The Sound of Dying

Sitting next to her bed, I can hear her breathing. I look over at a woman that vaguely resembles my grandmother. Her face has lost weight—her angular features looking even sharper in her final days of life. She stopped eating three weeks ago. She has had sips of juice and bites of ice cream, but nothing substantial. Her skin has become clammy. Her eyes are vacant. Out of kindness, one of the nursing aides has put lipstick on her. She has begun to moan. We can’t seem to discern whether this moaning is her confusion, brought on by the dementia that has plagued her for years now, or if she’s truly in pain. We can’t get comfortable in this space with her. It is too noisy. Her breaths fade in and out of being loud and quiet. When the breaths get too quiet we all hold our breath and look at her, wondering if this breath will be her last. We’ve decided this is a horrible day. One of the nurses reminds us: It is hard work to die.

I guess this is true. It is hard work to die. It is hard work to break down your body. You stop eating. You stop being hungry. You stop caring about everything else. You retreat into yourself. At some point, you just begin sleeping. And you sleep until you can’t wake up anymore. While sleeping, all these things begin to happen to your body. You get cold. Then you get feverish—like this final opportunity to sweat out what is left. Your feet begin to curl. From the bottom up, your body begins the shut-down process. Your lungs fill with fluid. You stop being able to swallow. It’s painful to watch—knowing how eminent death really is, but having no control over how and when. Eventually, your heart just stops. It gives up the battle. It’s like preparing for a trip—once everything is packed, all the lights turned off, and all the details are confirmed—you go. The hospice nurse tells us that the “spirit world” feeds her from this point forward and that she will get the energy she needs for dying from spirituality. I’m unsure about this nice, comforting thought. Right now I feel that every ounce of my energy is being ripped from me, stolen, and transferred, so that my grandmother can shut down her organs. I’m so exhausted I can’t even cry. I’m not even doing anything—just sitting. Just listening to the cacophony of noises her body is making.

I stand over her body and stroke her soft, grey hair. I whisper, “It’s okay, Grandma. It is safe for you to go. You’ll feel better.” I think about what might be happening inside her mind. They say people cross over in these final days; that they straddle both worlds—keeping one foot among the living and one among the dead. I wonder if she could communicate with her sisters and her husband Jack and her daughter Kathy. I wonder if they were calling out to her—“Boggie! Get in here! We’ve got so much to tell you!” She seems to be fighting death. I feel like my words would somehow comfort her; make it past the muck in her brain that has kept her from hearing us these last few days. No one else is believing this is possible, but I'm the ever-hopeful.

The skin on her forehead is already beginning to feel more like wax than skin. Her color has shifted drastically through the course of the day. She looks almost colorless now. I leave the room for some relief, to get out of earshot of the sound of dying. Down the hall an older woman wheels around in her wheel chair. All of the people on this floor have dementia. Visiting this floor requires patience—patience I fear I don’t have today. She wheels towards me, with a plastic baby doll in her arms, and begins the same conversation I’ve had with her three times already today. I politely smile, about to walk away and ignore her, and then I remember that this is someone else’s grandmother. So I ask her, “Do you need to know how to get to your room?” She says, “Yes. And you have beautiful teeth.” Outside of her door, she re-introduces herself to me. “I’m L.” I smile, despite my desperate urge to cry, “It was so nice to meet you, L. And your baby is beautiful.” She winks at me, “Thanks. He is my little treasure. Children, and visitors, are such a treasure.” Yes, L. They are.

It occurs to me that the staff here are saints. These men and women must have the same conversations and the same arguments everyday. Just in the last two days, I’ve already learned the routine with a few of them. You have to walk them to their rooms. You have to remind them that certain behaviors aren’t acceptable. Most of these people linger by the elevator, which can only be accessed with a code, hoping someone will take them off of this floor. They ask, “Where are we going?” and get upset when you say, “You’re staying here.” Many of them smile at you, as if you are their very own grandchild, because they don’t remember what their family looks like. That smile they have is so brief, that you don’t even have the heart to tell them that you really aren’t theirs. In twenty minutes, they won’t even remember you came in. Plus, anyone coming in is everyone’s family. There is an effective way to interact with patients with dementia—a nurturing lightness that requires empathy and patience. Dementia does horrifying things to the brain. I figure any softness they can experience with people is probably good, even though they won’t remember it.

B., a particularly sad, lost woman, wanders in circles, mostly. Her short shuffling footsteps don’t carry her far. She has been lingering outside of Grandma’s door. When I arrive at the door, I ask her, “Do you need me to take you to your room, B.?” She mutters, “Yes. What is happening in there?” I say, “Oh nothing. Margaret is just very sick.” She asks, “Oh. Do they know what’s happening in there?” “Oh, nothing B.” She asks repeatedly, “Did they figure out what’s happening in there?” I can’t help but wonder if B. can sense the death coming. They all seem to wander down here throughout the day, asking to come in, wondering what is going on. They say patients with Alzheimer’s are highly sensitive to emotions. Or maybe they just hear it. The rattling in her chest. The breaths that have become more shallow and sharp with each hour. The hospice nurse says, “There is hope in every hour with Hospice.” I'd like to hit her. I’m beginning to feel less and less hope in each hour. Hospice tries to make this experience pleasant for the family—they try to offer encouragement and advice to us as we struggle through this. I get it. But I can’t help but find myself agitated by the clichéd lines I’m being offered. I can’t help but want to throw things at these people. We aren’t stupid. Dying is hard. This is going to suck. Maybe I’ll print a brochure for Hospice to use for people like me—something that says, “The next few days are going to suck, but that’s why sweet baby Jesus invented bourbon. And cake.” Because the truth, is dying is hard work. For all of us.