In Methuen, Massachusetts a young woman is trying to prepare for a very early death.  It’s not her fault; she’s done nothing wrong in her nearly 27 years.  Indeed, from the very first she has been a bright, delightful person, quick to learn, quick to love pretty much everybody.

Inside her genes, however, something is not the same as most people’s.  She can’t fight off dysfunctional cell growth.  Her first cancer arrived when she was about 6, it’s not completely certain when, but she had been complaining of “back pain” for months before her mom finally got her to a “pediatric gastroenterologist” whose connections at Tufts Floating Hospital for Children found and diagnosed neuroblastoma.  There can be no worse day for a mother, unless it’s the one approaching inexorably, almost exactly 20 years afterwards.

That’s a short dash, 27 years.  In between those dates were 5 big battles with cancer, excellence in school, swim team, graduation from High School, excellence in college that included trips to New Orleans to help repair Katrina-damaged homes, trips to England and Ireland, visit to Paris through the Chunnel, Graduation from Wheelock College, Masters degree through Merrimack College, friends’ weddings, even one she coordinated, a trip to Peru and Machu Picchu only to run headlong into the fifth cancer struggle, now stretching into the last.  Loving teaching, early childhood and special needs, was not enough.  There never will be the full-time teaching position of which she dreamed.

How does one prepare for death?  I don’t know.  My good friend, Tony Fusco, prepared for his when an undiagnosed tumor in his brain stem proved inoperable, impossible to biopsy and ultimately fatal.  I got to sit with him the last Sunday afternoon before he re-entered the hospital to try some other treatments multiple neurologists had only the faintest idea might help.  I’d brought some nice scotch thinking we might enjoy a sip together but his gag reflex was so impaired he dared to sip only water.  It was a good afternoon and I expected he’d be home again.

When the only option of a feeding tube was offered, Tony realized – decided – that it was a tube too far: no further treatments, thank you.  His world shrank to a room at a beautiful hospice facility that was always busy with visitors and family.  He had a huge heart; it took a couple of weeks for it to go to sleep.

Clearly he’d prepared for the end.  He was 71.  At his funeral I told him that I knew where to hide a flask for when I’d join him on a porch where he now lived, where we could enjoy a sip and analyze the world situation.  He was a year younger than me.

How does one prepare at age twenty-six and three-quarters? Without an abiding religious faith it is hard to imagine.  She believes in God, but hasn’t had a lot of religious education.  I try to explain, but it is uncomfortable, certainly it was a year ago when the lung cancer appeared.  It represented a third kind of cancer, and her tiny body could tolerate no chemotherapy.  They operated and radiated, but the treatment was still a variation of repair and destroy with the overarching hope that the cancerous cells might be killed before the patient, herself.  Her breathing hasn’t been very good – or comfortable – since then.  Within a couple of months lesions were found in multiple places: brain, bones, pancreas and more.  Now at Dana Farber, they’ve radiated as many places as possible and she’s been taking an oral chemo pill with side effects.  It tended to slow down the growth, but never stopped it and now isn’t slowing it much, either.

There’s only one door open to her… to a place where the weaknesses of her body will no longer be a problem – a place where her health will become perfect.  One needs a reason to hope in order to contemplate passing through that door, alone.  Observers might say that she has no choice so “…she just has to deal with it.”

What does that mean: deal with it?  If one has any trust in God it should be clear that trying to pass through when angry and bitter is probably not the right approach.  One school of thought is that when you pass you’ll find exactly what you believed you’d find.  If that is a fade-to-black scenario, and hopeless, then that is what it will appear to be.  I believe that there is an eventual judgment, an audit if you will, of how well your tests were passed – tests you knew were coming when you agreed to accept the lifetime just ending.  Your “you” or your soul, may or may not have aced everything.  The life just ended may or may not be the last one you need to make your ascension, but Redemption is the unfailing lesson of the Bible.  It doesn’t make sense that in the matter of life and death itself, that the opportunity to redeem oneself would be absent.

For the soul, the agreement to accept a new life that includes the needed tests, is the greatest act of love expressable.

Another path of spiritual guidance says that not only are we responsible for our un-passed tests, or “karma,” but also for our reason for being, our “dharma.”  Both are part of judgment.  The more aware we are while on this side of that door, the more likely we are to meet and exceed the reasons for this life.  Life is not a knife-edge: Hell on one side and the gift of Heaven on the other; it is a path made broad by our free will.  The choices we make have meaning.

When someone passes very young, there has been little time to make bad choices, which is to say, few sins have been committed.  At the same time, few opportunities have presented for passing tests.  Maybe a life that ends in youth is lived sacrificially so that those around you can pass their tests.  Living that life is your test: a unique expression of love.

From the limited, somewhat fuzzy understandings of a human lifetime, this is my most comforting perception of the young lady’s life: one of sacrifice.  Neither I nor anyone else on this side of the door is privy to the purposes of the lives of others, and barely able to grasp the meanings of our own.  Still, this observer has recorded no imperfections in our young patient’s life. 

Is she comforted thereby?  Does she perceive the success of her life?  Or does she feel she’s been punished or singled out for “bad luck?”  I try to tell her to not fall into those ideas, but to approach the door with an open heart and mind, accepting of the possibilities of immense love on the other side.

Something she has earned.