Sad Days

I just got an email telling me that one of our clients passed away. A friend of hers came to us some months ago and asked us to help see if we could find any other treatment options for a stage four cervical cancer patient on Medicaid. We researched clinical trials all over the world, sent several prospects to the patient's doctor, and supposedly he checked them out and found that none was the right fit.

This comes at a time of year in which I feel great sadness at the anniversary of the loss of my friend David, and, in mid-January, my mom.

David was a remarkable person. Once, when we were together, he saw a blue heron and was so excited about the miracles of nature that it was contagious and completely caught my attention. Now, when I see a blue heron, I know David has come for a visit. Always when I need him. Then again, I suppose I always need him. Nobody has ever made me felt more completely accepted than David. What a wonderful feeling that was.

His wife told me that David used to throw change on the ground because, when he was a child, it used to mean so much to him to find a penny on the ground. Now, when I see a penny on the ground, I leave it for a child to find.

My mom died three years ago, although it seems like yesterday. She'd told us all along that she didn't want to be drugged up on pain meds. She had her first shot of morphine one night and died the following morning. She had been afraid of losing her bowels when she died, of messing up my dad's bed, of the pain, of the well-meaning people who would encircle her. She avoided all of that. She just stopped breathing. My dad left the room for no more than 15 minutes, and when he went back, she was gone.

My mom's absence in my life remains gut-wrenching. She forbade us from having a funeral or memorial, from sitting shiva (as we Jews do). So my brother and I took a day off and then went back to work. Bad idea. Grieving with others serves an important purpose in helping us to move on.

Our patient was a lovely woman named Nancy. I spoke with her a couple of times, but she was too sick from chemo to talk on a regular basis. So we dealt with her doctors. When we found a trial that looked like it might fit her -- so many of them required no previous chemo, and others were in China and other places around the globe -- we faxed the information to her doctors so that they could follow up by sending lab results and x-rays and whatever else the trial coordinators wanted. Nancy is not the first patient I've lost, but it nags at me -- could I, should I, have done something more, something different?

Death is complicated for me. I see it as my way out, as my light at the end of the tunnel I am living in. When it comes, it will be welcome. But I am so sad for Nancy, who would have done anything to stay alive -- she was willing to do and try absolutely anything. And I miss David and, even more, my mom. Death may be a gift to the sick, but it is not a gift to those who love them. Then again, knowing that my mom died exactly as she'd wanted helped me accept that, since this was her wish, I could not begrudge it to her by placing my own wishes first. But I miss her, still.

Maybe she has met David. They were both flirts, so perhaps they found each other, if there is a heaven. And maybe the two of them will help Nancy find her way.

And then again, maybe there is nothing after this life and they are just gone. Strange, how okay that would be for me, but how unacceptable that is for the people I love and care about.

My mom's death came before her suffering became unbearable to feel or to see. David was very sick but unaware, at the end. He died in California, so I was not with him. His wife's long email the next day broke my heart, but it was as it had to be. Today's email about Nancy makes me sad mostly because I know how badly she wanted to keep going, fighting, searching for answers. Sadly, I don't think she found any rest, any quiet, any peace in death.

I lost two dear friends in 2008 -- deaths I cannot understand. I've written about Iris; maybe you remember. She had a loving husband, son, daughter-in-law, and literally hundreds of friends who called her Mom. And Ruth -- I don't understand a god that takes a hero, a ground-breaking women's rights lawyer with two young children and a wonderful husband, and leaves me. It should have been me, not Ruth.

Some people say death brings closure. For me, it brings questions. It takes who it wants to, not those who want to be taken. It takes those who have not lived their lives, and leaves those who feel like their lives have been well lived and are ready to go. It takes a mom, a dad, a husband, a friend. This is all very confusing to me. I don't believe in god, but I do feel in my gut that death has some choice about who to take, and I am mad as hell at its randomness, although the fact that it is random may in and of itself be proof that it is no more of a real, thinking "being" than god.

I am not going to figure out this big philosophical dilemma today. Today, I will mourn Nancy. Tomorrow, David. Two weeks from now -- really, every day -- I will mourn my mom, as I mourn Ruth and Iris. And wonder why. Jennifer