Random and not so random musings from a 5th generation NE Missourian who became a 1st generation Episcopalian. Let the good times roll!

O God of grace and glory, we remember before you this day our sister Kirstin. We thank you for giving her to us, her family and friends, to know and to love as a companion on our earthly pilgrimage. In your boundless compassion, console us who mourn. Give us faith to see in death the gate of eternal life, so that in quiet confidence we may continue our course on earth, until, by your call, we are reunited with those who have gone before; through Jesus Christ our Lord. Amen.

--Book of Common Prayer, p. 493

Our blogfriend Kirstin left this earth at approximately 8 p.m. Pacific time (10 p.m. here in Missouri.)

Most of you who are regular readers to my blog know that Kirstin valiantly got in the face of metastatic malignant melanoma for as long as she could, before finally succumbing to the disease. She exited this life in the care of Hospice and attended by her roommate Andee, who participated in so many aspects of her care towards the end, including acting as midwife for Kirstin's rebirth into the company of Heaven. She was also attended by her own "company of Heaven on earth"--literally hundreds of people she knew through her blog and on Facebook--dubbed "the flashmob of grace." It is truly a testimony to the power of social networking on the Internet.

It's odd--the pain many of my friends have been experiencing on Facebook and in the blogosphere has been palpable. I've certainly had mine too, but there's a different quality to mine. Not "better" or "worse"--just different. I guess I'd best describe it as a veteran of "I know too well how this story ends."

Once again, my clinical nose detected a prelude to this. When Kirstin made the decision to cease chemotherapy, and made her announcement, her thanks, and yes, her "early goodbyes,"--I sensed this would happen much faster than what folks were cogitating as to the time frame. I have seen this one so many times. Once people semi-officially say their goodbyes, they simply take their leave from this world much more quickly than people expect. It's normal--very normal--for them to do that, and it's just as very normal for those around them to expect their loved one to be there tomorrow, just as they are today.

It's such an odd dance. We know they will be leaving soon...but not too soon, we all wish. The dying person, though, has already set his or her face towards Jerusalem. So, almost, without warning, the bottom drops out, and they fade quickly. They choose to accept more morphine at the trade-off of their cognition. Before you know it, everyone is in the death watch.

I've sat many times at the side of beds where the breathing has changed, first to a more shallow state, then to a more agonal, gasping one, with long pregnant pauses, and one knows death is imminent. I've watched the chests of those people, straining to get a look to see if they're retracting their chest muscles just a little too sharply and a little too upward--a sure sign they need their next dose of morphine. I always wince just a little bit for them. When I have actually administered the dose, I felt relief, too.

I've always been surprised at how few medical students, interns, and residents have actually sat with the dying for any length of time other than little quick checks and popping their heads in. Granted, they are busier in their clinical life than ever before. But I think it should be mandatory to have to sit there for a spell. This sounds strange, but I believe they miss out on something holy if they don't.

I've heard many of my Facebook friends damning cancer these last few weeks.

Oddly, I have not.

Cancer and I have a strange relationship. She makes me a pretty decent living, unfortunately. Somehow, it seems hypocritical for me to damn her. The pathologist in me, that eternal fatalist, knows none of us gets out of this life alive. I can't see the point in damning one way out vs. another. Almost every working day of my life I sign at least one pathology report that slaps a new cancer diagnosis on someone, or a recurrence. Cancer and I glare across the table at each other, like two family members who wish they were related to someone else but there's no mistaking we are related.

Cancer. She's a bitter, cruel, jealous, hardhearted wench--but I have to admit I have a respect for her. I respect her immortality in the glaring light of my mortality. We talk about how cancer cells are "immortal" in cell culture--they can be passed in culture far, far more times than viable, normal cells can--they ignore all the biological things that tell cells to age and die. They only die in human beings when their human host dies, or they are excised surgically. Even then, they cling to their own life with a desperation far beyond our mortal powers. All it takes is for one to escape and find a new home in their host, which is why we poison people with chemotherapy, and sicken them with ionizing radiation. They are the ultimate parasite, with a will to live beyond ours. I can't help but respect a will to live like that.

But I'll tell you one thing she does, that dropping dead of a heart attack, that dwindling to death from congestive heart failure's cruel "let's see how it goes today," way, that being untimely yanked out of this world by a fatal car wreck doesn't do--she gives people the opportunity for a type of closure that can truly be sacred. She gives her hosts the freedom to make choices, like when to stop treatment, when to crank up the morphine. At least in those terms, she's a genteel lady. She's an oh-so-bitterly cruel mistress in other ways, but when people have gotten to stage their exits with her, there's actually a kindness in the way they go.

So, no, I can't bring myself to damn cancer. I can only bring myself to grieve for a broken world and that things like her have the power to take those I love from me, at least in this life and in this plane of existence.

What cancer, does do, though, is remind me to live for today. She reminds me my ability to control only goes so far, and my wants and needs are not always what happens in life.

One of the things I have often told the dying is, "It's okay to go. I'll be sad--so sad for you to go, but I'll be okay. You run along now," and when it's applicable in their faith tradition, "You run along to Jesus."

I told Kirstin a couple of weeks before her death, "Stay as long as you can with us. But when you feel it's time for you to go, we will wait beside you and be faithful."

Kirstin held onto life with a passion. It only stood to reason. She was a passionate life personified. She might have been taken from this earth at roughly half the normal human lifespan, but she lived three full lifetimes, I believe, in those 40 years. I grieve her loss, but I don't grieve a single thing "undone" in her life. Obviously, there were many things undone in her life at the time she died. But there was so much "done," the "undone" becomes inconsequential.

I have thought so much about Andee during this time. I've thought about how, for so many months, she has done so much for Kirstin, and how much her own life has revolved around Kirstin's needs, her doctor appointments, and, as time went on, "Kirstin's condition." Suddenly, Andee's life is her own again. I suspect that "choosing for herself" will seem strange and bewildering. I think about the times I was a caregiver, and suddenly, that person was no longer there to care for. I remember my own emptiness when that hole so shockingly emerged. I suspect Andee will feel something similar to that for some time. My prayers go out to her as she navigates that void.

The strangest things seem "right" when one sits with the dying. For me, it's an old Bob Wills tune. It has popped in my head many times before in this situation.

I sat by my chiminea a lot, these last few days, as her tumors started robbing her of her strength and her mortal self, and I guess I shouldn't have been surprised, when that tune popped up again. But it just felt right, in that dance we'd been doing with her:

Stay all night, stay a little longer,
Dance all night, dance a little longer,

Pull off your coat, throw it in the corner,

Don't see why you can't stay a little longer.

We, the living, are the ones who never quite get the dance steps right. We pretend at times, the person is not dying. We think the dying will be at a slower tempo. We, God help us, at times, even "wish that dying thing would be over with." We get in a rush for the process to speed up, in order to ease OUR pain. But when the dying begins in earnest, we scream, "NO! Not now. Not yet."

The one dying of cancer? They, more often than not, leave us right on cue.

Kirstin, may you rest in peace, and rise in glory.


Hmmmm.... as always you provoke. I have been writing "I hate you stupid cancer" in comment boxes and on Facebook since February.

However, you have urged me to reconsider my position.

Having lost loved ones in various ways, yes, there is something, something big, in what you say.

However, I still want to say those words. These things take time.

We have a new saint in the Great Cloud of Witnesses and her huge, bright smile illuminates the heavens.

She will help us all, her person may not exist in this mortal place, but her soul and spirit and light shine on in eternity, ever brighter.

Well, Fran, and let me start with I would never presume to feel for anyone else. People feel what they feel! I am always in a weird place. My entire day consists of "putting names on diseases." Twenty years of being surrounded by disease, I have a weird detachment to them. They are just names for me. Have I been jealous that you can shake your fist at it and call it names and hate cancer? Maybe. It's part of that wonderful interchange we have, which includes being provoked in sacred ways!

A local friend of mine has been living with her breast cancer for a number of years now. More than once she has been told to make preparations for the end. However, she takes a very different view. The cancer is her - it is a part of her, it is her cells - she chooses not to see it as the enemy.

Unlike a bacterial invasion from tainted beef or vegetables, cancer springs up from within us. It is as much an expression of our bodies as a failing heart. In many ways it is too much life in those particular cells, too much reproduction, too much intransience, too much growth...

In any case, Maria, beautiful post. I have been at the bedside of a baby being born and I have been at the bedside of patients when they have passed on. Both are equally holy.

In our inability to completely live in the now (as our dogs try so hard to teach us) we cling desperately to life and fear death immensely.

However, I am always reminded of an image - did I get it from C.S. Lewis? - of the bowl of ice floating on the water - death is merely the disintegration of the bowl that allows the ice to mingle back with the great water.

Thanks Maria and renzmqt-- things I have thought but not put into words. My brother's cancer killed him in 4 days from diagnosis - but we all got to say goodbye and he had lived choosing to spend time with his kids and grandkids - not waiting. My thoughts here

I don't really have a comment, Maria, other than to say thank you. Beautifully and thoughtfully put. Solid nourishment in one of those times we are likely to forget to eat. Thanks for your comments along the way in recent days.

As a priest, one of the most intimate and holy acts I have the privilege of participating in is keeping vigil with someone in their last days, hours, minutes until their nephesh leaves their body. When Kirstin wrote of sounding like Darth Vadar two weeks ago (?) I knew. That still doesn't mean that I hoped she would be around longer but the signs were all there.

My brother is a pathologist, aware of the decisions he makes will alter the course of another person's life. It is another one of those privileges.

And yes Andee now is in freefall, having devoted all her time and energy to Kirstin's needs. It is a strange thing to be running full tilt on a treadmill only to have the electricity turned off. Such is the journey toward the end.

Much to ponder in your post.

Regardless, I still grieve. Perhaps for those of us who walk with the dying, when it is one of our 'own' all the others are wrapped up in there.

Twice during Last Rites - people have slipped away as we prayed. It is a holy moment.

Wonderful words, all of you.

Caminante, you are exactly right about "when it is one of our 'own' all the others are wrapped up in there." Kirstin's dying hooked into my friend John's dying earlier in the year...which hooked into our parishoner Vince's dying, which hooked into both my grandparents' dying...and the dying of other friends, and relatives of many special people I knew in traning at the Columbia, MO VA and the University of Missouri hospital...and on and on and on.

I have discovered when the "next" one dies, all those dying people come back to visit me, and all the bittersweetness comes pouring back.

Ann, your story reminds me of my friend John's last rites, not quite so fast, but not long after, and near the stroke of midnight on Easter:

I believe John wanted to see the kingdom of Heaven on Easter Morning, and he did.

Thanks, Kirkepiscatoid, for this post about your view on cancer. It clarifies a few things for me. And what you say about 'having the time to say goodbye,' strikes a chord in me, but I never felt that close to having to do that. During my period of being treated for colon cancer, I never hated it or assigned it a gender. I felt that I could not 'waste' my energy on that kind of thought. I tried to visualize chemo as cancer killers(which it is) ridding my body of any and all stray cells, and constantly thought about the highest possible odds of complete cure. If I could make all those low numbers add up to a larger one, I did it. It may sound totally Pollyanna-ish, but it's what I did. I have not completely dismissed the thought lurking in the back of my mind that even though I have been pronounced cured, it will prolly pop up again, but I also keep in there a thought about my wonderful surgeon said, "It's working."

Susan, your story reminds me of the woman who walked into my office one day and said, "Are you the person who signed my path report? I want you to show me my cancer."

At first, I thought she didn't believe it or something, but as I had someone pull the slides out of the file, she continued..."I want to see what it looks like. I want to look at it in its little beady eyes. I start chemo next week and I want to, when I'm feeling sick as a dog, have that visual picture of it in my head, as those little son-of-a-bitchin' cells gag and die."

So we sat at the two headed microscope and I gave her a "tour." Showed her the tumor, how it grew, how it was in the lymphatics, the single positive lymph node. I lost track of her when I moved to Kirksville, but I certainly do remember her!

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What a wonderful post and honor to the life of Kirstin. It is indeeed an honor to sit with someone the last weeks, days and hours of their life. Cancer is a cruel mistress indeed, but the privilege of being said goodbye to is a litlle bit of comfort in that terrible time.

I removed my other comment because I had strayed away from the original intent of your post Maria.

No need! I thought it was fine!

One of the best things you have ever written, Kirk--and I don't say that lightly.

Thank you for sharing your unique perspective. I have watched the fallout from sudden death--the anguish over rifts unhealed or words of love unexpressed. I have watched "the Long Goodbye" of Alzheimer's--the slow disintegration of memory and cognition and the pain of those left behind at being unrecognized and unheard.

When compared to those kinds of death, cancer is, indeed, a kindness. It is hard to see her so when the pain of losing/loss is so fresh, but I believe it is a great gift to know that you are going to die within a specified period of time. Almost all of us live as if we have all the time in the world--when we do not.

Thank you for reminding us of this.


Thanks. And when I think of "caregivers," Doxy, I often think of you, a caregiver of the nth degree in that "sandwich generation"--older AND younger. In my prayer time, sometimes I wish for you a day here and there, where the only person you have to care for, is you! Imagine it!

In my prayer time, sometimes I wish for you a day here and there, where the only person you have to care for, is you! Imagine it!

You just made me cry...bless you.

Your prayer will be answered later this month, TBTG. Kids and grandma will be safe with others and Dear Friend and I will have a week ALONE! :-)



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I'm a longtime area resident of that quirky and wonderful place called Kirksville, MO and am wondering what God has hiding round the next corner in my life.

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