One exercise in our Cancer Care Program asked the participants to complete a questionnaire that asked how alive they were. We have many lives, intellectual, cultural, emotional, spiritual… People have a family life, a business life, and more. We listed ten categories, ten lives in each of which there is a potential for more living. Six questions in each will show up those areas of strength and weakness.

Almost invariably with those suffering cancer the most neglected aspect was their recreational life. They seldom played. For fun, that is. The child in them had been lost, sometimes it had never been in evidence. Fun, not mere enjoyment, what children are all about, was altogether absent from their lives. So, there is a great emphasis on play and fun and laughter.

When someone is seriously ill, and in need of relief not only from physical pain but from sadness, depression, fear and anxiety, most people are inclined to show their concern with worried expressions, serious words of hope and consolation when the patient’s mood might be best helped by being lightened with a good laugh. We’ve been told by those who have studied this field that it is the best medicine.

Quite often, when the participant returned the completed questionnaire, it would show the very obvious need to lighten up. That was usually done by providing them with something to laugh about, but because it was important for them to learn to initiate helpful activities, they were challenged to return next day with a funny story – a joke or a gag, better still something to involve them in story-telling. That provides the opportunity to play, to get out of yourself as you do the necessary role-playing.

Dermot was a sixty year-old Irishman who came with his wife, Maggie, one Monday morning to start the five day program. He was very much the working man, now no longer able to swing a pick and shovel, a modest man who might have been taken for shy, but with still the glint of humour in his eyes, despite his pain and the dire prognosis he had been given. He needed some relief and his happy laughter showed he enjoyed it.

Next day, when they returned, he first announced in his soft brogue that he had obediently brought a story for me. An Irish one.

“I‘ve been in concrete all me life,” he began deadpan, “Like these two fellas in Dublin, Sean and Mike. Hard workin’ fellas, like meself, and not afraid of tacklin’ anything. Callouses on their hands from shovellin’ sand and cement six days a week. They read about a job startin’ in Saudi Arabia, and how they were lookin’ for concreters there.”

He was enjoying getting into the details as much as he had energy for. “So they trotted down to Aer Lingus and booked a plane ride to Saudi Arabia. First time they’d been up, and they didn’t know what to expect.

“So, over they go across the water and finally the pilot, or whoever it was, tells ‘em over the loudspeaker they’re flyin’ over Saudi Arabia. They’re peerin’ out the window, starin’ in disbelief at the scene below for ever so long. Till finally Sean says to Mike, ‘Mike’, he says, ‘the job’s too big f’r us.’”

The next day we had a call from Maggie. Dermot was too ill to continue with the program. He was soon to find it too difficult to get out of bed but he had no intention of leaving his home and the company of Maggie and their eight children. Nor were they wanting to relinquish their privilege of caring for him.

Over the next several weeks we visited them at home, HA providing palliative care now that the time for active treatment had passed and it was clear that the disease was no longer able to be controlled and death was approaching. Dermot for some reason was hanging on, not grimly, for he was reasonably comfortable, though now very weak. But it seemed he was loath to part with this loving family. Patricia, the youngest, was still at school, each day kissing him goodbye before she went off, each day running home to have more time with her daddy.

One day towards the end we visited again, and, while HA went in to the bedroom to attend to Dermot, I sat with Maggie at the kitchen table, just to be with her in her sadness. And as we talked about what was happening she began to weep, gently and with restraint. Suddenly, she pulled herself together, reached for a tissue to wipe the tears from her eyes. “I mustn’t let Dermot see me with red eyes,” she explained.

Here was the saddest of scenes. She about to lose her dearest love of nearly forty years, their precious children about to lose their beloved father.

“Why not?” I asked her as gently as I could. “There’s Dermot in there doing his best to do the same – trying to keep you from being hurt from the fact that he’s leaving you, trying to pretend it’s no big thing – when it’s the saddest thing ever for both of you.

“All these years together, all those times together and eight beautiful children the evidence of your love, never having been anything but open and honest with each other. And now, at this point, you’re both hiding how you feel, trying to fool each other.

“I’m going to take you in, while there’s time, and have you put your arms around Dermot and let him know your sadness, let him know how much you love him.”

Maggie looked at me for a moment, then came with me into the bedroom where this frail, worn man lay on his pillows. Without any hesitation she sat on the bed, bent over and scooped the slight figure into her arms and said, “Dermot, I love you “ – and would have said so much more had it not been for the flood of tears that made it impossible.

I left the room as Dermot responded with the most grateful expression of love and the fullest release of tears he had ever allowed. I could hear them talking, Maggie saying, almost teasing him, “Oh, Dermot, the first time in forty years, and you’re crying, too.”

They went on talking, and when, after a little while I went back in as she was settling Dermot’s fragile shoulders back on his pillows, he looked up at me with the most serene expression, saying, “I feel a lot better after that.”

That precious time of intimacy, of honesty and trust allowed them both from then on to be relaxed and free. No more tension from the need to keep pretending, each to the other. No more stiff upper lip. The reality of their love, and the discovery of how liberating it was to express their feelings, whether of love or fear, and still be safe, allowed them to be open as never before.

And not only with each other. That night each of the children shared that freedom, spending time with their dad, lying on the bed, reminiscing about their childhood, sharing their memories of times that were memorable because of him, all of them in their various ways saying their goodbyes.

HA had remarked, as we drove away from the house that morning, that she thought Dermot might now, with this freedom, be free to die the sooner.

The next morning, with Maggie and all his children around his bed, and his youngest, Patricia, saying Goodbye to him, Dermot kissed her, laid back on his pillow and died as gently as he had lived.

The sadness of this family in their loss was profound, their tears many. But inconsolable grief? No. Their grief had dissolved. They had served their loved one with their best care, affirmed his dignity and kept him close to them where he belonged. And the memory of his last days and the manner of his departure would be always their greatest consolation.

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