Mrs. G was one of the tiniest women I had ever seen. She was in her nineties. When I met her, she was enveloped in the blankets of her hospital bed, like a newborn wrapped in an over-sized baby blanket. She couldn’t have weighed more than seventy pounds. Her skeleton was easily traced for there was no muscle left. Purple veins cross-crossed under her skin, like a child had drawn on her with purple marker. Her skin was fragile and soft…ever so soft, like paper made from tissue wrap. Like rose petals. I loved touching her arm. Even over the hardness of her sunken frame, her skin was like silk.

You see, Mrs. G was dying. Quickly. Her tiny frame, her emaciated and fatigued body, was courtesy of stage four squamous cell carcinoma of the lung. That is usually a cancer caused by smoking, but Ms. G never touched a cigarette in her life. Her husband, on the other hand, smoked around her daily. He died three years prior of his own lung cancer.

Ms. G was a pianist. She loved music. Even dying, she recounted the works of all the great composers. She played the piano in the air, her deft and thin fingers commanding a tune only she could hear. She was sick but her mind was sharp. She had much to speak about. Her grandchildren. Her garden. Her parents. She tended to regress when she got her Morphine. That’s when she talked about learning to play the piano and that’s when her eyes were the brightest.

When in a peaceful delirium after pain medication, she told me about the keys of her father’s piano. The softness of the ivory. Her dad’s finger marks on the keys, telling her where to place her hands. Her father died when she was a teenager, but she continued to use his piano until she was older and married. She said following his fingerprints was like being taught to play by an angel.

As the days passed, she had more trouble breathing. Eventually, she was placed on a BiPAP. I’ll never forget how shocking it was to walk in the room and see this small woman strapped to an enormous face mask. She was alone at the time. The machine forced air into her. As it did so, it took away her ability to speak, dried her out, and imprisoned her. Never have I seen such a perfect example of a treatment being worse than the disease. Her delicate fingers were clutching the bed covers as the machine battered her with breaths. It was violence. The BiPAP was her aggressor. I couldn’t stand it and neither could she.

When I walked closer, I realized she was saying something under the mask. I lifted it. “Take it off. Off,” she whispered.

“Ms. G, if we take it off, we will have to give you lots of Morphine.”

She nodded.

I hesitated. “It will be…it will be the end. You won’t wake up.”

A single tear fell down her cheek. “I know.”

So we did it. We gave her a loading dose of Morphine and pulled off the monstrosity wrapped around her face.

She went quickly. Faster than expected. Her family did not get there in time.

But her hands were in mine when she passed.

Rose petals.

Playing music.