Thursday, April 18, 2013 – Day 9
Alan has been sleeping comfortably during the early morning hours. We can hear the rattling in his lungs.
Alan’s sister calls on the phone, and we put the phone to Alan’s ear and he raises his eyebrows once.
At about noon, I ask Alan if he is comfortable, and he blinks. “yes.” (I asked him to blink for “yes.”
Two hours later, at 2:00 p.m., Alan is wincing a lot more and there is more fluid in his lungs. I ask if he needs pain relief, and he squeezes his eyes indicating, “yes.”
A bit later, after he has gotten medication, I ask Alan if he is comfortable, and with his eyes closed, he squeezes them, “yes.”
We talk with the doctor this evening, and his medication is adjusted for comfort due to breakthrough pain from increased fluid in his lungs. The Fentanyl patches are more appropriate now than the liquid morphine. There is some brow furrowing; some coughing and some fleeting distress.
By 6:07p.m., Alan is very peaceful, with a relaxed face and no coughing.
Friday, April 19, 2013 – Day 10
At 12:40 a.m. the caregiver wakes me because she senses a shift in Alan. Alan’s breathing is more shallow and loud. His breathing sounds labored some of the time. I immediately go downstairs and get into bed with him. We adjust the bed to make it more comfortable for him.
It is disconcerting to hear Alan’s loud breathing. I don’t know how to interpret it. At 4:00 a.m., Alan’s heartbeat is 134 beats per minute. His breathing continues to be loud and fast paced, and it is no longer possible for me to communicate with him. I am extremely tired myself and stay in bed with Alan (but unable to sleep) until 5:30 a.m. I leave his bed at that point to get some sleep myself. I feel disturbed and know that something has shifted.
About 8:45 a.m., Alan’s feet are cold. His back and head are sweaty. His right foot is mottled blue.
It appears that Alan is in a coma. Nevertheless, I tell Alan that I am going for a walk and that he can pass if he wants to while I am out. The walk never occurs because the doctor arrives early. She does a neurological exam and says there is only some brain stem activity. The brain stem is keeping his heart and lungs functioning. The rest of his brain is not functioning. For about one day, Alan’s heartbeat has been 140 – 160 beats per minute. The doctor says that his heart is still strong. I talk privately with the doctor. I feel perturbed because I don’t want Alan to suffer, and I want him to be able to release from his body.
After the doctor leaves, I need to talk with a trusted friend, but I can’t reach her. Then I decide to call a counselor that Alan and I have consulted with for many years.
I put the speaker phone by Alan and the counselor talks to him for a couple of minutes. He is completely unresponsive. Then I hang up the phone, and put it outside Alan’s bedroom on the floor, and I close the door to his bedroom.
I want to do something to help him leave his body, but I don’t know what to do. I stand still and wait.
I stand still and wait. I start doing Therapeutic Touch (an energetic healing modality I learned from nurses in the 1990s) and I begin to talk to Alan. I vigorously sweep my hands a few inches above his body, from the top of Alan’s head, down his body, out his feet. I begin to sing sacred music to Alan.
I then talk to Alan lovingly and directly, the way we always communicate with one another. I talk about how we have partnered together for the last twenty-six years and that this is our last partnership, the last time we will work together. I mention how I created many ideas and situations for us, and how he always helped to manifest them. I tell him that he can let go now; that he can leave his body now. I stop, thinking that I’m done, and I stand still.
I feel compelled to look up and to the right and sense that Alan’s “spirit” has left his body even though his body is still breathing. “Alan, you’ve already left. You’re watching everything now. You’re only holding on by a few threads. You can let go now. You’ve been very courageous. I’m going to be all right. I’m going to usher you home. You can let go. I’m going to midwife you home.”
While I’m talking to him, there is an abrupt change, from one breath to the next, from that loud, rapid breathing to a very slow gentle breath, with his mouth wide open. He takes maybe two or three of these breaths. His last breath is so gentle that I can’t even detect it. He leaves his body.
Two friends are waiting for me in the house. While I am still in the room with Alan, one says to the other, “We need air in here.” They open both doors, front and side, to create cross ventilation.” My other friend is thinking, “Alan why don’t you fly out with the breeze?” A minute later I come out and say “He is gone.”
I call our doctor and she returns to the house. At 2:42 p.m., she examines Alan and declares him “dead.” She writes, “Patient has expired. No cardiac or respiratory activity. No corneal touch reflex. Pupils fully dilated. Immediate: cardiac arrest. Proximate: renal failure, dehydration.
The doctor tells us that when she left the house earlier that day, she called a consulting, palliative physician to get feedback on Alan’s trajectory. The palliative care doctor said that, based on our doctor’s exam and findings, Alan would likely live one to three more days.
Rather than it taking one to three more days, Alan left his body in fifteen minutes, with me by his side, loving him and talking to him when he took his last breath.