My daughter-in-law Katie died January 9 of this year of adrenocortical carcinoma. She was 26, and had been married to my son Josh for just over 15 months. From the time of her diagnosis, she lived another seven months. Katie had lots of friends and family that loved her and miss her now, and they all had a unique and important view of her life, but this is my remembrance. There will 6 or 7 installments, all based on a number of days: how long I knew her, how long she was married to Josh, how long we knew she had cancer, for example – each to try and remember things about the unexpectedly short time that our lives intersected. Each part will concern a progressively longer number of days.
Part 1: 1 Day
January 9, 2014. One terrible day. We had known it was coming for a while, and it seemed to be comfortingly distant – just over the horizon. It was, we knew, an horizon that was shortening rapidly. The previous few weeks had included indicators that forced us to see the unavoidable story that was being written between the lines. Then “the day” arrived. We had forestalled it in our minds for many months; now, it imposed itself on us. No further mental escape tricks were available.
She had been soldiering along and doing fairly well. Easy for me to say – Katie had been diagnosed with adrenocortical carcinoma in May of 2013, and the disease had taken its toll. We only saw what the last nine months of the disease did; we suspect she had it for as long as a couple of years – before she even met Josh. From the healthy, vibrant young women I met in the summer of 2012, she had been reduced, in a physical way, to a gaunt shadow of her former self. Much of her muscle mass had been eaten away by the cancer, and the largest tumor (there were, as Josh would tell me later, many) was prominent in her abdomen, just below her rib cage. It was the size of a football.
Katie had been in the hospital for about a week, and had returned home the day before. She was pretty weak, but we thought she would be out of the woods for a little while. On January 8, I went to work expecting to see her at the end of the day; lying in bed to try and get relief from the pain she was experiencing, mustering her beautiful smile to disguise how she really felt. Her response to the “how are you feeling” question was invariably “pretty good”, even when she was obviously in pain.
I got a call at midday from my audibly distressed daughter saying that Josh had to call the ambulance to take Katie back to the emergency room, as she was experiencing some disturbing heart issues. The diagnosis was not good; her vital organs were failing, and she had “hours to days” to live. It was hours. By 1:13 the next morning, she was gone.
The hours that led up to her last breath were some of the most difficult, but uplifting that I have ever experienced. That’s a pretty striking contrast, I know. Death is an unpleasant thing; we don’t like to talk about it much, except in abstract kinds of ways. We’ve invented clever euphemisms for it, to disguise our distaste: “she passed away”; “she’s gone to be with Jesus”; “she’s in a better place now, with no more pain”; you get the idea. Even for Christians that believe your final breath here transports you to the loving embrace of the Savior, it’s tough. Sure, it’s great to have the comfort that “absent from the body is present with the Lord” (another of those convenient, but in this case scripturally accurate, euphemisms), but the actual act of dying is not something any of us looks forward to. I think there’s a song lyric somewhere that says “everybody wants to go to Heaven, but no one wants to die to get there.” You don’t really want to be around when someone is dying, because the thought of them leaving for good is unpleasant. It also reminds you that your days here are numbered. When that someone is 26 years old and is your son’s wife of only 15 months, it is stark, unbearable, and full of sorrow.
I remember when my father died. At 70 years, he led a long and fruitful life, and got to experience all the things you’d expect from a lifetime. His organs had failed, or were failing: the side effects of renal cancer, treatments and unexpected emergency surgery. My siblings and I assembled with my mother and agreed to follow Dad’s wishes: he didn’t want to be kept alive by machines. All that remained was to turn off the machines and let him go. We went to stand by his bed and say our goodbyes, and I wept that he was leaving us so soon and there was nothing I could do about it.
For some foolish reason (or, perhaps, hopeful?), I expected him to soldier on with the cancer for a couple more years. After all, he had been doing fairly well – right up to the moment when he suddenly stopped. When the time came to turn off the machines, I couldn’t stay. My brother and one of my sisters did stay, to see that he was treated respectfully. Death, being the distasteful thing it is, was not something I wanted to stay around to see. I believe my father was indeed transported to the loving arms of the Savior at the moment he breathed his last, but seeing him make that quantum leap was too much for me to bear. I sat in the waiting room with my mother and awaited my brother’s confirmation that it was over. I regret not having stayed by his side, to hold his hand until the end. At the time I couldn’t overcome my dislike for the dying part of his going to meet Jesus. In retrospect, I was ashamed that I wasn’t “man enough” to stand there and watch him die. I’m pretty sure that had something to do with my presence at the moment Katie died.
I headed down to the VCU Medical Center (what we still call MCV) as soon as I got the call from Lindsey. It took me 30 minutes to find a god-forsaken parking place. I drove through the deck three times, hoping a spot would open up, but none did. The helpful soul in the pay-booth at the exit of the deck offered me a “free” valet parking stub, but my wife informed me on the phone not to use it, as she had already attempted that route and found it to be a multi-ring circus of inefficiency. I finally found a place on the street a few blocks away, and paid the meter for the two-hour time limit. I was actually a bit relieved by the fact that I had a two-hour limit; this would give me a convenient excuse to escape the uncomfortable vigil, if only for a bit, to find a new place to park. By the time I got in the hospital, my wife informed me that they were moving Katie to the palliative care unit. For me, whenever someone was moved to the palliative care unit, they were basically going there to die.
Traversing the labyrinth of hospital corridors, with floor numbers that don’t line up, and passageways that seem designed to confuse even the brightest of rats, we found our way to the palliative care unit and the little waiting room that would be our outpost for the remainder of our vigil. Some of Katie’s best girl friends were already there, and so were members of her family. The senior pastor from our church, along with another that Katie and Josh considered a good friend were there. The little room would fill to nearly overflowing before the evening was out, as other family and friends, and another pastor from our church showed up.
The tears of some were already flowing, for we all knew why we were there. Folks basically shuttled in and out as they went in small groups to say goodbye to Katie. She was still lucid and talking, and saying “I love you” to everyone who came in, bravely smiling and sharing the last words that would pass between them. My turn came, and bent me head to hers, and told her I loved her, and I was going to miss her. She said she loved me too, and “it was okay.” Her strength through her cancer ordeal amazed me; she never complained that I heard, and tried her best never to “impose” on the rest of our family (she and Josh lived with us for the entirety of her illness). Now, staring death straight in the face, she tried to assuage my fears for what was coming. I always appreciated the way she handled herself during her illness, and now I especially loved her for her effort.
After a while sitting and chatting with the others in the little waiting room, I was getting that uncomfortable feeling that Death was not appreciably far from making another appearance in my life.
Distasteful it us, precious, and we doesn’t want to be here when it’s happening. (apologies to Mr. Tolkein)
I felt like my wretched little coward alter-ego was looking for a way to escape, once again, the dying part of someone’s getting to meet Jesus. My two-hour parking escape hatch provided me with the chance to go out, catch a breath, and think about something else for a while. I told my wife that while I was out, I might as well run home and let the dog out. After all, the docs had said “hours to days” – this vigil might go on for a while.
Like I said earlier, it was only hours. I was making my way back to hospital when I got a text from Josh: “Can you get back here fast? Katie wants to say goodbye.” I responded that I was on the way, and his reply was “speed”. This time, I got a parking spot on the first trip through the deck (I still have that ticket sitting on the dash of my truck – 17:32 on 1/8/2014). I went straight to her room in the palliative care unit. Josh was right beside her holding her hand, which I figure he did for the better part of 12 hours that day – always wanting her to know he wasn’t going to leave her until the very end.
Katie had fallen into a near-coma the week before when her blood sugar got dangerously low, the side effects of the havoc that the cancer was wreaking on her organs. I remember Josh rushing into our room early in the morning, in a controlled-panic kind of way, saying “I can’t get her to answer me, I can’t get her to answer me!” An intravenous glucose drip in the ambulance had quickly remedied that situation before they even left the driveway. She had spent five or six days in the hospital as a result of that incident, waiting for her blood sugar levels to normalize, and providing Josh with one more thing to monitor and worry about. Now, about a week later, she was at the point where an IV drip of glucose was the only thing keeping her from returning to that state. She knew this, and had made the decision to stop receiving this drip, fully aware of the consequences. This is why Josh had urged me to hurry.
When I arrived in the room, they had removed all the monitors and IV tubes. When she slipped away this time, it would be for good. Knowing this caused the tears to well up in me, and I couldn’t stop them from leaking out. She said “it’s okay.” She also told me she loved me, and she would see me later. I know that’s true, but hearing it from her made me sadder still. She shared a few more words with me, kissed me back when I pecked her forehead, and I left the room. I had spoken to her for the last time.
I had said earlier that those last hours were both sad and uplifting. While the sad wasn’t done with me or the rest of our little band, the uplifting part was beginning. I am able to say this in retrospect, of course; it felt sad in that room right up until the time when Josh held his hand on her frail little chest and told us her heart had stopped beating.
Josh had been playing their favorite worship songs on his iPhone the whole time they were in the palliative care room. He and Katie had grown to love these songs of God’s love and care for them over the course of their marriage. The music, along with a devotional series they read together, had become part of their daily routine, among all the cancer dealings. Folks in the waiting room continued to filter in and out, praying with Josh and Katie’s mom Tammy, who held her other hand for the remainder the time there.
By 11:30 Katie’s condition had eroded to the place where her breathing was very shallow and her heart rate had slowed considerably. Nearly all the people who had stayed in the little waiting room were now filtering into her room, knowing that the end was near. I was sitting directly behind Josh, who lay beside Katie in the bed, still holding her hand, kissing her cheek, and whispering to her. I was essentially keeping him from falling out of the bed. Katie’s sisters sat or stood next to Tammy, and everyone else in the room was holding the hand or touching the shoulder of the person next to them, forming a chain that circled the room. I think we counted 25 people in that little room – it was packed. At one point the hospital chaplain dropped in to see if anyone needed any pastoral care or assistance. Discovering that we had three pastors in the room, and worship music playing, he declared that we would be okay on our own. He left to offer his services elsewhere. I appreciated that he made the effort.
One of the pastors from our church prayed aloud, and others in the room offered prayers. I think every one of us was pleading with God to take Katie into His arms, and relieve her of her suffering. Her breathing was becoming labored, and on one occasion she moaned loudly for an extended period. I thought for an instant that the little coward that feared seeing death would drag me out into the hall and down the stairs to the street – a safe distance away from any Jesus-meeting that might happen. I did step out for a couple of minutes, because the image of my father right before they disconnected him from life support popped into my brain, and it seemed too much to bear.
I wanted to be there to support my son, so I gathered my wits and my courage and went back and took my place beside Josh. My daughter and some of Katie’s girl friends actually joined the music on Josh’s iPhone, and sang one of the songs together. They were weeping at the loss of their dear friend, but heartened to know her next destination. I think that was the sentiment in the prayers of that entire bedside throng: “Lord, she’s suffered long enough, so please take her into your loving arms.” The scriptures say wherever two or more believers gather in His name that He’ll be there too. I felt His presence among us, and others there said they felt the same way. Some of the hospital workers commented to us later that they had never seen something like our little gathering before. They said many times in that palliative care unit folks did their Jesus-meeting utterly and completely alone.
It was about ten minutes before 1:00 AM when one of the pastors requested that most of the assembly should find their way out so the immediate family could have a private time with Katie. I don’t think we did anything different than we’d been doing for the past couple of hours. Now, though, her breathing was barely discernible. Her heart had slowed, too. We sat and prayed together, continuing to hold hands with Katie and Josh and Tammy. About 1:10 AM Josh leaned near to her face to see if he could still hear her breathing. He could not. He placed his hand on her chest; her heart had finally stopped. He said “I think that’s all.”
All, indeed. I was glad that their ordeal with cancer was over. For the assembled friends and family, it was a mercifully quick end to our vigil. For Josh, it was a transition to a new phase: one without his wife. Few 23 year-old men experience what he had been through in the last seven months. He had been her constant companion, her caregiver, and her strength. I was so proud of the way he conducted himself. He was more of a man than I felt I could have been at 23 – but then, I wasn’t presented with the “opportunity” that he got in order to find out.
I walked into the hall while he and Tammy sat with Katie. My wife went in after a while to try and help him do what he had not since she was diagnosed with cancer: leave her alone. Alone in that bed in the palliative care unit, where people went to die. He didn’t want to go. Being reminded by my wife that “she’s not here anymore, that’s just her body” was not much consolation to Josh at that moment. Her earthly remains were all that was left to symbolize their very short life together. He touched her hand and kissed her one last time, and we walked out into the hall.
Josh had to sign some papers so the hospital could do what they needed to do. Katie was to be cremated, so transportation to that facility needed to be arranged. There was nothing left to do, no emergency to attend to, no urgent need to address. We gathered our things, made our way through the rat-maze of corridors out to the parking deck, and drove home. We were exhausted: physically and emotionally spent. It was over.