by Carolyn Chapman •
We were driving back from Maine on Memorial Day when my cell phone rang. It was my mother. Peggy, her sister, had gone to the emergency room with shortness of breath and her local hospital had admitted her. I had just seen Peggy a couple weeks before at my cousin’s daughter’s communion, and she had seemed fine. Even though it wasn’t my daughter’s birthday party, Peggy had remembered to bring her some fun little presents– decorations for her bike’s wheels and some beaded necklaces and bracelets.
On Tuesday, I took a one-hour drive up the New York State Thruway to visit Peggy in Orange County. It was a hot, sunny day. I had music playing and the air conditioner running. The trees were so lush and green, in their prime, beckoning out over grassy fields. Commuting for her job as a social worker, my aunt had taken the same trip thousands of times.
On my drive up, I thought about a phone conversation I had with Peggy over the winter. Many years her senior, her husband was having health issues, and she was conflicted about leaving him when she had to go to work. She had sounded stressed out, and it was the first time in our relationship that the roles had shifted, where I found myself trying to support her, instead of the other way around.
When I entered her room, it was clear Peggy was uncomfortable. The doctors had found fluid around her lungs and inserted a tube to drain it (at bedside, no less). “Here, just let me stick this tube into your side,” we tried to laugh. I told her how beautiful the drive up had been. From her hospital bed, she glanced out the window and nodded.
Peggy wondered whether a recent fall had hurt her lungs—she was significantly overweight—but she also mentioned having a cough that never went away. She was a biology major in college, and I had done graduate work in genetics. She had an unbelievable knowledge of medical issues that challenged my own. Once we both acknowledged that we didn’t fully understand the cause of her symptoms, we changed the topic.
I told her about my current worry—a big controversy at my son’s nursery school. “Sounds like the wrong committee to be on,” she said, smiling. As I was leaving, I asked her if there was anything else I could do for her. She said the visit had been really nice.
Throughout the next week I got updates about Peggy's status from my mother, but I didn’t get back to see her until almost two weeks later, a Sunday which happened to be Father’s Day. She had been transferred to a larger hospital because she needed a special procedure that couldn't be performed at her local hospital. Further complicating the situation was that her husband had since been hospitalized as well, but was at a different location. His grown children (from a prior marriage) were managing his care, but he was unable to support Peggy himself.
When my mother, sister, and I walked into the ICU, we were happy and eager to see Peggy, anticipating that the procedure would have improved her condition. The mood quickly turned serious. We needed to put on gloves as we were informed that Peggy had contracted a MRSA infection. She, of course, laughed and smiled when we came in but we immediately gathered that she was in a lot of pain. While we were taking a break in the waiting room, a nurse came to tell my mother that they needed to put Peggy on a ventilator. A ventilator! We had no idea she was that sick.
Things unfolded rapidly. By Monday, we learned she had cancer. By the end of the week, we learned it was at stage IV and was untreatable. Peggy’s doctors and extended family struggled to figure out how much to tell her.
During one visit that week, my sister and I asked Peggy what we could do for her. She glanced around the room and looked up at us, with her eyebrows raised, trying to convey her meaning without being able to speak. The next day, we brought back cards, pictures, and silk flowers to decorate her room. We gave her a dry erase board so she could write messages to us.
The following weekend, I was the first to arrive at the hospital, and was alone with her for a few moments. Although Peggy knew she had cancer, she did not know that the doctors felt it was untreatable and that her care was palliative at this point. She wrote me messages about her interactions with the doctor that morning-- she was angry because he wasn’t sufficiently answering her questions. “The doctors don’t have all the answers,” I said to her softly.
The following Tuesday, the doctors gave Peggy their prognosis. When she knew she was dying, she wrote notes to family and friends, and helped plan her own funeral. She wanted certain songs: “San Francisco (Be Sure to Wear Flowers in Your Hair)” and “Row, Row, Row Your Boat,” sung in rounds. She wanted origami butterflies. She wanted the service outside. Thankfully, her husband’s health had improved, and the family was able to arrange for him to visit.
On the dry erase board, she asked me if there was anything I wanted to tell her: she didn’t have much time left. I recalled that as a child, I had accidentally put pen marks all over the armrest in the back seat of her new yellow Mustang. When she had dropped me back home, I was too mortified to say anything or to apologize. The next time I was in her car, the marks were gone. She never even asked me about it. I knew it was my last chance to say sorry, but I still couldn’t find the words. I didn’t want to make her feel bad that I remembered it.
Instead, I told her that she had a life well lived. She had loved all of us—her husband, her step-children, her grandchildren, her siblings and their spouses, her nieces and nephews, grandnieces, grandnephews and friends—for better, for worse, for richer, for poorer, in sickness and in health. She was non-judgmental in her love and so selfless.
Although the doctors told Peggy that she would not last more than a couple of hours without the ventilator, she decided she did not want to continue on the machine. She wanted to be taken off on Thursday night because she didn’t want to die on my son’s first birthday on Friday. With her husband, family and friends surrounding her, she fought harder than they thought she would. She gasped for breath for more than twelve hours. Only 55 years old, she died exactly one month after I had first visited her in the hospital on that sunny May day. Peggy was gone.
PDF available: Carolyn Chapman, "Aunt Peggy," Voices in Bioethics (2015).