October 11, 2003


Serious illness and death can bring down any family. But in my practice, I also witness stunning transformations and marvel that women can start their lives over in the face of immense loss.


"I am what I'm becoming." Those five words were the quiet conclusion to one of my patient's visits.


I have known her other self for many years. She's always been stylish, elegant and driven in a "get-the-job-done-right" kind of way. An independent businesswoman, she was not only successful, but also deferred to and sought out by people who wanted to brush up against her standards of taste and understated luxury.


When she retired, she took up ballroom dancing. She did it for pleasure, but also because dancing represented a whole new arena of exquisitely applied exactitude for her to master. She often practised the steps as she waited for me, and her concentration and attention to detail matched anything she had done in her four decades of work.


When she became a grandmother, she turned her formidable attention to her grandkids. Then she and her husband decided to move into a condo, and she happily offloaded a lifetime of accumulated treasures in a single, gigantic street sale, inviting all her friends to come and take away.


She began planning a trip to India, but fell and broke her leg -- seriously, cripplingly. While recovering from this mishap, she decided to engage the services of a meditation instructor and seer. A Buddhist monk who had the distinction of being a nun as well, and who was home in Canada on leave from the Orient, went to her home every day to teach my patient, chair-bound and with her leg in full extension, for nine weeks.


Time passed. When I walked into my examining room recently, a very different woman was looking back at me. I was startled by the new softness around her. Her clothing, skin and hair were all fluid and undone. She wore no makeup, but in its place, sadness covered her.


Her husband of 40 years had died. He became ill quickly, deteriorating and dying within weeks. Baffled and angry, she was stunned that his life had been cut short before he had realized his goals. And hers as well.


They had moved back into the heart of the city just a few months before he got sick. They had missed the action and verve of downtown life, the ability to walk to all their favourite places, to be part of the scene.


She wept in my office, both at his death and at her remembrance of his sense of loss. But her life's journey is far from done.


India beckons her again, and this time, her expectations of the experience are boundless and unformed. It is now her pilgrimage. Having spent her life dealing with fabric and colour, she has set her sights on examining the reds, carmines and gold threads of textile museums throughout India.


She has no deadlines, and despite her driving personality, no longer feels bound to achieve anything. For the most part, she'll be alone; a niece may join her for a time, and she has engaged a yogi to come to her hotel room every day and assist her in meditation. For the first time in her life, she's content in knowing that nothing is known of the road ahead, beyond being on it.


My other patient has taken the package -- she's too obstinate and too far into midlife to keep up any pretense of interest in her company's ever-rising sales quotas.


She had another dream: She wanted to set up a small travel company that would take a few clients every year to drive around her much-beloved Emerald Isle. To that end, she had qualified years ago for her commercial driver's licence. But no sooner had she left work than her father got very ill.


Being the spinster in the family, the one who'd never really left home, she postponed her travel-agency plans and shouldered the care of both her aging and ailing parents. It took three years for her father to die, and she watched over nearly every minute of his decline. Not surprisingly, her mother then got ill, and was looked after at home with the same keen, duty-bound care for another two years. The house gradually came to look like a nursing home, complete with hospital bed, stair glider, bare wood floors, medicines.


My patient's life revolved around her mother's ups and downs as the aged woman's mind slowly retreated into the distant past. Her outings were restricted to a senior's day-away program, which brought her daughter a few, precious hours to herself. Then suddenly, two quick downturns, a hospital stay, a fall when the staff had their backs turned for a moment, a broken hip, blood loss, a surgery with little hope of survival.


She hung on, but her mental deterioration was so profound that the hospital felt that acute care could do nothing for her, and sent the mother home.


When I got the call, the daughter was desperate and didn't know how she was going to manage. It took a full family conference for everyone to acknowledge that the mother's death was now being managed, and that palliative care -- with help from the community and church -- was the only option.


The end for this aged mother came in the presence and loving care of her family.


My patient, her daughter, was without guilt. She was content with the care she and her sisters had mounted and happy to be in charge when the end came.


Yes, she feels she has lost an arm, and yes, she misses her mother enormously. But she told me that she's now thinking of leading a group of friends to Ireland.


Both these women share the same impulse that becomes so evident when you lose the great love of your life. There's a richness and tenderness in the memory.


But then there's the awakening of a new spirit that is the gift of the heart, the bequest of one soul to the one who is left to carry on.

Dr. Jean



Doctor. Writer. Athlete.

Advocate. Adventurer.