Precious in God’s Sight

Papa and cat smaller

Today was a holy day as Nate stepped out of this world and into the next. The members of our family (as well as Mary and several Hospice staff) had kept a vigil around Nate’s bed for three days, not leaving him alone for a minute. The nurses had helped us learn how to manage his pain with helpful drugs. Pancreatic cancer is one of the most painful cancers that exists. We learned to read Nate’s body language carefully, even while he was unconscious, watching for signs of discomfort and anguish. If he paddled his feet, pinched his shoulders together, furrowed his brow or shifted in his sleep we knew he was struggling and needed help.

Yesterday morning Nate hit a new low. He was in tremendous pain, which yanked the rest of us into it with him. A nurse guided us by phone on how to escalate the meds, finally arriving in person to help us. Nothing we did seemed to settle him. The combination of drugs had gotten complicated, and we were keeping a desktop record of what we gave him, when we did it and a schedule of next doses, but even with that it was becoming more and more difficult to keep everything straight. When the drugs weren’t “getting” his pain, we were devastated.

Hospice offered to send a nurse who would stay with us through the evening and overnight. Her main function would be to manage the complicated medicine, although she would also be there to help if he passed away on her watch. We gratefully agreed.

By 5:00 pm yesterday, Nate’s pain began to subside. The added pain patches wouldn’t kick in until morning, but the increased morphine worked its magic, and he began to settle. We learned later that the orange-sized tumor in his lung had ruptured during this time, causing tremendous pain he could not tell us about in words. Later that evening fresh blood would flow from his nose, and brown fluid would spill from his mouth. Both seemed mysterious at the time, but later the puzzle pieces fit together, when the rupture was identified. From that point on, he was breathing with one lung.

Nate could no longer talk to us with his voice but spoke volumes with small facial expressions we carefully looked for. All 11 of us squeezed around the bed in his tiny room to express love, each one taking a turn with their father/father-in-law. Tears flowed and great things were accomplished. Gratitude poured from the hearts and mouths of each person. I, too, spoke love and thanks to Nate. We repeated Scripture to him, sure of his hearing. Mary and I sang all three verses of his favorite hymn: Blessed Assurance.

Nurse Sonia arrived at 6:00 pm and made an assessment of his condition, concluding he probably wouldn’t live til midnight. We braced ourselves and spent every minute with him. His makeshift bedroom was filled: the hospital bed, the big oxygen-making machine, extra oxygen tanks, a desk covered with medical supplies and as many chairs and stools as could be wedged around the bed.

At about 10:00 pm it looked like he was slipping away. His breathing became more shallow, each one spaced far from the next. He was in a deep unconscious state but was, at long last, resting without any signs of pain or even discomfort. His hand was relaxed as I held it. I sat on the edge of the bed and put his warm hand on my knee, a gesture very familiar to the two of us. For a flash it was just like old times, before pancreatic cancer.

I began singing quietly again, and Mary joined in. Nate, a non-musical person (except for Elvis Presley songs), had often mentioned his favorite hymns: “Blessed Assurance”, “Fairest Lord Jesus” and “A Mighty Fortress”. We sang them all, and gradually each of the kids drifted back into the room, lit by a dim green lamp. Some of us were softly crying. We quoted Nate’s favorite Scripture passage, Hebrews 12:1-3, about running life’s race. I told him, nose to nose, that his race was almost over, and he was close to the finish line. He was worn out and would soon be able to rest. We told him how proud we were of him in his running and his strong perseverance.

Despite the click-click of an oxygen machine, the little room became a sanctuary of worship. We lovingly spoke to him, caressed him, loved him. I talked right into his ear and said, “The Bible tells us an angel will escort you to Jesus. Do you see the angel yet? Its time to stop running. Just walk into heaven. No more pain. No more work pressures. No more trouble. You can leave us any time now. You’re ready to go, and we are ready to let you go.”

These words were difficult to say, but God kept my voice strong despite tears plopping on his t-shirt. The kids moved forward and said more nourishing things to their dad. Many of them broke into spontaneous prayer. The Holy Spirit was hovering over our little group, working his wonders in every heart and mind.

Finally we were quiet, listening to Nate’s erratic breathing, focusing on his face, waiting for the end. Every so often the nurse would move through our ring of protection to take his blood pressure or listen to his heart. “Not long now,” she’d say, slipping quietly into the background again.

Minutes passed, then an hour. Nate’s breathing didn’t change. Sonia was replaced with Dee at 11:30 pm, and as she stepped into the room to make her own assessment of Nate, our kids began easing out of the room. They stoked the living room fire and settled into chairs, talking quietly, waiting, until they drifted into sleep. No one wanted to move too far away.

Mary and I settled into our sleeping chairs on either end of Nate’s bed for the third night of watching over him. Dee stayed close, too, and we grew to love her tender care of him through the night. Once I opened my bleary eyes and saw her reading my Bible in the dim green light, sitting in the corner on an 18” stool.

When morning came, Nate’s blood pressure was 63 over 38, unchanged from the evening before, but his heart had weakened significantly, beating irregularly and “far away” as Nurse Dee put it. We continued to wait. Dawn came. Coffee was made. The little ones began their chatter, and life moved forward one more step. Dee shook her head in amazement as she listened to Nate’s heart.

“I can barely hear it at all,” she said. “He’s keeping himself alive by sheer will power.”

“He has a special heart for those whose husband/father has abandoned them,” I told her, “and he’s trying not to abandon us.”

“Better release him again,” she said.

Nate has always been a list-maker, so I made an audio list for him, coming close to his face. “Your taxes are paid. You have provided for me with life insurance. You have put my name on your bank account. You have completed your cards for the kids. Your children and your two brothers-in-law are going to take care of me. Your clients all send their love. Your business is being cared for.”

I listed every specific detail I could think of and then said, “And now its time for you to leave these things behind and go. I’m going to say goodbye now, and I’ll see you later. You’re so blessed to be going to heaven now. You’ll actually get to meet and talk to Jesus! I’ll be right behind you, and when I get there, I know you’ll welcome me.”

I kept one hand on his chest which was moving up and down ever so slightly with an occasional deeper breath. But he chose not to “go”. By 6:00 pm, although he had no pulse, he was still breathing. In the rest of the house, life kept happening. Two people left to pick up Chinese food. Two more walked Jack. Someone else took the little ones to the playground. Animated conversations were in progress.

Mary and I based at Nate’s bedside, marveling at how he continued to cling to life. Dee had used the word “rare” in reference to him being a pancreatic cancer patient able to hang on so long. She also told us it was unusual for pancreatic cases to die without intense pain, yet Nate’s face was peaceful and smooth. Dee said, “As I studied him during the night, it looked like he was getting younger and younger.”

We told her of all the prayer that was going up to God on this specific issue, a peaceful passing. She nodded like a woman who knew all about it.

At 7:20 pm, Dee was long gone, and we were wondering if we should call for another night nurse to help us. Mary said, “Well, go get your plate of food. I’ll watch.” But I hadn’t been in the kitchen 20 seconds when she came running. “You better come. It’s happening,” she said,” and I dropped my plate and ran. The kids set their plates aside and followed.

Putting one hand on his chest and one on his face, I felt him take three more slow breaths as I spoke my goodbyes and I-love-you’s into his ear, and he died. Our beloved husband and dad had finished his race. And he was healed of pancreatic cancer.

Passing the box of tissue back and forth across the bed, we all wept freely. I continued to hold onto Nate, caressing the arm, hand and face of the person I loved so much. But he began to cool off immediately. His face and lips turned ashen beneath the yellowed skin of liver failure. Within minutes his body was stiff and cold. The real man had departed, and it was obvious to all of us.

We stayed in our little womb-room and talked of how Nate had not so much died as been born to eternal life. The kids surmised about what he was doing “right now.” Through tears we smiled. And we prayed together, trusting God’s Word to be true and claiming every promise about heaven.

Nelson quickly stepped into his father’s shoes, calling Hospice and then the funeral home. Within a few minutes a nurse arrived with her stethoscope, listening to Nate’s heart for the full legal 60 seconds before pronouncing him dead. But one look at his body could have made that pronouncement.

The funeral director and his assistant arrived and wrapped his body in the sheets from the bed and simply carried him out of the house. I told all the kids not to look as they walked by, but I had to see. One man held him at the shoulders, one at the hips. His legs stuck straight out as if he was still lying in the bed. How quickly our “shells” become useless baggage once the God of life and death removes the real us.

After they’d gone, I said, “Now. What would Papa want us to do next?”

Several of the kids answered in unison, “Eat our Chinese dinner.”

And so we did.

“We grow weary in our present bodies, and we long to put on our heavenly bodies like new clothing. Yes, we are fully confident, and we would rather be away from these earthly bodies, for then we will be at home with the Lord.” (2 Corinthians 5:2 & 8 )

“Precious in the sight of the Lord is the death of his saints.” (Psalm 116:15)

The Long Goodbye (By Louisa)

Papa’s body has slowly been shutting down over the past 24 hours. We’re all here, each spending time sitting with him, holding his hands, kissing his cheeks and telling him how much we love him and appreciate all he’s done for us. By the tears that keep coming I think it’s obvious that each of our hearts are breaking over temporarily losing our Papa.

I’m writing to you this morning in place of my mom because she’s sitting at my dad’s side. For the past 24 hours she’s held her position there letting him know right where she is by talking to him, reciting verses, singing hymns, showering him with kisses and holding his hand. The nurse who’s been here all night said that in her 19 years of working in hospice care, she’s never seen a patient in the end stages of pancreatic cancer hold on this long, or seem as peaceful as he does. We’ve all been praying for a peaceful passing, knowing that where he’s about to go will blow this entire world out of the water. I think God’s answering those prayers.

My mom plans on giving a detailed update later tonight. As of now, Papa’s still holding on with a faint heartbeat and shallow breaths and she’s still by his side.

With Love,

Louisa

The Hardest Part

Life has changed dramatically in the last 24 hours. Nate’s pain has increased at phenomenal speed, and we’ve had trouble keeping ahead of it with the drugs Hospice has given us. Yesterday, from around 3:00 pm until 3:30 in the morning, he was extremely agitated, attempting to get out of the hospital bed with energy so forceful we needed the adult boys to “convince” him he could no longer stand on his weakened legs.

As we talked repeatedly on the phone with the Hospice nurses, we decreased the intervals between medicine doses until we were administering one thing or another every hour. During our struggle to determine how best to overwhelm his sky-rocketing abdominal pain, the nurse decided to make a visit.

Her summary statement was, “He’s shutting down, one organ at a time, and is very close to the end. Maybe tonight, maybe tomorrow. Men hang on longer than women and wait to slip away until their wives are not in the room.”

I told her I wanted to be sitting next to him holding his hand if I could, when he died. “If that’s important to you, then do that, but be sure your words give him permission to leave you.”

She assisted and directed us in changing the Depends and washing him, pointing out the bluish toenails and fingernails, as well as pooled blood at his knees, back and palms. She also changed his white t-shirt. Just as we were wondering how she’d get the old one off without upsetting him, she said, “We have a trick for that,” and pulled out a giant scissors. Even after the soiled shirt came off in four pieces, she continued to use her scissors to cut the clean shirt up the back, leaving the neck band in tact to hold the whole thing together.

“Voila,” she said. “As good as any hospital gown.”

Mary offered to stay the night, and we sent everyone else to bed with a promise to wake them up “if anything happened.” Dozing here and there between 3:30 and 7:00 am in chairs pulled up to his bed, we each kept an ear open toward his gravelly breathing.

As the light of dawn came through the window, his throat and mouth were filled with an ugly grey phlegm causing him to choke and panic. We called Hospice again, and the nurse returned, showing us how to place drops under his tongue to decrease bodily fluids including the ones in his throat. She remained calm throughout the process over a 90 minute period, even as Nate struggled, until gradually his body responded to the drug, allowing him to breathe easier.

As I write now, at midnight, oxygen is helping him, and medicine every three hours is holding back his pain. He’s sleeping peacefully, pink-cheeked from a 105 degree fever as his body tries to cool itself down.  We are thankful for his brief visits yesterday with each of our kids and several others while he was still alert and talking. They were able to give love and receive it, to share hugs and kisses and express gratitude. I’ll never forget how he worked to stretch out his thin arms to receive each child, winking here and there at things they said, using this creative way to stay in the conversation without words. Today those scenes could not have taken place.

This afternoon as Nate slept, the younger girls and I had a great conversation about what we’ll be feeling when we stand next to Nate’s non-breathing, cooling body. As the tears poured forth, we talked about his point of view. “We’ll all be crying,” I said, “but he will be happier than ever before. Let’s do our best to think about all that good stuff.” They nodded and cried.

As I hold Nate’s hand and watch him sleep, I search for a way to put this heavenly phenomenon into earthly understanding, so have pictured God putting the finishing touches on his dwelling place. Right about now he’s unfurling the rugs and putting fresh flowers on the tables. Nate’s prepared home (mentioned in John 14) is almost ready.

God knows what he’s doing within Nate’s body and in the lives of the others under our roof. He is perfecting his plans minute by minute, and we are trying to follow his lead rather than usurp it. I am keenly aware that our Lord has a specific moment in mind, planned from before Nate was born, when he will pluck him from this world and escort him into the next. No matter what we do or don’t do, that moment will not change.M and N in hospital bed

As we go into another watchful night of waiting and wondering when and how Nate will separate from his earthly existence, we hover between exhaustion and anticipation. As Nelson said tonight, however it works out, it will all be good.

“As for me, my life has already been poured out as an offering to God. The time of my death is near.” (2 Timothy 4:6)