by John Creasey
It turns out the partial information resulting from scans performed last week at UWMC hospital is generally viewed as good. There is more discussion. And more indecision. The adverb “When I take the chemotherapy” and the conjunction “If I take the chemotherapy,” is a noticeable part of the intercourse between Dixie and Dr. Chiorean. Dr. Chiorean advises three more treatments in three week intervals, followed by scans after a total of nine weeks. A compromise is agreed upon after further discussion, comprising a chemo infusion today and then three weeks following, a series of scans to further clarify the status of Dixie’s cancer.
We move on to F5 Bay 9, where preparations for the chemo infusion are being made. Within minutes a glitch shows up. Once again a reminder that nothing is easy when being treated for cancer. Dixie’s blood pressure has shot up more than 70 points during the last hour! The nurse rechecks. Then checks a third time. All three are mutually corroborating. Quickly Plan B is created on the spot and set in motion.
The chemotherapy nurse administers hydralazine, an antihypertensive high BP medication, causing a relaxation of blood vessels as they carry blood away from the heart and towards the organs and tissues. The exact mechanism of how hydralazine causes arterial smooth muscle relaxation is not understood by medical professionals. It is one of the yet-to-be-solved mysteries of medical science and the human body. But by the end of infusion therapy, her BP is down 40 points from its high. Still, this sudden spike in BP remains another unknown piece of her treatment requiring a close watch.
Speaking of food . . . well, on second thought, let’s not. It remains a major concern. The very thoughts and smells of food often bring Dixie to the point of nausea, not nourishment or pleasure. Food is altogether distasteful. Another one of chemotherapy’s unwanted side-effects.
Dixie is visited by a nutritionist specializing in cancer diets, and by nurse Jodie from palliative care. The result is additional information and a commitment to become more directly involved in helping oversee the home medicine schedule, which in and of itself is very challenging. It was so much easier when professionals were responsible during her hospital stay. Here at home base, medicines that once worked, don’t work now. Some never worked and are discarded. Some must be taken with/without food, etc.
Saturday 11 July. Thursday and Friday are downhill days for us. Deeper into the shadows. Lots of unrelenting pain. No nourishment intake at all. It is the weekend now. I think every crisis seems to take place on weekends when it is difficult to reach the folk at SCCA. I decide to leave a message for Dr. Marchand at UWMC. Within a few minutes she returns the call. We discuss the situation on speakerphone, so Dixie and Michele can be included. I watch Dixie’s countenance during the 15-to-20-minute conversation. Her pain level can be read in her eyes. We conclude with expressions of love and a promise of hugs to be shared again one day. The decision is unanimous. It is time.
The tipping point.
I leave a telephone message informing Dr. Chiorean. We are requesting Evergreen Hospice to assist us with home care. Dr. Chiorean’s nurse and the SCCA palliative care team return our call the week following, expressing their concerns and best wishes.
The shadows on life’s sundial lengthen further still.
Yet God continues to fill in the gaps with hope and love, goodness and peace. He reinforces these elements as we exercise our faith in the Valley of Shadows. We water them. We cultivate them. They are a portion of the fruitfulness to which we are called.
King David said to Solomon his son, “Be strong and courageous and do it. Do not be afraid and do not be dismayed, for the LORD God, even my God, is with you. He will not leave you or forsake you until all the work for the service of the house of the LORD is finished” (1Chronicles 28:20).
Good words.
Words to finish well by.
56
What I Learned from Dixie
Thank you God for love . . . for your love. But, Lord, the apathy I feel at times must grieve you. Please replace apathy within me with passion. Passion for the people you are passionate about. Passion for the work you want me to accomplish. Lord, help me model, encourage, and mentor others to seek passion, not apathy in their lives. Show me the way. Amen. ~ DLT diary, April 2004
Hi Dixie,
I pulled out my now very old handwritten copy of the tribute I did at your anniversary celebration at VCC. Not sure why I have saved it all these years, but I am so glad that I did because it is as relevant now as it was then.
Much of what I learned from watching, listening, and serving alongside you through those exciting as well as painful years continues to serve me well through my own good times and hard ones. Because I am naturally an observer and analyzer, I must have been watching you very closely! The result was that God used you to shape me in some very vital ways, and I have been able to build those into my own life. Now I model them to those who watch me! So I pulled out my tribute tonight and typed it up for you.
I love you and thank you from the bottom of my heart for being my friend and mentor. And for continually kicking me forward into places I didn’t want to go.
7 Attributes of a Highly Effective Pastor’s Wife
~ What I learned from Dixie in 15 years of doing life and ministry alongside her ~
Risk. Risk giving yourself to God. Let Him do His work in you no matter how hard or scary it is. Let Him stretch you into becoming who He wants you to be.
Recreate. Plan the fun times. Laugh much. Plan come-as-you-are parties, and laugh at what they look like when they show up at your door
Dream. Allow God to give you His dreams for your ministry. They will seem like just that—dreams. But with God’s involvement, dreams will become reality
Persevere. Sometimes you just have to set your jaw and go forward—but always as you pray. Whether it be family issues or ministry issues, develop a deep relationship with God in prayer.
Build. Build strong relationships with those God has placed alongside you. Invest yourself. Learn to be vulnerable and transparent even if it doesn’t come easily.
Trust. Trust in God no matter what the circumstances are or how things appear to be. Don’t give up. Trust and wait.
Love. Love is a choice, a decision. Love with your actions, love with your heart. Love with God’s unconditional love. Love in ways that people need to be loved.
Dixie is a highly effective pastor’s wife because, first and foremost, she sought to become a woman of God. ~ Nancy Heverly12
Some seeds fell on good ground.
They are like people who hear the word and remember it.
Their hearts are honest and good.
These people keep on believing,
and much good comes from them.
~ Luke 8:15 (WE).
57
The Most Important Thing
The Good News of the gospel, therefore, is not that God came to take our suffering away, but that God wanted to become part of it.
~ Henri Nouwen
What’s the most important thing? I mean really. What do you think it is? Like Moses of old, you stand on life’s mountaintop with God and you see the land of promise just ahead, bejeweled with golf courses and grandkids, fishing trips and sunny beaches. You’ve dreamed of this. You finally made it. And God is smiling. (That’s always a good sign.) After years of trekking through the workplace wilderness, you have arrived. It’s retirement reward day!
24 Dixie’s mountain
And then God tells you that others you’ve led safely through the wilderness will cross over, but you will not. It hits you like a stone from David’s slingshot. Your dream bursts like a bubble. You worked hard to nurture your bubble, only to have it poked by your best friend. And the question is still there. “What’s the most important thing?”
Then Moses went up from the plains of Moab to Mount Nebo, to the top of Pisgah, which is opposite Jericho. And the Lord showed him all the land, Gilead as far as Dan, all Naphtali, the land of Ephraim and Manasseh
, all the land of Judah as far as the western sea, the Negeb, and the Plain, that is, the Valley of Jericho the city of palm trees, as far as Zoar. And the Lord said to him, “This is the land of which I swore to Abraham, to Isaac, and to Jacob, ‘I will give it to your offspring.’ I have let you see it with your eyes, but you shall not go over there.” ~ Deuteronomy 34:1–4
Not all things in life are fair, but God is fair and in control of all things. His sovereignty is never delegated or shared. Not to lesser gods. Not to you or me. Yet he somehow remains intimately involved in our lives. Our days are in his hands.
The Psalmist says all the days of one’s life were recorded in God’s book, “when as yet there was none of them” (Psalm 139:16). In other words, our Lord knows where you were, where you are now and where you will be later.
Will you look back on life and say, “I wish I had,” or “I’m glad I did”?
~ Zig Ziglar
He sees you as you dance with joyfulness along the pathway, or stand perplexed at one of life’s crossroads. This way or that? What will it be? He does not make the which-way choice for you. Yet he does know which way you will chose.
He knows the exact number of your days, be they few or many. He knows when your last breath will be taken. He makes certain your life will not be “cut short.” You are in his hands. Someone once said, he is more than a Timekeeper who winds up history like a clock and lets it run its course. He is God Almighty, worthy of trust. All of your days . . .
And still the question remains. What’s the most important thing?
Life was his against all odds. Forty years in the palaces of Pharaoh. Forty more watching over his father-in-law’s sheep and learning the ways of the desert. Finally, forty years of doing his best, most fortuitous work, that of leading a slave nation to freedom through an unforgiving wilderness. So he lost it once or twice along the way. Is it fair that after all this he doesn’t get to so much as leave a footprint in the promised land?
Isn’t the promised land what life is about? After all the sacrifice and suffering that goes into it? Not even a toe print? Or a gold watch? What about the fruits of your labor? What about those world-class grapes? The grandkids? And the milk and honey. What about that?
Aren’t these the most important things?
Monday 20 July. This week Dixie continues to fight the good fight, and we with her. I admit to being weary, a kind of physical and emotional weariness that cuts more deeply than I dare allow just now. Dixie is exhausted, but with the right to be. I can’t let myself go down this path. Not yet.
I am weary in spirit as well. I do not question God’s seeing our tears, hearing the prayers. Yours. Ours. Everyone’s. You can count on him, no matter what. He never fails to listen, never throws away a sincere prayer no matter how poorly stated. On this sacred journey, I have learned he answers in his good time and in his own all-knowing, all-powerful way. I am also reminded his answers are not always those I choose.
On the physical level, Dixie has continued to lose ground since her extended hospital stay at UWMC. Her final chemo infusion is on 06 July. Her choice. No more chemo. The next week, pain and nausea continue to build, coming and going like waves of the sea, crashing against a shore already weakened by the storms. We remind ourselves. Often he waits until we are ready. Not for the answer we choose, but for the one he is preparing to give.
Our days are in his hands.
Tuesday 21 July. For some weeks we’ve recorded weight in double, not triple digits. Yesterday another pound was lost. The night passes with a grating 10+ pain factor, and this morning two more pounds are gone. Since 11 July, hospice nurses in our home have been doing their best, but meds are either not working or cannot be kept down. This morning an ambulance is requested and at 10:30, Dixie is transported to the Evergreen Hospice Center in Kirkland, our sister city to the north.
The EHC facility is designed to be homelike, much more than a normal medical center; with rose gardens, hummer feeders in windows, and a door from each room leading directly onto the outdoor patio. Room 8 is spacious, as hospital rooms go, and includes a private bath. Before we know it, a new medical team enters our lives. Barbara is a resident physician with nine months of training still remaining toward becoming an OB/GYN; Brynne and Cindi are our RNs. Everyone seems to be at ease and on a first name basis here.
Meredith is our newest medical doctor. She takes time to explain what is going to happen and what the goals will be. As she concludes, she asks if there are any questions. Dixie speaks up. She asks a question she has asked before, at another time and place, “Do you think the symptoms I’m experiencing are signs that indicate my body is beginning to shut down?”
Dr. Meredith hesitates for a split second. It is not the first question she is expecting from her newest patient. Then she replies forthrightly, “Yes. This is very likely what is happening,” and continues on with her explanation. When she is finished, Dixie thanks her for being honest and straightforward.
After everyone is gone and Michele and I are alone with Dixie, she looks around the room and out the window to where three small sparrows are flitting about the hummer feeder, trying to understand why their beaks won’t fit in the holes. They see the promised land with its refreshing sugar water, but just can’t get to it. I know how they must feel.
Dixie laughs. “I like it here,” she says. “If I need to come back again for my final days, I won’t mind at all.”
Michele and I smile. There is relief in knowing she feels this way. We agree. If home becomes too difficult, this will be a good place.
I have board meetings this week. We have agreed to close CASA 50+ Network after thirty-three years of training and supporting ministry to and through adults in life’s second half. An amazing amount of good work has been accomplished. Hundreds of pastors and lay leaders have been exposed to older adult ministry. But it is time. While the need remains for the message, the messenger has concluded its raison d’être. This is the final gathering of the board. A time of closure. We have a last dinner together along the banks of Lake Washington in one of our popular Eastside restaurants.
After dinner, while others go to their hotel rooms, I slip away and return to the Hospice Center. To Room 8. To sit for a while with the patient sleeping there, comfortably sedated, free for now from pain. There is no need to awaken her. She does not need to know I am here. Time passes slowly. This is a hard place.
Sunday 26 July. We pack up her few belongings and say goodbye to EHC today. The medications appear to have balanced themselves out under the watchful care of the hospices team. We are going home with a long list of medications and an even longer list of instructions. At 11 o’clock the ambulance returns along the freeway and through the city streets to our home, but no sooner are we there than Dixie has another vomiting spell.
I am anxious. Is it the result of the transition and transport, or did we leave EHC too soon? Eventually, however, she settles into her own bed. At least into the hospital bed that now serves as her own.
And so we wait and offer our own caregiving, along with periodic visits by the home hospice team. Our son, Stephen, is coming to be with us on Tuesday. After the doctors and nurses and specialists of all kinds have given their very finest efforts, perhaps this is the best kind of caregiving of all.
What? What is it you are asking? Oh yes. The question. In the midst of life happening, I had almost forgotten.
What’s the most important thing?
The answer is simple really. But profound. Put yourself in your last-day shoes and think carefully. What’s the most important thing?
When you are standing on top of the last mountain you will ever climb, the most important thing is that God, who gave you your mountain in the first place, is waiting for you there to spend your final day on earth together.
Life doesn’t get any better than this!
58
The Journey Ends
Her absence is like the sky, spread over everything.
~ C
.S. Lewis, A Grief Observed
Sunday 02 August. Amazing. We were told she would likely be gone in twenty-four to forty-eight hours after we came home. But she is still with us. Michele and I are her round-the-clock caregivers now. At 3 o’clock we awaken to administer her drugs. Michele has been our 24/7 companion and nurse since leaving the hospice center, staying here with us in our home.
Dixie is no longer able to speak. Her last words are to Michele, early in the week, while she is rubbing lotion on her mother’s hands. Moving around the bed she becomes aware that Mom is trying to get her attention. Making eye contact she whispers to Michele, “I love you, I love you, I love you.” Her final words. She is unable to say anything after that to anyone. We know she hears us speaking to her and conversing around her bed. Her countenance gives the briefest of acknowledgement as I lean into her ear and once again repeat the words I have said to her so often, “I love you, you know.”
As I start toward her bed, the room begins to move. I feel a sudden dizziness and nausea. Staggering back against the bed, I reach for somewhere to sit. The room, everything and everyone in it is whirling! I lay down. It’s worse. I’ve not experienced this before. What is happening? Am I having a stroke? I reach for one of Dixie’s sick bags, feeling as though I am about to throw up.
Michele is at my side now, asking if she should call 911. I tell her to wait. Maybe this will pass. But minutes later with no letup, I do something I’ve never done. I tell her to go ahead. Dial 911. Six very long minutes later, two young medics are at the door and soon I am in the ambulance on my way to Overlake Hospital.
Michele tells me later, “You all at once not being here tipped me over. No, it was more than that. It was that now you were sick, too, and I didn’t know what was wrong with you. It scared me. I watched you struggle in the bedroom . . . and suddenly the phone is in my hand and I’m dialing 911. My eyes go from you to Mom and back to you again. It is overwhelming, but I hold it together. I watch from the balcony as you are secured in the ambulance and drive away. I call Mark and Stephen and tell them to go to the hospital. Then I lose it. I can’t control the sobbing!”