BACK PAGE Passages The last time I visited my friend Joel, he was bedridden with periodic spastic convulsions caused by metastatic brain cancer. He was largely lucid, occasionally overwhelmed, and able to talk, laugh, and swear. But every so often, uncontrollable tremors took over his body. He was strong, but scared. I sat by his side and held his hand. With each wave of convulsions, I massaged his muscles and murmured quiet, soothing phrases in his ear. When the tremors subsided, we shared stories. He talked about dying, and fear, and the anticipation of going on unencumbered by an ailing body. He worried about letting go of the life he had known, of leaving his wife and children. He was scared of the convulsions, of the pain, of the loss of control. He wondered how long this passage would take. A few hours later, I flew home and went to work that same evening. I sat with a woman in labor through long hours of contractions. She was strong, but scared. She talked about the life she was leaving behind—late nights, long vacations, hiking, movies, sex, and independence. She was anxious about becoming a mother, determined not to repeat the mistakes her own mother had made. When the contractions stopped her thinking, she eased back into breathing, heart beating, breathing, breathing. She was so scared of the pain, yet determined to be strong. She looked forward to a life unencumbered by a pregnant belly, wondering how long this passage would take. The night passed slowly, and as her fatigue and frustration mounted, she could taste the edge of her endurance. Finally, in the wan blue minutes of the first morning’s light, the baby’s head emerged into my waiting hands. He cried before his body was born, and nestled up on his new mother’s chest. She held him, shaking with joy, forgetting of the hours of pain and fear, arriving at this moment, only dimly imagined beforehand. I wept. Three weeks later, Joel’s fatigue and frustration came to an end as he struggled to complete his own passage. I imagined him recognizing the futility of fighting the inevitable, and choosing instead to grow with it; emerging into a new beginning, arriving at the place beyond pain and fear. I wept again, both with the relief that his pain had finally passed, and with sadness because he and I will share no more stories. –Robyn Churchill
314 © 2006 by the American College of Nurse-Midwives Issued by Elsevier Inc.
Volume 51, No. 4, July/August 2006 1526-9523/06/$32.00 • doi:10.1016/j.jmwh.2006.03.002