A GOOD DEATH: What my mother’s last request taught me about grief, surrender, and letting go
“I want a beer. Coors. Just put one in your purse and bring it to me.”
Such a banal request wouldn’t sound so outrageous if it weren’t coming from my eighty-year-old mother about to enter the intensive care unit for a raging lung infection. Two days earlier, she’d landed in her doctor’s office with an intractable cough that I thought was a side effect of the immunotherapy she’d started for an inoperable cancer in her jejunum. But no, it was much worse—a serious pneumonia that had already killed lung tissue and now took priority. The cancer would have to wait.
I was not quite ready for the end, though I was thinking about the meaning of a good death as I took in the circumstances, the gravity of her predicament, and the noise of her pain. We were in a small corner space of the postsurgical recovery room following a procedure to suck out some of the lung’s culprits for culturing. The slightest movement triggered heart-wrenching wails. Murmurs of a dying animal. The feeling of powerlessness was viscerally uncomfortable but I couldn’t—I wouldn’t—walk away. And then her simple request for a beer riveted me to the spot, as if I were about to witness something extraordinary. A portal of some sort. The look on my mother’s face was indescribable as she locked her eyes on me and asked again in a moment of startling clarity: “I. Want. A. Cold. Beer.”
Searching for humor to quell the rush of emotions, I immediately thought how great such a scene would be for a Super Bowl ad. An old woman’s last dying wish: a cold Coors. Cue the excellently choreographed deathbed scene with angels in sight. But this wish was much more. It held a meaning only I could recognize. A private message for me.
Exactly ten years to the day of my mother’s hospital admission, I had walked my father into the same hospital following a diagnosis of treatable cancer. He didn’t make it out. He died eleven days later from an infection he contracted after a round of chemotherapy that had leveled his immune system. The last drink he’d enjoyed at home before I picked him up had been a beer to toast the fact his cancer had a treatment plan and the prognosis was good. He was ready for the fight. He was strong, someone I’d coxed down the racecourse just months prior for one of his masters rowing events. But then the infection that bloomed a few days into his hospital stay sank its claws in deep. We didn’t see that coming. Nobody did. The doctors scrambled to control it; when they wheeled him into the ICU promising to get him back to his regular room once he cleared the infection, I caught a glimpse of fear in his expression that will haunt me the rest of my life. I’ll never be able to unsee his terror. He was going down and he knew it. I pretended everything would be okay. But it wasn’t. I lied. And it was not a good death. “I’m glad he got to drink that beer,” one of the nurses whispered to me as my dad spiraled toward his end; she had noticed the detail in his chart. His undoing was awful, one of the hardest things I’ve ever witnessed. I didn’t want a repeat of that when it came to Mom. I also realized that a good death isn’t necessarily the death we want for someone; it’s the death we eventually learn to allow.
My mother rarely drank beer, and she hadn’t had alcohol in years. “Are you talking to the other side?” I found myself asking reflexively as she glanced up at me strangely from her gurney, surrounded by snaking tubes and beeping monitors. Was Dad on the etheric side of this room? I punched back, “Are you really asking for a beer given where you are, Mom?”
How fascinating: Dad got his beer when he believed he had a future; Mom asked for the beer when she was losing hers. Even though her eyes lacked complete focus, the urgency of her plea in her voice was unmistakable. “Beer. Please. You can just hide it in your bag.” Now her demand felt like an admonishment. As much as I felt like the parent in this position, her request cast me back to being a child taking orders.
I started strategizing, thinking I could use the beer as a ploy to delay her ultimate demise. To somehow give me more time to brace for the imminent death process. I wouldn’t bring the beer until I was ready. Hold my mother hostage here a little longer. When you’re about to lose the second parent, a weird current moves through you at the thought of entering the Parentless Club. As I experienced with my dad’s death, the missing starts before they are gone. Perhaps that’s the mind’s way of starting to cope. And to prepare.
She miraculously survived for several more days. But there would be no recovery. She reached the threshold, and we had to shift from treatment to palliative care. It’s a line you cross that changes everything. No surprise that a difficult, complicated woman would meet a difficult, complicated end. Unlike my relationship with my dad, the one with my mother was challenging for most of my life; we were polarities. Yet this final stage held no past in its container—it was all about the future now, and her eventual death. I think she knew she was stuck with me in this last chapter; my sisters would not show up. Part of me wanted to create one more fun memory and experience something new. I thought about smoking a cigarette, which I’d never done before, and doing so as she drank her beer. A closing act of rebellion that epitomized my mother’s way of life. This was it, after all. At least for her.
There’s a process in those final days and hours that is akin to labor in childbirth. You step toward the goal with methodical, intentional care, surrendering to each stage as it comes. But clearly the outcome is different. It can be a wondrous mix of beauty, torture, horror, hope, and hallelujah. This was the woman who’d brought me into the world, and I’d see her out of it. My mother knew she was dying despite the haze that had shrouded her brain for a long time. I was astonished by how coherent and communicative she was, a phenomenon known as terminal lucidity, or end-of-life-rally that no scientist can explain. When she begged me to “help her sleep” and asked, “Tell me how to go,” I said I didn’t know how it worked at this juncture. All the science, religion, philosophy, and spirituality in the world couldn’t inform this insoluble question. She was on the edge of something none of us can name. I told her to just let go and surrender. “You’re all done here, Mom. Go see Dad. It’s all okay.” Once I said those words garbled by my tears, I knew I was ready.
The nurse caught me the next night when I smuggled in her last drink. My attempts to be discreet were foiled by my emotions. Luckily, the nurse turned a blind eye to my transgression. “At this point,” she said, “I don’t care. She can have whatever she wants now. Just don’t do this again.” (Point taken.) My mother took only one small sip as if drinking from the chalice at the Last Supper. Confession: I brought her a nice pinot noir, not a beer, because I knew she’d enjoy it more—sorry, Dad. I thought this would be close to her final night but of course God plays jokes on us. I should have brought a beer.
No doctor could tell me how many more hours—or days—she would hold on. And hold on she did for another week. She got home in time to die just after midnight on a Saturday night in the den that had become her makeshift hospital room. It was quiet; it was peaceful. Ativan and a bottle of morphine that looked like children’s cough syrup helped cushion the fall. I was stunned by how “spicy” she remained until the very end. The doctors had used that word to describe patients before they tumbled into the delirious abyss that precedes death. Spicy. I took the word to mean cantankerous, combative, and exasperating—the essence of my mother. I had imagined (okay, more like worried about) this moment for years, wondering if I’d feel the urge to have that final conversation to clear out old grudges and issues. But no, there was no such impulse. We exchanged I-love-yous that were fifty years late, and I promised to make sure peace prevailed in our family, which had fractured since my father’s death. I asked her how I’d know if she made it to the other side and she said, again with so much ridiculous lucidity, “I’ll tell you about the weather.” Clever, I thought.
Minutes before she went over that mortal cliff, she wiggled, showed signs of agitation, and mumbled something to someone I couldn’t see across the room. Was that Dad coming to get her? My eyes released fresh tears of sorrow and shock as I searched the dimly lit room wishing for celestial-vision goggles. I didn’t see anything. I held her arm and hand, slouching toward her awkwardly from the bedside chair where I’d been stationed for hours. The stillness was surreal. No amount of watching death scenes in cinema prepared me for this moment in real life. I held my breath in a bid to stop time for a second. Then she broke into a cold sweat and took her last breath. Eyes open. Spicy indeed.
That was a good death. And somewhere in it, I like to think, she finally got her beer.