At the conclusion of the first night of our beautifully sensual life together, the man who became my second husband, breathlessly rolled over onto his side of the bed and exclaimed, “If I have a heart attack, don’t call the EMTs until I am cold and blue!” I could hear his smile in the dark and I knew exactly what he meant.
He was letting me know the sex was fabulous and summing up his advance healthcare directives in one, fun instant. You see, my second husband was a hospice and palliative care physician. He helped patients and their families discuss and prepare for death every day. I had lost several members of my family to accident and illness, so I knew how important his work was. We fell madly in love and were married soon after that delicious night. Falling in love in the prime of life, after having gotten our starter marriages and favorite mistakes out of the way, was glorious. We went together like peanut butter and jelly with the spice of chips and salsa. He took care of patients at our university hospital where he was on faculty and I continued my work in healthcare consulting with an assuredness about my personal life that I had not previously had the benefit of.
Several years into our lovely, content marriage, he found two lumps on the left side of his neck and was diagnosed with a stage IV, metastatic cancer. Now, it was us. We were the patient and family caregiver having to discuss and prepare for the end of his life. He lived for 22 months following the diagnosis. Having previously lost my only sibling and my mother, I knew just how bad it was going to feel when he died. I worked to honor my anticipatory grief while not letting it get in the way of the precious time we had left together. I went to every appointment with him. We laughed together and cried together. We put the property and cars in my name, downsized and moved to a condominium that I would be comfortable living in alone after his death. I offered him my full support – either way – each time he read and processed all of the risks and side effects of yet another chemotherapy, after a previous one had failed or made him too sick. He probably tried more chemotherapies than I might have but it wasn’t my illness and death it was his, so I simply offered my full support for whatever decision he made.
As he got sicker, I took care of him and just tried to be at his side and cherish our time together. I listened and made notes when he listed items he wanted to bequeath to each of his family members and friends. At his request, I read some of the goodbye letters he wrote to people who had meant so much to him. In the week before he died when he did not have the dexterity to type texts on his smart phone, he would dictate them to me, and I would write them and send them off from his phone and then read him the responses.
He had worked in a hospital since he was 18 years old, he felt at home in a hospital. When it came time to admit him to inpatient hospice, there was no difficult decision for me to make, I knew what he wanted because we had talked about it. He had been quite clear about wanting mild, palliative sedation and NO visitors at the very end. I felt an honor and closeness with him knowing that I was carrying out each and every one of his end-of-life wishes.
This is not to say any of it was easy, quite the contrary. Feeling the love of my life shrink in my arms and die was a heartbreak I will never get over. Listening to his wishes; taking the time to understand what was really important to him in the end; carrying out his directives even when people who had known him expressed surprise at the specificity or nature of them; being by his side in every way until his very last breath – that was an intimacy more profound than I ever knew possible.
In the end – and there most certainly will be an end – all we really want, is to know that we have loved well and been loved. Our preparation for his death did not lessen my sadness or grief, it brought us closer and continues to comfort me as I go on.