Conversations at Midnight

Despite our attempts to put it aside, death is always there, standing in the shadows, asking nothing more of us than to recognize it as a part of our lives and to claim it as our own. When we are young and vigorous, our own deaht seems like a myth. As we grow alder, we push death away like a friend who embarrasses us or a distasteful relative we refuse to acknowledge.

For me, as I write these words, death is a cancer moving through my skeleton and sending warning signals through my bloodstream. Within a year or two, it will claim me, but as of now, it is content simply to let me know that it is there. I learned of its presence, I have tried to come to terms it face-to-face to make it a instead of an adversary. This has not been easy. But with the support and encouragement of my wife, Kay, a teacher and therapist in death and dying who has met death often in her work, I have called by name the shadow that inhabits me and invited it to share, openly, the rest of my life.

The life story of every human being is a variation on the theme of loss through death - of every pet, every friend, every loved one, until, sooner or later, the self, too, is taken. Yet this familiar companion on our journey remains a feared and hostile presence until the end; a dark assassin who waits in shadows until he cuts down. Yet since there is no escaping death's company, doesn't it make sense to call it out of the shadows and make its acquaintance? This is the task that lies before Kay and me.

The only human death I have ever experienced firsthand was Karyl's, my first wife. The surgeon who opened her abdomen quickly sealed it up again. "Three months," he said. "There's nothing more to be done." And the wasting process of a wildly metastasized stomach cancer took precisely that long to result in death. There was no pain. The anodyne of methadone and Thorazine saw to that. Until the moment of death, Karyl's dying was marked by an undimmed clarity of thought and emotion.

We talked often about death - as a concept, as a looming presence - and less and less about life. In those months, as her world closed in about her, she was calm and without regrets. "It's as if I'm standing on a high plateau," she said, "looking out over past and future. There is nothing more to trouble me. I'm at peace."

While I am not enough of a psychologist to penetrate what may have been layers of denial and avoidance, I can testify to the tranquillity with which she awaited the inevitable hour. On the morning of the day she died, I entered the hospital room to find her brushing her teeth and applying her lipstick. We spoke fitfully as she drifted in and out of sleep. At about three in the afternoon, she opened her eyes again and said, "Goodbye."

"I'm not going anywhere," I said, fearful that she thought I was leaving her.

"No, but I am," she said, and before I could protest, she sank into the calm slumber from which she never awoke. There was a momentary pause, the gentlest of exhalations, and the invisible border between life and death was crossed.

And I thought, That's death? That's all there is to it? That's what terrifies us so? And though I felt the first terrible emptiness of loss, the wound had somehow already begun to heal in the presence of the larger mystery - the easy, gentle peace of her passing. It was strange to me that our doctor friends, especially, seemed incapable of dealing with the reality of Karyl's dying. It was as if her failure to be cured was an affront to their profession, the result of some moral weakness in her. This almost universal inability to come to terms with the blunt fact of her death forced her to be the comforter, to get them off the hook by demonstrating her acceptance of the presence of death.

Like everyone who has ever lived, I am deeply concerned about my own dying and death. In April 1991, I was told that the pain in my hip was caused by a further spread of the cancer that I had been diagnosed with two years earlier. Without further intervention, I could count on only one year of life at most. Maybe I could luck out with two.

I suppose that everyone who approaches death has the same desire to flee, to create a diversion, to put up a baffle, even though the battle might be a sham. I must know more about dying. Fortunately, I can usually find answers to my anxieties by sharing them with my wife, Kay, in conversations we share at midnight.

Herb: It's not death I fear most, it's the suffering before dying. Why is dying so hard?

Kay: Peace at the time of death can be yours throughout the whole time of dying. The anguish, the fears, are not physical but psychological. They interfere with the natural process of dying. But they are not a part of it. Like prejudice or superstition, they've been learned, and they are not in harmony with natural experience. We're protected in dying by defenses that are born in us. But we need to get back in touch with them. We've lost so much of our self-awareness that we have to be reminded of what we've known all along.

H: But how about the pain, the physical suffering? How can we come to terms with that unless we're doped into insensibility?

K: For all the patients in whose dying I've played a part, their pain, while real, has been transcended. The worst pain is not of the body but of the mind, emotions, spirit - the pain of loneliness, the fear of abandonment, the pain of loss, feelings of guilt or doubt. These cause the worst suffering.

H: I can say very bravely now, when I have no symptoms, that, even though I've been given a very limited time to live, I don't fear death. But I worry that I'll lose this courage as it approaches.

K: You have to understand that dying is a process of transition from one state of being to another. In all the cases in which I've been involved with people who are aware of their dying, I've found a growing perception of death that the rest of us don't generally have. I've seen it so often - we are protected by a knowledge that comes across the boundary separating this dimension of experience from what comes after.

H: Why is it that so many people are so often totally unprepared when death occurs for a loved one?

K: Our instinct for survival is so strong, so deep-seated, that we defend ourselves against it by denying it. If we bring it to the surface, we're called morbid. The American way of death is denial.

H: Is this a national characteristic - wanting to eliminate death from life?

K: I think it's particularly American. It's part of our mythology, our sense of youthfulness, energy, and individualism. Other cultures are enriched by their recognition that death is central to life, not some intrusion it's better not to think about. Death is un-American. It doesn't square with our philosophy of optimism, of progress.

H: The awkwardness of "last things" makes them seem more precious and poignant, but their loss does not seem to bring as much grief as I thought it would. I do want to hold on to what I have, who and what I love - but I realize that I must be willing to let them go. Haw do you feel now that our roads are beginning to diverge?

K: I'm conscious that this is your dying, not mine, so I'm not ready to "let go" of anything just yet. I feel the widening separation between us and realize that you are dying and I am not. There is a part of me that wants to say, "What do you mean, letting go or giving up? How can you let go of all this? How can you let go of me so easily?" I've probably tried to seduce you into staying longer by creating a beautiful place in which to die, by adding assignments in our conversations. And yet I know that this year of preparation and conversation has led to this. As your partner, I am pleased that you have come this far toward acceptance and understanding. As your wife, I am grief-stricken. I guess one final thing I want to say is how hard it is for me to be philosophical; at times, everything, all comfort, seems to fly out the window, leaving me broken and despairing. How can it be any other way?

On April 9, 1992, at 5:05 P.M., Herb died.

PHOTO: (BANUS-MARCH/FPG)

From Conversations at Midnight (William Morrow & Co.), by Herbert and Kay Kramer. Copyright (C) 1993 by Kay Kessler Kramer.