Before start reading: Not each death happens in the same way. While some of us bid farewell to our loved ones in hospital, in intensive care or at home, our personal experiences might differ other than the places death occurs. Therefore, your personal experience might be different from the one I have written below.You might not have been able to witness the last moments of the person you bid farewell to. I have great respect for all life experiences. I am grateful for the time you have invested in reading what I write.
On days I spend in hospitals, I have a lot of time to observe the relationship between the patients and their families. The deaths in my immediate family weren’t caused by an illness. I can tell that they happened fast, or even at unexpected times. Perhaps because of this, I observe the last moments more carefully and curiously.
Accompanying the last moments of your loved ones is a common process in Palliative Care services in Australia, the country I live in. When you get any training as a Death Doula *, you are also informed about these processes. If you are with the family, doctors and nurses try to inform you time-permitting.
Then, what is the use of this information? This is an issue I think about a lot. For my part, information enables me to remain calm, center myself and stay in the process without panicking. However, another unspoken reason for this calmness is my not being a part of the family or a close friend of the patient. Could I stay as calm for a long time in a person’s last moments I love so much? I don’t know.
The last hours of life have a unique silence. Although the silence I mention is the one associated with the person’s being unconscious or their sleeping most of the time, it is not exactly what I am talking about.
What I am talking about is the silence stemming from the intensity of the moments when the patient’s loved ones paying full attention to make any sense of their face, voice or small body movements.
Seeing that this silence created by the possibility of a last communication with their loved one getting ready for the transition or the effort to enable them to have as much comfort as possible in the last moments is due to love is one of the blessings my job provides me with.These last moments, which require a great amount of vigilance and effort on the part of the ones left behind, are, perhaps, a gift they give to their loved one. Therefore, it is a space to which they pay all kinds of attention and care.
My father was taken to hospital for cardiac arrest twelve years ago. After staying in intensive care for less than twenty-four hours, he died. A few hours before his death, my elder sister and me had the chance to bid farewell on doctor’s permission to the intensive care unit. Then, my approach to death, knowledge or experience was not like the one in my life now. All I knew was my intense desire to say goodbye and tell him how much I love him in the 10 minutes given to me. The noisy and congested state of the environment when I first entered the intensive care was replaced by a somewhat strange isolation including only my father, elder sister and me. The intensity outside was replaced by another kind of intensity inside me. I spent my limited time observing my father’s movements, listening to his breath and hearing him just in case he made any sound. Only one word, sound or slight movement; my father became the center of my world.
I find it difficult to do this for hours or days. However, during the time I spend in Palliative Care, I witness long times experienced with this intensity.
One of the pieces of information given to us, doulas, in the hospital is that when patients’ breathing changes and transforms into breaths with long intervals when you think every breath is the last one, we need to count to 60 between the two breaths and if the patient doesn’t breathe, we should call the nurse. As a doula, my spending this short one minute and counting in a calm way mostly is not like the experience of the loved ones of the patient. The curiosity, anxiety, fear, disturbance, sadness and maybe panic of that breath’s being the last one dominate their faces.
I understand the value of that last breath which brings parting to physical bodies when I look at the faces of loved ones waiting by the death bed. No matter how you escape from death all your lives, avoid talking about it or believe that you can delay it fighting; the last moments you spend with your loved one in silence while death serving its purpose in that room are one of the rare actions you present your “purest and the most real” effort to life.
*Doula is an ancient Greek word and it means a woman who helps (serves). Death Doula means a person who provides support for dying people and/or their families except medical support.