I Grieve For You

The problem with grieving is that its unpredictable, it can hit you at any time. When someone close to us dies, I don't think we ever really get over it, particularly if it was so heart-wrenching. My brother died shortly before his 14th birthday in a car accident almost 30 years ago and the pain of his loss never really goes away. They (the "experts") say that memory has no time reference.

I grieve for many different reasons and at unexpected times. Sometimes its simply because she's not here. Sometimes I grieve for things I can't say, for the times I can't share. I grieve for things that might have been. And I greive for things that were. I grieve for our friendship, for the comraderieship. I grieve that we will never be little old ladies together.

Love's Divine

Even now its really hard to think about the fact that Wanda is gone. I still miss her, miss the times we could have had together. This photo was taken on one of our last get together's at The Coffee Bean, about a month before she went into the hospital. Wanda had a fantastic wardrobe and always put herself together even though she was taking a lot of pain medication at this point.

When we first learned the cancer had spread, the days were filled with going to the hospital and taking care of details. But as the days turned into weeks and the visits to Wanda's room and then apartment became routine, I experienced a strange dichotomy. On the one hand, it was painful to watch her deterioration that she was going through on a daily basis, and seeing her response to what was happening. It was unbearably sad. I was grieving every day even as she was still alive. On the other hand, being with Wanda as her life was ending was very life affirming. It gave an urgency to the meaning of life, to what it means to be alive. It gave me the opportunity to recognize the finiteness of our lives which is what gives it meaning, makes it bitter/sweet.

And yet there were some funny moments. When I was at the hospital, I would answer the phone "Wanda's Room." So one day when I called her and answered "Wanda's room." She would sometimes pick up the remote to call the nurses and try to answer the phone. One evening as we were sitting around in the heavy atmospher, a young Philipino aide came in to clean up her potty stool. As he left the room, Wanda scrunched up her face and in a conspiratorial voice, said "I hate Philipinos." One had to see the humor in that situation.

The first week after she was home from the hospital she had some really good days. She was more lucid and she was optimistic about getting better. She told me, "I had a near death experience, but now I'm going to beat the cancer." This is the same attitude that she had had throughout her ordeal. I didn't know if I should be alarmed or if I should tell her that she was dying. I had read a book to help me prepare for Wanda's death, called "Intimate Death" written by a french doctor who worked in palliative care facilities. Her point was that dying people were very lonely because no one will acknowledge to them that they are dying when they know they are. So I wanted to acknowledge to Wanda that she was dying. But on the advice of the City of Hope end of life counselor, I decided to follow Wanda's lead. So the first week went smoothly. Clint had already set everything up before she came home, including the hospice bed. Debbie had arranged for the home health aides. These aides were great. Certainly they knew what they were doing and how to make Wanda comfortable. They cooked and cleaned and made sure that Wanda got all of her medication at the right time.

But it didn't take long for things to go downhill. Wanda started getting suspicious. She quickly grew impatient with the aides. She accused one of the aides of trying to steal her boyfriend. After a week had gone by, she became even more aggitated. She tried to rip her IV out; she pushed one of the aides downt he stairs; she tried to jump out of the window. The hospice nurses increased her medication and eventually added haldol to keep her calm. My vocabulary continued to expand as I learned about terminal psychosis. Terminal psychosis is the end of life process when the body begins to shut down.

I learned a lot of other things during that time too. I learned about how to be with someone who is dying. I learned to let go of my petty resentments and more importantly, petty rivalry. I learned to be more careful with friends and loved ones. "Love is all I need to know my name." Being with Wanda during this time taught me the true meaning of love.

Angels Live Among Us

None of us was prepared for what was to come. Although I knew this news of Wanda's cancer spreading was probable, when it did happen I was completely in disbelief. It seemed like it was all of the sudden. And those first days it seemed that Wanda's death was immindent, that Dr. K did not expect her to leave the hospital. I was driving to the hospital every day trying to deal with the fact that Wanda did not have long to live. I had not spent much time with her in recent weeks and months and had not paid that much attention to what was going on with her. I was pretty consumed with my own life. All of the sudden everything changed. My life was put on hold and I went into high gear to be with Wanda. The hospital visits were draining. Somtiems to drive to The City of Hope in Duarte was an hour and a half. And Wanda was having a lot of difficulty with her pain medication and the nurses and the nurses aids. I would sit and just be with her as others would come and go. It was as if as long as I was there, she would not die.

Clint was there often. As were others, Steve, my friends Debbie and Larry, Patricia, Debbie and Kelley, David, people from the Wellness Center support group. I noticed how some people had a hard time being in the room, not sure of what to say, how to be. Some were more comfortable, others were not. A particular good friend of Wanda's was Vivian (photo). Vivian came to the hospital as often as possible even though she worked on the weekend and had two small children at home. She was a read angel, givning Wanda the tender care she needed, taking her outside in a wheelchair to enjoy the outdoors.

Sometimes when other friends came, they really seemed a bit bizzare, too cheerful, too "its okay, there's something better on the other side." And one evening after a visit from a married man she had been seeing right up until she was admitted (let's call him "Chuck"), she seemed particularly upset and aggitated. She kept saying that Chuck was a rat. I couldn't get it out of her what it was that he had done so on the way home, I called him to find out. Of course he wouldn't cop to anything and all that happened was that we got in a big fight. And for some reason this seemed to please Wanda.

After the first week passed, Wanda's death no longer seemed imminent and we began to look to the future. During this time, Clint and I were frequently on the phone with each other at all times of the day. Clint was making arrangements for Wanda to go home. Dr. K wanted to put her in an assisted living home but Wanda clearly did not want to do that. She had no income and no means to pay for home health care. She was on Medicare and we were lucky to find home hospice care but they would not take her home without someone living with her full time. Just at the time this was being discussed with various hospital personnel, Wanda's friend Kelley walked into the hospital with her friend Debbie. Wanda was saying that she couldn't possibly live in a facility and that something had to happen, and Debbie said that she would pay for the home health aids. Clearly, there are angels who live among us.

The really sad thing is that Debbie had already offered, a few weeks earlier, to pay for Wanda's mother or sister to come from Austria. But neither would come. Not only was Wanda at the end of her life, but she was completely alone. She had friends but no one to step up to the task ahead. So Clint did. Another angel. He made sure that everything was taken care of even though he lived a far distance away and had his own busy schedule. We had the necessary legal documents prepared and Clint spoke with Wanda about how she wanted to her remains to be handled, etc. She could not have had a more caring friend than Clint.

"Every Day Is Precious"

We were all shocked when Wanda was admitted to the hospital in March 2005 with fluid in her lungs caused by the spread of the cancer. She had had a second surgery in January to remove cancerous lymph nodes under her right arm. But she told us her doctor had said that the cancer was gone. Instead what had really happened was that the cancer had spread. Everywhere. She had cancer in her right breast, in her left chest cavity, on her spine. Most likely in her brain. Without anyone knowing, she had been consuming huge quantities of pain killers and was in complete denial of her situation. She was telling us that the cancer was gone even though her doctors were telling her that the cancer had spread.

When she was admitted to the City of Hope for the last time, Dr. Marianna Koscywas asked Clint to be at the hospital with Wanda when they gave her the awful news of the latest test results. Clint was working on a film and asked if I could be there in his place. I walked into the hospital room a few minutes after the meeting had started. Dr. K was sitting on Wanda’s bed and was holding Wanda’s hand. Wanda looked small, pale, frightened. There were a team of hospital staff – shrink, social worker, and others, standing around.

I know that if I had been Wanda I would have been totally frightened. Dr. Koscywas was just explaining the test results to Wanda and showed them to her. The tests indicated that the cancer had spread everywhere. Particularly concerning was the tumor on her spine. Dr. K explained to Wanda that she wanted to keep Wanda in the hospital so that they could radiate the tumor. This was palliative, no life saving. It would mean that she would stay mobile until the end of her life. When Dr. K was done speaking, Wanda said “You mean I’m going to die?”

Marianna herself was crying. She said to Wanda “Every day is precious” a lesson I have carried with me to this day. I sat on the bed and held Wanda’s hand. We have never really had a touchy-feely friendship but I could not imagine what it must feel like to be told that you have 2-6 months to live. I cannot imagine how frightened she must have felt. The various hospital staff members standing around Wanda tried to comfort her with platitudes. I just wanted to yell at them to get out, to leave us.

Fortunately or unfortunately – depending on where you stand – Wanda was fairly heavily medicated. After the hospital staff filed out of the room and we were alone, Wanda immediately called Steve, a trusted friend from her cancer support group. I felt glad that she had him to call, someone who would know at least somewhat how she was feeling, what to say. Then we talked for a while and then I left to go back to work. When I went back later in the evening, it was apparent that the phentanol was keeping Wanda from remembering anything that happened earlier in the day.

I went to the hospital every night for the next several weeks. Sometimes Jeff went with me. Sometimes I drove directly from work. I spoke with Wanda frequently over the phone and was frightened by her quick deterioration. Finally Clint asked Dr. Kocsywas to change her medication and that did make a big difference in Wanda’s behavior. Although she was hallucinating and hypersensitive. She imagined that the nurses where trying to kill her. She was also terribly ungracious. One evening she told me that her friend Patricia had called but that “I blew her off.” I had the feeling that she felt like if she was going to die, there was no point to reaching out and connecting to anyone. I felt like she was trying to blow me off too but I simply persisting in calling and visiting her. It made me sad that she was unable to create any love around her but Clint and I did the best we could to make her feel loved and cared for.

It was clear that she was angry. She would go in and out of remembering that she was dying. One night – when she was more lucid she was cognizant of the circumstance and we went through her phone book to make a list of people to call. She was very adamant about not calling her close friend Sabine. Something had happened and she was angry. In fact, there were very few people to call.

May 12, 2005

On May 12, 2005, Wanda took her last breath. She was 45. I was not with when she died, although I had been there earlier that morning. She was alone in her room. Moira and Tes had just stepped out of the room to talk about the events of the morning.

The phone rang at about 5:30 am that morning. It was Tes, the home healthcare aid from Trinity Hospital, who had been with Wanda for the last 24 hours. I wasn’t surprised when she called because we had been expecting that Wanda would die any hour. Tes sounded stressed and asked me to come over right away. I only live about a five minute’s drive from Wanda’s apartment. When I got there, Tes told me that Wanda had woken up and had said, “A curse on you, you will die.” As a Philipino, Tes is a very religious and superstitious woman. Wanda’s declaration had frightened her.

But when I got there, Wanda was in the same state that she had been since that Monday. She was breathing laboriously releasing a soft moan with each exhale. It certainly looked like she would not last much longer but I did not stay. I didn’t want to be there at the end. I went home and got myself ready for work. At 10:45 am Tessie called me again, this time to say that Wanda was gone.

It was Jeff’s birthday. We spent the day in Wanda’s apartment waiting for the mortuary to come and take her body. Everyone came over, those of us who had been with Wanda these last months. Clint, her good friend and primary care taker outside of hospice and home health care, drove from Acton as he had done many times. Sabine, Wanda’s long-time German girlfriend came. Moira, her neighbor, and Tess were there. The nurse from Trinity was there.

We all sat around Wanda's small glass dining table and talked about Wanda and what she had gone through and what we had gone through. Trying to grasp that she was gone even though we had been expecting it and even hoping for it for weeks. Finally they came and took her. I didn't watch. And I didn’t cry. I was numb and couldn’t really feel anything. I think later Jeff and I went to dinner but we never did celebrate his birthday.

It wasn’t until a week later when we took Wanda’s cats, Matisse and Collette, to my friend Susan’s apartment that it hit me emotionally, and I broke down. It was overwhelmingly sad to be bringing Wanda’s cats to live somewhere else. I can clearly remember the day Wanda found Matisse. He's a big orange cat who had been sitting down in the alley meowing until someone finally came and got him. That someone was Wanda. She took him to the vet and then she adopted him even though she already had an old cat who, Nicky, who did not do well with a new cat in the house. Matisse was a loving, magestical cat with the most amazing green eyes. I have never seen a face like his. Fortunately they adapted easily to their new home and their new can opener/feeder.

Wanda was diagnosed with inflammatory breast cancer two years before she died from it. I don’t know all of the events that lead up to the diagnosis as we had had a falling out and did not speak again until I learned of her cancer which was about a year later. By then she had already lost all of her hair from chemo. I had sent her a card wishing her well and we picked up the friendship where we had left off. It had never been an easy friendship. I found Wanda to be a difficult person, self-absorbed and selfish and when our friendship ended, I was relieved. But when I learned that she had cancer that had spread I felt a stab in my heart.

So I spent the last year of Wanda’s life going through her cancer ordeal with her. We were always optimistic and hopeful that she would survive. We never doubted it. In January the year before she died she had her left breast removed. Like most women, Wanda prided the femininity of her breasts and she fought hard not to have the mastectomy. But in the end she conceded. I don’t think she ever got over losing her breast. It was bad enough that she lost her long beautiful blond hair. But one thing Wanda never lost was her courage. She would put on a wig and go out into the world. She was determined to live life to the fullest. She continued to eat with the same gusto she always had. She could outeat anyone I knew!

During this time, Wanda underwent an IME for a workers’ compensation case where she had fallen and hurt her foot while working as an animal trainer on a movie. I drove her to the IME and even though her appointment was early, we sat and waited for 4 hours before the doctor would see her. (Its a game those Workers' comp doctors play.) This would grate on anyone’s nerves let alone someone who was having weekly chemo treatments. But Wanda kept her spirits up and we congratulated each other on how well we had handled the long wait.

After her mastectomy, Wanda underwent radiation treatment. As anyone who has had radiation treatment knows, its hideous. It burns you from the outside in and zaps all your energy. It’s a frightening processs, Wanda told me that it makes you feel like warmed over death, literally. But throughout her treatment Wanda remained hopeful, optimistic that she would recover. She made plans to find a job, to get back on her feet. I was always inspired by her ability to keep going forward, to keep a positive outlook. She convinced me that she would survie.