From Here to There

David LaMotte


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There's no script...

When my first child was a baby, I took her to the beach, spread a towel, and carefully placed her in the middle.  She immediately dove for the towel's edge, grabbed a fistful of sand, and shoved it into her mouth.  In a panic, I turned to my brother Fred, a few years older than I, with two children of his own, and screamed, "Fred, what do I do?"

Sitting Buddha-like in his beach chair, Fred gazed out at the ocean, sighed, and said, "David, there's no script."

At the moment, I wanted to wring his neck, but his words have stayed with me, and I have found them to be profoundly true in those moments when the world demands more of us than we think we can bear— those moments when all we can do is "learn by going where we have to go."  Jenny, of course, was already hard at work spitting out the sand by the time I grabbed a water bottle and began plucking at her mouth with wet fingers.

The night we started my father on morphine, which I was to administer from a dropper bottle, I kept asking the doctor how much I should give and how often, until he finally looked me in the eye and said, "David, you can't do anything wrong here."  There's no script.  We learn by going where we have to go.

I often wondered whether that meant that somehow I had "helped my father die" by giving him the morphine. In the broadest and best sense, of course, I did help my father die (see A Good Day's Work for the full story), but it wasn't the morphine.  As I learned later, during my training as a hospice volunteer, morphine does not kill; it does not suppress the metabolism.  It merely relieves and relaxes the body so that it can do the hard work of letting go.

I start with these anecdotes to emphasize that there is no formula for all the decision-making that must occur when someone may be entering the final stages of life. What you will find here are my own reflections and anecdotes from twenty years of caring for the dying and thinking and writing about these matters.  My aim is not to tell you what to do, but to help you anticipate what questions to ask and what options to consider, and perhaps to offer some comfort and clarity about the journey ahead.

It is a journey, and it is a story you are telling, with your loved ones, as you go.  I hope the story that I trace here— from here to there— will help you as you trace yours.  And while there is no script, one thing is for sure: There is a deep blessing in opening yourself to the mystery and traveling this road with loved ones and with an open heart.  It's not so much that we let go of fear as that we let the fear go through us until it turns to love.

          • When, Where, and How to Begin

          • What Questions to Ask

          • Establishing Goals of Care

          • When to Consider Hospice

          • Enriching the Time

          • The Work of Dying

The reflections gathered here and under the six headings at right are anecdotal and personal.  Their aim is to help you anticipate what questions to ask and what options to consider, and perhaps to offer some comfort and clarity about the journey ahead.  For practical considerations and further support, go to Resources.