Tuesday, December 29, 2009

Boo's choice

For some reason, I have been struggling with myself recently ... about a decision I had to make in the early hours of January 6th 2009.

When Cliff was moved from ER to another ward, having suffered a massive stroke, the lovely Irish sister there told me that because I knew him better than her, that I was to tell her if I thought he needed more diamorphine (or morphine, I forget which) ... and at the time, he didn't seem agitated, rather he appeared to be sleeping, but his breathing was noisy. That's the only way I can describe it ... but he didn't appear to be in pain.

Up till the Senior Sister mentioned this to me, I hadn't even considered that he might be in pain. I simply assumed that he was dying, he was unconscious, he was sleeping, he would not wake up, and that my voice was reaching him on some level ... that he could hear what I was saying to him, and that he was not afraid.

I can remember the fear and panic rising within me when she said that.

PAIN. God no. I would not let him suffer.

This man would have died for me. I loved him then and love him still.

For the first time in his adult life, he was laying there, vulnerable, unable to protect himself, and he was the bravest, strongest man I ever knew.

And there was no way on earth that I would let him suffer any pain, that I would not protect him, that I would not do what was best for him, as I know that he would have done for me.

I knew beyond doubt that he was dying.

To give some context, let me share that at the time, I also remembered my big sister telling a nurse - in a different hospital - that, "it's about time she had some TLC, don't you think?" on the third day after our Mom suffered her fatal stroke. Her breathing also become more laboured/noisy, in fact, it sounded a great deal worse than Cliff's. I was pretty oblivious to the cryptic conversation that was going on next to me, until my sister gently explained to me that it was common practice to give patients an extra shot of diamorphine to help them die peacefully, painlessly and that, "it wouldn't be long now". I remember leaving the room when they administered the shot, because, even though in my heart, I absolutely knew this was the right (and loving) thing to do, I just couldn't watch it. I was 29 years old at the time.

So I understood what they were offering us.

The only issue I had was this. If he wasn't in pain, surely it would be better to allow him to die "naturally". That was it. But I would NEVER have taken my own selfish wish - of delaying his death - into consideration. NEVER. And, I didn't.

I announced to John (and Cliff) that I was going for a cigarette, and he came along. I can remember smoking that cigarette furiously fast, then telling John that I was going back to Cliff - and John extinguishing his cigarette half-finished, because he would not leave my side, just as I would not abandon Cliff. We quickly returned to the ward, and I went straight to the Sister and looked her in the eyes, asking her, "is there any chance at all that he might be in pain?"

She said that he might be uncomfortable, and in a heartbeat I asked her to administer the extra dose. I didn't even stop and think. There wasn't a choice as far as I was concerned. This was the ONLY choice.

I told Cliff that they were giving him something just in case he was in pain, and not to worry, there would be no more needles because there was a line in his arm already. That he could sleep, and that I loved him, loved him, loved him, and always would, that he didn't need to worry about anything anymore, that he didn't need to worry about me - I would be alright - that he could just relax and go to sleep. It's OK darling .... I shan't leave you, not for a second, I'm here baba ...

Within 5 minutes, his breathing went very quiet and I never left him or cried. I left him for a total of around 30 minutes during the 12 hours that passed between him having the stroke and taking his last breath. And never let my voice falter in front of him. I held him, soothed him, stroked his hair, held his hand, all the while talking, later whispering to him.

I can remember holding my breath literally just before he took his last - as if I knew on some primal level ... and when he stopped, I wanted to carry on holding my own - but my body would not allow me to do this.

I knew I had done the right thing. I was so relieved that any pain he may have had was short-lived and that he went without pain or fear.

It brought a whole new meaning to the old saying, "If you love someone ... you have to let them go" - I had had to literally put those words into action twice ... firstly, verbally telling him it was OK to go ... secondly, agreeing that they administered extra meds.

But almost 12 months later, I started questioning the decision that I made on that darkest of nights.

And right on cue, my favourite counsellor, Marty Tousley published this post and article from the New York Times. I read the whole article, and the viewers' comments.

And again, felt relief.

It had been the right decision all along.

If you truly love someone, you have to let them go. It's the last loving and caring thing you can do for them. It's a selfless act ... and it proves to them and to yourself, how much you love them. Because you put their needs above your own ... in fact you don't even stop to consider your own because they do not matter.

Only you.


  1. Hi Boo.

    Sitting here at work, and hardly working. Reading your post puts me right back to the time that I was making thos same tough choices.

    Michael received hospice services in our home. During his final weeks he became less and less able to put his thoughts into words that made any sense. He also began having trouble swallowing pills, so I had those that could come in liquid changed over, others I began crushing to get into him. When his breathing began to change I too recognized that he might be in more pain.

    Having hospice at home meant that they support you with supplies, information, and home visits, yet you are still the primary caregiver. One night I called the nurse to ask if I should still try to get all these medications in him. She explained that either way it was my call, but she was also able to point out which were truly essential to make him comfortable (morphine & haldol). She also let me know what symptoms, such as the rapid increased breathing, that might indicate some discomfort.

    I began to really feel the weight of the world on my shoulders, and the nurse could sense this. She told me that Michael put me in this role because he loves and trusts me. She said I was answerable to no one else. Do what I think is right for my husband, and because I'm doing it out of love, it will be the right decision.

    Prior to that conversation I felt that I needed to justify all my decisions with those around me. At that point I decided to stop recording the dosing on the log that everyone was reading when they were helping out. Bringing comfort to Michael was something between he and I. I always told him what I was giving him, and that it would help him ease through his dying process. It became a very loving process, one that I will never forget.

    Looking back I know that I made all the right decisions, and that he passed away as peacefully as possible. When he was about to take his last breath it became very obvious. I reached down to kiss him, and breathed in the last air that he exhaled. In this way I wanted to believe that he passed through me, and that part of him will always be within me. I breathe for the two of us now.

    You made the same very important choice for Cliff. It was the perfect choice, and he is at peace. There should be no room for doubt.

  2. Boo, I think you made one of the most courageous decisions that anyone is ever faced with. In no way would I ever look at your situation and judge you based on that, and those that do would be total idiots. I think you did an amazing, and selfless thing, and you should never for a second doubt yourself or your decision. You are an amazing and strong woman, with a wonderful heart. Much love hunny!


  3. Dan, thank you so much for sharing your own choice with me, and others. It is painful to relive, I know.

    Your own experience certainly parallels mine in so many ways, right down to knowing when it was going to be the last breath that they took ... and even though we both know (and knew at the time) in our hearts, that we did the right thing, it is always comforting to be given the reassurance that we have done the right thing.

    I loved what the Nurse said to you. He was your husband and it was your business only, that when you love someone you will only do the right thing for that person. What a wonderful person she is.

    I hope your afternoon passes quickly at work so that you can get some peace at home, Dan


  4. Mandy, thank you very much. I think that unless people have actually experienced this themselves, they really shouldn't comment, because they just don't know! It's kind of like asking someone to comment on how it feels to stand on the moon and look at the earth ... how would you know?

    Your words touched my heart - thanks again x

  5. i did not face this decision; my Dragon died too fast. i have no personal experience as a foundation to comment. but. should it have been me sitting beside my Dragon and it had to be made, i would have done exactly as you did. Cliff would have done it for you.

    you have my tears. you have my heart. some other place it's blowing like stink and my mind is far north of where i am; up in the wind that is blowing over my island. you also seem to be in a different place than where you are; a quiet, spiritual place where you made a loving decision for Cliff. we are both where we should be.

    the image is hauntingly beautiful and speaks to the anguish and toll the decision cost you. never doubt that Cliff knows you adore him and did everything possible for him. never doubt that he worships the ground you walk on. never, never doubt any of that. i know it's true. don't ask me how. i just do. trust me.

  6. wNs - I did a google image search for "hard choice" and that image just screamed at me!

    thank you for your lovely reply ... yes, we are both where we should be it would seem ... and I do trust you ... and I never doubt his love for me or mine for him xxx

  7. What a brave choice you made. I know the anniversary is coming up next week, and I'll be thinking of you. Keep up your courage.

  8. thanks Thelmaz, it wasn't brave ... it was the only thing I could do for him :-) Thank you for keeping me in your thoughts - I will need your support xx