Don’t Cut the Switchbacks

Switchbacking trail in the Grand Canyon.

When younger, I did quite a bit of backpacking. Many hikes were in California’s Sierra Nevada, but I’ve hauled lots of (not) tasty dehydrated food along the Appalachian Trail, into the Grand Canyon, and through lesser-known spots like the Marble Mountain Wilderness. I’ve tramped alone, led groups of youth and adults, and had wonderful experiences with friends.

On every adventure, I honored one of backpacking’s key mantras: Pack it in, Pack it out.

That mantra is first and foremost a reminder not to leave junk behind. Don’t litter! If you bring a Zip-lock bag bursting with delicious gorp, don’t discard the used plastic container on the trail after gulping the nuts, dried fruits, and other tasty treats. If you carried it in, you can carry now lighter version out! The same applies to food packaging after those fabulous freeze-dried meals are eaten and only foil or paper remains.

Though it’s tempting to reduce the load while crossing the rugged terrain, what you started with should be part of the finish. On grueling days, I’ve pondered tossing an unused pan behind a tree or “forgetting” a space-consuming water bottle at a campsite. Gotta get rid of weight! But I haven’t. I’ve shoved the stupid and unnecessary pan into the pack and trudged up the trail for more miles.

Other wilderness travel cautions include:

  • Leave only footprints, take only memories
  • Don’t cut the switchbacks.

These simple, enduring statements can also apply to hospice.

As you consider your life, what are you carrying? Even more, if you have a terminal diagnosis, and the span of your time on earth has seismically shifted from “some unknown day in the future” to a handful of months, what will you begin to pack for that “journey?” What won’t (or shouldn’t) you pack? With death, we rightly say that you can’t take it with you. Accumulating money no longer matters. The fashion statements or the expensive electronic toys won’t matter. The acquisition of trinkets or the collecting of knickknacks won’t matter.

Death strips us down.

Death, sometimes for the first time in our lives, forces us to see who and what matters most.

On the journey of dying, unlike backpacking, what you hoist onto your soul—not your shoulders—will be carried forward by the living.

Who do you need to talk with (or send a note to)?

Who do you long to say, “I love you” to another time or for the first time?

Are there words of explanation or acceptance withheld by you that beg to be shared? And sometimes it’s not the dying person with one more conversation to attempt, but the friend who regrets the angry words from a year or a decade before. It’s the son or daughter who angrily left home, but now has one more chance to unpack the rage or resentment and share the weight.

In the journey towards death, we will haul many things: fears, feelings of isolation, loss of independence and control, unmet career goals, and bucket lists with sites never visited. But what will we truly carry in our final days? Before we take “the trail,” can we leave behind the unnecessary and carry only the essential? Can we carry only what brings life, or shares life, or adds life for those who matter most?

What memories will be left with our final “footprints?” There are some memories we can’t regulate or plan. Regardless of the good work of a hospice medical team, there are deaths with too much pain. The “symptom management” becomes overwhelming. Certain deaths, because of the devious ways of an illness, become chaotic for everyone. Sometimes, the literal end results of complicated surgeries will be unsettling for the caregivers and the loved ones they support in the final days.

But long before any peaceful or panicked last breaths, I would hope there are opportunities to share in memories that will endure far beyond the final moments.

In the backcountry, while traversing high ridges, I used switchbacks to trudge up or down the slope. Switchbacks, often a Z-shaped trail, provide a slow—and safe—way to gain and lose elevation. Because they are almost like mountain staircases, it’s tempting to “cut” switchbacks, which will damage the entire trail and wreck the efforts used to create and maintain them. In hospice care, it can be tempting to seek quick fixes in our health or our relationships. With many medications, it takes time to work. With many relationships, it takes time to find the right words.

If there’s an opportunity to heal a rift with friend or family member, then try to heal it.

If there’s a chance to say another “I love you,” then say it.

If there’s a moment to laugh or cry or hug one last time, then grasp that moment.

Don’t leave litter on your trial. Leave the imprints of love.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. Wow, this piece was particularly useful. In a conversation just days ago with someone, they shared history that provided the why for their words and actions with their loved one. They had seemed to move back and forth, sometimes distant as if this was someone they’d just met. Then days or weeks later spending hours reading to the loved one, sharing the most detailed conversations or just sitting in silence as if they were afraid they’d miss some important word or action. I too have done some backpacking and the apt comparison some must traverse to get through the dying process to switchbacks was beautiful. As they shared I wondered aloud whether this winding journey was helping or just extending their struggle? They were frustrated at first and tried to find a middle ground they could live with but over time realized that as hard as it was to connect with those difficult truths and painful memories, it was the only path they could find to the healing realizations and context that allowed for forgiveness.

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