November 10, 2009





Big Medicine is published by Team EMS Inc.


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Erik Ronningen




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The views expressed here reflect the views of the authors alone, and do not necessarily reflect the views of any of their organizations. In particular, the views expressed here do not necessarily reflect those of Big Medicine, nor any member of Team EMS Inc.


















The Great Escape! Final Farewells [published to Big Medicine on May 7 06]--I was on the West coast presenting to a group of architects when the telephone rang. The secretary answered it in muted tones, and after a moment looked directly at me and said with quiet authority, “Sir, you have to take this call. It’s your wife.”

The telephone is one of mankind’s great inventions. It has given us the ability to instantly convey information over great distances. It was the telephone that brought my partner and me this unexpected business 2,100 miles distant. It was the telephone that my wife used to inform me that she had colon cancer.

I was in San Francisco on business in July 1994. Sarah, my wife of 27-years had dressed and was about to leave for work from our home in Mamaroneck, NY when she had the urge to pass gas. But it felt like more than gas, and upon inspection, she found blood in her panties. Curious but not particularly concerned, she took care of business and continued with her normal daily activities. When it happened a second time in as many days, she knew it was time to have it looked at.

Not the kind of person who frequented practitioners of the medical sciences, Sarah spoke to her dear and close friend, Liz Kelly who had recently been to a gastrointestinal specialist in New York City. The following morning she was in the office of Dr. Burton Korelitz on East 85th Street where he performed a colonoscopy and diagnosed cancer of the colon. His advice to her was immediate hospitalization at Lenox Hill Hospital, and surgery by the world-renowned rectal colon specialist, Dr. Norman Sohn. Sarah asked to use his telephone—and that was when I received her call.

Cancer is one of those words that brings with it instant fear— Few other words in any language evoke such a reaction.

Each one of us is going to die. It’s a fact... But it’s one of those universal facts that we each unsuccessfully try to keep hidden away—whistling in the dark whenever the subject tugs at the hem of our consciousness—pretending, hoping it will never happen to us. And that’s more the pity of it, isn’t it? Next to being born, death is the one most important event in our lives.

I excused myself, turning the presentation over to my associate and took the call in the chief architect’s office. “Hello, dear. Are you okay?” I asked with concern. And the whole crazy past few days poured out of her.

Sarah’s and my life together was no different than any other normal couple. Our marriage was filled with youthful love, hope, and dreams for the future. As the years passed, we slowly grew in understanding and true affection for one another. But our association was not without disagreements and arguments; the greatest percentage of which, in our youth, was about money and sex, in that order, maybe. Flip a coin...

As the decades rolled by, we began to learn to work together and to genuinely enjoy each other’s companionship. Our bond of friendship grew and strengthened, though we were still not without differences. Not differences regarding principles or ethics, but the daily petty little debates of opinion; …whether you floss before or after you brush your teeth. Do you put starch in the dinner napkins, or not? “I keep asking you to take your wet shoes off before walking across my clean kitchen floor."

Petty and trivial!

When we were married, my best man—an old and wise gentleman—counseled us, “Live each day as if it were your last.” I sagely nodded my head, as if my 23-years on this earth imbued me with great wisdom, acknowledging the prudence of his advice. But I, we had our whole life ahead of us. There would always be tomorrow; many tomorrows to apply his counsel.

As we approached our third decade of marital “bliss,” people− friends and relatives began to die; my best man, Sarah’s father, then mother, her two brothers, my stepfather, my best friend, then my brother-in-law, and numerous other friends. Death is a fact. But now it’s beginning to get personal. Then the demon, that feared “C” word had come to my home to roost.

“Hello! This is mortality knocking.”

The world-renowned rectal colon specialist performed his magic. Sarah healed nicely and was given a clean bill of health, though not without physical and, some mental scaring. Mortality was unceremoniously booted from our home and we continued our life as before. There are many more tomorrows…

We traveled, sharing the adventures, and argued before every single trip whether to pack two suitcases, or one. Her “honey-do” list included items I thought irrelevant, and I became increasingly more ingenious at putting them off. Long forgotten was the criticality of her condition from only a few years ago.

The events of 9.11 and my near termination on this earth from the collapse of the Twin Towers had a large impact on our attitude towards each other. We became much more forgiving of each other’s idiosyncrasies. We came to understand our petty differences as non-issues; silly and childish. We gave greater leeway, and became more tolerant of our irrelevant differences. We both began to think about, and to apply the admonishment given us so many years ago on our wedding day.

Eight years to the month from her first surgery, on Sunday morning Sarah telephoned our dinner guests from the evening before, inquiring if they had food poisoning. She had tremendous abdominal pain, and early Monday morning I bundled her into the family automobile and delivered her to the hospital.

“Knock, knock!”

Dr. Sohn had retired, and the new star of rectal colon surgery, Dr. Joseph Martz performed the honors. He removed most, but due to complications was unsuccessful in eliminating all of the cancer. After healing from the surgery, she survived the year of inquisitional hell that is chemotherapy. I became much more attentive to her needs, and we became increasingly close. Our love and friendship blossomed as her body began to submit to the dreaded malignancy gaining ground within her.

In June 2004, her third and final operation was performed. Dr. Martz, once again the surgeon, opened her up, carefully considered all the options and made the right decision to close. Sarah was in recovery when he briefed me at 10 PM. I shook his hand and thanked him for all his efforts and good work over the years. No remaining time was offered, but I intuitively knew that she wouldn’t live out the year...

A new, revolutionary chemotherapy was recommended which she flat-out refused, wishing to spend her remaining days on pain medication, rather than suffering the agonizing torture that is chemo. Quality of life was her desire. In July, we got the wonderful folks that are Hospice involved. At the same time, Sarah spoke to her office and informed them that she was officially retiring.

The final six-months were a blur. As her body began to shut down, the activity around the house increased exponentially. She would call me at my office when her pain was unbearable. I would rush home to be by her side, and hold her hand. I felt worthless, but it meant the world to both of us. When the pain subsided, she’d get up and putter around her flower gardens. She was a beautiful sight. Never a complaint. A strong woman. She sustained her high standards of conduct and continued to maintain a well regulated home.

People came and went. My sister, Kaaren took it upon herself, and asked if she could become the “Gatekeeper” for all the help our generous friends were offering. I gratefully accepted.

Four times during the past two years, we had cancelled a long wished for holiday to Great Britain. Once again we discussed the trip and she decided, “Let’s give it one-more-try.” We set the date for the end of October. We guesstimated that the healing from the June surgery would climax at about the same time the rest of her body would began to fail.

It was touch-and-go right up to the gate. On the final leg into Heathrow International Airport, she began vomiting—not from airsickness. I’d arranged for a wheelchair to meet us at the gate. The poor girl struggled all the way to our London hotel. “Find me the ladies room!” she demanded as we entered the lobby. While I did the formalities at the reservations desk, Sarah was vomiting her innards out. The next three days she spent in bed, vomiting. She was so apologetic to me, but nothing mattered except her comfort. On the fourth day, she felt better. I rented a car, and as we pulled away from the curb she quietly said, “Please take me to the hospital...”


Sarah knew her blood volume was down and so informed the doctors. We spent 24-hours in the hospital while she received two units of blood.

The following day we walked out of the hospital, hopped into our little rental and drove a couple hours west to the Fisherman’s House, a wonderful Bed & Breakfast. She immediately went to bed. We had day trips planned, but she couldn’t rise before noon. We managed to walk arm-in-arm on a blustery sunny day through the ancient stone circle of Avebury. And in the Red Lion Inn, located at the crossroads in the center of the circle, we hoisted a beer, a toast in honor of the ancient ones. Three days later, after an abbreviated itinerary we drove back into London and checked into a hotel.

Sarah felt well enough for me to wheel chair her through the British Museum late that afternoon, and craving a rich, juicy steak, we dined in the restaurant of the Millennium Hotel. It was her last “proper” meal. The following day we were airborne home and spent the weekend recuperating.

At the office late Monday morning, I received a telephone call from Catherine, a dear friend of over fifty years; a retired registered nurse who took it upon herself to help Sarah and me with all things medical these past ten years. “Hi, it’s me,” she said by way of introduction, knowing I’d recognize her calm, confident voice. “Sarah’s in the hospital. She’s undernourished and needs blood.”

I spent more and more time home during the month of November, holding her hand as she toughed out the waves of excruciating pain. Never once did she complain. Sitting up, she’d look at her mid-section and command, “Cut it out!” Commanding the pain to go away. Then she’d look at me and grimace a smile, collapsing back onto the pillow.

Lord, how I love this woman.

We managed a short dinner date at a friend’s home a week before Thanksgiving, and surprised my sister and her husband when we arrived for Thanksgiving dinner with them in their home. This was Sarah’s last outing.

She began losing weight. At 5 foot 4 inches and about 115 pounds, she didn’t have much to lose. She was a beautiful bride 38-years ago. She was an even more beautiful woman today; scenic blue eyes, luscious silver hair sprinkled with her original auburn, honey lips, controlled, even-tempered disposition, unafraid of death, her body, consumed by cancer was wasting away at a furious rate.

The first week in December was the beginning of the end. Mostly bedridden, she’d bolt out of bed and sprint to the bathroom to vomit—ten, twelve times a day. I’d be there to hold her head and have a cool, wet washcloth to wipe her face and help her back into bed. She no longer had the energy to shower, and a sponge bath became the norm. I hired a day nurse/aid to assist. My sisters were in and out frequently every day bringing groceries, shopping, running little errands. Catherine, our personal, friendly neighborhood nurse counseled me daily and ministered to Sarah. Arrangements were made for a funeral home. I refused a night nurse/aid, not wishing to have a stranger padding around my bedroom, selfishly wanting to administer to the increasing needs of the love of my life, myself.

The second week during a few hours of calm, Sarah quietly asked, looking me straight in the eyes, “Erik, am I leaving?”

The time had come, and I was yet unable to face the reality. I answered jocularly, “You haven’t left, yet!”

Am I leaving,” she demanded, stressing each word, her eyes locked onto mine.

“Yes,” was my quiet, simple, honest reply, as I looked deep into those beautiful blue eyes I’ve admired all these years.

“Thank you,” she said softly, relief in her voice, pausing, already knowing the answer but wishing confirmation. Then she started to weep.

“I wanted to grow old with you,” she cried. “There’s so much I still want to do with you.”

“And we will,” I assured her as she sank, spent of energy back onto the pillow.

“In our next life together.”

I thought I was going to suffocate. The emotion swelled up into my throat, neck and head. Tears began streaming down my cheeks. I turned away not wishing to show any weakness. I wanted to be strong for her as she still had a rough road ahead.

This was not going to be easy, I thought.

I knew the end was near. 38-years—and it was ending with me only just now beginning to understand the wisdom of “Live each day as if it were your last.” Was our pettiness so important to argue over? Certainly not. Life with my love would have been that much sweeter, and I would not now have the regrets of having said, or done that which could, I feared, begin to plague me.

Her meals consisted of chicken broth, tea, and water; using a straw, then spoon-fed. If she consumed a cup a day, it was a feast. Her vomiting increased; one-two quarts of ugly, brown, greenish bile each episode. I would help her sit up, holding a plastic waste receptacle for her to do her business in. Where was all this fluid coming from? She wasn’t eating anything.

Spoon feeding her some tea, in a moment of calm lucidness she looked at me and said, “I guess we’re beginning to say goodbye.” It was a statement of fact.

“I think so,” I said with difficulty, choking on the words. “Will you marry me again when we have the opportunity,” I asked?

“Yes. Oh, yes!” she wailed, reaching for my hands and squeezing them. She had so little fluid in her body she couldn’t tear when she cried, but I had enough for both of us.

Sarah had become so weak; often she didn’t know whether she was asleep in a dream, or awake on earth. “I feel like I’m two different people,” she told me one day.

“It’s the same you,” I replied. “Your Soul is free, anxious for release. And at the same time, it’s in prison, trapped in your body.

You’re about to make a prison break!” I announced.

The most beautiful smile crossed her lips...

She began telling me—talking out loud actually, to no one in particular—about the crowds of people around her bed. That she was having the most wonderful conversations with them. I would ask her who was there.

“Oh, you know,” she would say.

Once, I began naming names of friends who had passed away, and she would just nod her head, “Yes.” Then it got old and she said with annoyed understanding, “Oh, cut it out, Erik!”

For the next ten days or so, until she became too weak to speak and keep her eyes open, she continued to talk with friends, and described activities taking place that only she could see. At one point as I was feeding her broth through an eye-dropper she said, looking beyond the corner of the room, “Oh, look! There’s mom over there eating soup. ‘Hi, Mom,’” she said breezily, raising her right arm, waving to her. Her mother had passed away 24-year ago, but had obviously joined her for dinner.

On another occasion, clearly discussing with her friends—invisible to me—how much time she had left, she said, “Will it be fast or slow? Make it fast. Make it fast,” she said imploringly.

“Take it easy. We’re waiting for you,” was the reply she repeated.

On Christmas Day before opening the gifts, we had developed an annual practice of reviewing together the just past year; discussing our life together, appraising the successes, and assessing how we could improve upon our cooperation with one another. At the conclusion of our review, we would hold hands, and I would say a short prayer to the Lord’s Angels, thanking them for all the help, answers to our prayers given us during the year. I would conclude the prayer, “With Love and Gratitude.”

There was no Christmas for us this year. But I did sit beside the bed with her and attempted a one-sided review of the just gone year. I couldn’t tell if she could hear me or not, but when I held her hand and concluded the prayer with, “With Love and Gratitude,” she weakly said, “Hear, hear!”

Emotions were running strong for me just then. The love of my life, my wife of 38-years was approaching her moment of escape to the other side. I had no thought of myself, but only of her comfort and the wholehearted love I had for her... and her selfless suffering. I was in awe of her beauty and inner strength. I thought of the verse in Ecclesiastes that reminds us, “The day of death is better than the day of one’s birth.”

How true, I thought. To be released from the shackles and bondage of earth. No more the requirement to reside in this inhibited, often pain-ridden body with which we have become all too familiar.

Sarah’s time of release was rapidly approaching. The evening of the 27th she said, “It won’t be long now.” And the following morning she said to no one, and everyone, “Thank you for everything.”

These were her last words...

She had asked me a couple of weeks before, “How do people do this alone?” acknowledging all the wonderful help that was being volunteered to us.

“Truly, I do not know,” was my heartfelt reply of gratitude.

Night times were occupied with changing her colostomy bag, emptying the folio-bag draining her stomach fluids—poisons from the tumors, repairing the faulty plumbing of her catheter, and attempting to keep her hydrated.

I was exhausted, though I wasn’t that aware of it! On December 30th, I laid down next to her at 11 PM, attempting to take a cat nap. Her breathing was so loud and labored that I got up and spent the remainder of the night trying to give her water and make her comfortable.

Thinking she was not getting enough oxygen, and that I was starving her, I telephoned Catherine at 8:00 AM and explained the situation. She arrived 30-minutes later and assured me that Sarah was getting enough oxygen, and no, I wasn’t starving her. I was particularly disturbed about this and we sat in the living room discussing the current state of affairs.

Fifty-minutes later, Denise, the day nurse/aid standing watch at Sarah’s bedside, called, “Erik!”

Both Catherine and I went into the bedroom. She stood at Sarah’s feet, I at her head. Sarah’s breathing was loud, labored, and becoming more and more widely spaced.

I placed my right hand on her forehead, stroking it back over her beautiful silver-gray hair. Her beautiful, scenic blue eyes were concealed behind closed lids. Her honey-lips, cracked from lack of moisture. Those alabaster hugging arms, slack beside her, hands resting on her stomach.

One last, labored, long drawn out short breath...

It was 9:24 AM, December 31, 2004.

Sarah made her escape.

Thank you for everything.

Happy New Year!


A couple of days later I had breakfast with an old and close friend of mine. In the course of our conversation, he asked me an insightful and fascinating question: “What have you learned?”

I opened my mouth to speak, but tears immediately flooded my face, as I had given this subject considerable thought the past few months. “That’s a great question,” I barely eked out. “I can’t talk at the moment,” it felt like an apple was stuck in my throat, “but I’d like to give you an answer—at a later date.”

I wanted to discuss with him the 38-years ago counsel given us by my best man, “Live each day as if it were your last.” Had we applied that wise counsel, there would be no regrets, or sorrow, nor guilt this day; as we would not have said or done, or not done things for which we would later have cause to regret.

And the admonitions: Sink your differences, Bear with one another, Cooperation with Understanding, Work with

one another, Give the benefit of doubt... And how by applying this very practical advice each and everyday, would eventually eliminate strife amongst individuals, strengthen friendships, and dissipate enmities, thus developing more successes and eliminating failures. What could be more practical...?

This is what I regret: Not having made a greater effort to apply those practical admonitions with the love of my life, noble companion, best friend, and wife of 38-wonderful and memorable years.

This is what I have learned: Not to regret past mistakes, but to learn from them. That the cultivation of our friendships is more important than self-centered, obstinate selfishness, and irritable impatience towards one another, which brings strife and difficulties. That the efforts to treat each other decently and honestly, exercising discretion and tolerance, patience and understanding towards each other’s shortcomings, carries weight toward bringing together mutual cooperation and harmony between individuals.

The paradox is that we must suffer through the storms and tempests in the passage of life’s journey to gain the experience to begin to understand the wisdom of wise counsel. The counsel here is to remember our mistakes and not to repeat them.

Thus is true progress toward cooperation with understanding—learning to work harmoniously together—made...

Erik O. Ronningen
Mamaroneck, NY
June 2005










Erik Ronningen lives in Mamaroneck, NY.


He was married to Sarah for thirty-eight years.


I have been lucky enough to have known Erik for a few years and was privileged to have had the chance to have chatted with Sarah once or twice before she died.


Erik's reflections on 9/11 are some of the most powerful words on the subject I have ever read and remain online more than four years after we first published his essay. - HN


You can email Erik at






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