A Matter of Life and Death

When I was expecting the birth of my first son thirty some years ago, I took Lamaze classes to learn what to expect. I was facing my fears about this unknown passage. My kind then-husband agreed to be my coach, and he sat on the floor with all of the huffing and puffing pregnant women. The classes helped to allay my fears by teaching stage by stage what would happen during a healthy labor—including “transition” when my coach claims that I growled at him and said, “Don’t you Lamaze me.” He backed away from the labor bed and handed me off to the anesthesiologist with the epidural.

All was well and our beautiful son was born, scoring a 10 on the Apgar Scale.

Now death is the unknown passage that I am facing. Not imminently, so far as I know, but for sure. At age 61, it is becoming clearer to me that it will happen to me, too, and to people I love. No one gets out alive. Yet, there haven’t been any classes to teach me what to expect.

Until this morning. A series started in the adult Sunday school at my church devoted to “A Matter of Life and Death;” and the speaker today was The Rev. Dan Hall, M. D., who is an ordained minister and a surgeon. He has seen dying up close. I have never been with anyone going through that passage. My experience of the death of a loved one is that it occurred out of sight, neatly hospitalized.

He talked about matters such as palliative and hospice care and the importance of a health care power-of-attorney. Then he not so much segued but leaped to the question on my mind, “so what happens?” In compassionate but clear terms, he described a typical death, a death with some notice. He described the somnolence and confusion that often occurs as one is dying. Then he both described and demonstrated the labored breathing, pausing for an alarmingly long time after a series of shallow breaths. These Cheyne-Stokes breaths have been identified by and named for two doctors. I was learning a new vocabulary for a part of life that in my circle is rarely discussed. I learned about the Apgar scale and mucous plugs back in my childbearing years; I can begin to learn this lexicon of death now.

Dr. Hall answered questions from the audience about feeding tubes and electrolyte abnormalities, as well as a query about biblical guidance and the disposition of the body. However, my mind lingered back there on the breaths. Though the course of dying would vary widely, there is apparently a breathing pattern that is predictable enough to have a name. I am looking forward to learning more about this discourse of dying. That is not as maudlin as it may sound. There is something comforting in being able to come to terms with death.

Though I thanked him after church, I doubt that the good doctor had any idea how he had evoked a private sigh, an internal small step forward in me.