The moment I open the door, I know.
Grandma is dying.
She’s lying there on her back, arms left and right on the white hospital blanket; they are plump, full of water. Her mouth is a bit open – as always when she sleeps.
The round tip of her nose looks more pointed than usual, and her skin is smoother than I remember. Her chest rises and falls at regular intervals, but her lungs have difficulty breathing; again and again, deep, rattling inhales.
‘Granny?’ I whisper. I don’t want to scare her. ‘Can you hear me?’ No reaction. She’s fast asleep. ‘Granny? It’s me.’ Very carefully, I touch her hand. Nothing. Only the hissing of the airstream in her open mouth and the bubbling of the oxygen bottle in the background.
Just yesterday, I came back from a very necessary trip – even Grandma herself insisted on me going. ‘I know you’re always with me in your thoughts. I love you. I lo-o-ove you!’ she said on the phone, and I couldn’t have known that these would be her last spoken words to me. When I left, the situation was not quite that dramatic. Or so I thought.
She has been waiting for me.
I want to put my purse down and, in doing so, I clumsily kick the chair with my leg. The sound wakes her up. She opens her eyes, and they are huge. ‘Death eyes,’ is what the doctor will tell me later. But I know that already, without knowing it. I also know what I have to do. Instinctively.
‘I’m here, Granny. As I promised you. By your side. You don’t have to be scared at all. With me by your side, you don’t have to fear anything. You know that, don’t you?’
I have always been the strong one, the rock. A tiny nod before her eyes wander restlessly across the room. Right, left, ceiling. ‘Are you in pain, Granny?’ She softly shakes her head. ‘Are you thirsty?’ A nod. ‘Well, we can easily do something about that!’ I open the feeding cup. ‘Shall I mix, Grandma? Half and half with apple juice, as you like it?’ Nodding.
I help her drink. Her lips carefully close around the tip, and she swallows. Then her head sinks back deeper into the pillow, exhausted. I gather all my courage, softly stroking her grey-white hair. ‘You know what’s happening, Granny?’ An almost invisible nod. ‘All right. But I am here, so it is going to be okay. I love you.’
The door opens, and in comes a doctor. ‘Good day,’ he says, and shortly I wonder what he might mean. How could this day be good? I also think: if you come to a hospital as a family member and you don’t have to chase the doctor because he comes to find you himself – then it really is serious.
So I ask him: ‘Shall we speak here or rather in confidence?’ He takes a moment to consider, then he answers: ‘Rather in confidence.’ We leave the room. And in front of the door, he explains the whole situation to me.
Grandma had two infections in the past week, which weakened her considerably. But the real problem is the peritoneal catheter. It had to be put into use way too early, because her kidneys were failing already. That’s why the catheter couldn’t heal properly, and there was a leakage. The end of the dialysis. The end of Grandma’s life. ‘Theoretically, we could perform a haemodialysis on her. But she wouldn’t survive it, and it definitely wouldn’t be humane.’
My stomach clumps together, and I know he is right. I’ve known it since I opened this door. So I take a deep breath. ‘What would you do if it were your own mother?’
‘I wouldn’t let her suffer.’
I can feel my throat close. ‘Do you have palliative care?’
He says no.
‘Do you work with a palliative service?’
Again, he shakes his cotton-candy haired head.
‘Okay. So YOU are the man who shapes my Grandma’s way to the other side?’
‘Well, yes, if you want to say so.’ I believe I spot a hint of gentleness in his basset eyes.
‘All right. Understood. Then let’s talk plain: How can we guarantee that it’s going to be as pain- and fear-free as possible? What can we do? What can I do? She’s agonised enough during the past ten years!’ My voice breaks.
He talks about morphine and tranquilizers and some sort of sleepy state, and I have no idea whatsoever about anything at all.
I’m responsible for her now. It’s on me. And I’d do anything to make it as easy as possible for her.
As soon as he’s gone, I google and call a palliative service with trembling fingers. I’m so glad I did. Very calmly, they explain to me that the biggest difficulties in the process of dying are letting go, distress, thirst, pain, and fear. There is medication for everything, just not for letting go.
That enables me to discuss it afterward with the doctor.
He stops all of her regular medication and prepares morphine injections.
Then I call my second cousin. Anyone who would like to, should come now. But they have all been here already. My Grandma has had visitors every day: her former-maid-now-friend, my mother and her husband, my sister and her boyfriend, my Grandma’s only surviving sister, her favourite caregiver from the nursing home, and my two second cousins.
Even my Grandma’s second niece, who happens to work on the ward on the next floor, came to see her every day. Later, she tells me, ‘She was so happy about all the visitors and said, “How wonderful that everyone came one last time!”’
She knew.
Silently, I open the door and go back to my Grandma. She lies there, and my heart burns like fire. ‘Hey, Granny,’ I say. She looks at me and then restlessly into the air. ‘The doctor said we will be fine.’ I take a few breaths. ‘There are some really nice morphine injections. Like the ones your little brother had, remember? Everything is going to be fluffy. I promise you: it will not hurt. And I am here, by your side.’ She closes her huge eyes and nods slowly.
I walk around the table, so helpless, take her perfume and spray a pump onto her blanket. ‘Just because you’re dying doesn’t mean you can’t smell nice.’ Elegance has always been important to her. It’s the perfume her mother always used, and maybe I should have noticed something when she suddenly bought it weeks ago.
Almost inaudibly, the door opens again and my second cousin enters the room. Moments later, my other second cousin joins us. I definitely wouldn’t have to do this all alone, they assure me, and I am deeply grateful.
With the extraordinarily kind, patient nurse Madleen, we discuss the doses of morphine. As Grandma has been getting morphine pills for her back pain for a long time, she needs a little more. ‘Please give her a shot every two hours or so. The most important thing now is that she doesn’t suffer. Not one more second. She told me that’s what she wanted.’ Once more, I’m glad that we had those difficult, painful conversations a few weeks earlier.
And so we sit around her bed, telling the old tales. ‘Do you remember when…?’ Grandma wakes up now and again and falls back asleep. She is not alone. She is loved. Time passes by unnoticed. The sun sets and the sky glows in every colour – orange, purple, and pink. Directly in front of Grandma’s window and at the perfect angle so she can see the flaming spectacle without even having to move her head.
Maybe there is a Goddess after all.
By now she doesn’t nod anymore, and she can’t swallow. Our conversations ebb away. Softly, I sing the lullaby she used to sing to me when I was a child and slept in her bed. ‘Who’s standing outside, knocking so I can’t sleep all night…’
After that, we are still and silently watch the sun’s goodbye.
There is one word for it: peace.
At some point, my two second cousins leave quietly. I stay. Nurse Madleen comes in. Before she gives the higher dose, I gently lay one hand on my Grandma’s cheek and look into her eyes, really looking at her, deeply. She looks back at me, directly, this one last time. ‘Goodbye, Granny. My love,’ I say, smiling broadly with a tear-streaked face and eyes. A few seconds later, she closes hers.
Grandma and I are alone. I put my big hand on her small one and speak softly, as my tears drip faster and faster onto the linoleum. ‘I don’t know if you can still hear me, but I thank you for your love, with my whole heart. Thank you for raising me. I will never forget you. Because who forgets their mother? I know you said it would be hardest for me when you left one day. But don’t worry about me, Granny. I will survive. I survived so many things. And you will always, always be with me. No matter what I do or where I go. And you don’t have to worry about Grandpa, either. He’s fine and I’ll take care of him. It’s all done, Granny. If you want, you can go now. You’ve suffered enough. You don’t have to be afraid. It’s all right, it really is…’
The last syllables melt into one big sob.
Grandma breathes regularly; there’s no rattling anymore.
And suddenly I start to pray. ‘I know we haven’t spoken in a long time, but on the off-chance that you actually exist and you’re not angry with me – could you please make it so that Granny’s journey will be very easy now? She was a wonderful human being and left so much love here, and it would be nice if…’
She sleeps soundly now, and I become voiceless.
I can’t recall how long I kept sitting there like this, but it’s long dark outside when an inner voice says to me very clearly: ‘You should go now. This is the moment.’ I don’t contradict, and I take my things. A last, ‘Goodbye, I love you. I love you so.’ A last wave with a shaking hand, then I close the door. It’s okay. Is it?
My teeth hurt on the inside from crying, and I can’t stop. I don’t know how I find my way to my sister’s place – she and my mother aren’t in Germany at the moment – but I make it, somehow. I fall onto the bed, take a sleeping pill, wake up at half past six, and get ready to go back to the hospital.
As I put down my coffee mug to leave, my phone rings. It’s the hospital. It’s 7:29. I sit down.
‘Is this Miss Jessica Wagener?’
‘Yes.’
‘Your grandmother passed away this morning at 7:10.’
‘Okay. Okay. Can I see her and say goodbye?’
‘Of course.’
I hang up and slide out of the chair, down on my knees, my mouth open in one silent scream. Nothing is okay.
Then I call people. Then I sit in a cab. Then I stand in front of a white door in a hospital.
I’ve never seen a dead human being, but I open it without hesitation. Granny looks like yesterday, her mouth open a bit – as always when she sleeps. Only the apricot-coloured rose between her folded hands is different. I sit down next to the bed and look at her. Oh, Granny. Granny, are you really dead? I stare at her chest. Wasn’t there a movement? I put my big hand on her small one, and it almost feels like always, and I try to sing our lullaby, but I can’t because I’m crying so hard.
Nurse Madleen appears out of nowhere and quietly says her condolences. She knows exactly which question is troubling me without me having to ask. ‘No worries, she didn’t wake up. She slept deeply and soundly all night. I always looked after her. It was all very peaceful.’ There are no words for my gratitude, so I hug her. And she also knows what else tortures my mind: ‘Some people can only let go if they’re alone.’ And I know because my gran and I had that conversation. ‘The last bit I’ll have to do alone,’ she said.
And that’s what she did.
A little later, Grandma’s second niece, the one who works here, comes in and gives me a hug. We haven’t seen each other in decades, but it doesn’t feel like it. She tells me a bit about Grandma’s last week and how happy she was about all those visitors.
After that, my second cousin enters and helps me with all the calls and things and everything, and I am so, so glad not to be alone in this.
Then we have to do the hardest thing.
We drive to the nursing home to my Grandfather. I have to tell him that his wife of over sixty years has passed away.
I take a seat next to his bed and his hand. ‘Grandpa, you know that Granny was very sick.’ His face doesn’t move. ‘I’m afraid I have bad news. Grandma passed away this morning.’
‘Oh. Oh, really,’ he states. Even if his face shows no expression, there’s plain horror in his voice. I tell him everything, every detail, very calmly and with all the patience I can muster. ‘It was peaceful and painless and full of love. There was a sunset, and I sang for her. In her last waking moment, she was not alone. And it did not hurt.’
After minutes of silence, he clearly says: ‘I felt it. This morning I woke up at seven, and I felt it.’ And I know that this time it wasn’t his dementia.
I also know that we can somehow bear this as a family.
When I drag myself back to my sister’s apartment in the afternoon, I pass a colony of garden plots. It’s a wonderful, lush, rich late summer afternoon, the air vibrating and humming with life. The last rush before everything dies in autumn.
Suddenly, I hear Grandma, incredibly clearly: ‘Don’t be sad, my child. I’m fine, really fine! I’m frisky and jolly. I feel no more pain. I can walk and dance and jump again. If I’d known how amazing this would be – oh, I would have left much earlier!’
There’s an overhanging tree full of ripe apples. Granny’s voice again: ‘Oooh, look at this tree! So many apples! Oh, child – don’t be sad. Don’t cry. Enjoy life and all of its gifts instead. Enjoy nature, natuuure!’
I can’t help but smile. I’ve no idea if there’s life after death or what it’s like. But my Grandma is all right – wherever or whatever she is now.
Yes, life without her is going to be hard. She’s already so thoroughly missed, and always will be. Her wit, her advice, her hugs. Life without her feels like someone took away the cosy blanket. But over ten years of illness, fighting, pain, and suffering are finally over. And we’ll always, always have her with us. Her voice, her comments.
But above all, her genuine, endless love.