What We Talk About At The End Of Life
By Leah Carey
Oct. 25, 2016
As Arthur “Mickey” McCann lay dying in 2012, his children gathered at his bedside.
It was the type of gathering that many might imagine as their ideal ending – Mickey lead family prayers from his bed. He spoke about how grateful he was for the life he’d had and looking forward to seeing his wife again. He offered words of wisdom to his children.
Over the days, he spent less and less time in lucid consciousness. The family took shifts sitting with him and holding his hand. And then they started writing down the things he was saying – because, while he wasn’t fully present, he was still speaking.
“Have I gone?” he would ask.
“I guess this is about it. This is the end of my life coming up.”
“My feelings are mutual. You’ve done so much for me. So long for now.”
“For all that you’ve done throughout the ages, I thank you.”
Two of his children, Darcie McCann of Lyndonville and Kellie Pearson of Santa Barbara, California, spoke with me for this article and said that many of these utterances happened when Mickey was “semi-comatose” and that they didn’t sound like his normal conversation.
“Those are not words that my dad would say in common conversation,” Darcie said. “I don’t think he was talking to us.”
“Through this whole process we were kind of frantic to hear everything he said,” Kellie remembered. “You didn’t want to leave his bedside because you were afraid you were going to miss something.”
“We just had this great sense that he was greeting people and negotiating with people,” Darcie continued. “At one point, negotiating with somebody about, Why can’t I go now?”
The angels say enough
Lisa Smartt has spent the last several years studying end-of-life utterances like those that the McCann family recorded at the end of Mickey’s life.
She has a degree in cognitive linguistics and a great love of language. She turned her attention to the language of the dying as her own father was approaching the end of life.
“I was taught as a linguist to write down whenever I heard fascinating language,” Smartt said. “[My father] started saying things that blew me away, so I would write them down.”
He would vacillate between lucid conversation and seemingly nonsensical conversation from moment to moment.
Smartt remembered him looking right at her and saying, “Honey would you get me some orange juice?” and then a moment later saying, “Get me my oxygen tank for my trip to Las Vegas.” There was, needless to say, no trip to Las Vegas in the offing.
“A couple days before he said, ‘Enough, enough, the angels say enough. Three days later and it’s time to go,’” Smartt recounted. Sure enough, three days later he died.
“He said to me one day, ‘Lisa, there is so much so in sorrow,’” she said. “There are these incredible pearls and fascinating things that he said. So I wrote this stuff down.”
She assumed that she’d be able to look them up in a linguistics database and find information on people’s final words. “There was nothing,” she said. “There was stuff about end-of-life directives, but nothing about the language of the dying itself.”
In response to the lack of information, she collaborated with famed end-of-life researcher Dr. Raymond Moody to create the Final Words Project where they collect people’s end-of-life utterances.
They have discovered several common themes in the collection.
Visions and hallucinations
Smartt sees a clear delineation between hallucinations and end-of-life visions.
“If you’re highly medicated, you might have hallucinations,” she explained. “But the quality of the visions that people have at the end of life – of parents, or seeing beautiful landscapes – they have a very different quality. They tend to give people comfort.”
It’s not uncommon for a dying person to speak about seeing angels or previously-deceased loved ones in the room.
Smartt said that while hallucinations tend to be hard to break out of, people move in and out of visions and lucidity seamlessly, sometimes seeing both at the same time.
“Somebody might say, ‘Can you get me my checkbook, I have to pay at the gate.’”
Language of travel
A frequent topic of conversation for the dying is travel (this was also discussed by Martha Jo Atkins in part 10 of this series).
“My dad, he talked about taking the trip to Las Vegas – packing the suitcase, the bus, the plane, the train, the passport,” Smartt said.
“People seem to think more and speak more and respond more to metaphor,” Smartt said. “People talk about the big, momentous event. Golfers talk about the big golf game coming up, and they need one more player.”
These events usually relate to the person’s interests in life – someone who loves dancing might talk about the upcoming dance party; an artist might speak about a big art exhibit.
“There was one women whose father was a contractor and he went, ‘Oh my oh my, so many kitchenettes to remodel!’” Smartt said. “You could say, ‘Daddy, you’re crazy.’ But you could say, ‘I’m so excited for you, tell me about these kitchenettes!’ Really we don’t know what’s crazy or not crazy. Even if there is nothing beyond this world, this is the person’s experience in that moment.”
Repetition and intensification
In addition to the subject of conversation changing, so does the quality of the language, Smartt said.
“There are more cases of intensified language, and really complex uses of repetition,” she said. For example: “How much wider does this wider go?”
Smartt said a common assumption is that language will become simpler as people die, but in truth it often becomes more complex. They begin to resemble the language of music more than the linear language that we associate with conversation.
“I think we’ll find that as we approach death, the parts of our brain that are more associated with less verbal states – music and spiritual states … rhythm, intonation – I think those things become more prominent as we die,” Smartt said. “But I’m just guessing. These are total conjectures now.”
She still has much more studying that she wants to do – and, since people die every day, a nearly endless stream of study subjects.
If you have final words of a loved one to share, visit Smartt at www.finalwordsproject.org.
As her energy waned in the final week of her life, my mom was speaking less and less. Her voice became weaker. The things she said took on greater importance in my mind because there were fewer of them.
It was three days before she left us that we had the conversation that will live with me forever.
There were three of us in the room with Mom – her best friend and co-caretaker Sue, our good friend Julie, and me. Julie sat at Mom’s bedside as Sue and I did other things.
My ears perked up when I heard Mom say, “We’re in a car on our way to Tilton to see Julie.” Since Julie had just come up from Tilton to see Mom, and was currently holding her hand, Mom was clearly not participating in the same reality that we were.
Then Mom asked the question that let us all know that something different was going on: “Are we in a city?”
I said, “No, Mom, we’re in your living room in Franconia.”
With all the irritation of a mother whose daughter isn’t listening, she said, “I know where we are! But are we in a city?”
Us: “No. Why?”
Mom, with wonder in her voice: “Because there are all of these people here.”
Us: “Do you know who they are?”
Mom, with her eyes tracking back and forth under her closed eyelids: “Some of them.”
Us: “What are they doing?”
Us: “Do you want to go with them now?”
Mom: “No. I need two more days.”
Us: “For what?”
Mom: “To finish my library work.”
Us: “It’s okay. We can take care of that for you.”
Mom. “NO! I need two more days. Two more days!”
I will probably always wonder what the work was that she needed to do in those two days. Sure enough, it was on the third day that she left us.
The memory of that conversation still gives me chills. I think of it often. It reminds me that, no matter where Mom is and what she’s doing, she’s not alone. She’s got a whole city of people who were waiting to welcome her.
And there’s one other conversation that I hold dear. It was very different, and one of the greatest gifts my mother ever gave me. It’s the one that reminds me that no matter how alone I feel, Mom is always with me.
She had slipped permanently beyond the point of lucidity. She spent much of her time moaning and thrashing. It was upsetting, but I sat with her almost constantly.
When things seemed particularly difficult for her, I would often say through my tears, “I know this is hard, Mom, but you’re doing a really good job. I’m so proud of you.”
She made what I can only assume was a tremendous effort to bring herself back from whatever realm she had moved on to. She looked right at me and said, “You’re doing a really good job. I’m so proud of you.”
Those were the last lucid words my mother ever spoke. I carry them as a seal upon my heart.