Death is inevitable. But for many it remains the last taboo. Modern medicine means we can prolong life like never before. Assisted dying legislation currently before Parliament may mean – in special circumstances – we can control death like never before.

Health Central’s Death series will explore the health aspects of death & dying in New Zealand. This is the forth of eight in-depth feature and opinion articles.

Ice cream and pineapple, for me, will always be associated with dying.

As a seven-year-old, my farming family would go into town every Sunday so my parents could visit my Nan in hospital. Us kids were left behind at Grandad’s house and when they got back we had dinner – with ice cream and canned pineapple for pudding – before we drove home.

The adults had decided that our last memories of Nan would be of her at home propped up on pillows on a bed in the lounge – with one arm slim and the other strangely swollen with lymphoedema – reading stories to us; not of her final weeks of dying of breast cancer at the age of 70.

It may have been the right response. It was a fairly typical response for Pākehā families of my generation and a fairly typical example of end-of-life care in the 1970s.

That childhood experience not only subtly shaped my attitude to death and dying, it was also my only intimate experience of the dying process for many years. My other grandparents and elderly relatives died in their 80s after short, age-related illnesses, while I was living far away. And I didn’t go out of my way to become more intimate with the realities of death – staying well clear of open caskets at funerals and turning down the opportunity to join my cousin in viewing a special great-aunt at the funeral home.

So I was ill-prepared when, at the age of 36, I found myself as a carer at the deathbed of my best friend.

To be honest, I was not there by choice. I knew when I flew to the UK to visit her that there was a good chance it would be the last time we saw each other – unless a long-awaited lung transplant eventuated – but I had envisioned a teary farewell at an airport, not being present when she died.

I was definitely more scared than she was. She was in her own home, her child sleeping upstairs and her husband close by. It was what she wanted. I wanted to be anywhere else but there. Her kind but busy GP had spoken briefly to us. But even though I was at that stage childless, I knew more about what to expect in childbirth than I did about dying.

Her husband and I did our best. I know now her death was a quiet and gentle one, with none of the more unsettling symptoms that death can bring. With morphine pain relief she drifted into sleep, grew colder and colder as her circulation retreated into supporting her vital organs, and in the wee hours of the morning she gave a gentle cough, dribbled a little blood and was gone.

I expected to feel sad – and the loss was intense, but it was also profoundly peaceful, which I didn’t expect. And after wanting to run away, I found myself sitting and talking to my now dead friend as I combed her hair. My fear of the unknown that was death and dying had not disappeared, but it had dissipated to the point that it felt right to stay with her body.

As I’ve moved into middle age, I have lost more friends and family but was not present at a deathbed again until last year.

This time it was my much-loved sister-in-law (and aunty of my then-16-year-old son), who was dying an hour’s flight away. And this time it was in a hospice as the dying process and managing some of the symptoms of dying was more complex.

Again, when I booked the flight I didn’t expect to be at her deathbed – but in the intervening weeks her terminal cancer advanced and just before my son and I flew in she was diagnosed as dying.

Nearly half a century on from my own “ice cream and pineapple” protection from the realities of dying, I found myself worrying – like my parents before me – whether I was doing the right thing in taking my son to his aunty’s deathbed. Should my son’s last memory of his mischievous and fun-loving aunty be of her teasing his grandfather over Christmas lunch, or of her being semi-conscious, bald and breathing strangely as her body began to shut down?

But he was a teenager, not a seven-year-old, so I explained as best as I could what to expect and gave him the choice. He chose to come and say goodbye. We bought a silly soft toy we thought she’d love and joined her family for the afternoon in her sunny hospice room.

She only woke once that afternoon – to the family’s quiet amusement it was to the deep sound of her son-in-law’s voice, not the voice of her partner, children or grandchildren. And when my son sat beside her and took her hand to farewell his aunty in his own way, I was so proud.

It wasn’t an easy introduction to the death of a loved one but it had been the right choice for both of us. It took me decades to acknowledge and dispel my fear of death, but now I hope to have broken that cycle for my son so his experiences of death and dying to come may be approached with less fear and more understanding than my own.

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