Sunday, January 3, 2010

Francis' smile

Dear Family and Friends,

Francis had asked me over a week ago, because the sense of hearing is the last to go, -- to sing to him at the end. "I will hear you," he said. And I vowed I would.

"I will hear you" stayed with me ever since.

Earlier in the day yesterday when Francis began sleeping in reaction to the ativan (to calm the panic of shortness of breath when his lungs began to fill,) I had not seen him smile.

But by the time Lenora the weekend Hospice nurse and Jane arrived in separate cars late afternoon, Lenora observed Francis and pronounced she was pleased to see how peaceful he looked, -- how slow his breathing. In fact, except for ativan, she judged that Francis did not need to be medicated in addition to his regular pain med patch and pump. In other words, he was more alert.

So I sang to him the chant our friends had recorded and sent via email, -- "Set me as a seal upon your heart" -- as well as the whole Lord's Prayer, and a few Beatitudes in Aramaic, including of course his favorite.

Observing all this with Jane, Lenora pointed out several ways in which Francis was being very responsive, e.g. she told me that once, when my own eyes were closed as I sang, he opened his eyes and moved his mouth in an attempt to sing along with me! What heartening information!

Lenora said other interesting things: When before birth we're in the womb our lungs are filled with amniotic fluids, and then at death the filling of the lungs with fluid feels like coming home, full circle; it's soothing to the dying.

Then Jane and Lenora left. So in the interim, -- between 4:30 and about 7:30 when Jane returned, I was alone with Francis. I had to leave his bedside to heat up my supper but promptly returned to be near him.

Two nurses had told us that people near death often die while their loved ones are asleep, because it's too difficult to depart when in the presence of survivors. When I had told this to Lynn and Lee earlier, Lee said, -- "No, not for you two. That's not the way you do things."

It turns out Lee was right. Francis did in fact want me in the room, close to him. I sat on his hospital bed facing him, my legs straight alongside his buttocks and beyond, partly supporting his elbow. When I took both his hands in mine he immediately returned my hold. His hands were warm and his grasp was firm and grateful.

After Jane's return, around 7:30, Francis' movements had gotten jerky, so Jane called the Hospice nurse on duty. It was a different nurse who decided to call Dr. Inhorn. As a result Jane and I did medicate Francis every hour orally with liquid morphine, until it was obvious he didn't need more.

So no more smiles at the end, though he looked very peaceful until at 1:25 AM Jane saw the sudden change since we were changing vigil shifts: He simply stopped breathing. Dear Jane then deferred her place to me. I held his hands and sang again, just in case. But he had left.

When Lenora called this morning to inquire what happened, I told her about our having introduced the morphine as the night wore on. She said, that sometimes what looks like agitation in a dying patient is excitement about dying itself. I must ask her where she read this since it intrigues me.

But I'm glad there was that earlier period of greater lucidity when my darling Francis graced me with smiles to last me a lifetime.

That is the image with which I went to bed, and it was the image that greeted me when I awoke this morning, -- Francis' smile, engraved in my mind and on my heart forever.

Next update, -- about our washing Francis' body


  1. So Be It! Say hi to God, the angels and my departed friends and loved ones for me Francis. Jyoti

  2. You are loved Elaine! Jyoti

  3. I've never read anything so beautiful, Francis' smile, engraved in your mind and heart forever. XO