As I drove east toward the central California town of Dinuba, I could see the snow-capped peaks of the High Sierra Range. It’s not always possible to see them due to the trapped air from multiple pollutants, but as I made my way to visit Nancy, I couldn’t help but bow to the tremendous power of the Apu, the spirits of the mountains, the designation given to them by the ancient Inca people. I smiled knowing the journey Nancy made to reach her highest self on earth was nearing completion. Nancy faced her demons and was returning to the mother of us all. She faced the mountain with the clearest of vision.
I met Nancy Harris in our Palliative Care clinic when I was covering for a colleague and we kept seeing each other thereafter. As she opened up to me I began to think of our visits more as an emotional catharsis rather than a symptom management visit. We saw each other over the course of several months, and each time I noticed a more profound magnitude of confidence.
Nancy was born in Bakersfield, CA, a few years following World War II. She met her husband Charlie in high school during homeroom class. Coincidentally, they shared the same last name. Their daughter Natalie said, “They were the iconic couple of the 1960s.” Charlie, handsome and athletic, and Nancy, the beautiful cheerleader. They made a life for themselves in Washington State while Charlie played college football before returning to the Central Valley where they settled and raised their two daughters, Natalie and Juli. Nancy eventually returned to college and completed her bachelor’s degree and teaching credentials. She spent over two decades teaching young elementary school children
After much contemplation, Nancy made the decision to stop her chemotherapy, along with the support or her oncologist and family. The decision, her daughters would later tell me, was a huge moment and turning point for her. She was in her sixth year since being diagnosed with a Gastrointestinal Stromal Tumor (GIST). She would smile and tell me the things she was doing. Going to the central coast of California, taking a trip to Paris, and putting herself first—a self-proclaimed unnatural trait for her. But like all my patients, I tend not to see them as a person with a disease but as a human being, and someone who had a life before cancer or any other medical affliction. According to her daughters, she filled her life with good deeds and service to her community. Her passion for helping those with special needs, a devotion to her church and holding a position on the Planning Commission for the city of Dinuba serve as reminders of her civic achievements.
During our last visit at the clinic Nancy disclosed some significant and painful childhood trauma. Each tear displayed a memory of a tragic moment. It was our deepest session. As we neared the end of the hour she smiled and told me, “I am letting this go. I don’t want it to influence my life anymore.” I asked if we could meet the next week and she agreed.
I received an email from Natalie, less than a week later, letting me know that something dramatic changed in her mom’s condition. I was incredulous. I recently saw her and she looked better than I could remember. She was physically and emotionally strong. I agreed to come out to the house at their request. I was grateful they asked as I felt our business was not complete. I met her husband, Charlie, at the door and he led me to their bedroom where I met Juli and Natalie, who held vigil with their Mom. The precious intimacy among them painted a portrait of a loving family. We talked and I listened as they shared their many memorable experiences with their beloved. Nancy lay there peacefully, undisturbed by my presence. I felt the privilege of being there. These transformational moments are seldom lost to me when I realize how fortunate I am to be allowed to share a few moments with a grieving family rejoicing in the legacy-filled life of someone so dear to them. Birth is something we celebrate. Life is something we also celebrate. Death is a time of transition to hold in the same celebratory regard.
After answering some medical questions and saying goodnight, I walked with Charlie to the door. I got into my car thinking the experience had concluded. However, as I drove along the residential streets of Dinuba, I realized Nancy had helped me much more then I assisted her. Emotions poured out of my soul as the healing washed over me. Once again, I was the pupil, and the words of the lesson were for me to absorb. The paradox proved undeniable. The mountain was no longer visible in my rearview mirror. The past no longer owned the moment, and the future was only a mirage. Emerson wrote, “what lies behind us and what lies before us are tiny matters compared to what lies within us.” Nancy and her family penetrated my seeming impervious veneer of steel physician’s armor and touched my humanity.
I received a message the next day that Nancy had taken leave of her physical body. I felt her spirit laughing and flying freely. Free from any earthly bondage that might conspire to chain her to the posts of worldly regrets. I smiled again knowing she left on her terms.
Nancy was a loving and committed grandmother. She retired from teaching after she was diagnosed with cancer to spend more time with her grandchildren, Natalie shared with me. She also entered a clinical trial in an effort to help future generations affected by cancer. Her selflessness splashed effortlessly onto those she loved and the community she served.
The mountain, a universal metaphor, lives as an archetype in the collective unconscious of our mind. I witnessed Nancy become the mountain. For her, it was not a hurdle to surmount, or a battle to face, nor an emotional hike but the embodiment of what is holy, healing and real–the essence of life, or Sami as known to the Inca. Her journey is boundless, and her spirit breathes eternal joy onto those whose mission is unfolding.
Nancy became the Great Teacher of all lessons. Her legacy, I suspect, will have a variety of meanings to everyone she touched, including all her students from decades of teaching. Juli proudly told me that many people attended her mom’s memorial service. She described her mom as a person filled with compassion and love and whose encouragement touched many souls. I knew Nancy only a short while, but her impact shattered the hollow bones of my destiny. As I contemplate her transition I imagine her returning to the birthplace of wisdom, grace, and spiritual healing.