On May 10, 2006, my wife and partner of a quarter century, Deborah "Misty" Gerner, who was under treatment for metastatic breast cancer, asked me to call her nurse practitioner concerning a series of odd symptoms she had been experiencing. I called and explained these as best I could, and the response was quick and to the point. "Phil, get her in here immediately—in the four years we’ve been working together, this is the first time Misty has ever asked you to call me, rather than calling herself!"
A few hours later, a CAT scan showed a large, rapidly growing tumor in the lining of her brain that had been invisible only a few weeks before. Misty’s struggle against metastatic disease, which she had held off far longer than most people, had finally encountered an insurmountable obstacle. The prognosis: she had days, or—at most— weeks, to live.
Misty and I met in our late 20s, both coming from earlier failed marriages of the "young and stupid" variety that, in retrospect, would have better remained co-habitation. As a consequence, we lived together for quite some time before getting married. Our "first date," I liked to joke, was a six-week trip to Egypt, Sudan, Kenya, and Europe, though in fact we’d been involved for several months before that. Our "engagement" occurred on a snowy New Year’s Eve in a borrowed apartment when we decided, "What the heck, why don’t we get married!" This was several months after we’d purchased a house together. Our wedding was two weeks later on a -10 degrees Fahrenheit Chicago evening. The union was legalized by an ordained Presbyterian seminary student on whose dissertation committee I was serving; the premarital counseling consisted largely of a theological disputation between him and Misty—an Earlham religious studies major—on the extent to which the Almighty needed to figure into the ceremony.
This was obviously not a marriage under the care of a meeting. In different circumstances, it might have been—Misty was a member, and I a regular attender, of Evanston (Ill.) Meeting at the time—but we were in a commuting relationship, and in town together for just a couple of weeks, so the situation dictated instead a syncretic civil-Presbyterian-Quaker ceremony in a home with a dozen friends (mostly small "f") in attendance. Our honeymoon was breakfast at our favorite restaurant, and then I was off to teach a 10-am class.
Our situation was not ideal in those first years (is it ever?), as we dealt with professional demands that, at times, seemed (and quite likely were) explicitly designed to break up relationships: The 25-person department where I worked had only one person who was not divorced at least once, and it had experienced two spousal suicides the year before we started dating. Misty was the first tenure-track female professor in her department in her first job—at a Big Ten institution in the 1980s—and left there after a year. We spent three years commuting, first by car, and then by plane. Misty finally landed a temporary position at my institution, but multiple attempts to "solve the two-body problem" failed. In one ironic case, I received an afternoon phone call that began "Phil, I think we’ve finally found a position for you . . ." from an institution an hour away from one from which Misty had resigned that very morning.
We eventually found two quite satisfactory jobs at University of Kansas, though even there we faced strong resistance from senior colleagues, one of whom told us straight-out shortly after we arrived, "This department should never have hired a couple." Nor has it ever again. (The progressive social orientation of U.S. academia is, I would suggest, vastly overstated.) But the situation was good enough and, after carefully keeping our work separate until we both had tenure, we embarked on a long and highly productive research agenda that combined Misty’s interests in the Middle East and mine in the statistical analysis of political conflict. These efforts yielded the satisfaction of peer recognition, several National Science Foundation grants, and Fulbright awards for each of us to teach at Birzeit University in the West Bank, where we lived in an apartment just a few blocks from Ramallah Friends School.
Our offices were in the same building, eventually just down the hall from each other, and we generally went to work and returned at the same time, as well as sharing lunch whenever we didn’t have anything else scheduled. More than a few times we were told—in that self-conscious joking manner that tells you the person is fully aware of the implications of what they are saying—"I couldn’t possibly work as closely with my spouse as the two of you do." To which one could only smile and say, "Well, it works for us."
Our union was, like most successful relationships I’m aware of, one of complementarities, both at work and at home. Misty was comfortable with people, I with machines; our research project involved a system that required both human input and technical complexity. We could not have done this without each other; others had failed to construct similar systems, either because they could handle the people part but not the technical, or because they had created a complex computer program but failed to motivate humans to provide the knowledge required to make this relevant to the real world.
The pattern continued at home. In our first few months of living together we tried, following the hyper-egalitarianism of the age, to split household responsibilities equally. But in time we realized the virtues of specialization. It was clear I would never master the subtle interactions between laundry technology and women’s clothing ("Read the labels? What labels?"), and my attempts to do so typically resulted in devastation sufficient to create a temporary blip in the stock price of T.J. Maxx. While Misty enjoyed cooking on special occasions, she was more than happy to leave the day-to-day routines of putting food on the table to me.
And so this went on for a quarter of a century, during which time we became more and more likely to finish each other’s sentences, to know with a glance when the other was ready to leave a party, to settle into that familiarity—a vision of Hell to those in their 20s—where the most enjoyable thing in the world was to spend a Saturday evening together at home, sitting in the living room by the fire, quietly reading.
The relationship was not without its challenges, of course, and we spent quite a bit of our first years figuring out how to negotiate those. In most instances, old wisdom rang true. Most importantly for us: never go to bed without resolving an argument. Turning anger into humor was another, resolved in the final years—when the combination of the seemingly unlimited side effects of cancer treatment, pain, and ever-present uncertainty introduced many occasions of stress—with our adopting our own scapegoat-mediator, a little rubber shark, acquired on a trip to Hawaii, which squeaked when you squeezed it. The shark could be invoked to either mediate a dispute or accept blame for it as the occasion required. Silly?—Yes, but it worked.
By May 2006, we were three months past celebrating—or not, as Misty underwent major surgery the next day to replace a hip destroyed by metastatic lesions—the 25th anniversary of our (actual) first date. By that point, we had spent close to five years—first in 1995 with her initial diagnosis, and then from 2002 onward with the metastatic disease—in visits to the cancer center, with all its attendant expectation, hope, and fear. And now, unambiguously, we had come to the final act.
What followed was, without a doubt, the most extraordinary six weeks of my life as I cared for my dying companion. And not just for my life, but for our relationship.
As the tumors grew, Misty’s mental abilities deteriorated rapidly. On the day before the diagnosis, she had taught—with complete competence—the final class of the semester, on her beloved—if ever exasperating—Middle East, and I have no question that by sheer force of will she kept the effects of the tumor at bay until that point. But now its physical impact was overwhelming, and her brain began to suffer the ravages of the disease. Her speech first became unsteady, then positively quirky (she lost the ability to deal with nouns in otherwise grammatically correct sentences); her eyesight deteriorated; she was soon confined to bed. A brief attempt at whole-brain radiation therapy had no effect, and after ten days, with the consent of her medical team and plenty of tears all around, we stopped curative treatment and shifted into hospice mode. Misty’s firmest wish, which she had expressed a great many times, if incapable of expressing it then, was to die in our home in rural Douglas County, Kansas. It now rested on me to see that wish fulfilled.
It proved to be remarkably easy. At the time, and still three years later, I view that period as a remarkable experience, not one of trauma. Call it the miracle of death, in the same way that we think of the miracle of birth. A child is formed in an act of love, is born, is cared for through years of helplessness, matures, and with effort and knowledge and no small amount of luck grows into a healthy, happy, and complete adult. It doesn’t always work out that way, but as often as not it does.
And the miracle of death? An adult who has accomplished much, who was autonomous, in and of the world, the life of the party, the lion of the office, or the caregiver who could always be counted upon, now lies on a bed, taking shallow breaths, completely under the care of others, and turns inward, first to sleep, then away from food, and finally away even from water (yes, that happens). And then that person departs to a state that we imagine in so many different ways, and which, unlike so many things that we merely imagine, we will all someday reach. A truly remarkable set of events.
And the other miracle of death is the sheer cussed irrationality of this whole caregiver thing.
Relationships are built on reciprocity, are they not? And yet, where is the reciprocity of caring for a dying spouse or parent or friend? In a few days, or weeks, or months, the dying person will be gone, and then day-to-day life will carry on. There is no quid pro quo. And yet in precisely that time where we can expect no reward, our inclination is to give the most. Why?
That is the mystery, or the miracle. I recall reading about an excavation of a Stone Age campsite where the skeletal remains included those of an individual who had suffered grievous injuries that rendered them clearly incapable of obtaining food. But that individual had lived sufficiently long for some of those injuries to partly heal: incontrovertible evidence that they had been cared for. Here, the archeologist concluded, we are dealing with individuals we would unquestionably recognize as human.
Misty—as was her wont—lived well beyond the initial prognosis, but in the end she died, resting quietly in her own bed, a little after noon on June 19, 2006, at the age of 50. And with that, the vow we had taken together two decades earlier, that our marriage would continue "as long as we both shall live," was fulfilled.
I don’t pretend that this happy ending—and I do regard it as happy—is possible for everyone. We were very fortunate in our circumstances. We were two upper-middle-class professionals with full medical coverage, who were trusted with large quantities of potent painkilling drugs. At no point did her medical team pressure me to resort to heroic measures. I had a job I could simply drop for weeks without repercussions. Our legalized, heterosexual relationship was provided full protection by the powers of government, and not—as some relationships are—subject to the meddling of persons adamant that their highly selective readings of ancient and dimly-understood texts take precedence over the here-and-now of ties that may have been bonded in love for decades. Misty’s medical circumstances were such that, with the assistance and advice of hospice professionals, and the aid of a loyal set of—again, utterly irrational—friends (several, as it happened, Friends), I was able to provide palliative care in our home.
Change any of those circumstances and things could have been considerably more difficult, if not impossible. We were lucky; we made some of our luck; we prepared for the unexpected; and some things just broke the right way.
In the months and years that have followed, I have been constantly told, "I can’t imagine what you went through." And, "I couldn’t possibly do what you did."
On the second point I reply, in all sincerity, "Yes, you can and you would." Or, more completely, just open your heart, let your basic nature, your instincts, that of the Divine in all of us—or whatever you want to call it—be your guide, and you will do just as I did if the circumstances permit. That basic human impulse that sustained life in a broken body at a primitive campsite tens of thousands of years ago sustains it today, if you just let it. And that basic human impulse is simply love, is it not?
In terms of never imagining what I went through, prepare for the possibility that you will not just imagine it, but experience it. For those of my boomer generation, this will occur with increased frequency. Misty and I just got there a little earlier.
A relationship came to an end. This happened very gradually; I spent the next year largely in a natural process of slow and gentle grieving, combined with the complexities of finding good use for the material accumulations of a life that had ended well short of the promised three-score-and-ten. I kept an aphorism on my desk: "The only way out of the desert is through it." As months passed, I imagined myself first wandering aimlessly, then getting a sense of approaching the edge of the desert, and then finally, after a year or so, I had left the desert—still wandering, mind you, but wandering in the forest, and somewhere, sometime I would discover where I was going.
The final postscript: Misty had hoped that I would find another committed relationship, though as she was dying she expressed fears that I would not be able to do so. (I do machines, not people, remember?) About a year and a half after her death, after the usual awkward web-enhanced middle-aged dating experiences, a woman in my Buddhist mediation group—hidden in plain sight—suggested we go to a couple of parties together. Over the next year, we gradually became first a steady couple and, by the time this is in print, expect to be married. The journey through the desert ends as I—and Misty—had hoped it would, if at a place I never would have expected. The cycle is renewed: We are, after all, only human.