Hello all, this is Diane. I came down from Denver to Albuquerque when Marla had to go through emergency surgery at the beginning of February this year. This time it was to put a trach tube in her airway. It was becoming increasingly more difficult for her to breathe. The doctors felt that the cancer was pushing at her airway, causing it to close off, and this surgery was the only option to keep her alive. Sadly, I arrived after the surgery was completed. I never heard her speak again.

Marla was discharged from that hospital to home. There were no complications, except for pain. Ongoing, steady and then stabbing, blinding pain. About a month after the surgery she asked me to take her to the ER. She simply couldn't take the pain any longer. In the ER, it was decided to admit her to the hospital to undergo a pain evaluation. I believed it was a step to another treatment, and it turned out I was right.

Marla's pain was difficult to manage, especially what she called the pain "spikes". She would be fine and then all of a sudden jerk, turn pale and moan. The spikes were the worst, originating from the left side of her neck, where the cancer was most prevalent. If she took enough of all her medications to control the spikes, then she was incoherent. It wasn't how she wanted to live. The doctors agreed and transferred Marla to an in-patient hospice.

The in-patient hospice doctor had a plan. Marla was weaned from all the pain meds, and they were replaced with methadone. There was a week of adjustment, but for the first time Marla was free of pain. Being free of pain allowed her to start thinking about all the things she could return to. She became restless and bored. She hated being cooped up. She wanted to go home. One nurse commented "We're not used to seeing our patients walking around". Unfortunately, the doctors decided that, although she was vertical, they wouldn't allow her to return home unless someone else was with her there, 24/7. That's were I came in.

Originally the whole plan was for me to come down, take care of Marla's house and cats while she was in the hospital from the surgery, and then return home after a couple of weeks, taking with me Hester, a tiny five pound aging furball who had begun biting and scratching more than usual. I already had Kira, whom I had brought back with me the previous summer. Both were "problem" cats, and Marla's ability to deal with them lessened as the cancer worsened.

As it turned out, there were issues with simply filling prescriptions (all of a sudden Walgreens didn't have Fentanyl to prescribe), then helping Marla keep track of her meds all the while feeling helpless against her onslaught of pain, then taking her to the ER, then the hospital stay for the pain evaluation, then the in-patient hospice. I kept staying for it all, because someone needed to feed the cats. No, that's not right. I stayed to help my friend.

Remember I said "the doctors decided... they wouldn't allow her to return home unless someone else was there with her, 24/7."  That was the exact point when I knew I was in for the long haul. I decided I was that "someone".

So being the honorable Sherpa that I was, I gathered up everything and decided we were going "home". Marla was ecstatic. She talked of dying at home, with a cat in her arms, preferably Renee, which was her favorite at the time. But she also talked about finishing her latest book and then having time to spend as she pleased. Neither of us realized how little time she had left. We went home on March 16. By April 9 Marla would be dead.

During that last time home, Marla and I seemed to connect, better than we ever had. Although she was communicating with a Boogie Board (basically a board that can be written on, then electronically erased to be used over and over), we seemed to understand each other for the most part. It became easier to know what she was going to say before she wrote it out. Except for the pronunciation of Castiel, a character on Supernatural. I just couldn't say it correctly. Marla was very patient, writing out each syllable until I finally got it. I still want to call him Cas-steel. There was lots of hilarity, some crying. It was a good time, overall.

Now I'm sitting in Marla's kitchen, a month after she's gone. Slowly the house and storage unit are being cleared. The cats are confused, but I know they'll eventually adjust. The house will be put up for sale, the same for the car. The cats will come to live with me. A kind and generous relative is tending to the cremains of Marla, her husband and her mother, making sure they are given the reverence due them. And reverence is what I'm feeling as I'm trying to sort through everything. I'm the last person touching Marla's belongings, and I want to treat them with respect. With reverence. Maybe that's why it's taking so long to clear everything out. It's almost a holy activity, as if I'm blessing each item on toward its last journey.

During her stay at the in-patient hospice, Marla started keeping a sporadic journal, continuing it when she came home for the last time. I think she'd want others to know her final words, so I will start to publish them here, notating the date the entry was originally written. I may interject a comment or five in parentheses.