Kirkepiscatoid

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.