. I don’t want to hurt you. I promise you will do better, but only if you do your share.
Her eyes focused on me. She nodded.
She followed the rules, as much as reasonably possible. Her pain improved. Her joints calmed down. She could rest better. Her family time was once again joyful.
I had to keep in touch with a primary care doc and three sets of specialists. Her list of medications was long and expensive. I could see that in the long run this would not be a sustainable outcome. On the other hand, she was happy, and who knows, maybe tomorrow they would come up with a breakthrough treatment for one of her illnesses. Or all of them.
One day she came in with her daughter. She looked sad.
Talk to me.
“I just came from one of the other specialists. He told me that I was end-stage. Nothing else can be done. My time is limited.”
I knew that this moment had to come. Yet it’s always a blow. Even after all of these years it still feels like a defeat when disease wins the battle.
There is a new treatment. I read about it in a medical journal.
“He knows about it. He thinks that I’m too far gone.”
I respected her specialist. I decided to shift my focus.
What do you want to do? Is there anything that you want to accomplish with the time you have left? Any way I can help?
A long silence.
“We don’t have the money for me to travel, or do anything extravagant.”
It doesn’t have to be expensive.
“I always wanted to see a beach.”
I broke out in a big grin.
I may be able to help with that.
Immediate heightened attention from her and her daughter.
I have an apartment close to the beach in Puerto Rico. You can use it for a week. My treat. All you need to do is pay for your flights. Here is the web site for the resort. If you like it let me know which week is best for you.
A few weeks later all of the details were set. It was time for another office visit. Again she looked sad.
“I went to the medical school for another opinion. They don’t think that I’m a basket case after all. They want to try the new medicine on me.”
That’s great news. What’s the problem?
“Now that I may not die, can I still go to Puerto Rico?”
My initial tendency was to break out in loud laughter. Then I realized that she was serious.
But of course! No matter what happens you deserve this. Please. Do me a favor; go. Enjoy it. I’ll even allow you to have two drinks while you’re there.
And so it was. They had a great time. Of course she could not do the four hour hikes in the rain forest, but she got to see the beach, and she ate the local food, and she was able to relax. I was showered with dozens of thank yous at her next visit.
It has been several months. Her daughter came to the office a few days ago. Her mom had passed away.
“We had her on hospice. It was too much. She couldn’t stay out of the hospital. She finally begged us to let her go.”
I understand. I had to deal with the same issues when my mom died. A mixture of grief and relief that she was no longer suffering.
“She made me promise that I would come here to tell you how much fun she had on the beach. It meant a lot to her.”
Thank you. It meant a lot to me to see that she had at least one small reward.
I hugged her. She left with a smile.
Every day, at each hour, we have a chance to give others the sight of the beach that they so much yearn to be close to. Think about it. It did not matter when she was due to pass away. I knew the moment would come sooner or later.
Why do we wait to give until death seems inevitable? Why not be nice all the time? How do you know the next hour won’t be their last one, or yours?
Why don’t we walk around wearing goggles that turn everything we see into a lovely beach?
Think about it. We may be running out of time…