Facing Mortality: 20 Hours of Dying

It was only 20 hours--not even a full day-- but it was a very long 20 hours when I thought I was dying and facing my own mortality. 

It started with my doctor telling me there was blood in my urine.

I’m a month shy of turning 58, and other than being genetically cursed with high cholesterol and suffering through a long list of athletically induced orthopedic injuries, I’ve never had anything seriously wrong with me.

Until now. Having blood in your urine doesn’t fit into too many benign story lines, especially when you’ve had inexplicable back and hip pain for weeks and your mom died of cancer.

So a few days ago, around 11am, I had an ultrasound of my kidneys and pelvis. I asked the technician how long it usually took to get a report. She told me it usually took a couple of days and that they’d send a copy of it to my doc a day or so after that. No sweat.

The ultrasound took about an hour. It seemed routine. The technician apparently had her poker face on. I left the hospital without giving it another thought, did some grocery shopping, had some lunch, and then sat down to do some writing.

My phone rang around 4pm that same day. I glanced over at it and saw the caller ID: it was my doctor’s office.

For more than 30 years, I’ve worked as a nurse in every setting imaginable. I know the medical system inside out. It took me less than a second to understand what had been happening for the previous 4 hours. There was only one reason my doctor’s office would be calling me.

They found something. Something abnormal. Something that warranted putting my ultrasound films at the top of the stack for the radiologist to read immediately. Something that turned a leisurely 3-day turnaround time into a STAT report. Something that demanded a rapid follow up with my doctor, with whom I already had an appointment in 3 weeks.

I answered, already having heard the ensuing conversation in my head. We got the report and the doctor would like to see you. How soon can you come in? We settled on noon the next day.

T - 20​

Initially, there was a chaotic mixture of images, worries, and thoughts. My inner commentary ran from, This is probably due to too many anti-inflammatories and will amount to nothing to Will our 14 year old Siberian Husky outlive me?

My old self would have spent the entire night on the computer researching all the symptoms of every conceivable cause, trying desperately to reassure myself that I would be OK.

But I learned long ago that attempting to control the world around me does not really decrease fear within me. Only mindfulness of each moment–taking stock in being fully alive right now–and accepting each new wrinkle in each unfolding moment reduces my angst.

Meditating helped me get back to being fully present; by mid-evening, my mind has calmed. I regained the perspective that the chances of this being a life-threatening diagnosis were not all that high and that it was probably something needing attention, yes, but not life-ending.

But the fear was not gone. What could I do during the next several hours that would take what would otherwise be hours of tension and worry and transform them into time spent well?

I learned a powerful lesson about tackling fear back in college, when I was taking the most dreaded course required at my university–public speaking. I was gripped with terror at the mere thought of speaking in public, and my first speech beautifully reinforced my panic. I had to change something if I was going to survive doing this 12 times. I learned a tip from my best friend who had already taken the class: Instead of sitting in the back of the classroom, drenched in avoidance and wanting to go last, go up first. Walk straight into it. Immediately.

Like leaning backward off a cliff when trying to rappel, you must do the counterintuitive.

Trying to avoid the fear is the best way to feed it.

I decided to stick to what has worked for me since those college days: I walked straight into the fear. I chose not to consider the sorrow and loss my children, husband, and parents would feel (clearly this visual would only serve to intensify my feelings of powerlessness.) I decided instead to look straight into my own mortality and ask myself the important questions.

If the news is catastrophic, and it’s clear I won’t make it to the end of 2016:

What do I want to do with what’s left?

What insight or message do I want to make sure others hear?

Who do I want to meet?

Who do I want to thank?

I expected to be flooded with images of places I wanted to see, experiences I wanted to have, books I wanted to read or maybe even write.

Instead, I found I was flooded with feelings I wanted to feel.

I wanted to feel the joy of connection to my little tribe–my inner circle of family and friends.

I wanted to feel the kind of awe we experience when we see the Alps or the Cliffs of Moehr or the Western Wall for the first time.

I wanted to feel long lasting hope–about my family’s future and about the fundamental goodness humanity is capable of.

And I wanted to feel the warmth of God’s loving smile.

In that context, I knew instantly the first decision I’d make: I’d quit my part-time job as a home visiting nurse.

I found the realization both surprising and instructive; it was suddenly clear that the work, while perhaps valuable to my patients and home care agency, is not particularly nourishing to me. Many of my patients are so ill, I’m unable to make much of a difference in their lives. I was able to see that I often feel stuck, spinning my wheels, frustrated at the medical system that does not, will not, provide adequate interventions for my patients. Until this exercise, I honestly did not know that.

Then I thought about the people in my life. I thought about letters I’d write and videos I’d create for those I care about–videos of humor and memories and reassurance and gobs of love. I wondered: Why do I have to be dying to give that to them?

And what of this wish to feel closer to God? Why have I done nothing to reconnect with The Source from which so much love and goodness flow? Why do I only now, in a state of great angst and need, reflect on the distance I feel between me and God? Wouldn’t I benefit from that closeness regardless of how my life is going?

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It’s 8am and I’ve run out of things to say or even think. My husband has taken the day off from work to be with me for moral support. We have an agreement: Lunch and ice cream if the news is good, margaritas at our local beach bar if the news is bad. That’s as far as we’re willing to plan.

I have 3 patients scheduled before my doctor’s appointment. So I go into Professional Nurse mode and make the conscious decision to block any thoughts having to do with what I will hear at noon.

As I’m pulling into my doctor’s parking lot, I’m reassured that not only was I able to block out the negative messages while I worked, I was surprisingly effective with all three of my patients despite the firm grip fear had on my throat. Maybe I can keep functioning no matter what I hear next.

T - 0.  Here we go.

The doctor starts with the two most anticlimactic sentences I’ve ever heard in my life: “There’s nothing to be frightened of” and “I’m sorry we didn’t explain that to you over the phone.”

But I’m so relieved, I’m not even a little angry. I feel nothing but profound gratitude…and an immediate, overwhelming sense of empathy for all of the millions of people who have had their mortality dangling over a cliff for far more than 20 short hours.

The rest of the conversation is a bit of a blur, having to do with a CT scan of my kidneys to figure out why I have dots of calcium speckled inside both kidneys–something which I may have actually been born with.

It’s been a couple of weeks since those 20 hours of dying. I still have some tests ahead of me, still don’t have all the answers. But the insights I gleaned that day were extremely useful. I’ve reflected on them again and again: Why should the threat of death be the only thing that brings us to a place of genuine courage? Why can’t the threat of not living galvanize us to action? Why are we comfortable with being placid and safe, when those states give us no spark, no life juice?

They say that skydiving makes you feel tremendously alive, partly because you know you might die doing it. Wouldn’t it be more efficient to recognize that we might die doing pretty much anything, and that the small acts of courage in every day life are what really make us feel alive?

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