A journey through life, death, and living

The most unexpected moment of our extended drive through Canada and back last spring came on May 27.  While I kept and published an online travelogue of that trip, this moment doesn’t fit into a travelogue. 

 

We’d reached Plattsburgh, NY after a challenging week of both of us catching a virus and after I’d strained my back badly enough to require muscle relaxants, completely prone bed rest, and a walking cane when I was finally upright.  We spent a week locked away in a Montreal hotel recuperating.  That meant we had to miss the memorial celebration of our dear friend Ben Williams.  While we’d wanted to take the trip across the Trans-Canada Highway for decades, the timing was so we could attend that service.  We were within 130 miles of the memorial, but we ended up watching the video live stream on May 24 from our Montreal hotel room. 

 

A few days after the service, the hotel was full and could no longer extend our stay.  We were feeling better from the virus, and I could walk reasonably with the cane.  We left Montreal for Plattsburgh and were resting in our room watching an HBO documentary series that told the story of Stax Records.  The music and story had us in a good mood.  Mary’s cell rang.  The caller ID read that the caller was “Public Service.”  That seemed an odd ID, so she let it go to voice mail.  Within a few seconds of the last ring, my number rang with a call from the same ID.  I answered.

 

The caller confirmed my name.  He then explained that he was calling from the Pierce County coroner’s office.  There’s one reason a coroner’s office calls, so I knew it was bad news.  We only knew one person in Pierce County whom that office would be contacting us to discuss.  The caller then apologized that he was giving me this information over the phone.  He explained that our brother-in-law Bill had been found deceased in his apartment.  I’d already deduced something like that from the caller’s job title and the county.  But it made no logical sense as I listened. 

 

Bill was fighting lung cancer with a recent surgery and ongoing chemo treatments, but this was just two months into his treatment.  There had been no prior indication to me that he was at risk of death.  When I spoke to him two weeks prior, he sounded tired, and that was an expected part of all he’d recently experienced.  I’d been trying to reach him for a few days, but I figured I’d been calling at the wrong time.  I asked the coroner’s employee to explain what he said a few times so that I could process what he was saying.  Death rarely makes sense.

 

The coroner’s representative explained that a neighbor called police when she hadn’t seen Bill for a few days.  An officer came to conduct a welfare check.  When the officer had no response, he entered the apartment and found Bill.  The circumstances suggested that he died in bed of natural causes.  The officer called the coroner’s office who checked medical databases and found the records of his recent cancer treatment.  Mary and I were listed as emergency contacts there.  The coroner’s employee explained that the officer couldn’t leave the apartment and needed to know which funeral home to call.  I gave him the name of the cremation organization that Bill told me he’d joined.  I also explained that the most appropriate next of kin to make arrangements is Bill’s brother Peter who lives in another state.  I offered to give that number to the caller, but the caller replied that it also was in the records he’d found.  He would call Peter right away.  With that, we ended the call.  It all still made no sense.  I needed to call Peter and follow up.  Maybe he could give me some details that would help. 

 

To give some time for the coroner’s employee to make contact, I waited and then called Peter.  He had been as surprised as I was.  He had some additional details.  He had called Bill’s neighbor when he’d been unable to reach Bill.  Peter’s call to her prompted her to check on Bill.  She found newspapers piled at the door and called the police when she couldn’t get an answer at the door.  Peter and I discussed what the next steps were.  When Bill had the cancer surgery, he sent both Peter and me a detailed e-mail message that described what to do in the event of his death during that surgery.  I filed that without reading it, figuring that it was just an extra precaution and unnecessary since the surgeon told Bill there was minimal risk in the surgery.  Now Peter and I would have to read Bill’s instructions in detail.  Peter would have the bulk of responsibility, but both of would spend a lot of time in the months ahead managing the miscellanies of Bill’s life.

 

Some context:  Bill was my brother-in-law by marriage.  Mary’s sister Ana was married to Bill for over 30 years until Ana’s death in 2020.  We became the primary emergency contact for Bill because we were his only relatives in the area.  When Ana was alive, and for a few years afterward, Bill lived in the same community as we do.  For the last year of his life, he moved to a nearby community in Pierce County, the reason I could deduce the topic of the call from the coroner’s office.  For the three-and-a-half years after Ana’s death, Bill and I spoke regularly.  The two-week break in our regular phone calls (that ended with the call from the coroner’s office) was the longest we’d not talked in that time.  During our calls, Bill kept me apprised of what he was doing and, most recently, what was happening in his treatments.  It’s one reason I was stunned by this news.  He was in the early stages of treatment, not the late stages of cancer.  Everyone I’ve known at this point in cancer treatments was still at the hopeful stage of the battle.  By the time the county issued a death certificate, the coroner confirmed that Bill died of natural causes.  Still, though, now months afterward as I write, his death remains a surprise.  Much of the six months before his death had also been surprises for Bill.

 

Those surprises began on November 9, a little over six months before I received the call in Plattsburgh.  Bill had a colonoscopy scheduled that day.  Since he lived 40 miles away from where he planned to have the colonoscopy, and since the procedure was scheduled for morning, he stayed at a hotel across the street from the hospital clinic that would perform the procedure.  That way, instead of both of us having to be up at 5 AM for me to drive him there, he could get up at a more reasonable time, walk across the street, and I could meet him at the hospital.  I needed to be there to help him after the procedure.  The plan was to walk him from the procedure back to the hotel where he’d spend another night and drive himself home the next day when the effects of anesthesia were gone.  That was the plan.

 

On November 9, I arrived and walked into the hospital just as Bill walked into the lobby.  We serendipitously timed our arrivals perfectly, so we took the elevator upstairs to the colonoscopy clinic.  They took him in immediately, and I settled in for the one-to-two-hour wait that would follow.  I’d just had my own colonoscopy a few weeks before, and my wife had one a week before mine.  I knew this was a short procedure.  When two hours passed and I hadn’t been called to get him, I didn’t think anything of it.  There are a hundred reasons why medical procedures get delayed.  At two-and-a-half hours, I began to wonder what was happening.  At three hours, I was about to go to the desk and ask for an update when a nurse came into the waiting area and called my name.

 

She explained.  The colonoscopy had gone well; however, as Bill was coming out of the anesthesia, his heart rate dropped dramatically to around 20 beats per minute.  He had been conscious and communicating with the staff, but they were concerned.  The nurse and I got to the back room where Bill was resting on a gurney and as talkative as always.  His heart rate had returned to normal, but they needed to admit him to the emergency room so that a cardiologist could review what happened.  An attendant wheeled Bill’s gurney as we negotiated the elevators and hallways and arrived in the emergency room where there was some confusion about where to put Bill. 

 

The confusion got quickly resolved, and they put him into a one-person room – from my experiences with emergency rooms, an unusual step that suggested how seriously they took his condition.  They kept him connected to an EKG and monitored that closely for the next few hours.  Finally, the emergency room cardiologist determined that Bill needed to be transferred to their cardiac ward which was at another campus nearby.  November 9 was on a Thursday, and by the time they made the decision, it was late in the evening.  No beds were available in the cardiac ward.  They would try again on Friday to find a bed, and they would continue to monitor Bill carefully overnight.  I went home.

 

On Friday morning, I arrived to find Bill still in the emergency room.  The emergency services cardiologist strongly inferred a need for a pacemaker.  However, there wouldn’t be a definitive diagnosis until Bill could be transferred to the cardiac unit.  And if a pacemaker were required, it would have to wait until Monday anyway, since the schedule was full that day, and the hospital doesn’t implant pacemakers on the weekend.  So I visited Bill an additional two days in the emergency room where they monitored him until a cardiac bed opened on Saturday night.  When I visited him on Sunday morning, the hospital had transferred him to a cardiac bed.  There, the cardiac team diagnosed him with Wenckebach Syndrome, an irregularity of the heart rhythm.  He would need a pacemaker, so they scheduled him to have it implanted the following day. 

 

On Monday, I arrived as Bill was in the operating room receiving his pacemaker.  When the staff notified me that the procedure was completed, I waited in his room until they wheeled him in.  He was groggy but reasonably coherent.  By the time the surgeon arrived to check in on him, he was close to fully awake.  He and the cardiac surgeon discussed the procedure and its outcome.  Then the team left Bill to rest while I read news articles online.  I went back on Tuesday to give him a ride home.  That, I thought, was that.  He’d have to adjust to life with a pacemaker, but I’ve seen a lot of other folks do that.  It was fortunate they discovered the issue during the colonoscopy.   

 

Unfortunately, that wasn’t the end of the surprises.  Before they discharged Bill from the hospital, the cardiology team ordered an x-ray to check the pacemaker’s placement.  The placement was fine; but they also saw a mass on his lung and suggested further testing to determine what that was.  Within a few weeks that further testing revealed that Bill had lung cancer.  He wasn’t a smoker, but he had lung cancer.  It seemed unfair that someone who exercised to excess and didn’t drink alcohol or smoke would have cancer, especially lung cancer.  But there it was. 

 

Another cancer (of the colon) had killed Bill’s wife, Mary’s sister Ana, three years before.  After helping her navigate five years of cancer treatments that didn’t save her life, Bill was especially anxious.  The hospital recommended a thoracic surgeon to excise the tumor and an oncologist to manage the cancer overall.  In March he had the surgery and spent another five days in the hospital.  The tumor took hours to remove, but further testing showed no systemic spread of the cancer.  Within a few weeks, as he recovered from surgery, the oncologist prescribed chemotherapy once every three weeks.  He’d had one or two treatments when we left for our trip in early May, and he reported the effects were manageable.  Then in late May, six months after Bill went for a routine colon screening, I received the call I describe above. 

 

That was quite a journey:  from colonoscopy to a cardiac pacemaker to lung cancer and then death from natural causes.  Considering it now, my head still spins.  Life really is unscripted.

 

The experiences leave me reflecting on how I reacted to seeing people experience such dramatic life events when I was 20, or 40, or even 60.  In my twenties, I would’ve tried to have it make sense.  I’d be looking for the meaning that helped such a series of events fit into some grand scheme of the universe.  Was this an experience to prepare me for life’s challenges; was it a way of understanding the natural patterns of life and death; could I find some good in what happened?  I may have even kept that meaning-seeking approach into my thirties.  By my forties, though, I’d given up looking for meaning and patterns in life events.  I saw that people who lived self-absorbed, destructive lives thrived while people who selflessly sacrificed for others struggled.  I could be cynical about that and see life nihilistically.  However, I didn’t see any value in nihilism, so I avoided it.  But I stopped trying to find some grand pattern to life.  Instead, in my forties and fifties, I looked for lessons I might take to apply to my own life and the impact I wanted to have in that life. 

 

That changed, too.  As I entered my sixties and now in my early seventies, I no longer need a reason.  There aren’t lessons I can take and apply to my life in Bill’s death.  I learned from how he lived his life, as I’ve learned from just about every person I’ve known.  But his passing leaves me with no lessons to apply, no grand patterns to observe, and no meaning behind the death.  And now as I get closer to my own end, I’m okay with that.  I’m sad to have lost Bill.  I take lessons from having watched parts of his life, but not from his death.  His death just leaves me sad. 

 

That’s the biggest change from my younger days.  I can now understand and experience my emotions without having to take a lesson from an experience.  In the intervening 50 years, I’ve decided that death is loss – no more and no less.  I now experience it regularly as friends, family, and colleagues I’ve known die.  I talk with others my age and older who experience this, too.  As we age, we lose more of the people around us.  Our circles of relationship become smaller as the natural process of death continues.  Understanding and accepting the inevitability of that process doesn’t diminish the losses.  Those aren’t easy.  But without the burden of trying to decipher their meaning, I’m free to experience each death and reflect on what that person’s life meant in my life.  I retain each person’s memory as a vault of treasured, shared experiences.  And I retain my sadness as part of my knowledge of those people. 

 

Each of the deaths I’ve mentioned so far affected me differently because my relationship was different with each person.  Ben Williams (whose memorial service we intended to attend) and I were in graduate school together 30 years ago.  We’re of the same generation with similar values.  When we met, I was in my early 40s, and Ben and his wife Libby in their late 30s.  Mary and I connected with a few other folks during that time, and we all created a community that included one of the professors.  Over the years since then, we gathered sporadically, but the bond we began in grad school remained.  We’d begin discussions as if we were continuing a conversation from the previous day – even though a year or more might have passed since seeing each other.  During the pandemic, we met weekly for virtual cocktails via videoconferencing until that became bi-weekly and then stopped altogether as we all resumed more typical routines as pandemic restrictions lessened.  When Libby sent the group a note explaining that Ben had died from a sudden heart attack, through my tears, I couldn’t grasp his passing.  I still can’t since I expect that he’ll send me one of famously long e-mail messages suggesting that we should connect via phone or video conferencing.  No lessons or patterns to learn from his death, just loss and sadness in knowing I won’t get another one of those messages. 

 

Mary’s sister Ana suffered from both colon cancer and the early stages of dementia in her final years.  Though I met Ana before I knew Mary, Ana was someone I never knew well.  She talked a lot in her earlier years, but the talking was a way of keeping anyone from really knowing her.  She’d talk about martial arts (she became an expert Wing Chun practitioner), or politics, or the price of groceries, or any topic.  She didn’t talk to communicate and rarely acknowledged what anyone else said.  She talked to fill the empty space between her and other people.  It was a trait in her family as many of them did the same.  As she faded into dementia and the effects of cancer, it was hard for me to feel her loss as deeply as I would for others I’ve known more closely.  I was as sad for the way in which she lived her last years as I was about losing her.  Bill’s death similarly affected me.  In our regular conversations, he remarked at how isolated he felt after Ana died.  Nothing could bring him any joy or comfort.  I watched as Bill’s experiences reinforced my understanding of the need for personal connections in my life.  In some ways, I’m relieved to know that he died peacefully in his sleep.  And, as with Ana, I’m sad that someone lived in such melancholy. 

 

In these three deaths, I see the current state of my evolution about death.  I’ve been aware of death throughout my life.  My father died when I was 15, and other relatives’ and friends’ deaths contributed to my awareness of death as a constant in life.  Now, as I contemplate my own ending, I see how death leaves only emotions.  Each of the deaths I describe here, and all the ones I can think of in my life, elicit different emotions.  I’m left to sort through them to understand what I’m feeling and why.  That seems a big enough task to process without seeking meaning or purpose.  I share all this publicly as a way of expressing some of those emotions – and in the hope that someone reads this and can see a reflection of their own emotional journey.  While I don’t see grand patterns of life from which to learn, shared emotion is something that feels very human.  It’s by sharing joy and grief and everything in between that we affirm life.   So I share these emotions as a way of affirming my life and the lives of all whom I’ve known.