Abstract
L
Five years ago Lucy was diagnosed with stage 3 cancer in her uterus. She underwent several surgeries, chemotherapy and radiotherapy cycles—at times the cancer seemed to recede but it kept coming back in another spot, in another place. I saw her briefly in February—she was feeling well, but in March they found metastasis in her pelvis and this was a blow. Lucy's health deteriorated rapidly. I traveled to Colombia to see her—she walked very slowly to the bottom of the stairs where I was waiting and we embraced silently. Lucy was very weak, her abdomen was huge, she had high fever, and she was in terrible pain. Her oncologist wanted her hospitalized but she did not want to go back there.
We spent the afternoon together remembering our teenage years, talking about our fears and about death, and trying to find a meaning in her suffering. I asked her if there was anything that she needed to say or do, and Lucy said no. The only thing that she longed for was for her agony to end. She cried, her emotional suffering greater than the physical endurance. “This is too hard, I am tired, I am ready, I want to go. I now understand.” This last phrase still echoes in my mind—Lucy understood. She had to let go of her emotional ties and accepted leaving behind her husband, sons, family, and friends. She was ready.
Lucy had asked for sedation but her oncologist refused, so when I told her that she could be sedated if this was what she wanted, she opened her eyes and asked with a very surprised look, “Am I still autonomous?” I confirmed that she was—Lucy smiled and said it was the best thing that she had heard in a long time. We found a doctor with palliative care training who was willing to honor her wishes and those of her family.
At the end of that day I knelt beside her bed to say goodbye. Lucy placed her hand on my forehead and said, “Bye Lili, I am taking the best of you with me—we will always be connected.” I drove back home crying—I did not go into palliative care to accompany my best friend to die. She was suffering horribly and there was very little I could do to help her. I felt sad, angry, helpless, and frustrated with a health care system and a culture that still does not embrace palliative care. It has to be pushed through the cracks, delivered bypassing the conventional medical practice; and there are only a handful of professionals with adequate skills and training. And I was grieving.
The next day Lucy refused to see me and I was hurt deeply by this refusal. Selfish, egocentric, it took me a while to understand that she was letting go of me, and in turn I had to let go of her. How vain I was, as if the rules did not apply to me, as if I was above all. I realized that she was—as she used to when we were growing up—teaching me, this time not about living, but about dying. She taught me in two days what I had failed to learn in more than two decades. Thank you Lucy, wherever you are.