The Final Gifts of Life

Death is the act of transitioning from this worldly place and into the next existence beyond; the afterlife experience. It may occur due to the progression of a terminal illnesses or natural causes. It can also be sudden due to some type of medical complication or traumatic cause. Moreover, the amount of stress and anxiety may seem intensified when it comes down to the ordinance of the dying loved one’s wishes of being a DNR or DNI, rather they choose to seek palliative care once the illness has been concluded irreversible, or rather they prefer to be buried in a casket or cremated.

Not to mention, the amount of pressure this may impact the dying loved one’s family and responsibilities. It is not something anyone can entirely be prepared for, but it is a part of life. Hospice care registered nurses and authors of Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying, Maggie Callanan and Patricia Kelley, promote insight to death and how to deal with it based on their various patient experiences, knowledgeable background, and medical studies on the nearing death experience.

The novel opens with a brief introduction about a terminally ill patient named Laura, her husband Joe, and their Nurse Aide. Joe was very anxious and nervous, almost battering at any sudden movement or silence from his dying wife. He clustered tedious questions of sort regarding Laura’s well-being, if she happens to be in any pain, or if anything is wrong.

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Laura only replied through soft gestures and smiles, not talking much, but assuring her husband that she was okay. She was a teacher that retired when her first husband had passed and had decided to continue her education. While overseas on a study abroad program offered by her university in India, Laura had met another attendee apart of her tour group, Joe, whom she later married. After they both had settled into a small apartment, both of their children were all grown with children of their own, life never seemed better, until Laura was diagnosed with end-stage colon cancer.

Moreover, Callanan cites the various conversations that Laura would pronounce out loud that would be confusing even scaring her husband when she began speaking of it being “time to get in line and be with Susan”, her dead daughter. It is obvious that Joe had a hard time coping with Laura’s terminal illness. There are so many things to discuss, so many questions and conversations needed to had. Callanan states, “Not unlike a still pond disturbed by a falling stone, an impending death sends ripples through all the relationships in the life of the dying. Each person involved has his or her own set of issues, fears, and questions”. Joe hadn’t quite grasped saying good bye to his wife nor what his plans would be after she had passed, but this conversation elevated Laura being more at peace with her passing. Joe discussed his plans with Laura, said his goodbyes, and removed his anguish mindset so that they both could live out her final days until her next journey in afterlife.

In addition, Final Gifts highlights various physical, emotional, and physiological traits characterized by the terminally ill in the moments preceding their death. Callanan and Kelley categorize the near-death awareness into four different behavioral traits: preparation of traveling to another destination, the terminally ill apprehend the presence of non-physical beings, they regard the existence of another non-physical destination, and they seize the prescience of it being time for them to pass. These traits appeared to be generalized throughout entire book with each patient and their hospice nurse during this cohesive process. Moreover, Callanan and Kelley defend that, “beyond the simple physical and medical processes involved in dying, like birth, death is a fundamental aspect of life, which can be approached as a positive and construction element within its obvious limitations even if we don’t see what the patient (e.g., Emma) sees” (Callanan and Kelley, 1992, p.108). It seems unreal to try and fathom what the terminally ill may witness, feel, or describe going on psychophysically. In reference to Emma’s case, a mother of two children, that was in the final stage of her malignant cancer, had seen or her lack of words to really explain her near death experience she felt most at peace, and was calm.

Moreover, I choose this book, because death is a touchy subject. It is not something we normally think about unless we are dying or are caring for someone that may be dying. It is important to understand that some patients may not leave the hospital alive no matter what efforts and rapid response was administered, death happens, and I don’t believe it is something anyone can just get use to. For me, I have been fortunate not to have lost a patient throughout any of my clinical shifts, but I have also witnessed families in tears due to a poor prognosis counsel from the prescribing doctor. It was also difficult comprehending the severity of what happened to most of the stroke patients I took care of at clinic; most of them had a severe brain bleed that denied them any type of neurosurgery intervention, ranging from young to old age, or were fine one day and the next unresponsive. Final Gifts gravely impacted my practice as a Respiratory Therapist and future leader within this profession, because no matter the outcome taking care of others is a feeling that is almost indescribable. I love knowing that my plan of care impacted my patients and patients’ families in a positive way.

I loved being a shoulder to lean on when terrible news was received, a hand to hold when scared or in pain, or just to be a soothing voice my patients heard to assure them that they were not alone. It is what I enjoy waking up to every morning and impacting those I am caring for in any way I can. Callanan and Kelley, demonstrated a positive example as professional healthcare caregivers, they offered some background to death, various first-hand accounts to different patients and the terminally ill patients’ family’s perspectives, as well as relative advice in what it is the dying need from us as caregivers/family. Plus, we all have experienced what it is like to loose a loved one no matter the reason nor if it even has to deal with death itself; know that death of a loved one is not a loss, it is merely a gain of the final gifts of life onto our next journey, and until we meet those we’ve miss again. “What we have once enjoyed deeply we can never lose. All that we love deeply becomes a part of us”. –Helen Keller