Light, Bright, and Sparkling: February 2023

Most of December was a good month for Peter. In November he’d been in hospital for a week, at UCLA Santa Monica, with a “small” pneumonia, quickly wiped out with antibiotics, and some dialysis issues. He was released the day before Thanksgiving, and although I was pretty tired from all the stress I made a bang-up Thanksgiving dinner for just the three of us. Peter gobbled it heartily and said he believed it was the very best one I had ever made – and he’d had more than half a century’s worth of them! I cherish the pictures of him shoveling in that last Thanksgiving meal.

We’d had a golden reprieve following his dire illness at the start of pandemic three years ago, which was weeks of hospitalization with six pneumonias, six transfusions, and kidney failure. The wonderful UCLA pulmonary team saved him against all odds, and he was put on dialysis in June, 2020. This basically kept liquid away from heart and lungs, and gave him a new lease on life. Of course dialysis is hard and our lives became more limited, all the more because of pandemic! I became a full time caregiver, which got harder when he fell and broke his hip in September 2020. But he recovered from that too (as he seemed to rebound from everything - it was always said that he had more lives than all our cats put together), and the next two and a half years were what we called “golden time.” We appreciated everything more than ever before, rejoiced in being together, and enjoyed the small pleasures intensely. Peter would come home from dialysis tired and in pain, I’d have difficulty getting him upstairs and onto his day bed, but I’d bring him iced espresso and poppyseed cake like his grandmother used to make, then a delicious dinner, and he’d watch and relish his videos (political rants, the situation in China, hiking and camping in winter wilderness, cat videos, travel videos – he used to say he didn’t mind not going anywhere because the world came to him!). The cats would romp around him on his day bed, and soon he’d be feeling better again. We even did manage to go places – only last June, 2022, we were in Sequoia, at 7,000 feet, Peter eating an ice cream cone at Lodgepole, on oxygen! He’d go out to the coffee shop occasionally, sit in the sunshine, enjoy his books, and spent a lot of time sorting his poetry to decide which ones were to go into which desired collection. This was very important to him and he was so glad to be able to do this work.

Peter with ice cream at 7,000 feet, June 2022

But on Christmas Eve, I was all ready to get started with another turkey, when we realized that Peter, who’d been feeling under the weather, had to go back to the hospital. We never thought it’d be for the last time. The ER was fairly empty due to the holiday and there was no wait for him to be given a room on the geriatric floor, for observation. It soon was discovered that his pneumonia infection was back, and he was put on strong antibiotics. This was expected to subdue it as before, but every morning I’d wake up at home, check the UCLA online portal to see his overnight numbers, and the white blood cell count would be no better. I’d hurry to the hospital and sit with Peter all day, until bedtime. The main trouble seemed to be that they were unable to perform dialysis well – there were possible clots in the port graft, and none of the technicians could do it. And with less dialysis, he grew sicker. He became delusional, and they had to put mittens on him. No one was overly concerned about that, because “hospital delusion” is a very common problem with older patients, and indeed, when they gave him a port in his leg and were finally able to do a good dialysis, he snapped out of the delusions quickly. (Though they weren’t bad delusions; at one point he patted my nose thinking I was his cat Pindar.) He was able to chat and be read to, and I read him from Ulysses which he enjoyed. He was looking pretty well, like himself, with good vital signs, and no trouble breathing.

Then they decided that his arm portal was clear, so they’d try to give him dialysis in the arm. If it worked he’d soon be able to go home, as the pneumonia drugs were the “right” ones, even though taking longer to work than before. But the arm dialysis was extremely painful, and here’s what happened next, as I wrote to a friend:

“January 2. Well, things have turned sour again - Peter now has afib.

This morning he came out of the confusion and was lucid again. Really best he's been since he went into the hospital, and he and Paul and I enjoyed chatting together and figuring out how to work the TV news, etc. Then, the doctor said he'd have dialysis, and they'd try the arm because the scan showed it was OK; if it works, then they can take out the temp catheter in the leg. Fine. But the technician finds it has some clotting. She can get around it, put the needle in higher up. However, it was very painful, and Peter had not asked for Lidocaine which he always gets in dialysis because he assumed he'd get it. The pain triggered his trigeminal neuralgia (facial pain), so he got worse. He asked for pain medicine, hydrocodone. The nurse prevaricated, said she'd ask her superior, etc., but she never came back. I took matters in my own hands and went looking for her - she's not there. I saw a male nurse who had Peter last week, and told him the situation. He acted quickly, got the medicine (the girl had asked her nurse practitioner and then gone off). He gave it to Peter, who soon felt better, relaxed, and dozed off as the dialysis continued as it should. Paul and I left for me to drive him home to get his suitcase so he could return to the island. When I got back - there was Peter with heart arrhythmia, atrial fibrillation. The pain had given him afib disordered heart readings. Apparently pneumonia can push you into afib, as well as the level of stress. They scurried around giving him EKGs and getting blood samples and loading him up with Heparin. Peter was so exhausted, and when dialysis was done he had a little to eat and went to sleep.

What next. I think I can guess.

Afraid Peter’s systems are shutting down and doctors only making it worse.

Maybe I should go back and sleep in chair.”

Next morning. January 3.

“Got to the hospital very early. Happily his heart returned to normal rhythm during the night and has remained so. Whew. They want to do the procedure to clean up his arm graft today but the catch is that his hemoglobin is now very low, 5.4, because the heparin may have caused some internal bleeding, so he'll need a transfusion first. This we've seen before however and they know how to handle it. Not as scary as new heart problems developing. So perhaps we'll get him home to the cats before too long, after all. Here's hoping.

I've got a nice cappuccino and warmed chocolate croissant this morning. Peter's sleeping and I may have a doze in the backbreaking recliner. We're having a rainy week here, I like it. And if Peter only remains to delight my eyes, that will be good.”

Next letter a few hours later, to my friend:

“Jan, Peter died at 5:50 PM today. Code Blue was called and doctors paddled his chest and put him on a vent and I held his hand and told him we'd publish his poetry and take care of his cats. It was that awful dialysis that the pain sent him into arrhythmia and next morning after asking for some ice cream and pain medication, his heart numbers went crazy and 30 medics ran into the room while I stood crying in the hall and then they took him up to the ICU where he was on a vent a couple of hours and then his kind pulmonologist told me they couldn't bring him back anymore and his pressure was dropping, so was it all right, and I said yes, and he pronounced it at 5:50.

Paul managed to close library, announce a bereavement leave, and be on the last boat out before the storm. I was with Peter when he died, and Paul is with me now.”

I posted the following picture and caption on Facebook, and was overwhelmed by so many kind messages from so many friends, who seemed to understand what Peter and I meant to each other and did for each other. And I did have the feeling of a good job well done.

Peter Charles Birchall, January 20, 1944 – January 3, 2023

My darling Peter.

“In death and dreams the world revolves, a sea

Where gulls and lovers drown, and then are free.”

-Peter Birchall, 1965

Snippets from various letters and notes:

Paul actually had me laughing during my first day of widowhood, though he is more deeply affected than I thought and is having a hard time - I think partly worrying about how I'll be when he goes back to the island after his bereavement leave. He told people I was In Shock (because I was sitting next to a rainy window and shivered) and indeed I was, during the Code Blue, shaking while they were flattening Peter with the heart paddle, but it soon ended (for both of us). Today my half sister and her husband drove out here in the rain with a ton of deli food to have a little wake, or shiva, with us. This was incredibly kind, all in the old family tradition of bringing food so the mourners won't have to cook, and to keep them company. Afterwards Renee helped me to throw out Peter's drugs and useless hospital paraphenalia, which was a good thing to do as looking at them made me sad (Paul threw out the much hated commode himself). It was harder to put away his poor clothes...he had to wear short sleeves for dialysis and most of them were blood stained.

Tomorrow we go to the pretty green little local cemetery, Woodlawn, where suffragette Christabel Pankhurst is buried (she had a crazy California phase), and try to arrange for the cremation. He won't have a funeral or burial but in the spring, we will scatter his ashes at Sequoia National Park, which was his favorite place and where we did all our hiking. We know the spot, Peter and I decided on it many years ago because it's only a quarter-mile from the road and we figured we'd still be able to get to it when we were old crocks and it came time to scatter!

It is day 4, and I am still processing things and tending to cry when I see cookies I bought for him that he can't eat because you know, but I am here. Paul and I went to the cemetery, and they were so sweet, said they'd get transport and have Peter there that very afternoon, and soon do cremation and give me the ashes to take to Sequoia in late May. That was exactly what Peter wanted and where he wanted to be, and Paul and I felt so at peace for having set it all in motion. To our surprise everybody seems to think it's a lovely idea, and some dear relatives want to come, which will be wonderful. We’ll have a short hike and a poetry reading. I’m absolutely overwhelmed by letters, messages, flowers…I’ve had nearly a thousand Facebook messages, so kind and comforting. (Just a few who come out with jaw-dropping zingers like "To say you are a Widow is the worst thing I can imagine, I wouldn't wish it on my worst enemy!")

At Woodlawn Cemetery.

So Peter is gone. He couldn't help it, I couldn't help it, though we tried as hard as we humanly could, and beyond; but he was so very sick, and then too maybe warehoused a bit by being sick in holiday time. I don't know. I do know that when people say their dead person will always be with them it sounds unreal, but after 55 years spent together, never ever getting tired of talking to each other, well, I think he always will be there in my mind, and yet...a door has opened. It's exactly as if you had a cat in a carrying case and you open the door and the cat’s not sure if it's really possible to go out of the case and it sits bewildered there for awhile. That’s where I am!

Photo courtesy of Elspeth Scott

We're better than I ever imagined or dreaded we might be after such a earthquake of a catastrophe in our lives. I remember my grandfather dying three months after my grandmother of a broken heart (both when I was eleven; they brought me up and I was essentially orphaned then) and have heard that widowed people have a high death rate following loss of a partner. I feared I might crack up or something, having been enveloped in Peter’s love and support most of my life: could I survive it being taken away, would I return to being a numb waif again? But no, I feel surprisingly strong. Getting lots of rest, because I had such broken anxious sleep for the last few months. I have hardly fully realized yet the extent of the burden that round the clock care was for me - and that the load has been lifted. For the first four days I cried on awakening: where was Peter? oh dead. I don’t want to live like that, and hope it will abate. For now I am just in one day at a time mode, can’t see any farther ahead. I immediately knew I wanted to get rid of everything medical in sight, and I did that. Five 33-gallon trash bags were filled with pads and creams and inhalers and bandages - and half-sister Renee kindly took them away to donate. Tomorrow, Monday, the hospital equipment companies are coming to take away the rented hospital bed, three oxygen machines, a tank, and a CPAP. We're throwing away three of the five walkers, and so on. When the day bed in the living room is gone I can start doing three years worth of refreshing and make this a pretty place to live. Most important decision I've made yet: I'm going to move my work place into Peter's study, the only room in the house with sunshine and a view of trees and squirrels that he loved! His favorite books and family heirlooms are in there, and a lovely Turkish carpet, and I will feel Peter's best presence all around me. The cats are already learning to sleep with me on Peter’s bed that I have turned into a cat bed, and not waiting forlornly all night for Peter to return.

Cat bed

I don’t think I’ll write much about my widowed experiences, don’t want to dwell on that past a certain point, and I don’t want to become a receptacle or repository for the subject. Can’t think about projects yet anyway. Fixing up the study is as far as I can see just now. More will come, I'm sure, and I didn't cry even once today, though I had an odd moment when I realized that since I never read all the heavy books Peter does (did), I probably knew only a small amount of his thinking. Did you know he'd become an admirer of the Tao? I guess that was how he prepared himself for his oncoming death. But I didn't know anything about it. I just comforted him and pushed his walker and researched medical questions and brought him everything he liked to eat. It was enough.

Peter and I lived the life we chose and wanted: he wanted to write poetry, I liked working and we both wanted to read and write and be left alone. So we did, interspersed with lots of hiking and other travels. Never had to report to anyone, could be our own contrarian selves all we liked: nobody cares in California. He was saying just that a few weeks ago, what a good life we had. And we had a lot of it, with nothing but mutual affection and support from start to finish. To die at (nearly) 79 when he was so sick and clearly couldn't go on much longer, is not as bad as it might have been. People say I kept him alive for far longer than he’d have had without me, well, me and UCLA! I can't help grieving but I don't want to spend the rest of my life an emotional mess. I know I'm going to miss him horribly though, having him to talk to all the time and he knew so much, had such certitude, thought for himself. I've never been single and don't think I'm going to like being alone; but Paul is such a blessing.

Tomorrow will be a week, and we have hardly recovered from all the shocks - the shock of actually seeing him die, most of all. I hope in time not to be assailed by moments such as when I see the soap I used for his showers and it brings back images of how hard he struggled to walk into the shower. That kind of thing. It's why I am desperate to clean out everything that brings back the sick times.

Finally, to a Facebook friend who was an elementary school classmate of mine, who commented on how I was in the vanguard of what many of us would have to face, the burden of being the survivor of a mate, I started to answer but it turned into the account of the death, and I didn’t post it. Here it is now.

“Surprisingly, I don't feel I'm carrying any weight at all. Peter and I were together for 55 years, our every experience and thought intertwined; we pursued interests separately but they were similar, all about reading and writing and traveling. We both always considered that a thousand years together wouldn't be enough. Yet surviving isn't a burden, not for me. As his sole 24/hour caregiver I did not only do all I could, I did far more than I ever dreamed was even humanly possible for me to do! The last few months I hardly had a relaxed breath. I pushed a 200 lb. man sitting in his walker seat (I couldn't push a wheelchair, got a slipped disk from that, thankfully repaired with physical therapy) up hills through parking garages and medical corridors, got him into the SUV seat singlehanded when he couldn't walk and simultaneously juggled his oxygen and several sets of tangling cords; we both tripped on them numberless times, they were a torment. But I made Peter as comfortable as my imagination and capacity could conceivably contrive, at every and all moments, whenever it was possible. When I brought him home from dialysis three times a week he'd be exhausted and miserable; I had the food he liked, he had his YouTube videos and books and cats and soon he'd feel better and we could just enjoy being together again. As his COPD and pulmonary fibrosis got worse he couldn't walk to the bathroom without me walking beside him holding the 25-foot oxygen cord and seeing he didn't fall. When he did fall down or sat down on the floor because he was too wobbly to stand, I could not get him up; 200 lbs. (That man adored eating until the end, no kidney patient starvation did he have!) But he couldn't pull himself up. We had at least 20 paramedic visits in the last year; they'd kindly pull him up and put him in his bed. I was never a slave to Peter, but I was most certainly a slave to his illness. He was so stoic, sweet and patient, and never complained. There was no other option that was acceptable. Peter's stepfather was spending $300,000 a year in a care home, with round the clock private nurses, but such was hardly possible for us and the local “homes” available were not places I would ever willingly "put" Peter. He had me, and I could take care of him. Never mind my age and knee osteoporosis – I could do it, and that was that. I got stronger. He was going to enjoy life as much as he still could, and get the best attention to his needs medical and physical. So I don't feel any “burden” in being the survivor. I feel I did my best, and now I can breathe.

He'd had many hospitalizations and always recovered, with remarkable resilience; but this time after ten days in the hospital things weren't going well. The antibiotics weren't knocking out the pneumonia; they weren't able to give him good dialysis, the pain of it gave him afib, and the blood thinners for that probably caused internal bleeding. He was waiting for a transfusion to stabilize him but there was a blood shortage, and it didn't come. But he was quite comfortable while waiting, no thought of dying, and his last words were “Can I have some ice cream?” Then he dozed off. Then suddenly the heart monitor went wonky, the nurse ran into the room and screamed “Code Blue!” which meant that thirty medical people raced from all over the hospital and were doing chest compressions and all sorts of emergency measures. They told me to wait outside, and I had a glimpse of Peter flailing like a fish and hastily complied. Out in the corridor I was shaking and crying while the milling crowd kept well away from the Family Member, except for a chaplain who kindly stood beside me.

I hastily called Paul and said "I think it's happening now! Come home!" and Paul ran to the next boat (the last, as it turned out, as a storm hit and the rest of the boats were cancelled for a couple of days). Then I realized that despite hearing all the shouts of “I think it’s stopped, no, get another compressor, I can’t find one!” Peter was still alive in that room and I had to be there. So I went and knelt by him, held him and told him I loved him and would get his poetry published and take care of the cats. The chaplain said he saw him react when I touched him, and it was true, I could feel him relax as I spoke and that he knew I was there. Just then the doctor said there was a pulse: did I want to try some more or let him go? There were no instructions, but I said I knew them, Peter had told me. I said "Peter wants to fight if there’s any chance" and the doctor said "You got it." I told Peter the doctors would take care of him and I wouldn't leave him but the best thing he could do to help himself was just relax and sleep and he'd be all right. They took him up to the ICU and I sat with him for a couple of hours, he was breathing on a vent, but still warm and alive looking. I recited to him the two love poems he wrote me when we were twenty, but even though they sounded wonderful, this time when I spoke I felt sure he didn't hear me. Finally his blood pressure went down, the doctor and nurses looked at each other, and I asked was that it? The doctor said it was if I said so, I said so, and the doctor pronounced it at 5:53. Then the doctor (who was Peter's pulmonologist that had saved him three years ago and happened to be on hand to lead the fight for his life) kindly sat with me and told me how, when end stage renal disease patients can't be dialyzed, it’s like a cascade of breaking parts, and the heart stops. That was what happened, and nobody could have done anything. At 6:30 our Paul reached the ICU. Peter still looked just like himself, sleeping, and Paul closed Peter's eyes. We stayed an hour and then went down to the cafeteria where friends were waiting for us; got some Thai take-out and went home, now a family of two not three, with three cats, one Peter's very own Pindar. Peter will always be with me in so many memories and associations, and I have all his books and his cats and will fulfill my promise and get his poems published.

Peter and some of his poems on one of his last coffeehouse visits, November 2022.

The first few days I was in shock, and cried when I woke up in the morning: "Where's Peter, what does he need...Oh, that's right, he isn't here. Wait - he never will be again! - He has, he has DIED!" Sob. But mercifully that grew less intense. I hated it happening so much that I reminded myself briskly how sick he had been, that he could not live long no matter what, and that we'd had a lifetime of happy years, living exactly the life we chose and wanted and loved; so I could not wish for more.

So now I’m in my work place in Peter's own study, the loveliest room in a dark house, with sunshine and a view of trees where you see giant crows disporting themselves all day and the cats carry on longing chirrupping conversations with them. Peter loved that view and the wildlife until he had to move to the hospital bed in the living room; and now I shall sit there and work, amongst his things. And I’ve turned Peter's bed into a cat bed, so I would never sleep alone, and our three cats are continuing their good work as caretakers and consolers. Pindar has her place right by my side. So that is what widowhood is like for me so far, and based on my informal survey of my friends who've already been there, every widow is different as every woman, and every relationship, is different. I've just now realized how profound that stereotype is. And he wasn't heavy: he was my husband.”