If you’ve ever received medical care in the US and are fortunate enough to have health insurance, you’re probably aware of the voluminous mailings sent by the insurance company, outlining various costs of what is covered and what isn’t. She died in May, but I’m still receiving these mailings. Whenever they come, I open them. Each mailing is a separate snapshot into A.’s final trip through the healthcare system. Numerous mailings for her chemo and radiation. Another for the CT scan that revealed the lung metastasis that ultimately led her to hospice care. The one I received today covered a telehealth visit. It was the final visit with her oncologist. I remember that day. We saw him on the MacBook screen, both of us sitting there, waiting for him to enter the virtual doctor’s office. I don’t remember everything that was said, but I remember Dr. Venur being a compassionate listener; he was the epitome of respect and kindness. Regardless of the capacity, be it in the medical arena or a personal relationship, what do you say to someone knowing this will be the final time you see their face and hear their words? This person who will soon make the final, inescapable voyage into the beyond? The date of the telehealth visit was May 18. A. died just seven days later.
more sadness
Several weeks ago, Sydney, the 12-year-old gray tabby that A. adopted a couple years before we met, stopped taking her IBS medication in food. Over the last few years I was able to successfully mask it in her food using a variety of techniques. So, I began getting the medication compounded into liquid form and, up until recently, had few problems giving it to her via syringe. (Sydney is part feral and has never enjoyed being picked up or handled in anyway.) Lately, giving her medication has become increasingly difficult, and as such, our bond, although not broken, has been damaged. I cannot adequately express how much this hurts me. Sydney is the closest friend I have. Making a long, painful story short, I’ll be forced to put her down if giving her medication becomes impossible. For me, Sydney is the last living extension of A. Sydney turned me into a “cat person.” So, for these reasons and others, just the thought of euthanizing her brings me to tears. This will be another sad, heartbreaking ending I will have to endure. And it will probably be my last. I’m so tired of crying. So tired of fighting against this thing that is larger than me— this life. So tired of waking up every day, in the same bed, alone and afraid to face another day. Never— even in the darkest pits of my imagination— did I think this would be my life: a 44-year-old man, broken and alone. I spent Xmas, alone. I drink nearly every day, and with increasing quantity. Sleeping, despite prescription medication, is a constant challenge. I wish someone would materialize out of thin air. Someone to give me hope. Someone to live for. Someone to whom I can give myself. I just want A. to come back.
December 11, 2022
Sauced up and high, I left the show just two songs into Twin Tribes’s set. Despite sharing the same date as your birthday, I’d been looking forward to this show for months. But now that I’m here, I feel nothing but out of place. The club is packed. All these people. Then me. I barely feel alive, and the parts that do still pulsate only do so out of some primal urge. I’m already dead. “Dead man walking.” The rest of this— this existence is just a formality. So here I am, and the band is halfway into “Heart & Feather” and I leave. Just like that. I walk up the stairs and leave Lou’s. I make my way to the waterfront. The bay is black and cold. With the tingling taste of salt on my tongue, I try to still myself so that I can feel you. Come on, boo, I say. We’d be out right now celebrating your birthday, so if you’re going to show yourself, tonight would be the night. I’m still. Everything is quiet. I don’t even hear the waves lapping the shore. But there is nothing. You aren’t here. You are gone. All of you. No residual energy. No strange light in the night. You’re never coming back, so why am I doing this again? It’s the thoughts— the intrusive thoughts are now accompanied by memory flashbacks. Unprovoked, I remember the last time we ate at The Shanty Cafe before it closed for the final time. The picture I took of you remains on my phone. You, grinning with a piece of bacon in your hand. And then it’s gone. And another flashback flutters my heart. I’ve been walking out here for nearly an hour. I want to go home and go to bed. That dark, lonely bed. On my way home I drive by The Shanty. It’s gone. All of it. They demolished it years ago and now, there’s nothing but rubble and twisted fence. And before I can shut if off, my mind envisions the building as it once was. And there we are, just inside the front door, enjoying one final breakfast at our beloved Shanty. It was a nice time. We were happy.
I’m home now. It’s nearly midnight, and I no longer feel sleepy. I’ll be up all night trying to find peace from your memory. I love you.
demarcation
The worst day of my life occurred one year ago today. A. had been admitted to hospital the night before due to a recurrence of neurological symptoms. She had surgery to remove the tumor just 14 days prior.
I don’t recall the room number, but it was the 8th floor of the University of Washington Medical Center’s Montlake Campus. I worked in that very hospital a few years prior, on the 6th floor. A resident from the neurosurgery team came in, and as he’s saying the words “atypical teratoid rhabdoid tumor, or ATRT,” I’m Googling it. And I don’t even have to tap any of the search results to know that this is bad. The worst, actually. He goes on to say that ATRT is rarely found in the pituitary, and when it is, it’s nearly always pediatric patients, typically younger than 3 years of age. The surgeon himself, Dr. Patel, came in later that afternoon and shared more information, none of it good. There are no silver linings when one gets a diagnosis such as this. There is no hope. None. Sitting there, next to the love of your life, and the world is wrecked, practically immediately. A. was in shock, obviously. But me, given my medical background, I was completely aware of what was happening. And what would happen. “She’ll be gone within a year,” I remember telling myself. Over and over. The world is ending. Over and over. And the following day, December 11, she would turn 36. Her final birthday.
A year ago today, my world ended. I don’t rummage through the wreckage anymore. Somehow, it continues to pile up. Eventually, it will bury me. No more light. No more anguish. No more pain. Just gone. Disappeared. And the perfect beauty of nothingness forever. And while I don’t believe in the afterlife, you experience something like this and even the coldest nihilist will ask himself: Wouldn’t it be amazing if I saw you again?
still, 2019
into, 2020
in the back yard, 2021
snow
First snowfall without you. I remember how giddy we’d become at the first sight of snow every year. Went to Marymoor and all I did was think about you. You would’ve loved watching all the doggos playing in the snow. Every day I get these flashback memories of you. It feels like I’m watching a movie. About someone else. In a different time.
retrace
Today I revisited this park. The last time I was here, you were by my side. We came here for a walk after one of your medical appointments at the nearby hospital. I tried to remember where we stopped to enjoy the view. I tried to recall some of the things we talked about. And I tried really hard to feel your presence here. But there was nothing. Just a cold afternoon during a bright day. I miss you.
"and that's how you would remember me"
There’s a scene in season one of Breaking Bad referred to as the Talking Pillow scene. In it, members of Walt’s family gather and attempt to convince him to change his mind and begin treatment for his lung cancer. The meeting begins to fall apart, and as everyone is yelling, Walt decides he’s had enough; he whistles loudly and yanks the talking pillow from Marie. He says:
Skyler, you've read the statistics. These doctors...talking about surviving. One year, two years, like it's the only thing that matters. But what good is it, to just survive if I am too sick to work, to enjoy a meal, to make love? For what time I have left, I want to live in my own house. I want to sleep in my own bed. I don't wanna choke down 30 or 40 pills every single day, lose my hair, and lie around too tired to get up...and so nauseated that I can't even move my head. And you cleaning up after me? Me, with...some dead man, some artificially alive...just marking time? No. No. And that's how you would remember me. That's the worst part. So...that is my thought process, Skyler. I'm sorry. I just...I choose not to do it.
I’ve rewatched Breaking Bad several times over the years, but this was the first time I watched this episode since A. died. I couldn’t finish the episode. The line about “and that’s how you would remember me” broke me, and I realized then, for the first time, that the physical changes A. underwent as a result of her treatment has complicated my grieving process. About three months before she died, we attended a performance by her chorale group. Not being able to perform with her peers was so painful for her. Afterward, most of her peers, with whom she had sang alongside for several years, didn’t immediately recognize her. The steroids had changed the appearance of her face. She was unable to open her left eye. The chemo had drained much of the color from her complexion. It was awful, and my heart broke for her because, despite her not mentioning it, I know it devastated her. And it is that memory, along with so many countless others, that breaks me to tears.
The recent holiday and six and twelve month anniversaries have caused me much emotional pain. I now cry on a regular basis, and sometimes, once the tears begin, I fear I cannot stop them. I’ve stopped therapy. My insecurities ran amok and so I’ve left the support group. No one— and I mean no one— understands my pain.
No one believes me when I say my life is over. But it is. My mental health was declining in the months leading to A.’s diagnosis, and now— there’s very little left to salvage. And the idea I could meet new people or reimagine my life in this state is preposterous.
Losing A. was’t supposed to happen.
I remember whispering into your ear, “I’ll be ok.” And I think I believed it when I said it. But losing you has broken my life in ways I never could have imagined.
today: six and twelve
the loneliest time of year
Ever since my parents divorced, this time of year has been difficult, but never as difficult as this year. It was November 25, 2021. Thanksgiving morning. I drove you to the emergency room because something was wrong with your left eye. You couldn’t lift your eyelid. It’s called ptosis. And nothing would ever be the same. The CT scan revealed a tumor on your pituitary gland, and you were transferred to another hospital for emergent surgery, which happened the following day. After the procedure, the neurosurgeon, Dr. Patel, called. “It was everything we expected.” “The surgery went well.” “We’ll have pathology results in a week or two.” You felt great. They kept you in the ICU for a couple days, but you felt great. “A new lease on life,” you said. Ten days later, things began to go wrong. Ingestion of anything, including water, triggered violent vomiting spells. Back to the ER we went. You were admitted, and the following day, a day before your 36th birthday, our lives were obliterated. “It’s called an atypical teratoid rhabdoid tumor.” “Very rare.” “Chemotherapy and radiation.” As the neurosurgery fellow told us more, I Googled ATRT cancer. Without clicking on any of the individual results it became immediately clear to me that this was bad. The worst possible outcome, actually. And exactly six months after that terrible Thanksgiving morning, you were gone. Six. Months. I’m gone too, just in a different way. I’m alive, yes. But this isn’t living. More like simply surviving. I don’t know why I continue to do it, but I still vacuum the apartment. I wash the dishes. I go to work. But I don’t really know why. Aside from the cat, I have nothing left for which to live. My parents are gone. Sister’s dead. The only family I still speak to is a very supportive uncle who lives in Colorado. A friend who’s become more of an acquaintance throughout the years. When I look at my life now, it’s as if I’m assessing a battlefield. Everything is scattered. Things broken that will never be repaired. Craters and divots created by me and my dysfunctional personality. Bridges blown away. I don’t like Thanksgiving. Xmas is even worse. And New Year’s is a celebration of depression. My life is over. I’ll continue to collect useless trinkets along the way, but once it’s time to leave, I’m gone. And sometimes, that’s just the way it is.
130 days
Contrary to what you believe, my life isn’t worth saving. I’m no longer living, only surviving. Impulses are triggered by synapses of anger, grief and pain. Other emotions fail to elicit a response because nothing else remains. I’m not a man. Just a shell of a person. When you were still alive, I whispered into your ear, “Don’t worry about me. I’ll be ok.” Maybe I believed it at the time, but your absence has destroyed me more than I ever could have imagined. And so, nothing remains. My life has ended, and now I’m just killing time, waiting for a crack of light through the door, so I can leave and return not again. I wanted to make you proud, but I’ve failed you yet again.
terror
I’m terrified of all the memories of you I’ve yet to recollect. I know they are out there, somewhere, gathering and waiting to descend upon my heart. Waiting to remind me you are gone forever, like a stricken ship, unmoored and no longer cradled by the waters, sinking and gone from my eyes, forever.
110 days
I wish I could mold something, anything out of this cloud of grief and depression, but everything right now feels impossible. My days are not marked with joy, with happiness, with optimism. It’s all black. And if not for the cat, I wouldn’t be here.
Cruel
My thoughts sometimes get away from my mind and run loose like a frightened rabbit. What if she walked through the door? said a thought untamed by the cruel confines of reality. This and similar thoughts arise unprovoked, so there isn’t a way to protect myself from them. Those thoughts crush me, and the pain they bring only reinforces the idea that I will never be whole again, and this life— the act of simply surviving— is irretrievably broken, and I don’t know how much longer I can maintain the distance between it and the inevitable end.
Sink
I’m crying as I mop a dirty sink
Dinner for one
Dinner alone
I’m three months out and something is beginning to break
A crevice to wide
If I try I will die
Three months out and you’re everywhere out of sight
“Insight” Joy Division
Tears of sadness for you
More upheaval for you
Reflects a moment in time
A special moment in time
Yeah, we wasted our time
We didn't really have time
But we remember
When we were young
three months (92 days)
During her illness, A. and I were grieving. The lives we had once known were gone, and nothing would ever be the same. And in that, is grief. But the grief one experiences when they lose someone so close is more volatile, and the dynamic range is expanded. In the final weeks of her life, I would frequently visit the bathroom mirror. I’d look at myself when everything got too loud and say, This cannot destroy you. The words were like an anchor, a reminder that the experience may leave you broken and beaten, but it can’t destroy you. I don’t think I believe that anymore.
Yesterday was three months since she died. I also closed the sale on the condo we bought 16 months ago. Life is sometimes strange that way.
the final edge
Seventy-eight days since she died, and I’m struggling to envision myself still being here come June. My family, gone. The most important person in my life, gone. And in their absence is an emotional crater that can never be refilled. I’ve stopped asking myself, ‘Why?’. And while I’m careful not to pity myself beyond what is reasonable(?), one cannot help but ask himself why he must endure. Childhood trauma that altered the trajectory of my life before I could choose otherwise. A divorce that fractured everything. An abusive step-father that opened the door to alcoholism for my mother. Sister’s addiction and death. And finally, the death of A. Why must I endure this? I don’t. There is literally no one here to stop me from ending myself. But I’m not ready. The cat is still alive, although I can’t be sure how much longer, as even she seems to be edging closer to the final edge. And while I will concede that I have caught myself laughing (real, legitimate laughter), my days straddle red anger and total emptiness, the kind of desolation that gives you a thousand-yard stare.
Camus: “ There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy. All the rest — whether or not the world has three dimensions, whether the mind has nine or twelve categories — comes afterwards. These are games; one must first answer. And if it is true, as Nietzsche claims, that a philosopher, to deserve our respect, must preach by example, you can appreciate the importance of that reply, for it will precede the definitive act. These are facts the heart can feel; yet they call for careful study before they become clear to the intellect.”
sundowning
It’s called sundowning, and if you’re a registered nurse working on the inpatient side, you know the term well. Sundowning is a phenomenon in which elderly patients with a cognitive impairment begin acting out, usually during the evening hours. They become more confused. Agitated. Impulsive. As our day draws to an end, biochemical changes occur. Melatonin production ramps up, and dopamine levels decrease.
Lately, I’ve been experiencing my own sundowning. The past few days have been, dare I say, pleasant. A. routinely passes through my thoughts, but the thoughts rarely become disruptive— until the evening hours. As sunlight fades, the shadows grow long, enveloping my thoughts. And I can’t shake the fear that I’ll never recover from losing her. And I feel delusional for experiencing the relative optimism just hours earlier.
My therapist sends me a message, reminding me we haven’t talked in a while and expressing hope that I’m reaching out to others. She also reminds me of the dangers of being an introvert and self-isolation, especially as an introvert who is grieving.
I have been isolating myself. I chatted and exchanged messages with so many leading up to A.’s service, and then, literally overnight, they’ve all gone away, moving on with their lives while I’m still standing here, looking for direction.
Or maybe just looking for someone.
But who, exactly? How many within my small circle can even pretend to appreciate my loss?
Some people live through an experience (or series of experiences), and it breaks them. Sixty-two days later, I remain broken, unsure if whatever time I have left is worth the investment.
Maybe it’s just the sundowning talking.