Got a text message from a friend last night informing me that a mutual friend, who lives out of state “Is in full kidney failure, not expected to last much longer.” At this point in my career such news isn’t exactly “new.” I’ve experienced the death of friends, even those who, like this one, are younger than I. Two of my sisters and one of my brothers has died. I’m old enough to know that my generation will go the way of our forebears. We are mortal. We won’t go on forever.

Thinking of our friend, I tried to imagine how things are for him and his family. He’s been through a lot of health challenges and problems over the years. He is a brittle diabetic - lost a leg to complications of that disease a few years ago. There must have been a series of really tough decisions along the road for him, his wife and their children. End-stage renal disease is most often treated through dialysis with the hope that a kidney transplant might become available. I know people who have been dependent on dialysis for years as they await the outcome of the disease. I also know a few who have been lucky enough to obtain kidney transplant. Years ago another friend received both a kidney and a pancreas in a transplant and had a wonderful period of health following the operation. He was free from diabetes for that time and was able to live without the restrictions of dialysis multiple times each week. The end result, however, was a premature death. It didn’t last. None of us last forever.

When your kidneys are not able to filter the wastes and excess fluids that are in your body, all sorts of things get out of balance. Fluid starts to build up. Your feet and ankles swell. Worse, fluid build up around your heart. You can experience chest pain and shortness of breath. Sometimes fluid builds up in the lungs themselves. Your blood pressure rises. Nausea, vomiting, fatigue and weakness and sleep problems increase. You start to itch all over and the itch can’t be satisfied. Your muscles cramp and twitch. As all of these problems increase, your mental sharpness fades.

I don’t know what decisions our friend has made, but it sounds like they have decided to forego dialysis and simply provide care for the symptoms. His wife is an experienced pastor who has certainly been at the bedside of many who have made different end of life choices. She is a realist who has officiated at enough funerals to know that grief is a reality that cannot be avoided. I have no doubt that they have had long conversations about quality of life and the choices that need to be made.

He was such a jock. I am so not a jock. That didn’t stop us from being friends or having a lot of interests in common. He taught me a lot through the process of being an athlete who had to learn to walk with a prothesis and readjust his life to a permanent disability. He taught me that dietary restrictions and a chronic disease don’t have to rob you of your joy of living. His laugh was so deep and hearty that it filled every room he entered.

She demonstrated that a person can be spitting mad at someone and still love that someone unreservedly. There has always been fire and spunk in their relationship. They can disagree and love fully at the same time. My heart breaks when I think of her at his bedside. The skills honed over a career of being a pastor are of no help when it is your spouse whose hand you are holding. Theories of life and death and resurrection and grief and healing are all distant thoughts, but not immediately relevant to the moment. Her vigil is surrounded by a huge community of people who care, pray and offer support, but ultimately a hospital can be a lonely place when there are no more words for your prayers and no place you want to be than right where you are, even though you aren’t sure how you ended up in that place.

A different friend, who is a physician, commented to me in a conversation last week that no matter how much we learn, death is always a mystery. It forces us to face the unknowable. Some who have been resuscitated from near death experiences report a dream-like quality to the experience. Others have no memories of that period of time. I imagine that our friend’s mind is clouded by the disease and the drugs that are administered to treat the symptoms. Comfort care almost certainly means a reduced awareness of what is going on and perhaps a reduced ability to relate to the loved ones drawn to your bedside. It may be like hovering on the edge of sleep, dozing at moments, aware at others, but not really able to focus you attention.

Knowing my friend, his natural athleticism will be a factor. He isn’t the kind of person who simply gives up. Even if he had made the mental decision to accept death, his body has a great deal of strength and he has lived his life pushing the limits and the odds. This could take a bit of time. Not that time has much meaning at the border of life and death.

We join the vigil that is taking place there. I even thought of what I might say in a sympathy card when the vigil comes to its conclusion, though it is too early to write such a missive. Their sons are about the same age I was when my father died. His wife could easily have decades of widowhood like my mother. Life goes on. Even though we never get over the loss, we are not disabled by our grief. We speak of resurrection and reunion and we live in hope, but we realize that those, too, are mysteries that we do not fully understand.

Mystery inspires awe and wonder. “O Lord my God, when I in awesome wonder . . .”

Copyright (c) 2020 by Ted E. Huffman. I wrote this. If you would like to share it, please direct your friends to my web site. If you'd like permission to copy, please send me an email. Thanks!