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.

By Dr. Patricia Yarberry Allen

The lilac blooms were never like this. The heavy blossoms were almost purple and were exploding with life. Natalie loved their fragrance and measured the progress of late Michigan spring days against their appearance and maturity. On this day she would have lavished praise on nature’s gift to her garden, always visible from her window seat at the breakfast table.

The forecast had been for rain as we prepared to journey home for our last visit with Natalie, but none of us could remember such a warm and brilliantly sunny day this early in May.

Natalie Wolfe McIntyre was born June 2nd, 1927 in Erie, Pennsylvania. She grew up during The Depression. Cities like Erie were crushed by the loss of manufacturing. Families only survived by members all living under one roof. Natalie must have acquired her special devotion to family and close friends from this formative period.  She grew up to become a great beauty known for her long legs, blond hair, biting wit and an inability to tolerate phonies or fools. She was physically and temperamentally clearly identified by her Swedish and German genes.

Natalie was diagnosed with acute myelogenous leukemia in mid-January at the Cleveland Clinic. She was 80 and chose not to have the aggressive therapy that is required, not as a cure, but only to prolong life. She lived 15 wonderful weeks in reasonable comfort after the diagnosis and chose to visit with family and friends from all those times and places that she held dear. She used these days as she always did, living well and fully in the moment, but with the conscious knowledge that her days were limited.

On Wednesday before Mother’s Day, Natalie announced that she had had enough. She’d lost her appetite and was experiencing increasing discomfort. She chose not to have further palliative care. She was done.

Natalie prepared for the end of her life with as much care as she prepared for her daily routine. She chose cremation, not burial, for her body then joined The American Cremation Society, a source of some amusement since members received a special discount for this service.

The funeral service was planned with attention to detail and purpose. Natalie chose the music and Biblical passages from the Old and New Testaments, and she chose two of her beloved former rectors to officiate who had served at the All Saints Episcopal Church, the family’s church for 35 years. She wanted only one person to speak other than the clergy. She chose her only son – my husband, Douglas – to give the eulogy (it can be read here). She wanted a dignified service and a celebration of her life as a devout Episcopalian.

After the service Natalie wanted to have her ashes interred in the memorial garden next to her church.  She organized the after service luncheon at the family’s country club, chose the champagne and food and knew that her husband and children would make the guests comfortable.

So, we were called home on Saturday, May 10th to be with Natalie for the last time. Libby came from Montana. Douglas and I came by car from Kentucky where we had been to celebrate my mother’s 89th birthday. Catherine, Emily and Jane who lived close by and had been with her daily were there, and Natalie’s husband, dear Bruce, her loving companion of 54 years, was waiting for us when we arrived.

Hospice service began on Thursday and provided information and support. Natalie refused all medications and interventions. She did not want anyone interfering with her death. A family member stayed with Natalie constantly in her bedroom.

Douglas and I arrived at 2 p.m. after our eight-hour mad dash from the Tennessee-Kentucky border in our rental car. Natalie knew we were there and spoke briefly with great effort to each of us.  Throughout the afternoon she spent time with each of her children, their spouses and her grandsons.  Three special friends from her Thursday morning breakfast club and church arrived to say good-bye and Godspeed.

In all my relationships I am always “the doctor and…”.  The doctor and, in this case, the daughter in law whom she chose to treat as if I were her own child. As a doctor I had been present for many deaths, nearly all in a hospital setting. Memories of those deaths certainly did not fit the template of this death. Natalie was in her beautiful bedroom surrounded by her family and the music she loved. She was conscious and cogent intermittently until 4 hours before her death.

The most amazing thing for the doctor to witness was her breathing. She had been breathing like a marathon runner for 12 hours. It took all her effort to run toward her special finish line. And run she did.  Determined, focused and unmedicated.

We sat with her. One can almost feel that moment. One moment Natalie was with us in her body and the next, she was not. Just after midnight, I laid my head on her chest to be sure. In splendid Natalie style, she crossed that finish line at 12:05am on Mother’s Day, surrounded by those she loved.

The hospice aide made the phone calls necessary. Formal pronouncement of her death was made by a licensed Michigan physician.

At 4 a.m. the simple white van arrived from the crematorium to take the empty body away. She had asked that no one accompany the body “since I will not be in that body.” Two days later the ashes were returned to the family.

Natalie gave her children the greatest gift that a parent can ever give. She showed us how to accept death with a sense of both the inevitable and a sense of comfort with this, the last stage of life. She showed us how to make order out of the end of one’s days and in so doing how to leave the ones behind with grief but very few decisions. She showed us how to go forward into the next part of eternity, as we all must, with peace and dignity.

Natalie’s spiritual presence was felt by many of the family for the next 24 hours. Perhaps she brushed the shoulders in an ethereal way of those who needed her most. I do know that the spirit that animated the life of Natalie Wolfe McIntyre was a glorious and determined one. We certainly knew that we had better joyfully comply with her plans for her funeral, interment of ashes and “the after-party”.

One last note about that after party. I had asked Natalie two weeks before in a playful way if we were having her favorite champagne, Dom Perignon, at the lunch following her funeral service. She looked at me in amazement and said, “No, because I won’t be there.”

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  • Beth Portnoi Shaw May 17, 2009 at 8:45 am

    Where are the tissues?