Observations on the Last Days of a Loved One

            Sookja Kim Winters was four months into her ninety-third year of life when she died in our home last week.  She had been diagnosed with pancreatic cancer three months earlier, and she lived with us from that initial diagnosis until she took her last breath.

            Sookie was Jeri’s aunt (her mother’s sister) and was very much like another grandmother to our sons, Keith and Phil.  To me, she was a dear friend, an intellectual and spiritual companion, and a woman of great faith from whom I learned and shared much of the stuff that makes life special.

            When we celebrated Sookie’s ninetieth birthday in December of 2009, she could have passed for a woman of 70.  She was still in great shape physically, with a figure most women half her age would love to claim and a face that was amazingly free of the wrinkles or jowls or the facial puffiness that is the normal fate of those who survive to that exalted age.

            Photos of Sookie as a young woman show her to have been blessed with beautiful features, and it is no exaggeration to say that she was an ethnic beauty (a Korean-American, born in California of Korean immigrants).  But she worked hard to maintain her youthfulness and her physical beauty, swimming regularly at the Y (in San Francisco, where she lived with her third husband) and maintaining the same size-two dress size throughout her senior years.

            When she turned 90, Sookie declared that she intended to live to be 100, which I regarded as more of a statement of her sense of excellent health than a claim to be able to control those things that cannot be controlled.

            Death is one of those things, and when she suddenly developed jaundice right after the start of the new year, the inevitable was set in motion. 

            The diagnosis came quickly, after a long night in Sacramento’s Sutter General Hospital ER (where she received immediate attention and excellent care).  The next day, a surgical procedure relieved the blockage the tumor had caused, thereby restoring her natural color.  But, as subsequent tests revealed (and as is all too often the case with this most dreadful of diseases) the tumor had grown too close to important blood vessels to be safely removed.  Sookie was terminal.

            She accepted this news with what I can only describe as amazing equanimity.  “Attitude,” she kept saying to herself that first night, as if convincing herself that she would get it right in her head and deal with whatever was to come.  Thereafter, she never exhibited any sign of remorse or bitterness. 

            January was a good month.  Her pain (always a concern with this type of cancer) was controlled with relative ease (mild narcotics), and she maintained her mental acuity, reading any number of books (among them, Irving Stone’s “Those Who Love” and Morris L. West’s “The Shoes of the Fisherman”).  She also kept an active social calendar, as a steady stream of friends came to our home to visit with her.

            Her appetite during those weeks was good.  Always a small women (she never topped 100 pounds), she was committed to keeping her weight up for as long as she could, even as she was destined to drop steadily from 90 pounds at the outset of the disease to barely 70 at the end.

            But in January, and through much of February, she ate what for her were large meals.  Her tastes varied from her pre-disease years.  Suddenly she craved ice cream and steaks, among other items.  We went out to dinner with friends, just as we had in her healthy years, and, except for the fact that she was dying, things were relatively normal. 

            Throughout February she was still very much with it, writing letters to friends and relatives, keeping her calendar and chatting regularly with her husband, who, himself in failing health, remained in San Francisco.  I found it mildly ironic that she continued to have the same concerns about their relationship (some things never change) that had been a constant throughout their eighteen year marriage.

            During the last week of February, our younger son, Phil, came to visit.  They had a number of good chats, but when he left, she went into more rapid decline.  That weekend, another very close friend came to visit, and on March 4 the four of us went out to dinner.  It was the last time she left the house.

            At that point, she started to use the walker that Sutter General had provided.  (We used in-home hospice care, which worked well, as we were committed to keeping her with us, unless she required hospitalization at some point; she never did.)  By then her need for pain meds had increased and her energy levels had begun to wane.  She was less inclined (or able) to sit through a whole DVD movie with us and more likely to sleep late and take long naps during the day.

            Our older son was due to visit later in the month, and I began to be concerned that she may not last long enough to have meaningful visits with him.  But I think she made up her mind that she would, and she did.  Even though she was essentially bed-ridden by the time Keith arrived, she was still able to relate to him.  They shared several special hours together over the week he was here, albeit she was occasionally delusional by then as well.

            The delusions were caused by a combination of the narcotics and the lack of sustenance (she had, by then, given up on food and was only drinking minimal amounts of water).  Once Keith left, she essentially stopped fighting. 

            There was no quality of life at that point.  She clearly wanted to die.  But, as the hospice nurses told us, because her heart was so strong, it still might take a while.

            A while turned out to be one week.  She died peacefully, essentially in her sleep, at around 5:30 in the afternoon of April 4.  And, for whatever reason, her face bore a beatific smile that suggested a sense of rapture.