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My Mother, My Dog And The Hope Of Hospice

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My Mother, My Dog And The Hope Of Hospice

In my father’s last couple of years, as Alzheimer’s took him away from us, my mother was babysitting him 24 hours a day, unable to find a full night’s sleep, picking up what was lost with short naps during my father’s downtimes or when I stopped by to entertain him for a while, by playing cards or taking him with me as I ran errands.

There is no way my father dying was not in some sense a relief for my mother, but his death also stunned her to a degree that stunned me. One of the more profound lessons we will receive in this world comes from watching those who we love to have to bury those who they love.

She was struggling, moving through the day with a deer-in-the-headlights look, waiting for death to take her, too. Having moved from the house in which she had been raised to the home she had made with my father when they married, she had never lived alone until becoming a widow after 52 years with him. My mother couldn’t see what the purpose of a continued existence might be.

Her house was less than a mile from where I live with my wife, Punky, where I had moved my parents from their retirement home in Arizona when my mother could no longer care for my father and his illness on her own. I would check on her every day, usually for a cup of coffee in the morning on the way to work, and then a call to make sure she was alright when I got home in the evening.

But that left a lot of lonely hours between sunrises, and she began drinking too much. Three or four beers a day which, with the medications her doctor prescribed, was far too much. My sister, who lives in Colorado, would become alarmed by my mother’s slurred speech on phone calls.

I was concerned, too, and tried to talk to Mom about this, but someone who drinks too much does not like to be told that, and nice old ladies can at times be not so nice. I was in a difficult position because she was very dependent upon me, and I was not going to leave her alone. There was only so much “tough love” I could administer, and I wasn’t going to be much of an interventionist.

My hope – and rationalization – was that the drinking would be only a temporary float onto which she was holding, trying to keep her head above water. My mother was drowning in pain.

Fortunately, this was the case, and the problem resolved itself before becoming more serious. I stopped by on a Saturday morning and noticed burn marks on the inside of each forearm. I asked what happened, and Mom said she had trouble removing a pie from the oven. She also made it clear we weren’t going to talk about it. But, for the remainder of her life, except for holidays at our house or at a restaurant when she would have a drink before dinner, she lived a sober existence.

This is when Mom began to regain her composure. I have this image of literally seeing her back straighten. She began looking forward to a future rather than behind her, waiting for the end of her life to catch up with her.

My mother loved green vegetables. All vegetables, really, especially root vegetables. The food she had grown up with in England. Her father had taken care of himself for years after my grandmother died, until he was 85 years old, growing and cooking the same vegetables he had raised a family on.

For my father, on the other hand, meat, milk, potatoes, and corn constituted the food pyramid. He would eat a salad, as long as it came with French dressing, if it would have been impolite not to, and could be persuaded to eat his peas, but he didn’t spend much time looking at the produce on the dinner table.

Cooking for one, though, my mother found herself in green heaven. Salad every day, sometimes for both lunch and dinner. Broccoli, cauliflower, squash, spinach, and peas. Baked, fried, steamed, boiled. Casseroles, soups, stir-fries.

I had always thought, growing up, that my mother was a good cook, but it was not until I got out in the world a little bit that I discovered what good food is. There is something behind the idea of British cooking being bland. Healthy, yes, but not always the most exciting meals in the world.

What she had always been good at, though, was making pastries. Mince pies, fruit pies, pigs-in-a-blanket, which are sausage wrapped in pastry. Her pastry was perfectly light, buttery, flaking as thin as onion skin.

I remember neighbors asking her to make the pastry for them when they were baking pies themselves. She shared her recipe, but my mother only used that as an idea, saying that you had to make pastry by feel or you really couldn’t make it at all. She would wet her fingertips in milk or flour or egg yolk and flick it on the pastry while she was rolling or kneading it. Sometimes two or three flicks.

She baked pastries and cooked greens to her heart’s content for eight or nine good years, until one day at the grocery store – Mom was no longer driving by then, so I would take her shopping every week – she bought a couple of pie shells, telling me it was too tiring for her to stand long enough to roll out the pastry, that even the rolling itself was too much work. And, to be honest, she had begun to lose her touch in that last year she was still baking. We never told her but rarely finished one of the pies she made. I would usually eat a slice out of nostalgia and loyalty, but not more. She would still make fudge, though, until her final year—thick, heavy, delicious, criminally unhealthy fudge.

The Sharp Family. Photo by: Glen Sharp

She didn’t bake anything for what would be her last Christmas, apologizing for not having the energy.

Although she wouldn’t listen to the idea of me hiring a house cleaner for her, my mother, who had kept the most meticulously clean house, slowed down in that department, too. She would ration herself, reduced to cleaning one room a day. I noticed dust accumulating that, before, I would not have had the courage to enter the house. The stovetop would not be wiped completely clean.

I would do the dishes from the day before when I stopped by on my way to work and put in a load of laundry.

She was in constant pain and had broken her back several times  – the vertebrae cracking with normal bending and twisting. This would require two or three weeks of bed rest and, finally, the full-time wearing of a brace for support.

I worked close by and was able to visit three times a day for this, on the way to work to make her coffee and breakfast and help her to the bathroom if necessary, at lunch so she could eat and take a bath if she wanted, and on the way home, to make sure she ate and get her ready to sleep.

Scans and MRIs did not reveal anything other than osteoarthritis, but the pain medication prescribed for that provided diminishing benefit. She wore back patches all day long and sat on a heating pad or ice pack. Cortisone injections in surrounding tissue and the “gluing” together of the broken pieces of her back provided comfort, but only for a few weeks. I suggested my mother try a little cannabis, as it is called today, and was surprised by how quickly she agreed.

She could not fully grasp the idea of legalized marijuana – stuck in the reefer madness mindset – so her willingness to try pot was a clue as to how desperate she was for relief. As I left for the dispensary, Mom said, “Don’t get arrested.”

On July 23, 2019, three months to the day before she would die, my mother asked me to take her to the emergency room. “I can’t live with this any longer,” she said.

Although well-schooled regarding the British stiff upper lip, she cried at the intake desk when asking for help. We would be in the hospital for nine or ten hours – between waiting, tests, and examinations – but a shot in the hip and a small cup of some liquid within the first ten minutes rendered my mother comfortable enough to sit in a wheelchair for that whole day.

At six that evening, a doctor said the tests revealed the source of Mom’s pain. “Unfortunately,” she explained, “it’s cancer, and it’s not curable.” Some form of cancer – a biopsy would reveal it as breast cancer – had metastasized to her lower vertebrae. “I’m sorry,” the doctor said. “I recently lost my mother, too.”

After the biopsy, an oncologist told my mother and me that her cancer was very aggressive. The only form of treatment available would be radiation to control the growth of the tumors, which might allow her to live another six to twelve months. Without the radiation, she would live less than that. My mother had only one question.

Just in the past week, she had lost the ability to walk. She could stand as long as she had her walker or a chair to lean on, but she could not move on her own. I had to help her wherever she needed to go.

“Will I be able to go to the bathroom on my own if I have the radiation?” my mother asked.

“I don’t think so. You are not going to regain the function of your legs.”

“Then what’s the point,” my mother said, and the oncologist nodded his head. She said this with conviction and strength, and we all understood what it meant. I was the one for whom the doctor had to find a box of tissues.

We met with a Hospice coordinator, and then I took my mother home with me, where Punky and I would care for her. I took a leave of absence from my job, made room for a hospital bed in what would be Mom’s room, and removed the bathroom and shower doors for easier access to the facilities.

Titrating my mother’s level of pain medication was the initial, primary concern of the Hospice nurse, Susan. It took a few days to find the balance of medication – a mixture of morphine, Haloperidol, and Lorazepam – which allowed her to be comfortable without leaving her in a stupor. I was at first providing pills three times a day, upon waking in the morning, at lunch, and at night as she went to sleep.

The tumors were growing so rapidly, however – placing pressure on her spinal cord and other nerves – those adjustments to this mix, which always included an increase in the amount of morphine, proved necessary every few days, at least twice a week.

It was frightening to see how quickly the pain could escalate. Susan explained to me the stages of my mother’s decline. As I would discover, however, it is one thing to hear how one dies of cancer. It is quite another to actually see it.

It was not long before Mom needed medication more than three times a day, and the pain would wake her in the middle of the night. Losing the strength to call out, we attached a bell to the bed, which Mom would ring whenever she needed help. I was soon rising three or four or five times a night for medication or ice cream or to raise or lower the bed to a more comfortable position.

I have always been a heavy sleeper. Whenever someone would ask “if I heard that storm last night,” the answer from me would always be “no.” But being responsible for my mother affected me somehow. I would wake at the slightest noise from her room. If a tornado ripped through the neighborhood, I probably would have slept through that. But the slightest rustle from the other room, my mother shifting weight from her left hip to her right hip, for example, would have me jumping out of bed.

Whenever the dosage level was increased, the number of times my mother needed medication during the night would decrease. Both she and I would get a little more sleep for a couple of days. But by the third night, she would again be awake, often suffering in silence because she did not want to bother me. It’s a good thing I became a light sleeper.

In the last month of my mother’s life, she would be taking Oxycodone and Methadone in addition to the Haloperidol and Lorazepam, six or seven and sometimes eight times a day.

The fall where we live in northern California is my favorite time of year because the weather is so perfect—warm, sunny days followed by cool, crisp nights. My mother loved to be wheeled to the back yard where she would sit under a tree and look at my wife’s garden while she crocheted. I never knew a time when she did not knit and crochet. My whole life, no matter how old I was, I always had six or seven sweaters she had knitted for me.

Punky had just begun with the newly popular adult coloring books and introduced them to my mother. They would regularly sit and color together. Mom was in the best of spirits. Except for all the medication and her inability to stand, you would never have known she was dying of cancer.

Every morning she looked forward to a cup of coffee and a bowl of oatmeal with brown sugar and raisins. “Looovely,” Mom would say, her British accent becoming stronger as the number of days she had left decreased. I barely noticed the accent while growing up because I was around her so much, but at stores or whenever she met someone for the first time, it was usually the first topic of discussion. The only time I would notice was when she would speak to my Aunt Dot or Uncle George on the phone, after which her accent would be strong again for a few days, fading away by the end of a week.

She would crochet or watch a little TV until the Hospice nurses arrived, which she always looked forward to. Her favorite days were when April gave her a bath and put on clean pajamas.

For lunch, Mom would usually eat ice cream, growing particularly fond of Nestle drumsticks. Susan was glad Mom was consuming calories, unconcerned with the amount of ice cream. “We aren’t too worried about your long-term health here,” Susan said. I always appreciate good gallows humor.

She usually ate what we had for dinner but at first would eat in her room, uncomfortable, I think, with the idea that she was somehow bothering us by having “moved in,” as she put it. But eventually, she would let me wheel her to the kitchen table to eat with us. Her meals were not large, but they were complete. We always had greens, a love of greens being one of the ways I am most like my mother. She would talk with Punky about much I take after my father, usually in a complementary tone.

Mom would write weekly checks to me for her upkeep, which I would tear up and try to explain that she didn’t need to pay us. “I would have to pay at some convalescent home,” she said, “so I should pay you, too.” She was fixated on the idea of paying her way, and I couldn’t dissuade her.

I used to bang heads with my father when I was young, no longer a kid but not yet a man, either. I had long thought of him as the most stubborn human being I’ve ever known but realized after he died that I might have been wrong. My mother’s stubbornness was more subtle than my father’s, and she was never in direct confrontation with me. But it would assert itself more and more as she tried to retain her independence, and she proved to be his equal.

I learned quite a bit about myself – about why I am the way I am – as I cared for both my mother and my father as they died.

“If you don’t take this money, I am going to walk out of here,” she said. “How are you going to feel then?”

I finally offered a compromise. Agreeing to cash one check, I said, “If you die tomorrow, I make out. If you live for another two years, you make out.”

She agreed to the deal. “Let us not ever mention money again,” she said, and we did not.

I would stop by my mother’s house a few times a week to water plants and collect the mail. Her place looked as though it was either half-moved in or half-moved out. Over the months, I moved much into my mother’s room from her home. Small things. An end table she liked. Blankets and knickknacks that made her more comfortable. Nightwear and some clothes because she had a fantasy that she would get dressed to go outside one day.

“Is the yard being mowed?” she asked, not wanting cancer to be the excuse for letting appearances go.

Before becoming completely bedridden, my mother was very antsy, the edginess a side effect of the pain medication. Mom would want to sit in her chair out of bed, which she crocheted. Then she would want to sit in the living room. Then outside. Then back to her room. By the afternoon, she would want to be moved three or four times an hour.

My wife’s daughter, Michelle, who lives in Honolulu, sent CDs of Hawaiian music for my mother to listen to, which would provide comfort and relaxation. It was usually in the evening, after dinner but before sleeping, that Mom would become most restless, too tired to move around but not yet settled, either. This is when you could sense her apprehension about what was to come.

She kept her sense of humor. Speaking of the CDs, Mom said, “Take these when I’m gone,” then adding, “I guess you will anyway. They’re already at your house.”

Upon soiling herself for the first time, she asked, “Do I have to leave now?”

Twenty days before my mother died, we told her that the results of Punky’s biopsy confirmed she, too, had breast cancer. Life can be cold at times, but I didn’t realize until writing this what a minor cruelty it is that your wife has to schedule her mastectomy around her mother-in-law’s dying so that the caregiver/son/husband wouldn’t be stretched too thin.

“Take care of your wife,” my mother said.

A couple of weeks before her death, my mother stopped coloring in the books Punky had bought her. A few days after that, she stopped crocheting. When I asked why she said she could no longer see well enough. She could see shapes but not outlines or colors.

Susan explained that losing one’s sight is a regular occurrence as death nears. But with her daily visits, Susan was well aware of Mom’s condition and said she was not on the verge of death that the cancer had probably spread to Mom’s brain and was taking her vision.

The pain increased daily, and we correspondingly adjusted Mom’s medication. She was regularly awake during the night, restless and uncomfortable. I had to feed her the breakfast oatmeal because she would get tired of carrying the spoon from the bowl to her mouth.

She soon lost control of her bladder. This led to diapers, which was morally deflating for her, devastatingly so.

The first night with the diapers, Mom was unusually restless. She couldn’t fall asleep. Punky checked on her at ten that night and immediately got me. What she had seen was that Mom had crawled out of bed into the bathroom and was leaning on the counter trying to open her bottle of morphine pills, but she didn’t have the strength.

When I caught her, she began crying, pleading with me to give them to her. “Please let me die,” she begged. “Let me die.”

She couldn’t stop crying as I took all her medications to another room and put her back to bed. “Shit,” she yelled, torn between anger and despair.

This would be the worst night of all the nights in which I cared for my mother as she died. The last day of her life was terrible, but at least then, there was a sense of relief that her suffering would soon be over. There was no such hope on this night.

I couldn’t say everything would be alright. That things would get better. They weren’t. They were going to get worse.

“Am I supposed to just lie here in bed until I’m dead?” she asked. I was not enough of a philosopher to answer that question, nor am I any wiser today.

Mom asked me to call John, the Hospice case manager, who she liked a lot, thinking he would understand.

“John is not going to help kill you,” I said. “He would lose his job and probably go to prison.”

“Please, then, I am asking as your mother. Give me those pills. Let me die.”

I held my mother to me and told her I couldn’t. Until this night, my mother had been so brave and in such wonderful spirits. She liked her solitude, but she truly appreciated not dying alone. The inability to stand, however – the cancer was eating her legs like they were ears of corn – and now the incontinence had carried her into territory that was too much to bear. She had prepared herself to die upon hearing she had cancer. What was proving more difficult to endure was the process of dying. The psychological process of enduring the decline. Of having to watch yourself be stripped of the dignity that constitutes a human life.

Her crying quieted as I continued to hold her and apologized to her that she had to endure this. I was sorry for not being strong enough or having the foresight by which this suffering, and the suffering that was to come, could have been avoided. I apologized for the death my mother was going to have rather than the one she deserved.

Punky said watching my mother beg to die was the saddest sight she had ever seen in her life.

California allows assisted suicide. But it is a bureaucratic, paper-pushing process, requiring multiple levels of approval and planning far in advance of when the choice to die might be made. I know from this experience to begin the bureaucratic process as early as possible if I am ever in the situation again. But it is not right to disallow a proper, dignified death to those unaware of all the paperwork beforehand or for those for whom mother nature works more quickly than human bureaucracy.

I don’t see why once a patient is already in the Hospice program, that Hospice personnel cannot be granted some authority in the matter. At this stage, premature death is no longer a concern. By this time, suicide is no longer in any way an avoidance of existential responsibilities. It is not a running away from life. It is the meeting of life, and its end, head-on. It is a matter of dignity.

What stopped me from helping my mother end her life had nothing to do with the law or social niceties. The only manner we had for her to die was a combination of strong pain medication and sedative drugs. Trying to force dozens of pills down my mother’s throat, hoping that would stop her heart from beating before she threw the pills up, could have been as ugly a death as the one that lie before her. There would not have been much dignity in a death like that, no relief in her final breath, no sense of resolution, which is the primary purpose of taking death into one’s own hands.

It has been two years since my mother died. And being able to care for her to the end of her life has been one of the greater blessings of my life. Knowing that my wife and I brought my mother as much comfort as possible in her final months brought me great comfort as I mourned her passing. It brings me comfort still. But I failed my mother that night. She should have been allowed to die. She had fought a good fight, and it was over. All that was left after this was the torture. Her last hope for dignity died with my weakness.

She wanted out of bed, so I sat her in the chair. I sat with her, and we talked until past three o’clock that morning. The medication helped calm her down. But mainly, it was sitting with me, talking about her life and talking about dying. Mom admitted she was scared. She had not been scared before, but that night she was.

“Death is near,” she said. “I am failing so quickly, and I don’t know how bad it is going to get. That’s what scares me.”

We talked about Dad and my sister, Sandy. We talked about her life growing up in England. She was a child during WWII and still had the gas mask she wore on the nights they went to the bomb shelter my grandfather had built in the backyard.

She remembered the time I brought home a frog I caught at a creek and then lost in the house. We couldn’t find it anywhere but could hear it everywhere. My mother didn’t like it. What she didn’t like even more, though, was when it no longer made sounds.

“Did that frog get away?” my mother asked. “Or is it still here? Is it dead? Glen, is there a dead frog in this house?”

I suggested that she talk to Pam about this. Pam is a social worker for Hospice, and she visited regularly to check on Mom’s emotional state. We are not a religious family, and my mother declined visits from members of the clergy.

Mom didn’t feel as though she needed much counseling, either, and was comfortable with her decision to die rather than seek treatment to extend her life. “I’ve had a good life,” she told Pam. “I’m being taken care of by people who love me, and I can’t ask for more than that.”

But wanting to die by swallowing a bottle full of pills reflects a different emotional state than the sentiment of peace we had seen thus far. Mom didn’t want to talk to Pam about this, either.

I broke down talking to Susan about this the next morning after she examined my mother. I told Susan how we had put our sixteen-year-old dog, Kommeer, to sleep the year before. Kommeer had bladder cancer and was suffering. I asked Susan why we are allowed to treat our pets in a more civilized manner than the humans we love.

Susan was sensitive – she had certainly seen this hundreds of times, if not more, and no one enters the Hospice program without the utmost concern for the dying – but said, “It is a struggle to come into this world, and it is a struggle to leave.” I like Susan a lot. She was wonderful with my mother, and my mother looked forward to seeing her every day. But I do not understand the logic behind what she said. That type of thinking is the exact kind of argument that was once made against heart surgery for people with cardiac disease.

Part of what my mother and I talked about that long night was her not wanting to use diapers—of her not wanting to relieve herself in bed. Susan understood this. “For some people, it is the last stand of their life,” she said. “Their last hold on any sense of independence,” Susan suggested a port-a-potty right next to her bed. Mom was to ring the bell for me whenever she needed to go because she did not have the strength to lift herself from bed and step onto the potty.

But I woke on that first night to the sound of a crash at 5:30 in the morning and found her and the port-a-potty lying on the bedroom floor; my mother covered in urine. I washed her as she lay on the carpet, put on a clean nightgown, and lifted her back into bed. I spent a while letting her know I appreciated that she wanted to let me sleep but that it was much less trouble, in the long run, to wake me instead of trying to take care of herself in this way.

Once in bed, Mom said she wanted a maple bar for breakfast, but when I returned from the donut shop, she had fallen asleep. When she woke, she was not interested in the maple bar. She did not consume anything that day except for water. Two days later, I fed her a piece of toast along with a few sips of coffee, and that would be her last meal.

I could feel then what a toll this was taking on me. The night Mom ate the toast, I cried as I gave her the last round of medication, thinking she might die during the night, and this was the last time I would see her. The last time I would hear her voice. I was tired, but not in a way that a good night’s sleep could cure.

I woke one night with the sense she had gone and, walking toward her bed in the dark, stepped on the remote control for the bed, which had fallen on the floor. I must have cursed, and the noise woke my mother. “I have to pee,” she said. She had to go again at five but would, fortunately, ring the bell for me.

The port-a-potty was a short-term solution. Before, without being able to walk or even stand on her own, she had enough leg strength to provide points of balance. I could set her weight on one leg as I changed holds on her in order to move her around.

But her legs by this time were nothing more than appendages, with absolutely no strength in them. Without being able to rest my mother’s weight on her legs – to use them as poles – she was dead weight. Moving her had become too much for me.

She began sobbing again as I said I couldn’t help anymore. I couldn’t lift her onto the port-a-potty. She was crying so loud I covered her mouth, not worried about waking my wife – who was undoubtedly already awake – but not to wake the neighbors.

The next morning Susan told Mom the only alternative left was a catheter, to which Mom agreed. The emotional wear of the night before and enduring the insertion of the catheter had exhausted her, and she fell asleep by early afternoon, not moving for sixteen hours. I kept peering in from the door to ensure her chest was moving.

She woke me at 5:30 the next morning, yelling, “Something is in my vagina.” I had to explain the catheter to her because she didn’t remember what had happened before.

“Hold my hand,” she said, and I did. “I think I’m dying.” She brought my hand to her lips and kissed it. “I don’t want to leave you.” Her death was six days away.

Breathing became more difficult, especially at night, and I had to raise the head of the bed as high as possible and would rub my fingers on her chest in an attempt to loosen the mucus building in her lungs. Oxygen was at first supplied intermittently, but by then, she was on it constantly. Her feet were swelling from less blood circulation.

She could no longer chew by this point, taking only water and ice cream. Once, when asking for ice cream, she added, “Make it quick,” and then smiled. I put ointment on her lips because they would become parched.

A couple days later, Mom began gurgling as she breathed, sounding like a bong. This could have been funny and something to joke about with her, except the time for laughing had passed. I knew from Susan that the gurgling was what led to the “death rattle,” which would be the last call.

I would not sleep much for the rest of my mother’s life. The gurgling became very loud. And unnerving. She could barely speak and struggled for every breath. All I could do was sit next to her, holding her hand, hoping that was some comfort.

She couldn’t see, could barely speak, and had to wrestle the air for every breath. She was fearful again and cried, saying she wanted to die. I wiped the tears from her face. No food, no water, just lying on her back, suffocating. If that is not the definition of torture, I don’t know what is.

For most of my mother’s time in Hospice, she was content and comfortable. When people speak of a dignified death, they are describing my mother’s experience until her final days. That is when dignity left the room.

On what would be the day before her death, Mom declined a bath that morning. I knew as I saw April to the door this would be her last visit.

Exhausted, I went to bed at 8:30, once my mother had fallen asleep. Waking a couple of hours later, I was apprehensive to check on her but found her comfortable, sleeping soundly, snoring, with no gurgling at all.

But later that night, the gurgling returned. This time with a wheezing, almost whining sound that I at first thought was a call for me. I squeezed her hand, but there was no response. Her eyes were rolled halfway into her head. She had no apparent awareness of anything around her

I sat with her, unable to leave because I did not want her to die alone. My father had not died alone, and I did not want my mother to die alone, either.

As soon as Susan arrived that morning, she called for “continuous care” – a nurse to sit with my mother for the remainder of her life. Unable to swallow at all, when I used an eye dropper to give Mom her medication, it would drool down her lips. Susan and another nurse inserted a renal catheter so I could apply the medication in that way. I used the eye dropper the same way but flushed the catheter with water to clean the line, ensuring Mom got all the pain relief possible.

Jocylin, who took the late afternoon shift, spoke with a beautiful African lilt. Upon telling me, she was from Ghana, I said, “Ike Quartey,” referring to the top 1990s welterweight. Jocylin smiled and said, “My husband’s favorite boxer is Azumah Nelson.”

“He wasn’t bad, either.”

My mother’s struggle to breathe reminded me of a fish left on the riverbank to die, but Jocylin said she was not in pain. I said I would have to take her word for it.

“She will be with God soon,” Jocylin said, which hit a nerve in me. I must have been worn rawer than I realized from the past few months.

This world can be a frighteningly mysterious and often painful place, with no end to the suffering in sight, and I am generally tolerant of the ways each of us find to make some sense and provide some comfort from it all. Caring for my mother must have left me less tolerant than usual.

“You see this every day,” I asked, “how can you believe in a God like that?”

Jocylin finished freshening my mother’s pillow and then turned to me, holding me with her eyes. “I have to,” she said, which I imagine is as eloquent an apology for a faith as will ever be necessary.

Apologizing to Jocylin for my rudeness, she nodded her head in forgiveness, I hope.

I had left the room and was sitting at the kitchen table when Jocylin came to let me know my mother was no longer breathing. I returned with Jocylin to see my mother at rest. Calm, relaxed, and untroubled, with no sign of what she had endured the past couple of weeks.

I kissed her and began speaking to her. I talked about Dad, about how she could now see him again. And as I did this, I realized that you cannot love in this world – you cannot love another nor be loved yourself – without holding on to some belief, however illusory you think that belief might be, that the world, in the end, is a kinder and more caring place than all evidence suggests.

In addition to counseling, Hospice also offers dog therapy. A pet can be provided for comfort and companionship along the road that, ultimately, regardless of how much one is loved or how well cared for, the dying must travel alone.

But that wasn’t necessary in our case because of Wilma and Betty, year-old sisters we had picked up at a rescue fair that spring. These dogs are snugglers and Wilma, in particular, took to my mother. As soon as she did her duty and ate and took her morning walk, Wilma assumed her position at the foot of Mom’s bed and stayed there – except for a few trips to the backyard – until dinner time.

Along with the crocheting and coloring, Mom also contented herself with a little reading. She didn’t get to finish her last book, Kevin Kling’s The Dog Says How. I didn’t know this until after Mom died, and I was cleaning her room when I found the book while going through her nightstand, with the bookmark resting between pages 64 and 65. The Dog Says How and the bookmark are now on my bookshelf, where they will be for the remainder of my days.

I guess Mom had to stop reading when she lost her sight. I don’t know why I didn’t think of that. If I had known about the book, I could have finished Kling’s stories, reading to her just as she had read bedtime stories to me nearly 60 years earlier.

Kling is an actor and storyteller, and The Dog Says How is a collection of humorous and sometimes philosophical essays. My mother found comfort in them, but she didn’t get to the title story.

In “The Dog Says How,” Kling writes about how, ultimately, we don’t have as much control over our lives as we like to think we do. He mentions Dante’s “Inferno,” in which Dante describes Dis as the stage of existence we must pass through on our way to paradise. Dis is the underworld, “the place of shadow and reflection, a place to contemplate and round off the rough edges of torment and desire.”

I’m not sure what sins my mother contemplated at her end, but what this story says, at least what it said to me only a couple of days after her passing, is that watching someone you love die is its own form of purgatory. The suffering might be nothing short of torture for the one dying, but for those watching the dying, it is a powerful lesson in humility.

Kling describes his own near-death experience following a motorcycle accident, about seeing the light and how he consciously chose not to follow that light but to return to earth. He remembers being able to make that choice. Since that day, Kling has not feared death and has a sense of peace about one day seeing again all those he has loved and lost.

Wouldn’t that be wonderful?

God bless Hospice.

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