A "Friend Request" from Atropos

Atropos

Atropos, dread
One of the Three,
Holding the thread
Woven for me;

Grimly thy shears,
Steely and bright,
Menace the years
Left for delight.

Grant it may chance,
Just as they close,
June may entrance
Earth with the rose;

Reigning as though,
Bliss to the breath,
Endless and no
Whisper of death.

-  John Myers O'Hara


In Greek mythology, the Three Fates, or Moirai, held sway over the lives of all mortals and, in some interpretations, the lives of the gods as well.  Clotho spun the thread of each life.  Lachesis measured and allotted the thread to each person.  And Atropos, the inexorable, cut the thread thereby ending the life. She chose the manner of each person's death; and when their time was come, she severed their life-thread with her "abhorred shears".

Atropos has been in my thoughts ever since she decided that she wanted to be my friend.  In truth, she's always been there - sometimes visible, mostly hidden in the shadows.  But recently, she has moved in and made herself at home.  And that's prompted me to meditate on my relationship with her.  Maybe we need counseling.

It seems that we wish to treat death as if it isn't an integral part of life.  We often view it as a tragic and unwanted outcome that befalls "some" people but hopefully not us or our loved ones... at least not anytime soon.  The truth is that death surrounds and permeates us just as the ocean surrounds and permeates fish.  Death is right here... all around you and within... encoded into your very own DNA.  Our survival instinct dictates that we will strive to avoid it, but the best we can hope for are delaying tactics until we inevitably reach the event horizon of life.

I do believe that we as a culture need to spend some time rethinking how we live and work with death... and what it means to make friends with Atropos.  This edited TED talk was shared recently to commemorate the passing of Emily Levine.  Here she discusses her feelings around being given a terminal diagnosis of Stage IV lung cancer.  I don't necessarily view her perspective as being "correct" and it is certainly contextual given her circumstances.  But I do find her viewpoint refreshing and very much in touch with reality.

If you wish to view Emily's unedited talk, you can find it here.

On March 5th 2019, my mother, Norma Lee Gray, passed away.  She was 92 years old.  In early February after discovering that she had suffered yet another hip fracture, we made the decision to shift her to hospice.  It's hard to say goodbye to a parent - I don't want to minimize that.  But, to me at least, her passing "made sense" or felt like proper closure for a life.  The Fates had apportioned her a thread of 92 years.  She had lived well and left a legacy in her children.  She died peacefully supported and surrounded by love.  Is there grief?  Absolutely, but it is tempered with the sense that this is the way that a life "should end".

A week later, five days after mom's memorial service, I was on a plane to Boston.  Martina had moved to Maine in September.  The last time I saw her was before Thanksgiving.  There had already been two aborted attempts to travel up for a visit.  This time, in light of mom's passing, I was more determined to make the trip - despite any reservations from Martina or her family.

I'm going to share some things that are personal, blunt, and uncomfortable.  Feel free to close this tab and go back to your cat videos and political pissing contests if you wish.  No offense taken.

To recap her journey with disease:  In July 2018, Martina was diagnosed with Stage IV pancreatic cancer.  This is considered a terminal diagnosis and the treatment pathway is determined by the patient's age, general health, and desire to live.  In other words, there are some situations where nothing more than palliative and hospice care make sense.  Not so for Martina.  She was put on a very aggressive chemo regimen that was ultimately devastating to her health.  In the middle of the first round of chemo, Martina in coordination with her sister acted on her emphatic desire to relocate to Maine in order to be with her family.  This was a difficult time for everyone, and, in my opinion, some unwise choices were made.

The assessment at the end of the first round of chemo indicated that the treatment had yielded no positive results.  The cancer had continued to spread.  Simultaneously, Martina had realized that relocating to Maine was not a good choice for her.  She was physically frail and in a deep depression.

In January, Martina was admitted into an immunotherapy trial at Dana Farber in Boston.  The immunotherapy was said to be "less impactful" than chemo in terms of side-effects.  In a relative sense that is probably true.  But Martina's health continued to deteriorate as did her mental and emotional state.  The immunotherapy seemed to have stopped the cancer's spread, but not the downward spiral caused by the disease and the side-effects from treatments.

In midst of her health issues, my relationship with Martina has been, to put it mildly, tumultuous and strained.  Even before she got the Stage IV diagnosis, there were red flag issues that I was working diligently to ignore.  Once she relocated to Maine, I was left with time and space to really start unpacking and coming to terms with those feelings.  But then how does one have a difficult relationship discussion with a person who is terminally ill, severely depressed, in failing health, and only conscious/cognitively functional some of the time?  The short answer, of course, is... you don't.

So I packed up all of this and brought it with me on the plane to Boston - no extra charge for the additional carry-on luggage.

The nature of life - at least, the nature of life for me - is a movement from stasis to transformation and back to stasis again.  Using a paddling analogy, it's much like peeling out of an eddy into the river's flow, paddling in the current for a while and then punching into a downstream eddy.  I've had no doubt as to what state my life had been in over the past year.  I am very much in the flow of the river, and that means that the river is very much in control.  You can skillfully work with the river to stay safe and be present with the journey, or you can fight against it and end up in a cautionary tale that your paddling friend's share over a memorial beer.

So interpret it as you like, but with my life very much in the current of the river, I chose the follow my instincts and training:  I gave up the illusion of control and relaxed into that movement.  Because within the flow is where the unfolding of life occurs.

I landed in Boston and first made a stop by the Roxbury VA hospital to visit a friend.  I had not seen Claudia in over 30 years.  In that ensuing period, she had endured many life challenges including suffering a catastrophic spinal injury that left her a paraplegic.  She had been admitted to the VA in order to treat pressure sores that had gotten out of control.  Claudia was to be bedridden in the VA hospital for months as the wounds were allowed to heal.

I went to Roxbury hoping to offer support to a friend who was struggling.  What unfolded - where the flow of the river brought me - was to a friend who made herself available to support to me.  Between her and the guidance provided by my karmic sister, Marcy, I was able to navigate a particularly challenging section of river over the coming week.  Thank you Claudia.  And thank you Marcy.  I doubt that I can ever express how much your collective presence and support meant to me.  And I love you both.

The next morning, I was traveling north on I-95 towards Ellsworth, ME relieved to be clear of Boston before St Patrick's madness consumed the town.  But I was very much traveling into the unknown.  I had not been able to talk to Martina for weeks.  Martina's sister, Amy, while open to the idea of my visit, was anxious and overwhelmed with the thought of my arrival.  Martina has become emotionally unpredictable and adding unplanned events to her world would often lead to unpleasant situations.  I do need to state that I have a lot of compassion for Amy.  She has stepped up under some of the hardest circumstances one could imagine and tirelessly cared and advocated for her sister.

Martina did not want visitors that evening and I was unable to see her.  The next morning, Amy took her to the ED to be treated for dehydration.  By mid afternoon I was finally able to speak with Amy and then with Martina directly who asked me to please come to the ED.

I had not seen Martina since mid-November.  The cancer and the side-effects had left her malnourished and emaciated.  Bearing witness was hard.  It is a memory that I pray will fade and one that I will gladly not share.  But as I looked at her, I realized that Atropos was there staring right back at me.  So I smiled at her and walked over and I held her and I cried.  In that moment, all the grievances and the wounds, all the anger and the conflicts... all the unfinished business was burned away until there was nothing left... except love.

The truth is that Martina is dying.  Whether it happens in a week or in six months, the thread will be cut...  the inexorable Atropos will not be swayed...  and no amount of wishing or treatment or denial is going to change that.  The only thing that can be attended to now are her suffering and her fears.  So I did what compassion demanded and became the ally of Atropos.  On that first day, I asked Martina what she wanted to have happen.  She said that we she wanted to live a little longer.  I told her that I understood.  Two days later, I asked her if she wanted to keep fighting and I got an emphatic "yes".  So be it.  Before I left, I held her hand and tearfully looked in her eyes and told her that whenever she was ready, it would be okay to let go and that all of us would be okay too.  She nodded and said, "I know".

The day after I returned home, Martina called me.  That in itself was surprising given the state she was in when I left.  But what she wanted to tell me, in a weak voice, was that she thought it was time to let go and that she wanted me to come back to say goodbye.

As I write this, I am hopeful that her family will be open to shifting Martina into hospice care where her pain and her discomfort can be better managed.  She hasn't been to the ocean shore since she came home.  She hasn't been with her dogs in months.  My wish for her is to be able to treasure whatever life she has left.  And, yes, I do hope to return to Maine to say goodbye.

One belief that is being burned away for me is the notion of fairness.  My mom passed away after living a full life.  Martina's life will be cut short by disease.  Fair?  As I told my kids years ago, 'fair' is a skin complexion or the place where you go to ride a ferris wheel.  If you really want to lose your illusions of fairness, go sit in the waiting room of the oncology wing at your local children's hospital.

But I do believe in love... and in her dark sister, grief.  They bind us together in an unbreakable web that holds even after we cross over life's event horizon.  And with that belief, I am more willing to accept and work with - if not truly welcome - Atropos and her "abhorred shears".  I also still believe that life is amazing and precious and worth living.  Intuitively, I sense that we all willingly signed up for this trip... being fully aware of the risks and the eventual outcome.

I'll close with a prayer from Mary Gauthier.  And she's right; every single one of us could use some mercy now.