My days in Colorado with Kristin mostly rolled into each other. Each morning, she left a menu, and Luke told me his activities for the day in case I wanted to join him. I usually declined unless he was going for a bike ride, since he shared my love of bikes, and he’d cleaned up an old red Schwinn ten-speed for me to use. My days were filled with people-watching through the living room window, long, lazy bike rides, and wondering why I still felt paralyzed. I found no answers, and then I thought about an old fling, Joshua, who used to have access to psychedelic drugs. Maybe they could help me shake this. At the very least it would be an interesting way to spend the afternoon. I called him.
My use of psychedelics up until that point had mostly been for healing purposes with the occasional recreational use during Halloween in college (horrifying choice) and at the Burning Man festival (a good choice, then and always). My experiences with LSD, psilocybin, ayahuasca, ketamine, and DMT have taught me that a hallucinogenic experience allows one to look under the hood to reveal a truth that may be hidden in the subconscious mind. Even recreational use is healing in its own way. Psychedelic and entheogenic drugs are medicine.
Joshua and I dated while I was in law school, and we remained acquaintances. Hoping to strike up a new fling—because nope, I wasn’t done trying to distract myself with men—I was disappointed when I realized that my attraction to him had waned. I couldn’t tell if it was our time apart, his unkempt appearance, or my depression. I didn’t flirt back but nonetheless, he offered me a bar of mushroom chocolate. I turned it over in my hands, noting that there was nothing to distinguish it from a regular bar of chocolate, except the wrapper looked like it was made with a home printer. With a wink and a cautionary smile, he didn’t take any money for it. “Use it wisely,” he told me.
One afternoon, I decided to eat most of the bar. Luke and Kristin would be gone all day, so I could do whatever I wanted. I told Kristin of my plan and while she was hesitant, she knew she couldn’t stop me. I set up a chair in the sun in the fenced-in backyard of their small house and unrolled a yoga mat in case I wanted to stretch or roll around. Peppermint tea sat ready, as psychedelic mushrooms can sometimes induce nausea as they kick in. A neo-soul playlist curated especially for this purpose played as I set an intention for my psychedelic journey: “May I see truth.”
The next few hours were a blur. I swayed to some of my old favorite songs until I couldn’t stand the sound of music. Colors swirled and poignant memories came and went, as though I were watching a stylized reel of my life. At times agitated by the sunshine and feeling vulnerable outside, I’d go indoors. I sat in the living room on the oversized blue couch by the window. Kristin’s English Mastiff dog, Chloe, kept my body company while my mind went on a journey. As I did on most days, I looked out the window longingly.
The difference was that this time I started to cry.
People outside were engaging with life with seeming ease, unaware of the undoing that was taking place within the tan house on Lowell Street. They were walking with their children and dogs, driving for errands, and picking up their mail. For months, I’d been unable to do any of these basic tasks, yet I thought I remembered a version of myself who could.
Where had she gone? It seemed impossible that I could have lost sight of her, but I couldn’t find her.
I was an empty house.
No joy.
No hope.
No sense of self.
No value to the world.
No value to myself.
Nothing.
A pretense I’d been holding on to crumbled like a wall in the Acropolis. And with it a set of beliefs about myself and the world. That if I did the “right” thing—practice good law, be a good daughter, get married, use my gifts in service, do what I was “supposed” to do—I’d have a good life. I’d be perfect, happy, fulfilled, complete. Who was I in the absence of what I’d been told made a good life? Which parts of me developed to mask trauma, to feel worthy, to keep up my armor, to avoid being judged? Which parts of me were true?
The tears continued, and I wondered if I had finally broken. The floodgates wouldn’t close despite my best efforts. After a few hours of being unable to stop, I called Kristin at work in desperation.
When she answered, I fought through the tears. “Something is wrong.”
Her tone was urgent. “Are you okay?”
“No, no, no, no. I don’t think so,” I admitted, finally defeated.
I could hear her fighting to stay calm. “Okay. So what is wrong?”
She was met with silence and sobs. “Are you going to hurt yourself?” she asked. Suicide had crossed my mind, but only as an abstraction, never an act. I didn’t want to die, necessarily. I just didn’t want to feel like this anymore. The pain was too great.
“No, I won’t.” I was telling the truth.
“Promise me,” she begged. “I’ll be home in half an hour. Call your therapist and call me right back, okay? PROMISE ME!”
I called my therapist in L.A. She asked basic questions about how long ago I’d eaten the mushrooms and how I was currently feeling. “Broken,” I told her. “I’ve finally broken.” After listening to my situation and the flood of tears, she suggested an inpatient facility. “No,” I said, vehemently and without hesitation. I thought about it. Then I said no again. Hell no. I had spent nine years in a prison of my own making at Legal Aid, and six months in the equivalent of solitary confinement at The Dungeon. There was not a chance in fuck I was going to a facility.
I would not commit myself to another place.
My therapist was familiar enough with my bullshit and self-justification to be unsurprised. She gently suggested I think about it and let it slide. Those people need help, not me, I thought.
And yet, I was one of “those people.” I could not manage my life on my own. I could not go to work. I needed someone else to cook for me. I wouldn’t eat without pressure. I needed someone to wash my clothes. I needed someone to pay my bills. I needed someone to hold me up. I needed someone to run my errands. I needed someone to dry my tears. I’d never felt so helpless and small. And I didn’t know why I felt this way. Only that the feeling was overwhelming—and it blocked out everything good in my life and everything that felt good about being me.
Kristin flew through the door before I could finish my therapist call. Still in her work clothes, she sat with me on the couch for the next few hours while I finally shared with her how sick I was. When Luke came home, she took him aside and he disappeared again. That night, I cried everything left inside me as my sweet friend sat vigil, bearing witness to my little death. I had come undone.
For some, this psychedelic experience would have signaled “bad trip.” For me, this was the most productive of them. Years of smiling, going through the motions, and pretending I was okay while depression ravaged my mind and body had taken their toll. I was powerless against it. I was finally able to see myself clearly and admit that I was desperately sick.
“We’ve got to talk about how we’re going to get you healed,” Kristin said to me gently the next day. “I know you well enough to know that you’re not gonna go inpatient—right?”
I nodded emphatically.
“Okay, then, what about medication?”
“I don’t want to take any drugs,” I blurted.
Kristin’s eyes widened and her mouth fell open. We both started laughing. I’d just eaten some psychedelic drugs the day before, and she knew me; I was no stranger to an altered state of consciousness. “You know what I mean!” I said, laughing. “Not those kinds.”
I knew plenty of people who had gotten great results by using pharmaceutical medications to treat their depressions. My therapist had suggested them too many times to count. Yet I’d always been resistant to pills. I’m sure this was a stubborn remnant of my twisted idea of strength. It might also have stemmed from a healthy distrust of the Western medical system as a Black person. Aside from a daily thyroid replacement for multinodular thyroid disease and eight hundred milligrams of ibuprofen once a month to calm a uterus that seemed to choose violence to shed its lining, I didn’t take anything else. Unsurprisingly, my end of life decisions for care and treatment request mostly holistic methods. We forward our values for living into our dying.
Further, I was unconvinced that my depression was due to a chemical imbalance. I’d already self-medicated and numbed myself with marijuana, wine, travel, and romance for too long. I was being called back to myself and it was time to heed the call. The mushrooms had shown me what I needed to see, and it was time to make a choice.
“So what’s left?” Kristin pleaded.
I shrugged. No one else could tell me what I needed to do to heal. Or to live. Only I held the answers.
I decided to revisit my meditation practice, which had gone by the wayside. I needed to hear me again—my real thoughts, my actual reasons, my true desires, my underlying intentions, my truth. Since I’d used my subconscious mind to see the problem, I wanted to try to use my conscious attention to heal it.
That’s not a safe option for everybody, for sure. I wasn’t even sure if it was the “right” course of action for me. But I felt compelled to try. I’d been a dedicated daily meditator for most of my adult life. But this time, when the going got tough, rather than double down on meditation, I stopped. It got too hard to be with myself—the good, the bad, the uncomfortable, and the hidden. Shadows, monsters, ghouls, and secrets. It can be a scary place, to sit still, particularly if you’ve gotten good at running, like I had. I needed to enter the liminal space.
Stillness isn’t my forte. I walked before I was one year old, and I’ve been in motion ever since—fidgeting with my rings, hands, or clothes even when the rest of my body appears still. I can’t handle any caffeine because it makes my insides itch. I use exercise to burn off the excess energy, but meditation helps me glimpse the stillness that my body can’t seem to find otherwise. I get ants in my pants when I’ve been in one place too long, but my father has always reminded me that when I do not know where I am going, I should be still.
I didn’t attempt real deal meditation until I had to survive law school. In college I’d picked up smoking both tobacco and weed, which allowed me to be with my breath, away from the noise and stimulation of parties. It was my first unintentional meditation. But in my early tries of mindfulness meditation, I’d sit, frustrated that I couldn’t calm my mind long enough for anything to go still. Breathe in, breathe out—fidget, fidget, check time, move legs, touch hair. Fidget. Wonder what my crush in first grade was up to at that exact moment. Where you at, Chad? Fidget.
I almost gave up until I realized that my job wasn’t to tame what meditators call “the monkey mind,” but to observe it. To practice paying attention to where my mind chose to wonder, the ruts into which it fell. Meditation is a practice, after all. It is a practice of noticing the mind, but not quieting it. Of finding stillness in the liminal space, the space between two breaths.
We experience many liminal spaces while living. Stairways and elevators. Winter break. Airplanes and doorways. The interlude on Maxwell’s Urban Hang Suite. The Brooklyn Bridge. Dusk. Dawn. Broken to breaking open. Birth, the quintessential transitional place. Through puberty, we sit between child and adult. When engaged, we are not single and not yet married. And as we lie actively dying, we are no longer of this world but not yet of whatever comes next, if anything at all. In culture, rites of passage mark our liminal spaces. In Western culture, few rituals exist to honor the liminality. Sitting vigil with the dying is one such ritual. Humans are notoriously uncomfortable with liminal spaces—which is why we sometimes need a guide to sit with us.
A young woman named Summer breezes into my life three months before her death. Knowing that it is soon approaching from a late-detected and terminal breast cancer, she wants to plan a home funeral to take the burden off her friends. She also wants to make sure she has the type of service she wants. At twenty-six years old and until recently estranged from her family, Summer’s heard of death doulas and finds me courtesy of Instagram. Social media is a way for her to connect with other young cancer patients, feel connected to popular culture, and get support through her dying process.
By the time I meet Summer she has already begun to embrace her rapidly approaching death. “I’m supposed to be too young to die! But it’s coming anyway!” she says. She is bracingly matter-of-fact, which is surprising given her age—fifteen years before doctors usually begin suggesting mammograms (and a good thirty years before people are “supposed” to get breast cancer). She’d ignored the lump in her breast her ex-boyfriend found a year earlier. Her primary care doctor also didn’t think much of it, given her age and unremarkable family history with the disease. When her lump was eventually biopsied, everything changed. The treatment plan was aggressive: chemo, radiation, and a double mastectomy. That worked for a short period, and Summer experienced the joys of remission. Then the cancer reemerged in her lymph nodes and quickly metastasized to the rest of her body. Her boyfriend left soon after.
I am in awe of how gracefully Summer shares this news with me, and I tell her so. At this admission, I wonder if I’ve put my big foot in my mouth. Without using the word, am I calling her “brave”—a dreaded word among the terminally ill? While it seems like a compliment, people living with serious illness don’t have much of a choice about living with the disease. Illness is present. Cancer throws a shit avalanche at people and while there are choices in how to face it, merely living with illness doesn’t make someone brave or heroic.
Many of my clients have told me that others encouraging their bravery and heroism disallowed them from expressing fear or anger. It encourages faking the funk by plastering on a smile. A sick person doesn’t want to have to do that, nor should they have to. My own depression showed me that honesty can be a common victim of illness. I knew how easy it was to put on a brave smile, and how lonely it could be behind that smile.
Summer is no different. My rapport with her is easy and immediate. She wastes no time letting me know what’s up. “While we’re at it, please don’t let anyone say I ‘lost’ my ‘battle’ with cancer, ’k?” She rolls her eyes and I groan theatrically.
The war analogy is so embedded in our language about disease. We say people “fight” cancer, or “lose” their lives, as though our bodies are not nature itself engaging in the regular ole cycle of birth, decay, and eventually death. When we use language of battle, we make winners and losers out of people we love when in reality, their bodies are either responding to treatment or not. Plenty of people who want to “win” against cancer still die. Did they not “fight” hard enough? Are they not “heroes”? Some feel empowered by the war metaphors and for them, they’re useful. But it’s most helpful to gain permission first before using such language to ensure that we are not alienating those who don’t feel like fighters, valiant soldiers, or brave. Some are just sick and tired of being sick. They don’t want to fight.
Even though she is dying, Summer is “winning” her bout with cancer, as far as I am concerned. She’s still cheerleader-cute with a button nose and full lips, a blond, feathered, shoulder-length wig, and an attitude that recognizes since her time is soon up, she’d better be unapologetic about who she is. She continued horseback riding lessons when she felt well enough though treatment, and had her breasts reconstructed to the size she’d always wanted them to be: “34D-plus,” as she calls them. “Too bad no one has played with these tattooed nipples,” she says. When she offers to show them to me, I giggle and eagerly accept. She lifts her Rihanna T-shirt to show her newish, braless breasts. Her nipple tattoos look three-dimensional, with pinkish-brown areolas and little brown dots for the Montgomery glands that mask her scars. Even though I’ve only seen a few white women’s boobs up close, I think these look pretty convincing.
“I love these super tits,” she says while slowly shaking her shimmy and squeezing them. In another life where she isn’t yet dying, the guests at Hooters would have loved her.
She gets sad when talking about not riding horses again. She vacillates between and holds joy and grief in a way that people decades her senior don’t know is possible.
Her small home is cool in temperature, and two windows are open. It smells faintly sickly sweet—like caramel and medicine. Taking a look around, I wonder what she wants done with her possessions. She lives in a 425-square-foot studio garden guesthouse in the San Fernando Valley in Los Angeles with only a hot pot to cook her meals. Her kitchen counter is lined with dishes of various shapes and sizes and her shot glass collection. She’s decorated the place with her hats and wooden blocks with calligraphy words written on them. No “live, laugh, love,” but many other inspirational quotes. It feels like the first home of a young person—framed concert posters on the walls, twinkle lights behind the bed, a secondhand olive green couch acquired for free from craigslist. I feel a deep sadness knowing that her life will be over before she buys herself a new couch or switches out the posters for artwork.
I check myself again, but this time for the judgment and ageism that is rearing its head. Is Summer more deserving of my sadness because she hasn’t yet marked adulthood in a way I deem meaningful? Summer’s approaching death highlights one of my embedded harmful beliefs about people who die young. People often project their own fears about dying onto others. I am sad Summer hasn’t had much experience as an adult, even though being an adult is not always fun. She left home and forged a life for herself when she was seventeen years old, finding a job, paying taxes, and snagging cost-efficient furniture that looks pretty good. At seventeen, I hadn’t been kissed and only made $6.25 an hour at the movie theater. Perhaps she is more adult than I regard her as. I remind myself (again) to stop judging the life experiences of others.
Ageism is rampant in deathcare and in grief. It’s well-meaning, but still not so nice. We tend to place greater emphasis on a person who dies young, ascribing greater misfortune to their death, while at the same time largely erasing the fact that young people die often too. When a young person dies, we call it a tragedy, since they “had their whole life ahead of them.” What Summer has lived so far is her whole life. Denying this denies the absolute and sovereign timing of death.
“I don’t care what happens to most of this stuff. I’ve already told my friends that they can take what they want, and the rest can be thrown away,” she tells me. I ask about her sentimental possessions, but she hasn’t amassed many recent ones. “My sister can have my P!nk T-shirt, though.” It’s the first concert she went to. She’d left items from her youth in her childhood home when she fled after making allegations about her stepfather’s sexual abuse. When her mother chose to side with her stepfather, Summer moved to L.A. from the Midwest, hoping to cash in on her looks in the film and TV industry. But she struggled to find an agent or work beyond being cast as an extra, and she decided to stop communicating with her family. As the end of her life approaches, Summer changes her mind and reconnects with her mom, Betsy, and younger sister, Georgia. Upon hearing that Summer’s cancer will end her life, they come to L.A. to be Summer’s caregivers and plan to stay until she dies. On this day I’m visiting, Betsy and Georgia have stepped out to give Summer and me some time to ourselves. I suspect they also aren’t ready for the frank conversation we are about to have about Summer’s funeral. She wants an alternative one—a home funeral.
Summer has decided that she wants to be laid out at home for a few hours after she dies. She’s seen a video about home funerals and since her friend group in L.A. got much smaller through her treatment, she wants those closest to her to have some time with her body before she is cremated. After relying heavily on these friends through her treatment, she doesn’t want to start another crowd-sourcing campaign to pay for anything else. Her ashes are to be sent home with her mom. Imagining her ideal deathbed, Summer focuses on orange roses, her favorite flower. With this detail we envision a deathbed where the flowers are placed on her bed and body and decorate her apartment. The Lumineers song “Don’t Wanna Go” will play as her few loved ones gather.
She plays it for me. Listening to the lyrics, tears come to my eyes. Despite the fact that I have been with many clients, I always feel strong emotion in the presence of someone whose life will end soon. It doesn’t make me any less professional. It just makes me human.
Through my work, I’ve learned to love people who are leaving. It’s a hazard of the job. Inevitably, they die. And while I know it’s coming because it’s the precise reason why we are working together, it doesn’t make it any easier. In some ways, it’s harder. I know all of their fears of death, their worries for their families, concerns about the messes they might leave. And I know that they journey directly into it anyway. There is no choice. It makes me love them more.
Summer is emotional too. She doesn’t want to die, but she knows her time is near. She is ill. In the months that we’ve been working together, her appearance has changed. Hollowed cheeks. Gray pallor. Slow movements. Slurred words. Blue veins visible under her skin, especially over her new breasts. Her life light is fading. And she is clear about how she wants that light to go out.
After making plans for her body to be removed after her death by a company that will directly cremate her, and discussing that her implants will have to be removed before the cremation, we talk a little about religion. Like me, Summer was raised an evangelical Christian. And also like me, she never really vibed with the idea of heaven and hell. She rejected Christianity after she left home and hasn’t looked back. Until now.
“What if I’m wrong?” she asks, drawing out her syllables.
“Right? Like what if we should have gone to church every Sunday?” I respond playfully.
“Or if we shouldn’t fucking curse!”
“Well, you’re about to find the fuck out! Let me know, okay?”
We laugh about it, but I keep the conversation about religion going since it seems to be on her heart. The deathbed is the most important time for what’s most pressing on our hearts to take center stage. Soon there will be no more time to talk about our heart’s burdens. By the end of our session, Summer has chosen which parts of Christianity she wants to keep and has decided that she would like to get baptized. Just in case. Although she doesn’t believe that she will go to hell for rejecting Christianity and living secularly, she still harbors some doubt. Better safe than burn in eternal damnation. I celebrate her choice just as I would if she were Muslim, Buddhist, Hindu, or a whirling dervish.
The way I doula places secularity at its core. The needs of clients from differing religions are pretty universal. This allows me to stay secular in my approach to help them prepare for dying. We generally all die the same, except for what we believe comes after. I can support clients to get clear on what they believe without muddying the space with what I believe. Also what I believe changes, shifts, and redefines through every death I attend and day I live, so it’s a crapshoot on any given day.
I chat this over with the hospice chaplain, who is tickled at Summer’s eleventh-hour conversion. So am I. And so is her mother, who’s been begging Summer to come back to church since she left home. She is finally getting her wish—her baby will go to heaven, according to her beliefs. I can tell how much this means to her. My parents would probably be ecstatic too. Pastor Joe performs the baptismal rites, sprinkles some water on her head, and thanks God for forgiveness for Summer’s sins. When he leaves she says, “Some of those sins were really fun to make. Is it okay that I’m not sorry for them?” Her levity is balm for my spirit, and I tell her that I’ll ask Pastor Joe on her behalf (and a little on my behalf too).
Since Summer’s time to die seems to be approaching, I visit her again the next afternoon. Walking through the patio door into her room, I can tell something is different. Summer is sitting in bed and pulling at her sheets, feebly trying to uncover her feet and lift herself up. Even though she only weighs about as much as my left leg, she isn’t able to get herself up, as disease has withered her muscle tone. Repeatedly, she mumbles that she needs her suitcase and that she wants to leave. She’s frustrated, a marked departure from our visits before. There is a quality to her behavior I’ve seen in clients close to death. I offer to help uncover her feet but it doesn’t help.
Recognizing her behavior as terminal agitation, I ask where she wants to go in case I am wrong. Summer mutters mostly to herself but in response to my question, “Somewhere. I dunno. Somewhere else. Anywhere but here. I want to go. Help me.” But there is nowhere to go. Active dying is near. Terminal agitation (sometimes called terminal restlessness or hyperactive delirium) is the anxiety, agitation, and confusion that is present at the end of life but more marked than the mood swings that accompany dying. The dying person may seem angry, distressed, impatient, restless, and unable to relax. The metabolic and physiological changes one undergoes while the body’s systems shut down may be one of the causes, but no one really knows. I wonder if it is a last-ditch effort to try to escape death. Antianxiety medications can relieve the symptoms and are often prescribed by hospice teams when available.
Betsy tells me that Summer has recently been given pain medication, so we can rule uncontrolled pain out as a cause of her distress. Georgia is upset that her sister is being curt with her. I explain to Georgia that Summer’s behavior is likely because of her dying process. I’m not sure how much it helps. The nurse will soon be on her way to check for other causes of distress. Until the nurse arrives, I sit with Betsy, Summer, and Georgia and try to calm her using the playlist she’d made that she’d told me would help her through emotional distress. Summer’s playlist sounds like what you’d hear in a yoga nidra class. Music choices are part of a standard conversation I have early in my end of life planning work with clients: together we make a list of simple comforts, rituals, nurturing words, music, poetry, and texts or religious verses to help them through the emotional distress of dying.
When the nurse arrives, he confirms Summer’s symptoms. She is not reporting any pain. The nurse asks me to prepare Betsy and Georgia for what is coming; we’ve gotten close, and he trusts me to deliver this news. I explain to them what to expect in the coming days and make myself available for whatever they might need for the night ahead. They’ve been understandably upset by Summer’s misery but are grateful to hear that relief would soon be coming, even if that relief is death. After Summer falls into a deep sleep, I head home for some rest, knowing the days ahead will be transformative. Each death is.
I only sleep with the ringer on when a client is actively dying. Sleep quality is poor anyway knowing that someone I’ve come to care for is making their departure. This night is no different. Normally, I leave it up to the family as to whether they’d like me to be there close to the moment of death. Some want me there with them, and others just want to know that someone cares. Others need questions answered, and others call after the death has occurred. It’s all okay with me, as long as they feel supported. Summer herself has requested that I be there for her death and Betsy eagerly agrees. I otherwise trust my clients in their innate ability to die.
Disoriented, I wake up at 7 a.m. to the shrill ringing phone and make a mental note to change it to something that sounds less like military trucks signaling that war has arrived in my town. Summer’s breathing has changed significantly, and Betsy hasn’t slept a wink, intently focused on her inhales and exhales. They are jagged and slowing down over the last hour. Death won’t be long. Quickly splashing cold water on my face, I brush my teeth, grab a protein bar, and head off to sit vigil with Summer in her liminal space.
When entering a room where dying is imminent, I pause before walking in, reminding myself to treat each death like it’s my first. In ritual, I touch the doorframe in a reminder that I am crossing a threshold. Whoever I meet on the other side will change me. The Alua who enters will not be the Alua who leaves. Death changes everyone. Silently, I repeat the mantra I’ve adopted for myself for this work: May I speak truth. May I speak love. May I be my highest blessing.
Like active labor, active dying is an equally juicy liminal space, deserving of total sacredness and honor. After all, dying is the space between here and there (wherever there is). In most natural deaths, there are a few recognizable signs that death is near. In the days and hours before death, the dying individual begins to disengage with people in their lives and their attention turns inward. Kidney function slows, reducing and darkening urine output. Blood pressure drops, as does body temperature. The extremities are cool to the touch and the skin turns blotchy, which is called mottling. This is also evident in darker-skinned people. In this liminal space, the eyelids fall slightly open, but the individual no longer responds to stimulus appearing in front of the eyes. The mouth then falls open and breathing patterns become irregular. Life hangs on a single breath.
As I enter the room, I can feel the shift in energy. A stillness has started descending, which will blanket the room when Summer leaves it. I center myself for what is to come, knowing fully that there is nothing to do but hold space for and bear witness to this inexplicable event. I am so lucky to get to stand in the doorway to existence, walk in, and walk out, transformed by the power of life and death.
Crossing the threshold, I set my death doula bag of tricks by the door. The cute Moroccan camel-leather duffel bag holds a few items for ritual: books of poetry, a singing bowl, blank paper, candles, essential oils, incense, matches, Agua Florida, a pouch of dirt, and a pouch of tea leaves; and items the family can use in natural deathcare: cotton balls, underpads, washcloths, hair ties, tissues, lotion, Castile soap, a hairbrush, and a small bowl for washing. My doula bag also holds a bottle of water, an apple, Cheez-Its, a phone charger, and whatever juicy novel I might be reading at the time. Gotta stay hydrated and balanced. There are also various fabrics to dress up a space, just in case.
Betsy holds a tissue worn to fluffy strings of cotton in one hand and her daughter’s left hand in the other. Her eyes are bloodshot and her hair is disheveled. One look at Summer confirms that she is actively dying. Her weakened and irregular pulse reinforces it. In a whisper, I tell her I will kiss her, before I place one on her forehead and notice that her button nose has started to turn bluish at the tip. This is cyanosis—another sign of active dying. Her brown eyes are slightly open but not responsive to any stimulus. Her mouth lies slack and her breathing has turned mechanical, slowing to about seven to ten breaths a minute. The body is doing its job to shut itself down. I grab the orange roses from outside that Summer loves and put them on the nightstand. Then, per her request, I put one in her hand. I kiss her again and whisper again that she is doing it right.
For the next three hours, I alternate between rubbing Betsy’s back, singing songs, hugging Georgia and reminding her to breathe, holding Summer’s hand and counting her breaths. They slow to six breaths a minute then speed up. This is likely a breathing pattern called Cheyne-Stokes breaths. The space between her inhales and exhales is short and sharp, yet a seeming eternity passes between each. Together, we hang in this liminal space with Summer, also holding our breaths with her until she does not inhale again.
Summer has died. And then, the sacred stillness envelopes and holds us all. It is ripe with wonder of life and the awe of death. Betsy and Georgia tearfully and reverently wash her body with my instruction, rubbing a washcloth dipped in lavender oil–scented water over her face, arms, torso, and legs.
Together we change her into a crocheted white gown she’d chosen prior to her death. We spread orange roses around her. The friends she’d asked me to call come to her house, dressed in white. She’d also wanted them to wear the hats she’d collected, so they each put one on—a motley assortment of trucker hats, cowboy hats, bowlers, and fedoras. One by one, they say their goodbyes as the others mill about, nibbling on snacks and consoling each other. She’s also asked that they each have a shot and take a glass with them. I take a shot but leave the glass for someone else.
After an hour or so Pastor Joe comes and leads us in a Christian funeral, including a short sermon. Understanding the significance of a recently converted and dead Christian, he weaves it into the service and we sing secular songs of Summer’s choosing. When it is over, we hold hands around her body until the crematory comes to take her body away while the Lumineers’ song plays.
The grief at Summer’s death looks just like it does when an elderly person dies. Looking around, I see the same grief—bowed heads, murmured voices, quiet tears—that I would have at an elderly grandparent’s funeral. Yet culturally we would expect the grief to be greater because Summer was young. Ageism in death also rears its head when expressing condolences. In grief, ageism sounds like “She lived a long, full life” or “ You got sixty-five good years with her” when talking about the deaths of older people, even if those years were shit. When we say that someone who died lived a “long, full life,” we end up unintentionally minimizing the grief experience for the person who is grieving the death of an elderly person. Can they still not be sad, even if Grandma was old? Who can say if someone died too soon? Or if they experienced everything they wanted to? Maybe Grandma wanted to fall in love one last time and her prospects were cut short by only living ninety-seven years. It hurts no matter what.
Summer was young at the time of her death, and her body was no longer responding to treatment. But she was healing. There is healing available in death even though we often think of health as the antithesis of death. The word healing often indicates that something can change and improve for the better, yet we know that a person cannot be “cured” from death. The best we can do is bring comfort to the dying process and support in healing emotional and spiritual wounds. Sometimes “healing” is leaving a sick body.
In her dying, Summer healed her relationship with her body. This was evident in her chosen metaphor—she was in a “dance” with cancer and did not make her illness the villain—and in her pride in showing off her freshly tattooed nipples. She healed her relationship with her family and healed her relationship with religion through her death. She reconciled the life she’d had with the one she’d wanted. Summer had the good death that many dream of, even if many might believe she “should” have had a longer life. But because she died when she did, her life was complete after all.