Yet again, reminding all you medical people out there, most folks do not see dying on a daily basis. And most folks would not consider any bit of it “normal” (i.e. “usual, typical, and common”). We hospice people like to say that we “normalize” symptoms for family, and prepare them for what to expect when their loved one comes close to death. But even the “experts”…the hospice team…don’t know any more than the next guy out there sometimes, what is the best route to take.

We “experts” are perplexed, confounded, and at a complete loss at times for the right paths-like preparing the patient who may bleed tremendously at the end of her life from her lack of blood cells due to her Leukemia, or the man whose breathing will be in the vice grip of respiratory failure from his ALS. What to do, what to say, to make any of this very real and terrible process seem normal? Death sometimes comes gently without much fanfare, and sometimes arrives like a roaring lion.

I was blessed at the end of November to witness a birth, fraught with danger due to the mother’s preeclampsia and the baby’s incomplete gestation, and heard the nurse say, “Even though there are procedures and guidelines that we use in each birth, your baby’s delivery will be a totally unique experience”. Ah, I thought, here is someone who knows; we can make it all seem regular and usual, but it never is…

And in this case: a birth that included an unexpected life flight to a major medical center with the mother; while we all waited to know if this very predetermined, “ordinary” process-birthing- was going to be survived by the mother of the baby. We take so much for granted, when considering the events of birth and death. I had a patient today, when I asked how she visualized her dying, tell me she expected to “just die in her sleep”. (Sounds so easy, so normal and natural!) I certainly did not expect the arrival of my newest grandchild to be a life and death struggle, I was anticipating a “normal” birth, just as all my deliveries had been. The delivery nurse was so right… we had “a totally unique experience”.

And so it is with dying: “normal”…yet one of a kind.