A Lesson from Death: Be Present to Everything
All the grit and all the grace.
This post shares the accompaniment of a friend who passed after managing a terminal cancer diagnosis. If you’re seeking support for cancer related concerns or questions, please reach out to the American Cancer Society’s Hotline.
Sabrina walked steadily toward me independently, dragging a roller bag on the filthy streets of New York City. She arrived with the sun that morning just after a red eye flight, followed by an Uber ride from the airport to my one bedroom attic apartment in the Bronx. Casual clothes hung off of her ever-thinning body, while a beanie covered her now pixie-length hair.
“The best breast cancer doctors are in New York City, Jo.,” she educated me. “I need another opinion.”
The memory of the last time I had held Sabrina had left me. Certainly it wasn’t at the end of our study abroad program in El Salvador in the Spring of 2007. I had seen her since, maybe in San Francisco when we both lived there. Now 17 long years later, the leaves fell from the nearby trees on the streets, as her warm body met mine in a loving embrace after far too much time.
A year or so before, doctors diagnosed my 38-year-old friend with Stage 4, triple-negative, metastatic breast cancer. I made sure to understand what that all meant before she arrived:
Stage 4: the worst and final stage of cancer.
Metastatic: the cancer had spread throughout her body. By this time, it lived in her left breast and her leg, then advanced too quickly to her jaw and brain.
Triple-Negative: the tumors lacked the three primary bio-markers chemotherapy attacks to shrink cancer cells.
“If I had a magic wand,” the specialist began, while pulling back the thin gown to reveal an upside down shaped, pink tumor sticking out of Sabrina’s left armpit. “What would you want me to do for you?”
Sabrina smiled wide—her full lips stretching across her narrow face—like she always had when happy or mad, then laughed.
“I want to live!” She said. “I have a three year old.”
Sabrina’s hope matched the aggression of her breast cancer. I could feel both the weight of her fatigue and the strength of her will when I held her narrowing waist, as she wiped her crying eyes on my shoulder. The doctor offered no new information except to try the clinical trials Sabrina had researched in advance of the appointment.
We took the D subway home and rested. As soon as we arose, we dove into clinical trial research. She found studies realistic to her constraints that might shrink her tumors at best or restrict further expansion at worst, while I became her cancer ChatGPT: reading, translating, and interpreting complex medical jargon, benefits, and risks into understandable brain-bites for her already flooded-too-full mind with chemo fog and sorrow and grit.
I’m ashamed to admit how fascinating I found the content, while my suffering friend wrestled with whether to participate in the early-stage trials that might save her life or end it sooner. We called treatment centers, talked to physicians, left messages on machines, but all for nothing. None of the trials accepted the dying mother who sat before me.
For today though, we were living—and in New York City no less! A former home of Sabrina’s when she served the city’s most vulnerable as a social worker, NYC held Sabrina’s other old friends. I grabbed the tickets for us both to see the newly released Broadway show, Hell’s Kitchen, based on the teenage years of Alicia Keys. We headed back into the city and jumped on the D to meet her friend for pizza.
In the dimmed light corner of the restaurant, I watched Sabrina, as she caught up with this old-friend-to-her and stranger-to-me. Awe pooled my eyes with tears, as I caught my sweet Sabrina so suspended in the present. She did not hide the gravity of her grief, nor succumb to it. Her joy stayed just as stubbornly on her face as that tumor did on her left breast. Life and death lived so harmoniously in my friend’s thinning and resilient body. Her and her friend took turns sharing stories, as cheese stretched between sharp teeth and hands holding tomato-sauced bread. And I had the pleasure to witness this, hiding my glittering eyes and grateful and grieving grin behind the cornered shadows to not draw attention to my soft cries.
We said goodbye to her friend and headed to the theater to watch the play about the nascency of life, the courage of creativity, the grief of death, and the longevity of memory. I reached across the arm rest between us, grabbed Sabrina’s hand, and squeezed it gently during the funeral scene.
When her skin met mine, she handed me—whether intentionally or not—this simple truth: that presence was the point.
To be present meant to hold everything—the pain, the purpose, the pursuits of the now, and the back then, and the what will be—simultaneously. Death and life are no more a binary, than the passage of time is a linear chronology. Instead, existence is just this: two friends holding hands, watching the world in silence surrounded by the violence and vision of life, while both dying. She, simply faster than me.
Sabrina returned home to her husband and her daughter a few days later and left me one request: “Will you organize a reunion for all of our study abroad friends?” She left the word “urgently” out, but she knew I knew it had to be soon.
A few months later, I returned to a former home of mine to be with Sabrina, and I was not alone. 16 of the 24 of my study abroad classmates flew, or drove, or took public transit to the two Airbnbs we rented near Sabrina’s home in the San Francisco Bay Area. It was Dia de la Amistad Weekend—or “Friendship Day” as celebrated in El Salvador—more commonly known as Valentine’s Day. Instantly, it was as if we had never left that country called the savior all those years ago.
Nearly forty now, our adult selves certainly still reflected the bright-eyed hopeful glow of our youths, but our faces frowned with fine lines, and our hearts held the responsibilities of families and careers, and our shoulders carried the weight of the future we could not see back then. The one where as many of us who could would gather for the first time since way back when to celebrate the life of our friend Sabrina. And to say goodbye.
For three days, we ate and sang, reflected and prayed, scrapbooked and slept, visited the local beach and swam in the sea. Played. Sabrina—dependent on a wheelchair now for mobility—joined us almost the entire time, and her daughter and husband for the scrapbooking evening. Together, her three-year-old and the rest of us cut and pasted pictures and glitter and captions to colorful pages that we all pulled together in a three-ring binder with letters written about who Sabrina is to us. So that when the taller-than-a-toddler could read in the future, she could remember the past of her mother through the present memories of her mother’s friends. We left our contact information too, in case that little one growing so big, so fast ever desired to reach out to us.
Sabrina was ready to return home to rest. So, one of the musicians in the group blue-toothed a favorite Salvadoran song to the speaker, “Casa Abierta,” or Open House. The guitars strummed in the background and the singers sang, while we all watched each other, one-by-one, approach Sabrina to say a final goodbye. With the support of a walker, Sabrina stood up and held us one at a time, wrapping her barely there arms around our full and healthy bodies. She looked each of us deeply in the eyes and said, “I love you.” Then, “I will see you soon.” We all knew how unlikely that was, but chose not to question her persistent truth. Sabrina clung to the hope of a miracle like her body stayed so attached to the future where she could raise her only daughter.
A few days later, Sabrina and I returned to the doctors’ office. Wound management was the best they could offer her now. The physician removed the bandage from her tumor, which had spread across her left breast. Red pustules filled with puss pushed up through the skin, a gaping necrotic wound wrote the future of a daughter who would lose her mother any day now. On Easter of the same year, Sabrina joined our ancestors.
A number of our friends flew out to attend the memorial, where they could mourn alongside Sabrina’s family. Her young daughter wept with sadness and leapt with joy throughout the celebration among her generous community. The miracle of Sabrina’s life continues to connect the now 23 of us—who met in Central America nearly two decades ago—back into regular and intimate relationships, as does the sadness of her life lost far too soon. We all stay in touch via a group chat and plan on meeting every year to celebrate our lives and commemorate the death of our beloved friend.
Sabrina returns to me often in my memory, usually while I’m walking. I imagine her, with that gorgeous smile that could so effortlessly communicate both, “I celebrate your joy!” and, “Don’t ever think like that again.” Now, Sabrina bears witness to my existence: my living and my dying all at once in community. And reminds me to hold the paradox of the present nestled and trapped between the former and the future: all that has been, all that is, and all that will be. This continues to be her gift bestowed upon me: to be with life and death in all of its painful complexity and live in awe of this devastating beauty.
Rest in peace, my love. Thank you for your being.