A Journey of Grief

The Last Days of a Life Well-Lived

Part I

It has been an interesting and challenging journey over the past four and a half years.  In April of 2020, just as things were being shut down for the Covid-19 pandemic, my wife was diagnosed with Stage 2 Pancreatic Cancer.  We didn’t go into a panic, although she was probably more fearful than she ever let on.  We discussed how we would take a positive approach with full expectation that the Lord would bring healing and allow her to continue living the productive life she had always led.  It was stage 2, so we thought that the tumor would be removed quickly and after some precautionary chemo and radiation she would be cancer free.

The location of the tumor proved to be a big obstacle to that goal.  It was located at the confluence of all the veins that fed into the liver, causing her to be jaundiced.  A stent had to be placed in the bile duct that emptied the liver and that, in itself, proved to be quite an adventure.  Our gastroenterologist who had performed the biopsy of the tumor and made the cancer diagnosis attempted to place the stent in the bile duct.  In order to do that, a hook needed to be placed in the vein leading to the pancreas so that the stent could be pulled into the right place.  However, the hook kept slipping around a corner and into the wrong vein.  The stent placement had to wait 2 days so that a surgeon could place the hook in the proper place.  Once that was done, the next day our gastroenterologist was able to place the stent in the bile duct.

Then it became a waiting game.  We were referred to a world renown liver transplant doctor who had performed countless “Whipple Procedures.”  The Whipple Procedure is an extensive surgery that requires a long horizontal incision across the stomach.  During the surgery the head of the pancreas where tumor was located is removed, along the gall bladder, part of the stomach lining and small portion of the small intestine.  But the location of the tumor made the surgeon hesitant to perform the procedure immediately.  He said the tumor needed to be shrunk away from the veins against which it was pressing.  That was in late May. 

So, she started chemotherapy treatment with the main treatment being a very powerful drug called FU4.  (Don’t ask).  Unfortunately, she did not readily respond to it and the tumor’s growth was not stopped, just slowed down. They went to a plan B.  Her markers dropped with that treatment, but only during the 3 weekly doses.  The protocol called for a one-week break.  During that week her markers jumped right back up.  It was like whack-a-mole.  It wasn’t until December, 2020 that the surgeon felt like the riskiness of the surgery was low enough to attempt removal of the tumor. 

After the surgery, he was very pleased with how it had gone, seeing no evidence of cancer in the margins.  However, the next day he had a very somber look when he met with us.  As it turned out they found live cancer cells in the tumor and in about a third of the lymph nodes that had been removed.  A month later the cancer showed up in her lungs and in her liver.  A biopsy showed it was not a new cancer, but just the spread the cancer that had started in the pancreas.  I think my wife fully understood what that meant, but I was still in denial, even up to the very end. 

She was admitted to a clinical trial with experimental drugs that targeted the specifics of her cancer.  Foundation One in Boston, MA did genomic testing to determine the nuances of her cancer.   We were sent to MD Anderson for treatment.  However, her liver counts were over the limit for the trial’s very strict guidelines and she was eliminated from the trial before it even started (She would have been the first person in the trial). 

Then an infection around the incision of her surgery caused her to be eliminated from an immunotherapy trial after only one treatment.  We were out of options.  We came home from Houston, had home health come to the house to administer a daily infusion of antibiotic to treat the infection.  Our gastroenterologist said we should call hospice after the course of antibiotic was completed.  It was less than three weeks after that conversation that she went on to the arms of Jesus. 

Throughout the treatment she had an amazing amount of energy and grace.  People who saw her and didn’t know she was sick would never have guessed it.  She had started to work from home because of the pandemic and her employers were gracious enough to allow her to continue doing that even after everyone else had returned to work at the office.  She never missed a deadline and was a true source of inspiration and encouragement to everyone who knew her. 

After the surgery, she had to take digestive enzymes orally to make up for the decreased production of the enzymes by the pancreas.  Any dairy or refined sugar in a meal caused it to just run right through her.  She dropped down to 108 pounds from 154 pounds at the time of her diagnosis.  At 5’ 10” tall she was just a beanpole.  It was hard to watch her slowly waste away.  But, in spite of that, she had the energy to pack up a house and set up a new house (half the size of the one we left).  It was incredible.  She insisted that we leave the big house we had because the smaller house would be easier to take care of and it would not be full of the memories we shared in the bigger house over the 7 years we had lived there.  She was concerned for my well-being after she was gone.  But it seems that once the new house was put in order, it was the last thing on her checklist.  After that she experienced a marked decline in energy and 6 weeks later she was gone.  My youngest son came to see her the last two weekends in June.  The second weekend he took me aside and said he couldn’t believe how much she had gone downhill in just a week.  She started becoming more dependent on me for everything until over the last two days I had to carry her to the restroom and spoon feed her for her last meals.

The day before she died, I was giving her the 8 am dose of liquid morphine that had been prescribed just the day before.  I left her hospital bed that hospice had brought to the house in order to clean the baby syringe.  When I came back into the bedroom she was throwing of some ugly greenish brown bile.  It was a smelly mess that required all I had to keep my own breakfast down.  I texted my daughter-on-law (they lived just across the alley from us).  She was there in a flash and called the hospice nurse on her way over.  The hospice nurse told us that the greenish brown bile as a sign that the end was near and that she didn’t expect her to make it through the night.  We took turns sitting up with her and she made it until late, Saturday morning.  We called the family in and told her it was okay to go and that we would be fine. 

She fought hard for every, last breath.  Finally, at 10:32 am she took a long, slow breath, in and out and was still.  About a minute later my youngest grandson came into the room.  When she heard his voice, she raised back up and started the labored, heavy, uneven breathing that she had been experiencing all morning.  It shook all of us up because we thought she was already gone.  Then about 4 minutes later she took another long slow breath, in and out.  Finally, she was gone.  My youngest son looked at us and asked, “Are y’all feeling the same strange mix of relief and angst?”  That captured the emotion that we were all feeling.  That feeling has never completely left me to this day.  I think about her every day and miss her every day.  I am continually reminded by others about the incredible way she touched the lives of virtually everyone she met.  That was evident by the large crowd at her funeral and the large number who watched it online. 

I do not understand why she was taken.  Everyone would have predicted that I would be gone long before her.  I have had two heart attacks and she was never sick a day in her life.  She was my rock, the one who kept me centered and focused.  I have floundered some since she has been gone.  It is a task to “reinvent” yourself after 42 years of partnership.  A large part of my identity was tied to the one who had been my best friend, lover, and confidante.  However, my complete identity is tied to the Lord Jesus Christ and he is the one that is getting me through all of this.  God is good.