The Ultimate Transition

She was only fourteen. Fourteen. A tiny wisp of a girl, a pale, sweet, freckled face encircled by ringlets of short red hair. And she was going to become a mother. She had gone into labor the night before, things had stalled, and her labor was to be augmented with pitocin. When she went to her local hospital, her blood pressure had shot up, so she was transferred to our unit. She labored in the haze of a magnesium-induced fog, an attempt to prevent the seizures for which she was at risk because of her blood pressure.

The father of her baby was nowhere to be found. "He's too young for that" his parents had explained to her. I'm thinking...hmmm...well, he wasn't to young to make the baby...and she doesn't get to say "I'm too young for this". Instead, she prepared to raise, with the help of her family, the little boy that she carried.

She had wonderful support though. Her sisters were there...all four of them, all with the same fair skin and curly copper-colored hair. They ranged in age from mid-thirties to late teens. It seems our little mother had been a surprise baby herself, conceived during a rebound relationship of her mother's shortly after her sister's (half-sisters, but sisters, just the same) father's death. It was not lost on her that she was the offspring of yet another absentee father.

Her mother wasn't there. I didn't know why, but many telephone calls were going out to friends and family who seemed to be in close contact with the soon-to-be grandmother. Perhaps there wasn't transportation, or enough money for her to get the several hundred miles from her home to her daughter's bedside. That happens a lot on my unit...we transfer mothers in from hundreds of miles, covering three states. A lot of the families of the mothers we care for are desperately poor...too poor to follow the ambulance or Medivac helicopter to our hospital.

I felt sad for her. A woman needs her mother when she is about to give birth...especially such a young girl-woman; but this precious young woman was surprisingly, yet precariously stoic...the kind of stoic that made me caution myself to choose my words...even the inflection of my words carefully...lest I cause her to burst into tears.

Her sisters were lovingly, literally at her beside. When they weren't hovering near the telephone, they hovered over their laboring sister, rubbing, massaging, loving, wiping away the occasional tear. When she balked at the idea of getting an epidural, they encouraged her...gently...to reconsider. "So much pain", they murmured, more to each other than to her..."why take more?"..."especially when there's a choice".

She chose the epidural. While we usually allow only one support person bedside during epidural administration, I broke policy and let them all stay, because I couldn't bear to tear them away from their little sister who seemed to depend on them so. She suffered no untoward side-effects from her epidural, so I placed her foley, tucked her in, and stepped out of the room.

I felt a tap on my shoulder. When I turned around, I faced the oldest sister, who was wiping a tear from her cheek.

"I wanted you to know...we're not purposely being rude to you"...rude??? They had been anything but rude. I thought they had been perfectly lovely, and I told her as much. "Well", she said, "Thanks...but there's so much going on...I just wanted to let you know; She doesn't know...and we're all having a difficult time keeping it from her. Our mother is dying. Literally. Probably tonight. She has breast cancer".

Now, how many times does a nurse hear something like that? Not often, I would imagine, even on a unit prone to as much melodrama as ours. But, indeed, this was the situation, and here we all were: A fourteen year old girl about to give birth to her first child; her four older sisters to whom would soon fall the responsibility for them both; a still fairly young woman, their mother, hundreds of miles away, slowly slipping into that pre-death coma from which she would never wake up; and me, not quite certain how to respond to the sad uniqueness of it all. Instinct took over and I wrapped my arms around the now sobbing sister, as I held back my own tears.

I showed the sister our family consult room...the little room near the back of our unit that is used for physicians to talk to family members when things aren't going as planned with the birthing women they are supporting. It holds an institutional wood and vinyl couch, and two chairs, along with a lamp and a selection of out of date magazines; not much in way of comfort, but at least it's private...and it has a telephone.

The sisters each took turns going into the consult room to check in with the family that was caring for their mother. She was "in and out" they said. She seemed to be aware of what was happening to her "baby" daughter. Through a haze of pain killers, she had been repeatedly asking to speak her, but the family wanted to spare the laboring girl the pain of knowing her mother's death was imminent.

Our little mother slept through most of her labor until she abruptly sat up in bed and called out for her mother. "He's coming now! When will she be here?" I checked her, and indeed, her baby was nearly crowning (pretty rare for a first-time mother). I called out for a "doctor for delivery", and instantly the dark womb of the room became once again a bright, too-noisy hospital room. The sisters took their place around the bed, I "broke the bed down", the resident took her place at its end and began exhorting the girl to push.

She refused. "I won't!" she wailed..."Not until she get's here!" We all stopped and looked around at each other. By now, anyone who was involved in her care new what was happening. Eventually this baby would be born no matter if his mother pushed or not...but as often happens, his heart was slowing with each contraction as her body moved him ever closer to his birth. Most babies do fine, even with this...but it can be unnerving if the birth isn't imminent...if the mother isn't helping things along by pushing...at least a little.

The youngest of the four sisters finally broke rank from the Circle of Women around the bed and picked up her cell phone...you know, that piece of equipment that you're not supposed to use in the hospital because it might interfere with the other machinery? Too bad...she was on a mission, and I wasn't about to stop her. She punched a speed dial number, spoke quickly into the phone and placed it next to her laboring sister's ear.

"I will. I promise. I know. I love you tooooo.....", and her little body twisted up off of the pillow with a powerful involuntary push, and as her sister lifted the cell phone high in the air, a tiny, five-and-a-half pound little girl wailed her way into the world amidst the sobs of joy, surprise, and heartbreak of her mother and aunts (so much for the accuracy of late-term ultrasound). Time of birth...4:01 A.M. Grandma was listening.

After promising into the cell phone that she would call back soon, the youngest sister snapped it shut and began to attend, along with her older sisters, to her little sister and niece. As a group they dried the baby off, and placed her against her mother's body. The older sisters, mothers themselves, gently encouraged the new mother to hold her daughter close, showing her how to feed her, pointing out every precious, miraculous, infinitesimal little finger, toe, and wisp of downy, copper-colored hair. The baby never cried, not once after her entrance announcement...but curled into her mother's warm body, turned little her head sideways, and watched her aunts smiling down at her.

I moved around the room as inconspicuously as I could, clearing away the delivery paraphernalia, charting, and tidying up between checking on the new mother and baby. Once satisfied that all was in order, I left to give the new family their privacy. A few minutes later, the oldest sister walked up to our reception desk and asked for me. When I approached her, she asked me..."What time was she born?" A tear rolled down her cheek with my answer.

"Our mother died at 4:05".

Now I was crying...and not just a dainty little sympathetic tear or two to streak down a cheek...no, I had to be sniffling with the red nose and blood shot eyes of someone who has had entirely too little sleep...it wasn't pretty...but it was heartfelt, and the sister knew it. She asked that no one say anything to her little sister until she had had a chance to get a few hours sleep, after which they would tell her, and of course we all agreed...but it wasn't easy to stifle those tears and act cheerful while I helped the new mother into a wheelchair and tucked her baby into her arms for their trip to her postpartum room.

As often happens, I never saw this patient or any of her family again. I wonder how she reacted when she learned of her mother's departure so soon after her daughter's arrival. Two souls had literally crossed in the night. Did they reach out to and greet each other along the way? Did that precious little baby feel the warmth of her Grandmother's kiss on her cheek? Will she carry a tiny, almost imperceptible memory of it with her? She will most certainly experience her love through the love of her very young but very special mother and her very special Aunts. She is part of a very special Circle of Women indeed...one that reaches down from heaven, flows through her family, and wraps itself around her.

A bittersweet story...but a very fortunate little girl.

METAPHOR FOR STEVE

Years ago, my husband and I discovered a wonderful place to unwind and regroup at a rustic inn located in a hiker's wooded paradise an hour or so by car from our home. While we were there, I had the most profound conversation with the owner of the inn, Ellen...

Ellen had taken over the management of the inn from her mother, Ann, who had died several months before from mouth cancer. The inn had long been a dream of Ann's, one that she had been able to bring forth in spite of countless obstacles; and just as her dream was coming to fruition, she became ill. During her transition from life on this earth to whatever "hearafter" she, I, or anyone reading this might believe in,she wrote a short book..."A Journal of a Dying", that chronicled her last weeks, and the love, support and care she received from her daughter and woman-friends as they accompanied her to that door through which only she could pass.

After learning that I had once worked with a hospice organization, and was at the time, both a doula and a nursing student hoping to study midwifery, Ellen gave me a copy of her mother's journal to read. I spent three hours of a rainy Saturday, snuggled in a chair by the wood stove in the common room of the inn, and devoured the book. Ann spoke clearly to me, and whoever else had the opportunity to read her words, "hear" her voice through the pages she wrote while she waited to step into eternity. The last chapter of the book was written by Ellen, as Ann had lost the strength to write. It was a bittersweet ending, but one filled with the joy and hope brought by knowing beyond a shadow of a doubt that this life is not the total of our experience...it's just the beginning.

I was so overwhelmed by the book, that I sought out Ellen to tell her how much I loved it. She responded with the most amazing thoughts. I can't remember her words exactly, but they were something like this...

"I knew you would appreciate it. I remember having my own children; and while my mother was dying, I remember thinking how similar dying seemed to labor...it's unimaginable pain; it's incredibly hard work; the people you love do everything they can to help you through it, but you know that, ultimately, the only person who can do this is you; and just at about that point, a "peace" comes into the room; a laboring mother seems to become unaware of what's going on around her...she's moved inside of herself, accepting the inevitable, gathering all her will and power to get this done; the dying person begins to seem as if they have one foot in this world, and one in the world they are about to enter; and then, just when you think you you can't take another minute, not another second of this, a life tumbles into the room, or through to the next dimension, and there is sense of profound relief. No more pain, no more struggling. Lots of tears...but also a sense of joy...as bittersweet when a loved one dies, as it is a celebration when a loved one is born. It's two poles of the same experience".

I was speechless (and if you knew me, you'd know how extraordinary that is). Ellen's metaphor was so profound to me. I've never forgotten it. Indeed, I'm privileged to see this miracle of transition several times a week as I nurse mothers through their labors; I remember seeing it when I worked in hospice, and I saw it when I held vigil with my mother, my brother, and my sisters as my father died.

And now I'm seeing it with Steve...a wonderful, anointed, learned man, a special friend, someone who my husband and I, although we don't see him often, will miss dearly when he dies. I wrote this entry for Steve, his beautiful (in every sense of that word) wife Sharon, and their three equally beautiful daughters. Steve is dying. He's fought his disease with all the strength and resources at his disposal; and now he's accepted, probably more fully than anyone else, the inevitable outcome of his journey.

It isn't fair! He's too young. He and Sharon were just getting back to that "just you and me, kid" phase of their marriage when the responsibilities of parenting give way to more time for each other, and a future filled with grandchildren, travel, and many more happy expectations. He's well-known in his field...his contributions are huge...and there were many more to be made; but those are my gripes. Steve seems to have made his peace with it. Here, I want to share parts of the last few entries he's made in the online journal he keeps to communicate to his family, and to scores of friends, clients, and colleagues who love him dearly...

+++++


Wednesday, April 30, 2008, 10:22 PM, CDT

This is such a strange and surreal time - standing in the gap between earth and
eternity. I feel that all I need to do is
take a nap or exercise and then everything will be
normal. Then I recall that I'm wearing a powerful pain
patch, taking anti-nausea medications, am getting IV
fluids for advanced and terminal cancer. I'm blessed
to have wise medical counsel so that I can experience
these beautiful though surreal days of quality.

I believe that shortly I will be called into eternity. I will be
called by a new name and go to a place that has been prepared for
me. I will recognize my new name when I hear it. When we
encounter God, there's always a change. and often a struggle accompanies this transformation (ed. emphasis mine)
I'm living the struggle, encountering God in
new ways, being changed...


Friday, April 25, 2008, 04:37 PM, CDT - Greeting Friends and Family,

An interesting thing has been happening. Various persons have
responded to our current circumstance by saying that they feel
called by God to show love in a special way to us. I'd like
to put this in a larger context. Think of the words like
calling, promise, covenant. One way God calls us to serve is
by specifically laying on our hearts something that we can
promise to another person. For example, someone could say, 'I
promise to look out for you in your dating relationships with
young men in the absence of your father.

So times like this transition between earth and eternity
provide a special summons to think through these
opportunities. I want to challenge you to think about how
God may be calling you to make a divinely inspired
commitment, promise, or covenant to someone's needs that
you are keenly aware of and you are equipped to serve. Is
God speaking to you?

In this simple and practical way we are loving one another.
And that's what it is all about.

Wednesday, April 23, 2008 10:38 PM, CDT

Greeting Beloved. This is the most important message I've yet
sent to you from my perspective. This morning I h ad a most
surpassing spiritual experience. I want to place it into
three parts (1) the context, (2) the message, (3) and the
experience.

(1) The context is that we had just decided to pursue hospice
care in order to have quality of life for the remainder of my
life rather than furter treatments or interventions since my
diagnosis is terminal. I see th is as an opportunity to
celebrate the transition between earth and eternity. So with
this backdrop I went to sleep at 12:30 AM and awakened at 5:30
AM with an incredibly crystal clear message. The message
follows:

(2) Peace.
Life Death
Live a good life.
Do Good.
Accept Salvation through Christ.
Die.
Live Eternally.
Peace.

(3) Lastly let me convey the experience. I had the most
overwhelming experience of PEACE that I have ever had in
my life. So my wish for you is that you too find Peace
as God calls unto you.

I love you. thanks for your ceaseless prayers and support.
Steve.

+++++


This is the best way I could think of to pay tribute to such a
remarkable man, and his beautiful family...to share his words in context with the words Ellen shared with me all those years ago. In response to Steve's
encouragement to make a "covenant to someone's needs"...that I am "equipped to
serve", I'm blessed with several, at least. My estranged friend Kathy will be getting a bouquet of yellow roses on her 50th birthday this month (she's from Texas); I'm seeing my husband, and my love for him in a whole new light...and my life in a perspective that, while it is full of potential and possibilities I now
remember to remind myself is a gift, just as it is in the here and now; and I'm blessed
to be "equipped" to provide nursing care to women as they labor to bring their
babies into the world. I'm blessed to be able to say that this is my calling.

Steve's calling was to help people heal their relationships...with their partners, their families, their God, their selves. He continues to do so in no less
a profound way than he did while he shared his gift in countless books, journal articles, or, most importantly, face-to-face sharing with those he felt called to serve...and who felt called to reach out to him. His work has "given birth" to renewed marriages, healed relationships, and a unique form of therapeutic communication that is being taught and used with great success all over the world.

I can't quite bring myself to say the the words..."I will miss you, Steve". Because your presence will always be strong in your written works, and in the love you shared with the people you guided through pain to healing. It will be strong in my memories of your voice, your smile, and yep, that little sigh of frustration I could just barely hear, and that oh, so subtle quizzical look on your face when I just wasn't "getting it".

Steve, I "get it" now.

And I thank you.

Thanks. It seems like such a tiny word relative to all you have done for us.

That is how you loved your God; that is how you loved everyone who ever had the
privilege of meeting or knowing you.

And yes, that is certainly what it is all about..