The end, my friend

I am drinking what is possibly the worst cup of coffee of my life sitting in the deserted “sky café” on the 7th floor of the Care and Discovery Center, the 1.2 million square foot flagship University of Chicago Hospital. There are 436 private rooms here. In one of them, on the floor above me, in room 8003, my friend is dying.

 I wish I did not know what it was like to sit by the bedside of a person I loved who had reached the end. But I do.

Or rather, I thought I knew. I had been by Tom’s side, held his hand when he fell asleep, when sleep turned to coma, when his heart stopped. We were all there, me and the children, “there” being the living room of the house we had shared for decades as a family, “there” being a room with bay windows facing out to rhododendrons and oaks and firs, “there” being a bed made with soft linens from our closet, with pillows that had cradled our heads.

 And then there was room 8003, brown and beige and gray, anonymous, all metal and plastic, designed for hospital efficiency, designed for the kind of end-of-life interventions that happen in those 40 states—Illinois being one of them—where the dying person cannot take charge of their own death. In the hospital, hooked up to multiple machines and IV infusions, her surroundings cold and unfamiliar, my friend was being visited by doctors who were suggesting yet another invasive procedure. It was not curative. It might not even be palliative. But they were doctors, and this was a hospital, and when you are a hammer, everything looks like a nail.

 “What do you want?” I asked after the doctors left, after the nurses left.

 “I am miserable,” she said. “I want to die.” There was no drama, no tears. It was a statement of fact.

 “I would like to go home and die there. I would like to be with my dogs,” she said. She was coherent and cogent but went in and out of fitful slumber. But the doctors told her that the stress of transferring to home and the extraordinary level of care she would need while there made that impossible. She knew that was true.

 The next “best” option was to be transferred to an in-patient hospice. There were two associated with nearby hospitals. She, my dying friend, had done the research from her hospital bed. She would have to have conversations with the admission people. She would have to find out if there were beds available. Her doctors would have to “recommend” her for hospice. And then, if she were to be transferred, she still would not have control over the end. She still could not say: I want to end this misery. But at least she would be in a softer, kinder atmosphere.

 I sat with her most of the morning.

 “There is so much to say,” she told me during a moment of wakefulness. Both of us were silent. “But really,” she added, “there is nothing to say.”

 We had known each other for 40 years. She closed her eyes. I listened to her labored breath.