A TIME TO DIE


dying

Typhoon Omar hit the island of Guam in August of 1992. Winds reaching speeds of up to one-hundred-fifty miles per hour blew the roofs off buildings, toppled houses and devastated the Chamorro population, the natives of the island. I was twenty-one years old, a navy corpsman, flown out as part of a medical relief party. Our mission was to assist U.S. Naval Hospital Guam, which had received a huge influx of patients due to the typhoon. Naval hospitals were built for the medical needs of active and retired military personnel and their immediate families. On the island of Guam, the idea of immediate family was stretched to include aunts, uncles, cousins, and even more distant relatives. Few seeking medical treatment were turned away, regardless of their military affiliation, and the hospital was heavily populated with the island natives.

Typhoon Omar was brutal, but the island had recovered quickly. When I arrived, the worst part of the crisis was over. The winds had subsided, and our presence was no longer needed. Instead of being part of a relief crew, I ended up spending much of my time exploring the island alone. I visited Two Lovers Point, a cliff situated high above treacherous ocean waters, where, according to legend, a lovely maiden and her one true love, forbidden to marry, leapt to their deaths in the waters below. I hiked the densely forested Boonies and swam in the clear, warm waters of the white, coral beaches.

I quickly developed an admiration for the Chamorro people, their history and culture; intrigued by their resolute belief in the Taotaomona, the spirit of the island. If one respected the island, the Taotaomona was thought to help and bless them. If one disrespected the island, the spirit became angry and worked against them, hindering them in every way imaginable. The Chamorro people were as much a part of Guam as the land and the surrounding ocean, believing they would become part of the Taotaomona when they died, their spirits forever entwined with spirit of the island, as were their ancestors before them.

“You must ask permission of the Taotaomona before entering the forest,” an elderly Chamorro man told me. I was getting ready to enter the Boonies for a short hike. “You must ask permission before cutting down a tree or hunting an animal. If you do not, you will anger the spirit of the island.” He shook his head sadly. His ancient eyes scanned the horizon. “That is why there was a typhoon. So many do not believe, and their actions have angered the Taotaomona.”

My time on Guam was not all fun and games, however. It was a paid vacation, interrupted by spurts of work on a few of the hospital wards. It was on one of the hospital wards where I would learn a valuable lesson. A lesson about life, and a lesson about death.

I happened, one morning, to walk by one of the hospital rooms. A young doctor, a navy lieutenant in his early thirties, wearing a white doctor’s smock over his khaki officer’s uniform, saw me passing by and motioned for me to join him.

“Corpsman,” he said, “Could you help me in here, please?”

“Sure, Doc,” I said, stepping into the room. A diminutive Chamorro woman in her late seventies sat on the edge of the bed, wearing a hospital gown. She looked up at the doctor, a deep frown wrinkling her dark, determined face.  I sensed I had entered the room in the middle of an argument.

“Mrs. Khalida,” The young doctor said, “I assure you, you are not dying.” He ran his fingers through his brown hair and looked at the patient in frustration. “Please,” he said, “we ran every test we could, and they all came back normal. You’re in perfect health.”

“No, Doctor. It is my time to die,” Mrs. Khalida said. Her small hands gripped the front of her gray hospital gown. “I will not be going home. I will not be going home, ever. I will be joining my husband today.”

The young doctor glanced at my uniform name tag and motioned to me.

“Mr. Taylor will help you get dressed and pack your things,” he said, sliding the phone on the bedside table closer to her. “Please call your family. Have them pick you up.”

Mrs. Khalida ignored the phone. She rubbed her hands together and looked pleadingly up at me.

“Make him understand,” she said. “I will die today. I know that it is time. Please do not send me home.”

The doctor shook his head.

“Mr. Taylor,” he said, “help Mrs. Khalida get dressed and pack her things. She has been discharged and needs to leave.”

“Yes, Sir,” I said. The doctor turned to Mrs. Khalida as if to say something, decided against it, nodded at me and left the room, leaving me alone with the patient.

“Ma’am,” I said, “can I help you get dressed?”

“I can dress myself, young man,” she said. “I may be dying, but I am not sick.”

“Please,” I said, “will you get dressed for me? I can help get your things together.”

She sighed resignedly.

“If I must, then I must. Will you bring me my clothes? They’re in the closet.”

I got her clothes, a pair of white pants and a cool, light blue shirt, from the closet and brought them to her. I pulled the curtain around her bed to give her privacy and began putting her other items into a hospital bag.

“The doctor is wrong,” she said through the curtain. “He does not understand my people. He does not understand it is my time to die.”

“He said you’re healthy, Ma’am. He can only go by the test results. Would you like me to call your family?”

Mrs. Khalida pulled the curtain back. She was wearing her street clothes and hospital socks.

“Where are your shoes, Ma’am?” I said.

“I will not need my shoes,” she said.  “The dead do not need shoes.” She sat down on the bed and picked up the phone. “I will call my family now.”

While Mrs. Khalida called her family, I continued putting her items into a bag. I heard the faint sound of ringing through the receiver she held to her ear. A muffled voice answered.

“I am in the hospital,” Mrs. Khalida said. “I am dying. I want you to come. Tell the others. My time has come, and I want to say goodbye.” She told the person on the other line the room number and hung up the phone. The doctor stepped into the room. He saw Mrs. Khalida dressed in her street clothes, sitting on the edge of the bed. He smiled at me.

“Ah, good. I see you got her dressed,” he said. “Did she notify her family?”

“Yes, Sir,” I said. “She just called them.”

He turned to Mrs. Khalida.

“You will see this is for the best. You have a lot of years ahead of you. You’re a very healthy woman.”

Mrs. Khalida did not answer. Her eyes studied the white linoleum tiled floor. The doctor grinned at me, nodded and left the room, closing the door behind him. Mrs. Khalida looked up at me.

“Healthy,” she said, a disgusted look on her face. “Healthy has nothing to do with it. Healthy people die every day. It is not about health or about sickness. It is about time. There is a time to die, and it is now my time.”

I placed the bag containing her personal items at the foot of the bed and sat down in one of the chairs, facing her.

“Why now?” I said. “The doctor said you’re healthy, but you believe it’s your time to die. Why?”

“You would not believe me, even if I told you,” she said.

“Try me,” I said. “I really want to know. You seem to be very sure about it.”

She turned from me and looked out the window.

“My husband let me know it is my time,” she said, “my husband and the Taotaomona.”

Mrs. Khalida said it happened when Typhoon Omar first hit the island. The small home she had lived in with her husband, and where she had lived alone after his death a few years earlier, was hit hard by the typhoon. Half the roof was blown off and one of the walls had fallen in. The powerful gales of wind had shattered the windows and the power was out. She hid under the relative safety of her bed while the storm raged against her house. Her home was near a cusp of woods at the edge of the Boonies. When the storm passed, she climbed out from underneath her bed, and entered her living room. She looked out through the glassless windows at the cusp of woods where her property ended, and the Boonies began. There was a creature standing there. He was extremely tall, above eight feet. He looked human, but she knew he was not a human being.

“It was the Taotaomona,” she said. “And standing next to the Taotaomona was a young man, a Chamorro. He was wearing a marine corps uniform. His dress uniform; the one he was buried in. He waved for me to come to him.” Her eyes glistened with tears. She turned away from me to stare out the window. “He was my husband, not old, but young, like he was when we married. But I was afraid. I did not go to him, though I knew my time had come. He was there, standing next to the Taotaomona. He kept waving for me, beckoning me, but I would not go. He was sad. He turned away from me and walked into the Boonies with the Taotaomona. It was my time, but I did not go.”

“But you’re still alive,” I said. “Maybe it wasn’t your time.”

“It was my time, and I did not go. I must go today. I must, or terrible things will happen. The spirit of the island is about balance. If I am alive when I should be dead, then everything is out of balance. No. I must go with the Taotaomona. I must join my husband.”

About half an hour later, someone knocked on the door. I opened it to find several people, all Chamorros. Mrs. Khalida called to them in her native language. They entered the room and surrounded her as she spoke, her eyes brimming with tears. Though I could not understand the language, I knew she was saying her goodbyes. They began to weep, hugging her and speaking with her, one by one. More family members began arriving, and soon the hospital room was filled with people, men, women and children. More arrived, squeezing into the room and spilling out into the hallway. I did not count them, but I am sure there were above fifty people. Many were weeping, and the sounds of their grief carried out to the rest of the hospital ward. I stood by the window, trying to make room for the family.

The doctor entered the room, making his way through the throng. He stood at the side of the bed, turning to the weeping family members.

“Please, please,” he said, gesturing with his hands to calm them, “Mrs. Khalida is not dying. She has been discharged from the hospital. She’s very healthy, let me assure you. You can take her home now.”

Mrs. Khalida said something in her language, and the weeping grew louder. A woman sitting next to her on the bed let out a great, mournful wail. The doctor looked at me, questioning. I shrugged my shoulders. There was nothing I could do but watch. The doctor turned to Mrs. Khalida.

“Ma’am, you really must leave. You’re upsetting your family.”

Mrs. Khalida spoke to the woman sitting next to her. The woman stood up and Mrs. Khalida lifted her legs onto the bed, lying down.

“I told you, Doctor,” she said. “It is my time to die.”

The weeping intensified. The woman standing nearby began wailing again. The family members in the hallway also began weeping. The doctor looked helplessly around him, and imploringly at me. I shook my head. I could not help him. Mrs. Khalida reached out and held the hand of the wailing woman. She smiled up at her family and said a few words in her native tongue. Then she simply closed her eyes.

I watched as her steady, rhythmic breathing became more and more shallow, becoming erratic as minutes passed by, the muscles of her diaphragm moving in and out, her lungs barely drawing in air. This was Cheyne Stokes breathing, almost always present at the natural end of life. The heart would continue to beat, pumping air from the lungs to the body for as long as it could, but the oxygen in her lungs was not enough to sustain life.  I pulled her socks off and saw the tell-tale signs of mottling, purple and edematous ankles, a pooling of blood and body fluids; another sign that death was near. I looked up at the doctor. He stared down at the tiny Chamorro woman who was in the middle of Cheyne Stokes breathing. His face was pale. He looked up at me with wide eyes. I pointed to her ankles. He looked down at the mottling in her ankles and shook his head in bewilderment. He took out his stethoscope and listened to her heart, looking up at me as he did.

“Is she DNR?” I said. DNR or Do Not Resuscitate was an order to not perform cardiopulmonary resuscitation in the event of death.

The doctor nodded.

“She signed one when she was admitted. I tried to talk her out of it.”

We watched, the family weeping around us, the doctor, a man of science, baffled by what he was seeing, until Mrs. Khalida took one final gasp of air and relinquished it, a rattling sound coming from deep within her lungs. The doctor placed the end of his stethoscope above Mrs. Khalida’s heart and listened to her apical pulse, his eyes on his wrist watch to mark the exact time of death. Moments later, he nodded. Mrs. Khalida’s time had come.

I visited the Boonies once more before leaving the island. I placed a hand on one of the trees at the edge of the forest, and asked permission to enter from the Taotaomona. There was no answer, save the rustling of leaves in the tree above me.

“Thank you,” I said, taking the rustling of leaves as permission.

I stepped out into the forest, feeling much safer, having asked and received permission from the spirit of the island. After all, if I had learned anything, it was that science did not have all the answers. Perhaps much could be learned from the natives of the island of Guam, whose ancestors had lived there from time before recorded history. Perhaps there are some things about life that science does not have an answer for. Things about life, and, as Mrs. Khalida had proved to me and the young doctor, things about death.