San Francisco Tales: Locked in and letting go

Categories: Opinion.

Today, I observed a brief but beautiful exchange between a physician and a woman who had been sitting vigil at the bedside of her mother, who was slowly breathing through her last hours of life.

Weary, with reddened eyes through lack of sleep and tears, she was reflecting on the changes she had observed over the previous two days.

“Yesterday was wonderful,” she says. “Really magical. The room was filled with family and friends. We all got to say goodbye, to tell her that we love her and to hear her tell us she loves us. But then when everyone left and I was the last person left in the room, her pain increased and she got more and more sleepy.”

Overnight, things continued to change and by the time we visited this morning she was deeply unconscious despite not having had any medicines for her pain for over eight hours.

Her daughter told us that her mother had become agitated; when she had reached out to try and hold her hand her mother had asked to be left alone and had swatted her hand away – it seemed out of character and had upset her.

The doctor nodded slowly and said: “Do you remember when you were in labour? And you were so locked in to your body that you knew exactly what you needed? Sometimes that meant the people around you didn’t always get that. And it’s hard to communicate that because you are utterly absorbed in the story of what is happening in your body?”

She nods. Death was brand new to her, but she understood this, it was a scenario she could relate to.

In this moment, she recognised what it means for her mother to be dying, she was able to see her mother’s agitation as a way for her body to make its needs known. Her closed eyes were not a rejection, they were an inward-turning of awareness, a focusing and a preparation.

Dying, like giving birth, is a time that body and mind are occupied and absorbed entirely in doing exactly what the body naturally does.

Withdrawal is a natural part of dying – if our awareness remained acute and outward until our last breath we might never feel prepared to leave our loved ones. This closing down that can cause so much upset to those sitting vigil can be reconceptualised as a necessary and beautiful aspect of letting go of one’s hold on to life.

In the moment of recognising this, the doctor had given this patient’s daughter reassurance without platitudes, realism without brutality, and a calm sense of death as a natural and embodied process.

This article was first published on Laura’s own blog (Impermanence – Reflections on compassion in end of life care) and republished here with permission.

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