Jaundice
She’s in the bathtub this time. Her skin is yellow and her eyes are unfocused. Her cheekbones are prominent and dusky in a way they hadn’t been before. It makes her face look like a skull. Alicia still manages a smile, even if only for a second. She’s a consummate optimist with a default altruism that continues to shine despite her stage 4 cancer diagnosis. No one expects a diagnosis like that, but the younger you are, the harder it hits. She always asks how I’m doing during our visits, which we’ve switched to video since her illness has worsened, leaving her weak, in recalcitrant pain, and unable to eat. She’s used to caring for others—a mother, a wife, a friend—and still has trouble focusing the visits on herself, despite their inherent purpose. The audio sounds hollow in her bathroom, like she’s far away, or at the bottom of a well. Things are worse than last week. She tells me as much but also its obvious to my trained eye. She is dying. She is very close to death.
Her eyes go out of focus, and she says she’s too tired to speak much longer. She is in pain. I say, this is suffering but it doesn’t have to be. She understands. I don’t want to give up, she says. I want to say, it’s not giving up—it’s acceptance. Death isn’t the end of a game. There is no losing, only truth. I settle for letting her know that no one is giving up. Her husband takes over. His feet are in the periphery of the video screen. I can hear his voice echoing in the bathroom. His calm line of questions, poking and prodding around the reality of the situation, all circling around the big one—Is this the end?
Alicia was hoping to make it to a specialist appointment on Monday. A small glimmer of hope that somehow there was a way to correct her course. But she was off the map. It’s Friday evening. Telling someone how long they have left is part sorcery, part science, part experience. I’d been meeting with Alicia weekly for months and had seen her condition wane. We both knew she was close, but today, she was peering over the edge. I’m not a quitter, she says. We both knew it wasn’t about staying in the fight. Cancer is not interested in winning, only killing—losing its own life force in the process. Cancer doesn’t hope to make it out. It hopes nothing. Thinks nothing. Feels nothing. After the medicine has reached its limit, we battle cancer like we battle gravity or time. I think it’s time, I say. I know she says.
Alicia died the next morning in her husband’s arms, with as little suffering as modern medicine can provide.
The edges of the universe have been travelling into an unknown since the beginning of time. Not far behind, the last gasps of burning star light follow suit. On the other side of that wave of existence is where I imagine Alicia now. As the morphine took its grip. As her breath slid away. Whatever was left—be it spirit or ghost or essence—felt the current of time, and the universe stretching its wings from the heart of its birth, and she was carried away to whatever exists on the other side of it all.