The Unwinding of the Miracle - Julie Yip-Williams Page 0,136
became the wonderful home she made for us—she was sick the whole time, it must be said—this room was our master bedroom. Here, in this sun-splashed room, with its view of the Statue of Liberty, Mia and Isabelle were conceived. Here, we looked out at the most dazzling sunsets in New York, and had some of the most intimate conversations of our marriage. Here, feeling flush with the future, we planned our life together.
In the end, here was where we tried our very hardest to make Julie’s last days comfortable.
For the entire last year, Julie had been leaving us in stages. The mets were increasing, everywhere. By late fall, she had had several bouts of pneumonia, and we discovered that she had a new tumor in her lung the size of a peach, which she chose to have irradiated, just to buy some more time. Even so, we knew that Thanksgiving would be the last Thanksgiving. Christmas would be the last Christmas. Her birthday in early January 2018 would be her last birthday. The pace of her decline was accelerating, and in the end stage of metastatic disease, the stage known as active death, the life leaves you by the hour, and the pain increases exponentially. To keep up, the home hospice aides had to increase her pain medications to astonishing doses just to keep her as comfortable as possible.
Monday, February 26—exactly three weeks before Julie died—is a day that will always haunt me. As she became ever sicker, Julie was prescribed a dizzying array of pain medications, and during the weekend before that day it was clear to me for the first time that Julie had become somewhat incoherent. Seeing this shook me deeply, not just because I finally understood the horrifying truth that her life was almost over, but because no matter how much her body had betrayed her or how brutal a particular treatment might have been, the power of her mind had until then been entirely undiminished. Seeing Julie struggle to figure out what day it was, watching her fumble with names, hearing her speak in a whispery voice that was so profoundly unlike hers—those things were, in themselves, utterly devastating. I tried to squelch the panic rising in me, and by searching her phone I was able to figure out that Julie had an appointment scheduled with her palliative care team at Memorial Sloan Kettering for that very afternoon.
By the time we got to the hospital, Julie had rallied and was her normal self, and we sat together in the small room at MSK and waited to see Dr. R.S., the head of her pain management team. As a palliative oncologist, Dr. R.S. encounters an emergency in every room he enters. And yet he is a man who radiates goodness without fail. Taking me aside in the hall, he gently told me that it was “a matter of weeks, not months.” It turned out that he had just said the same thing to Julie, and when I walked back into the room where she was still quietly perched on the examination table, she and I locked eyes in a way that I will never forget. With that single look and without a word, we both knew that it was over.
Dr. R.S. and his team sent Julie directly to the hospital for what was to be the final time. I remember how she wept in the examination room, how she said she wanted to go home to be with the girls, Chipper, and me. Julie didn’t cry easily, God knows, and so I saw it as my main objective at that point just to get her home, no matter what it took. She had planned this part of her illness meticulously, and her plan did not include being hooked up to machines in a hospital. She wanted to die here, at home, in this room.
But first, her oncologist and palliative care team had to get her pain under control and assess her quickly changing condition, to determine how best to make sure that her last days were tolerable without the intravenous medications that only a hospital setting could afford her. With no time to waste, the doctor told us, very bluntly: Get the home hospice team in place, quickly. Make final preparations, now. It was time.
The morning after her hospitalization, Julie was foggy from the opioids, which meant that she was functioning merely at a normal adult level of cognition. And she was tearful,