What it's like watching someone you love die

(originally published 10/12/06)

WARNING: UNCOMFORTABLE SUBJECT MATTER

That includes me.

When my wife was diagnosed with breast cancer last year, I had seen what medicine could do, and I believed cancer was treatable. My mother had fought it and won. She had lost several organs, but she has lived years beyond the six weeks she was given in 1999. We also seemed to be blessed because my wife had gone to the hospital with pneumonia just about the time the first tumor became noticeable, so she was able to bypass weeks of waiting for a biopsy and was diagnosed right away.

We knew it was going to be a tough fight, but it was one I never thought we'd lose.

After chemotherapy, a mastectomy and radiation treatment, we thought it was all over. We even bought a house, expecting to spend years together.

That happy delusion ended in late December, when she started getting bumps on the area the breast had been removed. At first I thought they were boils or pimples. Turns out they weren't.

The cancer Deb had was an aggressive strain. It was first noticed when it was pea-sized. Less than two weeks later, it was about fist-sized. Then, I suppose, we should have guessed it had already spread beyond the breast and into the lymph nodes, from where it could travel anywhere in the body. The surgeon removed most of her nodes then, but by then it was too late for anyone to do anything.

We didn't know that, of course. We just thought it was time for more chemo to knock this thing out for once and for all. We heard the cancer was in the chest wall and there were spots on her liver. OK, not good news, but not end-of-the-world type stuff. Back into chemo we went, and at first it seemed like we were winning. After the first round, the spots on the liver were nearly gone, and the bumps on her chest nearly vanished. We thought one more round, and she'd be able to take a break. We tentatively planned a trip, even a cruise in January with Barenaked Ladies.

Then after the next round, we were told the cancer had stopped reacting to the drugs. A bump on her chest re-emerged and was growing. The spot on her liver had grown. She was having trouble breathing, which was attributed to pleural effusion, or fluid building up outside the lung, compressing it. She was given a different drug, one that we hoped would be more effective.

She couldn't tolerate the Xeloda, though, and ended up in the hospital. She was having trouble breathing, and we again thought it was because of fluid outside the lung.

What we didn't know was the problem was inside the lung. The cancer had taken hold. Because of her weakness, chemotherapy was not an option. The doctor told us to consider hospice care to make her comfortable. I don't think even he knew how bad it was, though, because he told us there was a chance she could regain her strength and re-enter treatment.

When the doctor left us alone to discuss it, the first thing she said to me was, "I guess that means no cruise."

We agreed to stop treatment. But we also agreed that if she could get better, she would go back into treatment.

So I brought her home for what I thought would be a few weeks of recuperation. That was Friday.

The weekend is a blur to me. She was groggy and uncommunicative, something I blamed on the painkiller she got. I made a note to talk to her regular nurse on Monday about reducing the dosage so she'd be able to concentrate. I stayed at her bedside, talked to her, gave her what little food she felt like eating, welcomed the women from her support group who came to visit. At no point did I think anything but recuperation.

Monday morning the nurse came, and I asked if it was the painkiller making her groggy. No, she said. The dying process had begun.

That was about 8:30 a.m. Deb was gone by 4:15 p.m.

Now, I realize I had seen the same signs with Deb that I had seen with my father when he passed away. I just didn't realize what they had meant with Deb. So though we had lived with cancer for 18 months, it was only those last eight hours that I realized it was a fatal disease.

I stayed by her bedside the rest of the day. I kept talking to her, retelling the story of our life together, from our first meeting, to my awkward proposal in our pajamas, to the things we had planned to do. When I couldn't think of anything else to say, I went over to the bookshelf and pulled out her copy of "Winnie the Pooh," her favorite childhood book, and read to her.

About 2 p.m., her breathing became harder, and she started moaning with each breath. I called the hospice nurse and asked if she could come over and increase the painkiller dosage to make her more comfortable. By the time she had arrived and examined her, her breathing had settled down. I thought, good, she's comfortable.

The nurse told me, "Her last great adventure had begun." .

I held her hand for the next hour, telling her I loved her. That she would always be my girl. That she had made me the happiest guy in the world. I was determined that the last thing she would hear in this life was how special she was to me and that I loved her.

And it was.

The nurse and I watched her last breath. Then black fluid began to trickle from her nose. First I thought it was a nosebleed, but then the trickle became a torrent, from her nose and her mouth. It was as if all the cancer, all the bad stuff within in her had known its job was done and it was time to go.

The nurse put the stethoscope on Deb's chest, listened and said, "She's gone."

I held it together long enough to step outside and call her mother and father. I cried a little during both calls, but I was able to get the message out. Then I called my mother, and by the time she got on the phone I had no strength left. I remember seeing the construction workers building a house down the street looking at me as I wailed in pain and sorrow.

Then I went back inside and asked to help clean her up. I had promised to take care of her, and I wasn't done.

When we had finished, I noticed something that I hadn't before.

Deb's last act on this earth was to let me know she was OK, that it was finally over, that she had finally found peace.

She was smiling.