Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.
Edna. Pat Allen's Mother

Edna Arnold Yarberry

My mother, Edna Arnold Yarberry, died on Saturday, February 23. She would have been 94 on May 6 . I asked to keep the vigil at her bedside for  her last evening. and had the honor of talking her home.  The compassionate nursing staff kept her safe and comfortable and gave me comfort as well during that night and early morning time.

I have been present at the side of the dying since I was a teenager working in a small rural hospital in Kentucky, as a medical student, and as an intern and resident in my training program in New York. I have witnessed peaceful deaths and have been present when interventions to prolong life caused suffering and often led to no increase in duration of  life.   I have always been comfortable with those who are dying when the person is older and ready enough to go on from here to the hereafter. It is much harder when the person is young, has unmanaged pain, or is unable to make peace with the inevitability of death. Mommie was ready for her soul to go on.

The mitral valve in Mommie’s heart had been damaged from rheumatic fever when she was young. It was replaced at just the right time when she was 81, with excellent surgical skill and an easy recovery. The problem was that she outlived her heroic replaced valve, which worked nonstop for 11 years, 7 months, 22 days, and 3 hours—more than 350 million heartbeats from the time of the replacement until the heart could no longer work. The sell-by date on her valve was just 10 years. She got an extra 19 months and a few days more.

When the mitral valve fails, blood pumps back and forth within the heart rather than pumping forward. Blood backs up and fills the lungs with fluid (this is called congestive heart failure or pulmonary edema), making it so very difficult to breathe; it’s more like breathing under water than just breathing air. Mother’s doctors were a geriatrician, a cardiologist, and a nephrologist. They worked miracles for about 18 months after the valve began to fail; then medical interventions provided only temporary  relief of symptoms.

I had promised Mommie years before that she would not suffer needlessly and that she would not die without a loved one present with her. Palliative care was not available in the assisted living center where Mommie lived for the last four years and three months of her life. I had asked about hospice care when it became clear that Mommie’s kind of illness was not likely to be a sudden stroke or a heart attack. It was likely that she would linger and suffer, with a potential middle-of-the-night ambulance ride to the small local hospital where the death would take place.  Hospice has not been integrated into this facility, nor is this unusual.

Mommie and my sisters were always ahead of the curve, however.  Mommie knew when to insist that she be taken to the regional medical center in Bowling Green  at 4 a.m. when the staff in the assisted living center could not provide any further relief for  her breathing difficulties.  My sisters knew to take her  where her doctors would make her comfortable as long as medical treatment worked. As soon as she arrived in the Medical Center Emergency Room, respiratory therapy and drugs to remove the fluid from her lungs helped her to breathe.  This medical team also knew when to discuss how to make her comfortable when there was no treatment left.

My sister-in-law is a volunteer in a hospice program in the same town as the regional medical center, and she helped my family understand the need for compassionate care for the dying. Mommie’s illness worsened too quickly  for her to make it to the top of the long list of people waiting for hospice care, but the hospital medical team decided that palliative care in her hospital room would be the right thing to do, “while her name is on the hospice waiting list.”

I arrived on the Wednesday afternoon flight to Nashville and began my last journey to all I know as home as the sun was setting. Darkness was filling the open sky covering the long, long stretch of Interstate 65 as we drove north to Kentucky. Mommie was waiting for us. I have heard that the dying do wait for those they love, and this has now happened to me twice. Once, when my mother-in-law Natalie was dying, she, too, waited for us as we drove the eight hours from Kentucky to Orchard Lake, Michigan.

Mommie was so tiny and so frail. Her breathing was labored, but she let us know that she was glad that we had come to be with her. I took the first night vigil, and after two hours of alone time with Mommie, I asked the nurses to call her medical team to begin some medication to decrease her suffering. She had a peaceful night, then a noontime rally the next day with my brothers. They sent us a photo and called us to return to talk to her. The moments of awareness that they had seen did not last long.

The palliative care doctor had made an evaluation the day before, and palliative treatment was begun on the second day we were there, on Thursday afternoon. Just a bit of medicine to take away the anxiety that occurs when there isn’t enough oxygen going to the brain, and a little pain medication to ease the suffering. She had another 24 hours before I began my last vigil with her.

I brought the Episcopal Book of Common Prayer with me for this night. I first read the Evening Prayer service .  As the long night progressed, I read the prayer for the sick, then the prayer for the dying. I told her how much we loved her and how she had given her children not only life, but hope that each of us could have a good life. I whispered to her not to linger, because her work here had been done. The nurses and aides who cared for Mommie were constant in their attention and support.

I had promised to call my sisters and brothers, my husband, sons, and stepsons, when Mommie approached death. There are signs that those who have spent time with souls who are leaving recognize. I knew it was time to make those calls around 3:15 in the morning. My husband and three of the four sons who had loved their grandmother came to stand watch. My elder son arrived with his 15-month-old son, Jack, and his wife just as Mommie was leaving us. They did get to say good-by. She had waited for them.

We read the Prayer for the Dead. We kissed her farewell. Mommie had a long life with many chapters. And she had a good death. We should all have this kind of leaving.

  • Erika Lively April 23, 2013 at 8:35 pm

    Pat Allen,

    Nothing but respect for you, an inspiration, and your lovely mom, who with her southern charm, and wit made me smile from the inside out! A blessing it was for you, and her both to experience something that is natural, yet unfamiliar and individualistic, death. The waves of love which surrounded her from her family were perfect traveling partners.

    Love and Respect from a old exercise friend.

  • cheryl fleming April 15, 2013 at 11:10 am

    Dearest Pat,

    I read with tears of joy the life of your mom, your family and how you were there for her at this sunset was soon to be her last. She had a wonderful life, and you are a product of that wonderfulness! My thoughts and prayers go out to you and yours, as you fondly remember your mom and those memories will comfort you with each new day.


  • Liza Near March 11, 2013 at 10:04 pm

    God Bless Edna and God Bless You my friend and life saver. You both were (ARE) so blessed – and I am so blessed to have you watching over me – whispering things to ME to keep me happy and healthy. I love you Pat! I hope each day Edna whispers something in your ear!
    Love you!
    Thank you for caring for ALL OF US!

  • Mary Ellen Rooney March 11, 2013 at 7:37 am

    Dear Pat,
    Thank you for sharing this utterly beautiful, moving, heartfelt and wise writing about your mother’s death. You have provide a much-needed guide. Although I was orphaned by age 35 I did help my beloved brother cross when he died of aids at 53. It was a privilege to be with him. These moments require great love and courage. with appreciation, Mary Ellen

  • Judy Mings March 10, 2013 at 7:06 pm

    Dear Pat,
    I too cried when I read your post. The love between you and your Mommie is so easily seen. Your Mother was so blessed to have you and the family by her side so she could pass over peacefully. May all your readers take heart and prepare for the inevitable for them and their families. I am also very passionate about this due to recently losing a brother.

    I have two Aunts staying at the facility where your Mother was. I had the pleasure of dropping in to see your Mother a few times. It was always a pleasure to visit with her. She was a sweet lady to be admired and everyone enjoyed her artwork. We will never forget Edna and Edna’s Art Gallery.
    I am so very sorry for your loss! Keeping you in thoughts and prayers. God Bless You and the much needed work you do for others. Take care!

  • Stacey Bewkes March 7, 2013 at 3:23 pm

    Dear Pat
    What a lovely tribute to your dear mother (as you know, mine was Mommie as well) who I feel so fortunate to have met on several occasions. A wonderful, talented, nurturing woman who raised her daughter to be the same. She was blessed to have both you and such a peaceful death. Everyone should be so lucky in all those ways. Sending my love to you and your family,

  • abigail congdon March 6, 2013 at 3:40 pm

    dear Pat,
    i am so moved by your experience for what it was, for how beautifully you have evoked it, and because my experience with my mother as she went was so similar. it is a gift to those who have not experienced this loss yet to know there are ways for it to be positive~ it is fundamentally so human, so right and so life affirming to help our loved ones, and ourselves, experience these losses this way.
    i feel especially poignant today for your loss as i am caring for several weeks for my daughter and 1 year old grand daughter here in nyc. how the pages of the book of time and generations keeps moving from page to page~
    thinking of you and your lovely Mommie.. affectionately, Abigail

  • Susan Ringo March 6, 2013 at 11:06 am

    Dear Pat, I’m so sorry for your loss, and at the same time so full of admiration for the way you and your family moved through this difficult but inevitable transition. I too sat vigil at my mother’s death many years ago…and relived both the honor and the torture (for me) while reading your loving and insightful piece. I had the pleasure of meeting your mom a bunch of years ago in your office…what a doll! – as they used to say.
    with love and so much respect, Susan

  • patricia yarberry allen March 5, 2013 at 11:04 pm

    I am so grateful to each of you who found the time to read this post that was about not only the death of my mother but about end of life care. This is a subject that each of us needs to care about because we don’t all die suddenly; many of us will die slowly and if no preparation is made, die with suffering.
    I wrote this to encourage all of us to make arrangements with loved ones about our wishes for comfort and care at the end of this life; to prepare for a good death when possible.

    These many comments have lifted my spirits and strengthened my connection to this incredible community of generous and intelligent women. I send you my deepest gratitude.

  • Toni Myers March 5, 2013 at 11:50 am

    Thanks, Dr. Pat, for your eloquence in sharing your mommie’s story. I cried reading it, for you put your readers there in your circle of love, reverence and grief. I want the same for myself and for those I love.

  • Karen Free Royce March 5, 2013 at 9:06 am

    Dear Pat,
    Thank you for sharing this beautiful piece about you mother and her death, truly a passing from loving arms to loving arms. My thoughts and prayers are with you as you absorb this momentous change. I’m so glad you had the Book of Common Prayer with you.

  • Diane Dettmann March 4, 2013 at 9:30 pm

    Dear Pat,
    I’m so sorry for the loss. Thank you for sharing your mother’s final journey surrounded by her loving family. Your story is a wonderful tribute to a beautiful relationship, a caring family and spending those last moments of life with someone we love. Keeping you in my thoughts in the days ahead.

  • Patricia Moscatello March 4, 2013 at 7:51 pm

    Dear Dr Pat,
    It is with a heavy heart that I send my condolences for the loss of your Mommie.
    Thank you for sharing a beautiful example of a gentle passing surrounded by love.
    I will keep that example close to me as I will soon be faced with a passing of a loved one.
    Love much,
    Patricia Moscatello

  • Dominique Browning March 4, 2013 at 7:04 pm

    Dearest Pat,
    How fortunate your mother was to have you there, whispering her out, and how fortunate you were to be able to say such a tender, loving goodbye. A good death, indeed. And a beautiful way to celebrate what was clearly a good, strong, love-filled life. Thank you for writing this.
    Much love,

  • mary karr March 4, 2013 at 6:41 pm

    Oh, beloved. What a beautiful consolation you give us all while bearing your burden. Glad you have another angel. Also sorry. Love, mk

  • Claudia Schappert March 4, 2013 at 6:40 pm

    Dear Dr. Pat
    So sorry for your loss. A beautiful tribute from a beautiful soul.

  • Roz Warren March 4, 2013 at 5:02 pm

    So sorry for your loss. Thanks for sharing this experience with us.

  • ann buttenwieser March 4, 2013 at 2:46 pm

    Dear Dr. Pat:
    This is a beautiful tribute to your mother, your family, and especially to you. You were fortunate to have your mother in your life for so long, and she was fortunate to have had you in hers.
    I send love during your time of mourning, and continuing admiration for all that you do and are.

  • Anonymous March 4, 2013 at 10:45 am

    Your cherished mother was carried from this realm with all the love and devotion she had shown to her children. A fitting end for a generous and loving parent.

  • Elizabeth Turner March 4, 2013 at 10:39 am

    Dearest Pat,

    I am so thankful to have known your wonderful and precious mother. I am thankful that she lived so many years – loving and being loved. I am thankful that she was surrounded by those she most loved and who most loved her at the time of her death. I am thankful that you were able to keep your promise to her that she would not die alone and that she would not suffer needlessly. There is so much to be thankful for. It is not an oxymoron to speak of a good death, and you have described just such a death: dying in the presence of those we love, having had some time to say “goodbye, I love you, and thank you,” with pain managed. But there is also the deep sorrow of her death. You will be in my prayers and my heart during these days of mourning.

  • maria campbell March 4, 2013 at 10:39 am

    Dear Dr. Pat,
    Loved your wonderful essay about your mother’s death.
    Thanks for sharing it with us.

  • Beverly Schwartz March 4, 2013 at 10:38 am

    Dear Pat,
    I am so sorry to hear of your mother’s death; I feel almost as if I know her because you have so often written about her–her influence on you, your family celebrations, her wise counsel, her humor. But she had a wonderful long life and, as you describe it, the kind of death that, if we could choose, we might all wish for.

    Thank you for detailing that death. For me, there is comfort in the details–as I’m sure there is for you.

    Best wishes, Bev

  • Chris Lombardi March 4, 2013 at 9:10 am

    Pat, when I learned Sunday about Mommie’s death I was so sad and worried about you. Your tribute here is as beautiful and inspiring as we knew her to be. Holding you both in my heart, now.

  • Dore Hammond March 4, 2013 at 8:10 am

    Dearest Pat,

    I am very sorry about the loss if your mother.

    You relationship with her and your amazing
    life as a mother and doctor was something I am
    sure must have given her great pleasure.

    Thank you for this article which will help guide
    me when I soon will be caring for my mother.

    Best Always,


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