Thinking Mortality

I’m not naïve. Cancer is a deathly illness. I’ve worked as a nurse in internal medicine wards in Groningen, the Netherlands, and Heidelberg, Germany, and I have taken care of palliative patients. An aunt and a cousin died of cancer. Additionally, I have lost friends to cancer here in Finland.

Especially the metastasis in the liver worries me as I know the outlook for liver metastasis tends to be poor. I could be more exact and look up survival rate statistics, but Google is not exactly a comforting platform for cancer patients. I’d rather stick to the careful words of my doctor who first wants to see if the tumour responds to the chemo treatment.

Likewise, the hospital keeps their message generic. In their leaflet they claim to be one of the best cancer hospitals in Finland. I’m wary of such propaganda, especially if it isn’t backed up with facts, but I must put my faith in their hands, so I take their word for what it's worth. And let’s face it, I felt very well taken care of during my overnight stay on the ward.

Of course, I also know people who have recovered from cancer. We talk, write and share experiences. They, the survivors, give me tips on how to deal with the side effects of chemotherapy. They advise me about nutrition and self-care and remind me to live by the day. But our conversation also makes me realise that I’m not in their league. I’m in a completely different category, unit or line-up. I’m on the other side of the fence and their grass is so much greener. Their energy levels advance per day while my leukocytes stay low. Their hair is growing back. I just bought my very first wig. They returned to work. I have no idea what’s going on in the office. They thrive and I feel I’m hanging by a thread.

Unfortunately, I cannot ask the deceased how they managed to prepare for their death so it’s time to think and rethink my own mortality.

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The first time I seriously dove into the topic of death was in 2009 when I wrote an article titled “Over My Dead Body” for the online newspaper 65 Degrees North. In it, I interview an undertaker and a priest. 

Investigating my own death in a foreign country helped me to understand that I can prepare and communicate my wishes far before my demise. Already 14 years ago, my husband and I agreed that for practical and financial reasons, we would not ship our remains back to the Netherlands.

Some years later, during a burnout/depression, I sneakily hoped someone would crash their car into my shiny black Ford Maverick, my all-time favourite family car. Thoughts about death were never far off. Luckily, with the help of a psychologist, life became cheerful again.

But the realisation that life is not endless has been there ever since. When the word cancer for the first time fell, I certainly sensed panic and sadness, but not disbelief. I never thought this couldn’t happen to me.

Like anyone else, I’m hard-wired for negativity. It was hard to see any positives during the first weeks after the diagnosis. I was convinced the end was near and my mind was racing, thinking of arrangements for my death.

Weird enough, I’d brought up the issue of making a will already a year ago but now it became urgent. I called a lawyer specialising in inheritance issues. I hope, depending on my condition, to manage to meet up with him sometime between the third and fourth chemo.

Furthermore, I read books about different ways to die and discussed the options over coffee with my husband. He thinks I’m too much pulled by irrational feelings. “It can go both ways. We don’t know at this stage,” he tried to comfort me. Despite his calming words I saw fear in his eyes and know he is as worried as I am.

To get off the subject I started talking about something more trivial: the music for my funeral. During our Canadian years (1996-1999), I became familiar with the music of  Antonín Leopold Dvořák. As an immigrant plagued with homesickness, his New World Symphony instantly resonated with me. But it was this short melancholic piece out of a cycle and originally written for piano that made, and still makes, me weep.  I feel No. 7 reflects me and my deepest emotions and I know that the violins and flutes will comfort my family during our final farewell.

My husband promised to store the music on his computer.

But I’m not only talking to my husband about dying. I discussed my death with my therapist, too. Euthanasia is illegal in Finland, so I ask her what other choices I have when the end is nearing. It seems I can either die at home, in a hospice or at a hospital. During my years as a nurse in different hospitals, I’ve seen people dying peacefully and dignified but also in great fear and distress. To process our thoughts and feelings, my nursing colleagues and I always reviewed the palliative care process of each patient and unanimously agreed that it's better to stay calm until the end. But now, so many years later, I realise there’s an additional aspect, namely my sense of responsibility. As a mother and wife, I don’t want to saddle my husband and children with fear and trauma after my death.

I know, staying calm and composed is easily said (thinking of my stress levels during the first chemo), but I do have time after all. I understand now, a month after the diagnosis, that I won’t pop my clogs immediately. I do have time to practically and emotionally prepare for my last journey.

Staying calm is a cognitive and behavioural thing. I’m convinced I can work on my bearing with the help of family and my therapist. Or more realistically: if I will get some more years, let’s hope I will, then I’m sure those new qualities – an aura of calmness and dignity – will suit me for the rest of my life.