For the last couple of decades, I was trained to save lives. I sat shoulder to shoulder with others who drilled this in me when I was green, sometimes even through humiliation. I learned to perceptively read patient cues, develop quick reflexes, and think on the spot in critical moments, wherever and whenever life was compromised. I always threw lifebuoys into the ocean when I was called into action. This is medicine. More recently, this training served its purpose for my own mother’s condition as we mapped out her treatment plan with an incredible oncology team.

My metamorphosis began when my mother reached the point in her illness where she could no longer be cured of her disease. First, do no harm and hope still remained my cornerstone goals. However, I soon realized I had to remove the thick medical lenses over my eyes that I carried for so long. With hospice and palliative care on board, I was unlearning some strong-held concepts in medicine. I began to re-wire my own neuro-circuitry to look at clinical symptoms in a completely new light. Something else took over. Priorities changed. Instead of addressing and treating vital signs, I watched them closely and paused. My focus shifted and became about upholding my mother’s three wishes. These three wishes were ultimately her saving grace, my saving grace: To be home. To be surrounded by her loved ones. To be comfortable.

This new approach to care required me to step into vulnerability, follow my gut, and drop all plans while taking in each minute as it came. Death and comfort” collided at times in my mind. Death and dignity felt like they were old neighbors who didn’t get along. Death and peace felt like oxymorons. But once I let this new stranger into my heart, my world changed. I was getting a degree in death. Death became my teacher. Death and faith started to hold hands. Death and beauty walked into the horizon together.

I had experienced death with patients throughout my medical career, and I had lost and seen my own grandparents pass away and supported close friends mourning their losses. However, this time it was my mother. The one whose body I came from.

Caring for my mother with every innermost fiber of my heart was the easy part. What was hard became letting go of her and everything I knew about life and medicine. I decided to lean into those moments when she needed me most. I was in awe of my family, who watched and did the same. While walking in such uncharted territories, I asked death to be my friend. When I became aligned with what stood in front of me, I was finally free of any fear and worry. I became alive and approached each moment with all my senses, like a traveler on a new journey, a child discovering the world around her.

My mother was my source. The one whose scent and soft skin felt like a protective blanket. The one who stood arms open and watched me grow. The one who enjoyed talking about her grandchildren. The one who knew I was always there and could always count on me. The one who challenged me in the best of ways. The one whose life was infused with fine art and detailed design. The one who let me vent unapologetically. The one who always knew what I really meant to say by the slight shift in my voice. The one who did everything possible for her family—even the impossible. Giving was her life’s purpose.

If who you are at your death reflects the life you led, my mother exuded patience, strength, kindness, and a love for all beautiful things even in the last hours of her life. She was a life-long caregiver, and during the weeks leading up to her death, she became the care recipient for the first time. It was refreshing to witness her living in the present moment, worry-free, taking each day with such grace and gratitude.

It is a priceless gift to be at the edge of the platform of life, watching and allowing your mother to go. It is a gift to be able to listen to her words and uphold her wishes. It is a gift to have been given such a love throughout my life, to love wholeheartedly in return, to carry on that love down to so many more generations to come. My mother was a gift to all those she touched. Her dignified, tender, beautiful life and death will shape those who loved her for the rest of our lives.

Roxanne Almas is a developmental behavioral pediatrician and an associate professor of pediatrics at UCSF Benioff Children’s Hospital, specializing in children with complex neurodevelopmental conditions. She also serves as the wellness coordinator for the Division of Developmental Medicine at UCSF. Fluent in French and proficient in Spanish, she centers whole-person care that honors trauma, equity, and family partnership. Certified as a narrative medicine and yoga nidra facilitator, she explores how storytelling and rest support resilience and healing in health care. She leads UCSF’s Narrative Medicine Circles, conducts workshops nationally, and was selected as a writer for the Breathe: Honoring the Voices of Healthcare film series. Her writing appears in Bioethics Today and KevinMD. Outside of work, she enjoys writing, gardening, and finding the sacred in the everyday.

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