Pauline Faithways: Sr. Annette’s Life and Death With Dignity

Sr. Annette Margaret Boccabello, FSP
1956-2012

The Saturday before last, St. Patrick’s Day, Sr. Annette would have been 56 years old. People say that matastatic breast cancer claimed her, but how could a disease that they call “stupid” be victorious over such a human being? Jesus had claimed her for his own at Baptism, sacramentally marked her as his own throughout her journey, received her as his own over thirty years ago among the Daughters of St. Paul, and then “came for” her as his own just two months ago tomorrow.

I’m sitting in her room as I write. Whatever few belongings she had are gone, but I feel her here. Keenly intelligent, she had her finger on the pulse of the world as few others I know. She was gifted with a good sense of humor, indispensable in bearing with herself, with the rest of us, and with God! Sister Margaret Moran recalled that only two days before her death, Sr. Annette entered a near-death crisis. Addressing herself to Sr. Annette in her eulogy, Sr. Margaret said: “You whispered to me: ‘Jesus is coming.’ I responded: ‘That’s great, Annette, let him come.’ You softly requested: ‘Pray.’ So we began praying, ‘Jesus, Mary and Joseph I give you my heart and my soul….’ We continued praying this like a mantra. After about a half hour, you pulled through the crisis with your bright eyes and that little smirk.

“‘Wow,’ I said, ‘You really scared us!’
“‘I scared myself.’ Then after a few moments: ‘That was really funny. Don’t you think I should have a popsicle now?’” (Popsicles were the only food she could keep down.)
“Sr. Donald piped up: ‘Hey, Annette, did you see Jesus?’
‘No, he never showed up!’

“Well,” Sr. Margaret concluded, “he may have stood you up once but we know now that he didn’t play that trick on you a second time. Like Renoir’s masterpiece of the Promenade which hung in your room, he came and took you by the hand and said: ‘Come then, my beloved, my lovely one,’ and now he has led you down that bright path into eternal Light!”

Whether as marketing director, publisher of Pauline Books & Media (PBM), or director of the Spanish Distribution Center (Paulinas Distribuidora), her practical spirituality, broadmindedness, and love for our mission helped her grapple with the never-ending challenges of evangelizing through the communications media. It’s hard to lose somebody like that, whether we agreed with her at times or not. She was ours.

And still is. We were privileged to journey the Pauline road with her, which included more than six years with cancer and her decision to stop unproductive treatment. When she felt up to it, especially in the final years, she joined us for prayer and meals. One of the last conversations I had with her was at lunch after everyone else had left. I had things to do, but I stayed those extra fifteen minutes or so, not knowing when another opportunity like that might come. She talked about her family, about letting go of situations she knew she couldn’t fix, and about her trust in God. What stays with me is the memory of her peace and her witness to what matters most in life.

So it doesn’t surprise me that I would be contrasting her approach to life and death with what we’re facing between now and November here in Massachusetts. Voters are being prepped to decide a “Death With Dignity” referendum, that will enable physicians to administer a lethal injection to those judged terminally ill, who want to end it all to avoid pain, powerlessness, or the worry of being a burden to others.

“Our instincts so often tell us that facing death means facing fears about loss of control and dignity, increasing dependence on others, intractable pain, dying too soon (or not soon enough), increasing costs, being alone, and fear of the unknown,” writes bioethicist Fr. Tad Pacholczyk in “Facing Terminal Illness Realistically,” a syndicated column that appeared in the Catholic Herald of Madison, WI, on Oct. 27, 2011. Add to that our “I Did It My Way” approach to both life and death, and it’s no wonder that physician-assisted suicide legislation seems to be gaining traction even among people of faith.

A decision like Sr. Annette’s is different. Rather than take her own life or ask someone else to do it for her, she accepted the course that the disease was taking, as well as the ineffectiveness of treatment at that stage. She ran across Fr. Tad’s article and found it especially helpful in coming to the conclusion that God was telling her it was time to embrace the natural end of her life on earth. He had written:

“[I]n a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn’t, someone who understood that the damage is greatest if all you do is fight to the bitter end….[A]pproaching our own mortality with a greater dose of realism helps us make better decisions about when to roll back the medical interventions and focus our energies on preparing for death.”

Understandable as it is, when people deliberately hasten their death, they run from the fight not against disease, but against their own fears. Besides, while accepting or refusing treatment truly is their decision, irrespective of what loved ones want (Sr. Annette said as much!), causing their own death deprives them and those closest to them of an important part of their lives and of their inner growth as well.

My sister and I cared for our parents for several years in difficult circumstances. There were times we wanted the problems to go away, even to be over. But we were gifts to each other, we and our parents, living and dying with grace, in the broad sense. Many people learn volumes from such an experience, just as we did and are still doing. Like Sr. Annette, our parents bowed gracefully out of this world, teaching us the final lesson of their lives—what it really means to die “with dignity.”

With niece, Suzanne

Sr. Annette did live and die “her way” as she felt God was calling her to. She requested and received respect for her privacy from family and community. Her two sisters, plus a niece and nephew—all of whom she loved dearly—spent time with us and with her, but only as much as she felt she could handle. In her final days she was accompanied by only a few of us, as she had asked, so that she could prepare herself attentively and lovingly to meet the Lord. Mary Steele, the director of nursing for our infirmary, considers her a “pioneer” in her way of being present to this period of life. Each sister’s passing motivates us all to thoughtfully plan for our own care under one aspect or another; Sr. Annette’s gift to us is her discerning heart.

Sr. Donald Maria Lynch, who knew Sr. Annette for thirty years, was also her health care proxy. She and I conducted a kind of e-mail interview about what it was like to journey with Sr. Annette over the past six years:

What was Sr. Annette’s main concern as she approached death? What was her greatest consolation?
“One of her main concerns was that some of those who were close to her were not ready for her to die. Once Sr Annette made the decision to stop treatment, she was very much at peace because she felt she had done her best to discern God's will, but she did worry about others who were close to her who might not be ready for her to go.
“Regarding consolations, at least one of the most significant was having the time to focus on the end of her life. The hospice care she received kept her comfortable enough so that she was able to approach death consciously being present to God and focusing on the fact that eternity was ahead.”

How did she deal with the pain that accompanied the disease and the treatment?
“She didn't tend to speak or complain much about her pain. She was practical in dealing with the pain: she would follow the suggestions of her physicians, but also explain as best she could how effective or not the pain treatments were. Prayer and meditation were always a part of her journey, but at those times when pain wouldn’t allow her to concentrate, she would either gaze at a picture or image that meant something to her or would simply say occasionally that she put her intention to pray before the Lord.”

Did she ever feel like a burden to us?
“At times she did feel like a burden, but it wasn't something that was constant. It would usually come upon her after especially painful periods. But she was patient with herself. That is, when she was feeling a little better, she would reflect back on those times and express more a sense of gratitude because of the care and love given to her, whether through physical or spiritual care.”

Did she ever consider ending her life sooner than her actual death? What made her decide to keep going with treatment? What made her stop?
“The more time that passed, the more Sr. Annette asked the question of whether or not to continue treatment for the cancer. In the last two years she began to discuss it regularly every time her current chemotherapy stopped being effective because each treatment’s success lasted for shorter periods of time and the side effects began to require more frequent hospital stays. Finally it seemed the side effects were greater than the benefits of the chemotherapy. Sr. Annette wanted to be as ‘aware’ as possible as she entered the final period of her life. By stopping treatments and receiving hospice care, she was able to spend more quality time preparing for her death, and had the grace to be able to be at home rather than at the hospital.”

How did she keep her spirits up?
“Some of the ways she kept up her spirits were: prayer, the apostolic work she could help with, keeping abreast of news in the world, the Church, and the country and remembering all of that in prayer, doing her artwork (painting and drawing), staying in contact with an online cancer group, visiting with her sisters in community and family, sharing a special meal when she was feeling up to it, and even watching a favorite comedy show!”

How did her art or any other activity keep her focused on what was important to her?
“I think her art, her apostolic work, and her prayer for others helped give her journey context. She mentioned that these things gave her a sense of peace and also broadened her view, that is, they helped her focus on the needs of others, on caring for others.”

How did her family and her community support her?
“She relied especially on the prayers of her community and family; I think that meant a great deal to her and was an important source of strength. Sr. Annette wasn’t a person who spoke a lot about her illness, but she appreciated the small, everyday things that her family and community did for her: giving her apostolic work that she had the strength to do, having simple conversations with others, and providing special food she could enjoy.”

How did prayer sustain her?
“I’m sure Sr. Annette could say so much more, but prayer seemed to be the underlying current that carried her through each day: giving her the peace and strength to continue her journey, keeping her connected to the Lord and his love, to her family and community, and to the needs of others, of the world.”

*****
We tend to connect hope with extending life. A person says, “There’s no hope” and means, “there’s no cure.” We often apply an all-purpose adage, “Where there’s life there’s hope,” not only to moral reform, but to physical progress as well. It betrays how we think about life and indicates the line we draw when we think that it doesn’t pay to hope anymore. Sr. Annette tells us something different. There is always hope, because hope is naturally human, and Christian hope, which trusts in the eternal love of God for us all, is supernaturally human: It brings us where we were created to be forever.

Click here if you would like to make a tax deductible contribution for the renovation of the Daughters of St. Paul infirmary. Or you may make a check payable to the Daughters of St. Paul in any amount and send it to:
Sr. Ann Eileen Heffernan, FSP
Health and Retirement Fund
50 St. Paul’s Ave.
Boston, MA 02130.

For further study and reflection:
Other articles by Fr. Tad Pacholczyk: “Making Sense Out of Bioethics”. See especially:
“Euthanasia: broken memories, bonds”.