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.
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.
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.”
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:
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!")
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!
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.
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.
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.
The two poems he wrote for me when we were in our early twenties, that I spoke to him while he was dying:
To the Onlie Begetter:
SCYLLA AND CHARYBDIS
Come gentle darkling of my mid-night world,
Dark child and mother of illicit dreams,
Breathe passion in my ear, till passion furled,
Unfurls itself, and as a zephyr seems
To waft away those sorrows and the griefs
That press upon me ever when awake
Forcing my course between the tortuous reefs
Of here and there, and life and death: I quake.
Love's nightly chimaeras do not deceive;
Sleep is no balm to soothe the troubled mind
Of one who prays, and yet cannot believe
That in life's search there is something to find.
Life's desperate affirmations but confirm
Death's power over life, - and the grim worm.
Incony Denny, sweet nectar of my lips
Incantatory dream, an incense haze
Of raptured nights that dawn into short days
I pray devout between your sacred hips.
Your child-stretched stomach and your child-stare eyes
Illuminate the grayness of my gloom
I am a bird, bereft, without a plume
That soared to heights only to drown in sighs.
In death and dreams the world revolves, a sea
Where gulls and lovers drown, and then are free.
Death certificate cause of death:
New Onset Atrial Fibrillation
Right Lower Lobe Pneumonia
End Stage Renal Disease, Acute Anemia
Some pictures from our life together...First, recent ones, from Peter's last months (though we didn't know it).
Some pictures from our life together...First, recent ones, from Peter's last months (though we didn't know it).
And in the after times...