The Story of Helen Payne (Part Two)
Wednesday, November 5th All Things Considered

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Helen and her family
LINDA WERTHEIMER: This was Helen's immediate family -- children, spouses, grands and greats. I lost count at around 75. Although many people there knew they would probably not see her alive again, there was nothing mournful about this gathering.

Sister Missy, slender and athletic, regaled the group with accounts of a recent motorcycle trip to Kansas City. Sister Jenna, considered the beauty of a very good looking group, said that she had come "to play" in the family volleyball competition, in high-heeled sneakers.

There was an enormous amount of food -- hotdogs for the kids and everythingyou'd expect at a Southern picnic lunch, including a platter of deviled eggsserved on a tray of cracked ice.

SOUND OF BARBECUE BEING TURNED

FAMILY MEMBER: The ribs are done. You must brown them...

FAMILY MEMBER: We -- yeah, now put the -- they brought the sauce out, didn't they?

FAMILY MEMBER: Yeah.

SOUND OF FOIL RUSTLING

FAMILY MEMBER: All righty-then. The ribs is ready.

LINDA WERTHEIMER: Sister Joyce, the picnic was at her house, has her own dynasty going -- six girls, all grown, and like Helen's daughters, all good looking.

They sat on their mother's front porch to talk about their grandmother, a woman who raised 10 children; who cleaned other people's houses and ruled over her own. They spoke of her imposing presence; the way she communicated disapproval without talking about it; and they agreed that along with standards, their grandmother had style.

GRANDDAUGHTER OF HELEN PAYNE: I always think of Grandma as like a beautiful, elegant lady because she always dresses so neat and partic – you know, with her dresses and her hats, she always come out glamorous. It's never, you know...

GRANDDAUGHTER OF HELEN PAYNE: No jeans.

GRANDDAUGHTER OF HELEN PAYNE: ... a lot of T-shirts or jeans or none of that.

GRANDDAUGHTER OF HELEN PAYNE: And also, Grandma's a major part of the family because she keeps everything together, and everybody like draws into her whenever we have gatherings. Grandma is like the center of all.

GRANDDAUGHTER OF HELEN PAYNE: All the daughters had a lot of kids, so when we all came, it was like a family reunion all at once, every weekend. So Grandma, like I said, she always had all the supplies. I don't know how she knew to have enough franks or enough, you know, bread or enough breakfast, but we -- nobody ever went hungry at Grandma's.

GRANDDAUGHTER OF HELEN PAYNE: And I tell you that we really think about it -- Grandma's getting the opportunity to do something that a lot of people don't get to do. She's able to do the things that she wants to do before she leave. So, she's still cleaning the house up before she leaves.

SOUND OF CROWD

FAMILY MEMBER: What are you looking for...

FAMILY MEMBER: Hey Jenna and Missy, you all gonna get a song over here? Aunt Dee Dee, come on. Curtis, too. Come on.

FAMILY MEMBER: Here they go, girls.

FAMILY MEMBERS, SINGING:
I'm down here Lord
And I need your power
Show me the way
Please Lord
Show me the way
I'm down here Lord
And I need your power
Show me the way

APPLAUSE

LINDA WERTHEIMER: People who are terminally ill often wait to die until after an important event. The picnic was such a milestone in this last summer. In mid-Augst, Helen began to vomit blood. We arrived one day to find Glenda, Dee Dee, and Jenna armed with spray cleaners trying to banish the smell of blood from the bedroom.

Helen was very weak, sleeping almost all the time. The hospice nurse, Dixie Orrison, told us it was a matter of days. We talked to Dixie in her office.

DIXIE ORRISON, HOSPICE NURSE: At this point, there's not a lot that can be done for this other than keeping her comfortable. And certainly, bleeding is the major concern, and pain. And what -- what we do advise folks at this time is to have some dark towels there to absorb the bleeding, because it's very frightening to see blood on some light piece of material. It looks like it's an enormous amount and it's just scary. To use the bolus doses of her pain medication as often as they need to keep her comfortable.

Additionally, I stopped at the pharmacy and took some suppositories for nausea and vomiting -- she had medications by mouth, but she's starting to have trouble swallowing; and educated them on how to use those.

WERTHEIMER: Do you think that Helen's death is going to be a difficult death?

DIXIE ORRISON: I think for Helen, it will not be a difficult death. I think if the bleeding does occur, it will be a difficult death for the family. I think that we can keep her comfortable with the pain medication in her pump. I think it's always distressing to families, though, if their loved one is bleeding because it literally looks to them like this person's bleeding to death and it's a very upsetting thing.

LINDA WERTHEIMER: In addition to visits from Dixie, the family talked to Terry Moon, a hospice social worker, who also tried to help them with what was coming.

TERRY MOON, HOSPICE SOCIAL WORKER: This is hard, and this is hard for most families in that now you're seeing -- especially with a mother -- you're reversing the roles. We're coming full circle. The mother who gave us birth, now we're going to help her die. And I think it is incredibly hard for them to watch their very strong, incredibly strong, proud, wonderful matriarch mother now come down to a very weak -- needing total care. And that's hard to watch. It's hard to care for; it's hard to watch.

SOUND OF CROWD AT CHURCH

LINDA WERTHEIMER: Helen Payne died early on the morning of the 25th of August, and the funeral and burial were the following Saturday morning at the Second Shiloh Primitive Baptist Church, with Elder Carol Newman presiding and Sister Odelle Carter singing.

SOUND OF A CHOIR

The small church was filled, and the crowd flowed into the dining room and outside, listening to the service under the windows and through the doors of the little church. The service was almost two hours long. The hymns and scriptures were Helen's favorites.

CHOIR:
Shaking earth and a velvet sky
It is finished
It is finished

SOUND OF FOOTSTEPS ON GRAVEL

LINDA WERTHEIMER: She was buried next to her husband, near her parents' graves, in the little plot beside the church, just a few feet from the road. Family friends filed out of the church, carrying the flowers to the graveside.

SOUND OF TRAFFIC AND FOOTSTEPS

At the funeral, Glenda said that her mother's last hours were not the peaceful falling asleep that she had talked about; that it had been awful; that Helen was restless and distressed and that nothing could soothe her. Glenda blamed the hospice staff and the doctors for not telling her that could happen.

But three weeks later, when we saw Dee Dee and Glenda again, Glenda was ready to acknowledge that everything that should have been done had been done -- but she was miserable. This woman, who had taken charge, promised her mother she would see it through and kept her promise -- Glenda was almost immobilized by grief and loss.

CRABBE: I've been feeling right bad here, I mean every, you know -- I just -- and I can't figure it out. I keep thinking about -- I don't know what that's about -- but I keep thinking about Mom. She would come on a Saturday night, and Toots would pick her up for church Sunday morning.

And I keep thinking her clothes are hanging in the closet right here. And every now and then, I'll go over and open the closet, you know, but -- and I have no idea. And it stays in my mind all the time -- that her clothes are hanging in the closet. I don't know. I'm just gonna miss her, I guess.

LINDA WERTHEIMER: Dee Dee, what about you? How are you doing? How do you feel you're doing?

DEE DEE PAYNE: Well, it's -- I'm numb. And it's just, you know, gradually wearing off, so I guess pretty much like Glenda, I don't know either. I just go on each day. You know, I go to work and I have my happy, but when I'm alone, I just think. So I guess I try to keep busy to keep from thinking. It's easy to say you gotta go on. You know you do. But I don't know, it just seems different now, because in the past going on included, you know, her. So it's -- she's not there.

LINDA WERTHEIMER: Well, let's go back to the beginning. Do you think you knew what you were in for when she said she wanted to be at home? She didn't want doctors to do anything. She just wanted to be home and to be comfortable.

GLENDA CRABBE: Had no idea. I just knew if that's what she wanted, then I was gonna just be there to do whatever was necessary. I didn't have no – I mean, it was a -- it was hard. It was -- for me, it was like all that work and I couldn't -- I couldn't stop the end from coming. At the end, I couldn't stop it. And I do -- I really believe that I'd rather have – to have gone and visit her. You know, someone else take care of her and I would just go and just be with her like that. But to be with her all the time and take care of her like that, it was just like...

LINDA WERTHEIMER: Glenda, you took a lot of this on yourself. How do you feel about your other sisters and the role they played and what they did?

GLENDA CRABBE: Well, if I was looking at it like I feel today, I think they did the right thing. I wished I could 'a done it. they just had to endure mostly Mom's death. They knew she was dying, but to not be there when she was at some of her sickest moments. Then, she had a really sick day, and I knew she wasn't going to live through that day. And I don't know what it was for her, but it was like -- it was like at the last minute, I just couldn't do nothing for her.

DEE DEE PAYNE: Mom was in so much pain, she was just -- you know, moaning and groaning and moving. And Glenda was like by the bedside and trying to keep her mouth from getting dry from, you know, she was dehydrating and -- to see death actually coming and we knew that it wasn't going to be much longer. We knew that. But I guess to have to sit there and watch that made it all seem like it wasn't worth it -- just for that moment. But it was worth it, 'cause we had her at home. She was with us.

CHOIR:
I will trust in the Lord
I will trust in the Lord
I will trust in the Lord
'Til I die

ROBERT SIEGEL: This story was made possible by the extraordinary generosity of Helen Payne and her family, for which we are deeply grateful. If you'd like to read more about end-of-life care and the processes of grieving, visit our website at npr.org. You'll find transcripts of this week's series there, too.

Tomorrow on the program, one doctor's attempt to change the way Americans die. This is NPR, National Public Radio.


Dateline: Linda Wertheimer, Washington, DC; Robert Siegel, Washington, DC

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