“The worst thing that could happen has happened,” my sister, Sarah, tells me. “I died. I’m dead”
“But if you’re dead,” I ask her, “how can you be talking to me?”
“I’m in another place. You wouldn’t understand,” she says. “Nothing matters anymore.”
Sarah is one week into hospice care. She has decided she is done with treatment. She is on a steroid to reduce swelling in her brain, but the cancer is wreaking havoc there. In two months she will die.
I don’t argue with her, I accept her reality. And I see in what she tells me the truest expression of her anxiety: in her reality the greatest hurdle has come to pass—she is dead, and she no longer has to fear dying.
I go to visit her. There is no other way to say it—I am going to say goodbye. She is barely Sarah anymore, although her dry humor shows itself in flashes. The cancer has eroded her short-term memory. All day long she awakens from a semi-sleep and repeats “I must be out of it. I don’t know what’s been going on.” I tell her she’s been sick. Sometimes she rallies and says she’s resting to get well. Worse is when she does remember, when she knows she has cancer and is dying. Still, she worries more about her family than herself.
“I guess I’ve had some bad luck,” she says one morning and begins to cry. Later an old friend calls. Maria tells me how Sarah taught her to think for herself and follow her heart. On the phone, Sarah comes alive, laughing and chatting with Maria. Later she tells me she’s lucky to have good friends.
Her greatest pleasure is chocolate mousse cake. She wants to go to the grocery, and when we get there she leads me directly to the bakery. Back home she tells me she’s not hungry, and while I am busy elsewhere she serves herself slices of cake.
In a week I am gone. I can think only of the time we didn’t spend together, of the opportunities we’ve missed.
The reality my nieces and brother-in-law live with worsens. Sarah hallucinates more. She begins to refuse her meds, she’s agitated, not sleeping, not eating, not talking. Death is painful but merciful for all.
Sarah, living her values, thinking of others, has donated her body for medical research. Her husband holds a small memorial on the west coast.
On the east coast her family of origin holds a memorial one month later. We make sure there is chocolate mousse cake on the menu. We tell everyone to enjoy the food, the drink, and the company because that is what Sarah would have wanted. Her old friend Helen tells us how Sarah was the one who saved her from her dreadful family life by believing in her, loving her, and laughing with her.
Some days, out of seemingly nowhere, deep grief returns to me. I miss her, and I am sad for the suffering she endured. I try to remember the lessons of those last months of her life, those months of her dying—to lean on my siblings and let them lean on me; to treasure my good friends; to enjoy the indulgence of a rich dessert. But most of all those last months taught me a lesson I have to remind myself of over and over again: to keep things in perspective. Small anxieties are stand-ins for ultimate fears, and we have to face down those fears as bravely as Sarah did the day she said to the doctors, “I’m done.”