Spee Braun on world of the sick / world of the well

Obituary

Tue, 01 Nov 2016 18:45:46 +0000

Ellen Key Harris-Braun, 50, of East Chatham, New York, died at home Friday, October 28, 2016. Born in Atlanta, Georgia, she attended high school in Rochester, New York, and graduated summa cum laude from Yale University with a BA in anthropology. A life-long science fiction reader, she turned her honors thesis on the use of anthropological concepts in science fiction into an application to Del Rey Books, the sci-fi division of Random House. There, in the early 90s (before the Web) she began an email newsletter, including writing advice, that ultimately became the independent Online Writing Workshop, which she and her husband, Eric Eugene Harris-Braun, directed. During her last few years at Random House, she was part of a pioneer group in charge of that publisher’s online projects.

Ellen was a midwife. She trained as a childbirth instructor after the birth of William, her first child, then became a doula after the birth of Jess, her second. As she began her midwifery studies, she served first as a public member of the Commission for the Accreditation of Birth Centers and then as director of data development for the Midwives Alliance of North America’s division of research. As a Certified Professional Midwife, she attended home births in Massachusetts and New York, working with River and Mountain Midwives and Local Care Midwifery.

She and Eric designed the data collection software for MANA’s statistics website, an ongoing project that recently led to the publication of a landmark study of almost 17,000 planned home births. In 2014 she received the MANA Star Award for her contributions to the profession, and that organization has named its two research awards (one for students, one for practicing midwives) in her honor. In 2015 the Midwifery Institute of Philadelphia, where she had been pursuing graduate studies, established the Ellen Harris-Braun Midwife Scholar Award and presented the first one to Ellen.

Her love of words and her sharp wit – often described as not TSA-approved – were relished by her friends and family and have been passed on to her children. Evidence can be found on her blog, World of the Sick/World of the Well, an account of her illness that is at once informative and, almost to the end, a delight to read (ellen.harris-braun.com).

In addition to her husband and children, Ellen is survived by her mother Kathryn Key Montgomery of New Orleans; her siblings, Anne Montgomery Hunter of San Francisco, Debra S. Hunter of San Rafael, California, Lisa M. Hunter of Madison, Wisconsin, James Paul Hunter of Atlanta, and their father James Paul Hunter of Charlottesville, Virginia; her step-mother, Laurie Randolph Barili Harris of Atlanta; her brother- and sister-in-law Jens and Spee Braun; ten Harris cousins; and beloved members of the Quaker Intentional Village-Canaan. Her father, David Jesse Harris of Atlanta, preceded her in death.

A memorial service will be held at 11 am Saturday, November 12, at the Old Chatham Quaker Meeting House. Her family and friends are grateful to the helping circles that have sustained them and to Rufus Collea, MD, Elizabeth Hanlon, RN, and Jeffrey Arp-Sandel, MD. Memorial gifts may be made to the Ellen Key Harris-Braun Research Fund at the Foundation for the Advancement of Midwifery (www.foundationformidwifery.org).

Memorial Service to celebrate Ellen's life

Sun, 30 Oct 2016 10:17:30 +0000

A memorial service in celebration of Ellen’s life will be held at the Quaker meetinghouse in Old Chatham, NY, on Saturday, November 12, at 11:00 a.m. with a reception to follow. Directions may be found on the website of Old Chatham Quaker Meeting here. If you plan to attend from out of town and need overnight accommodations, please email memorial@harris-braun.com.

We hold deep gratitude for all your love, prayers, chocolate, healthy food, and other support that made it possible for Ellen to spend her final months at home surrounded by loved ones.

We welcome your Ellen stories and memories here on this blog or by snail mail to Eric at 229 Bradley’s Crossing Road, Stop 19, East Chatham, NY 12060.

Time to fly

Fri, 28 Oct 2016 21:41:57 +0000

Ellen took her last breath around 5:40 p.m. this evening. Her death coincided with the start of two gatherings of communities deeply important to her. Here in the Quaker Intentional Village-Canaan, we were coming together in the Farmhouse for the start of our semi-annual retreat. A few miles away at the Quaker conference center Powell House, midwives were gathering for the annual weekend retreat of the New York State Association of Licensed Midwives. This weekend will see many tears mixed with storytelling and sharing of memories. We welcome your Ellen stories and memories here on this blog or by snail mail to Eric at 229 Bradley’s Crossing Road, Stop 19, East Chatham, NY 12060.

Candles flickering

Thu, 27 Oct 2016 21:22:14 +0000

With candles flickering on the windowsill beside Ellen and soft daylight fading outside, we enter a night with winter-time temperatures and marvel at how the seasons are changing so markedly during this period of Ellen Time. Ellen’s body continues to diminish before our eyes while her spirit fills up the room. We are grateful that we’ve succeeded in keeping her at home all these weeks, thanks to Eric’s dedication and that of the other caregivers, as well as the support from medical and hospice professionals.

Our records aren’t 100% complete, but it seems that the last day that Ellen ate a grape or two and took a sip of grapefruit juice or lemon tea was October 16^th. That’s when she started having trouble swallowing and that’s only been getting harder, causing occasional coughing that we try to soothe. Since September a year ago, Ellen dealt with edema (swelling) of her left arm and hand, and a few days ago we noticed her slender well-shaped hand reappeared. Unfortunately, that same hand is increasingly causing her discomfort, likely pins and needles and pain from neuropathy, and we’re exploring a shift in her medications to address that.

With steroids out of her system, Ellen’s high cheekbones and gorgeous jawline are once again revealed. Here is a photo of her lovely face, taken 27 years ago.

Guest post: Dropping in

Sun, 23 Oct 2016 19:47:41 +0000

Contributed by Ellen’s sister Lisa

Aaron and I arrived today from Wisconsin, to see Ellen and everyone else here and because we’d been scheduled to come this weekend for months and were told we’d be needed. We have so appreciated Spee’s blog postings and everything everyone in this loving circle has been doing to support Ellen and her world and to keep her comfortable. So at Spee’s invitation (and as she continues to recover use of her left hand after last week’s fall) here is our experience today of seeing Ellen and being in the midst of the community of care that surrounds her.

Kathryn insisted on picking us up from the airport. We dropped suitcases at Jens and Spee’s and they offered hugs and hospitality. When we went on to Ellen and Eric’s house, Anne U had been sitting with Ellen, and as Aaron and Kathryn and I arrived from the airport and grocery, Eric was just taking over with Ellen. Anne gave us an update on Ellen’s afternoon, which included some wakefulness and time sitting in her chair, then Anne left. Will and Jess were off with cousin Natalie shopping for used clothing; later they came home with their finds. We helped Kathryn put away groceries and make a dinner plan, and after a while Eric came down to greet us with warm hugs and a somber manner, and let us take some time to sit with Ellen ourselves.

She was asleep; we are told she is now sleeping for most of the day and night. She looks very different from the time of our last visit: sicker, thinner, and somehow paler. She was settled in her own bed, and though the equipment of illness (wheelchair, etc) is in the room, there was no aroma of illness or sense of medical interruption as she slept. I was immediately struck by the fact that Ellen is at home, in her own bed, with her own purple comforter tucked around her, with the gorgeous colors of autumn outside her own window. There was a slight furrow to her brow that her core care team has tried hard to interpret, and Eric, Kathryn, Anne U, Shivani, and hospice nurse Elizabeth have established a routine for her pain medication and other functions that seems to be giving her relief and ease for this new, quieter phase. This afternoon Ellen was breathing comfortably and the room was silent except for the patter and occasional fury of steady rain on the roof above her bed.

We decided not to risk waking her by hugging her or speaking but sat peacefully by her bedside for a while before Eric joined us; then we headed back downstairs where the kitchen had been cleaned by Claire the day before, where Josie had left a list of her cleaning projects that week, where the refrigerator was full of good fresh food from a lot of loving QIVCers, neighbors, and other friends, and from Gina who brings homemade food every Friday. Will went to pick up Eric’s friend Jean-François from the train station, and when he got home we sat down to dinner - Eric upstairs with Ellen and JF - while Jess and Will joined us with Kathryn. When Shivani arrived to be with Ellen, Eric and JF came down to eat.

The house glowed with the dull light of a rainy fall day. Pink and yellow snapdragons brightened the kitchen counter. Tomatoes of all sizes and shapes - small green cherries, big twisty orange ones, large round variegated red and yellow orbs - were spread across the living room windowsill in advance of the first frost. Everything felt very quiet even when there was talk. Part of this seems to us to be the stillness intrinsic to the location of QIVC. Part of this seems to be about the sadness that Ellen’s voice is almost entirely absent and that the hard work of caring for her as she dies now goes on largely without her active, verbal, conscious participation. Part of this is the set of decisions made earlier this week as recommended by Elizabeth, the hospice nurse, and summarized below by Spee:

The overall idea is that we caregivers will back off and give Ellen the space to “do the hard work of dying.” She has one foot in this world and one in the next and we need to help her go. We will no longer proactively engage with Ellen and seek in-this-world connection with her (ah, the grief in giving up those exchanges of words and gestures we were having). We will not ask her questions about her state, although we’ll certainly still be assessing her comfort level and seeking to keep that high. We won’t ask her whether she wants us to do X; we’ll say, “I’m just going to give you X now, which will help you be more comfortable” and proceed. We will, however, console and reassure her and continue to let her know we love her.

So part of the quiet in the house is about the integrity of purpose that the grieving, determined people who love Ellen bring to her care. Part of it is about how different this experience is for everyone involved.

We are grateful to be in this caring community today, and grateful for Ellen’s life, the life she has shared at different points with us and others, the life she has made here with her family and community.

Below is a photo of the four sisters: Lisa, Deb, Anne, and Ellen

The Gifts of the Death Midwife

Mon, 10 Oct 2016 21:49:30 +0000

Ellen has been sleeping away the hours, in the wheelchair, in the rocking chair, and on her bed, the bedroom couch, the office couch, and even her mom’s bed. When she’s awake, she’s often up and about, traveling in the manner we’ve previously described but no longer packing up. She’s also talking a lot less and we miss her wit. In addition, she came down with some kind of infection yesterday, with swelling, redness, and pain on the right side of her face and neck. The doctor, nurses, and Eric are trying to figure out how best to keep Ellen comfortable in the face of this new development.

Last winter, Ellen began asking her dear friend and colleague Shivani if she would be Ellen’s “death midwife.” During the spring, Shivani queried Ellen on what she imagined a death midwife would do. Ellen didn’t provide much guidance, but Shivani has done an incredible job feeling her way into this role. She creates and holds sacred the space around Ellen, she lifts up the beauty she sees in Ellen even as illness wreaks havoc on her body, she provides hands-on care of Ellen’s body, she prepares her emotionally for dying, she helps ease Ellen’s journey in any way she can, and she comforts and assuages fears and guilt not just for Ellen but for all of us. She is guiding Ellen’s way out of this world the way she guides many babies into this world. It’s so interesting to hear her and other midwives speaking of the similarities they notice in these two life passages. Early this morning, Shivani wrote:

... Yes the absence of her wit is different. I was just thinking how challenging it is that most of what she has to say is in some defense of her body. Don't move me... No that way... Can we just wait a minute... I want so much for her to die feeling loved and held. But as with birth, and most things, sometimes it is our job to merely be witness and quietly shine our hearts like a steady light.

Ellen would want to provide you with more resources on this topic of death midwifery, but there's not much available yet in the U.S. culture. More common is the death doula role - see Dying is hard. Death doulas want to help make it easier.

Here is a photo of midwife Michelle teaching Ellen to suture.

Packing up

Wed, 05 Oct 2016 22:25:54 +0000

Sunday marked Ellen and Eric’s wedding anniversary and quite a few of you may remember that wonderful gathering on a crisp October day 22 years ago. We’re blessed these days with bright and sunny weather that brings beautiful light and color into their home and offers lovely sights out the windows – soaring birds, deciduous trees tipped with bright colors, happily grazing sheep, horses, and white-tailed deer.

For days Ellen was restless, touring around the upstairs of the house, going from place to place in the wheelchair (with help) and moving items here and there, sometimes with an evident purpose and sometimes not. At one point earlier this week, she was on the go for 22 straight hours before finally falling into a deep sleep. Since then, she’s still driven to be on the move - she’s been spending quite a bit of time packing her bags - but with a bit calmer pace now and much more rest and sleep in between. Whew, say the primary caregivers (husband Eric, mom Kathryn, sister Anne, and friends Anne and Shivani).

While it seems Ellen’s arms and legs are staying relatively strong for all that restless activity, we’ve noticed other changes in the past week, notably Ellen has more discomfort, more confusion, increasing difficulty swallowing, and more labored breathing. Working with the hospice nurse, who’s checking in daily, we’ve responded by moving away from medication in the form of pills and offering more liquid pain medication and temporary boosts of oxygen.

So it continues, with Ellen’s inner core shining through to us from time to time as we seek this way and that way to make her journey as comfortable as possible. As you can imagine, we have many moments of sadness, yet we are lifted by and so grateful for Ellen’s sweetness, her smiles, her waves “hello” and “goodbye,” and her wit. Yesterday when sister Anne was the caregiver on duty, Ellen got from her wheelchair to bed by herself before Anne could get close and assist. Anne told her she should have waited for her, and Ellen replied in a sing-songy voice, conspiratorially, “Don’t tell Mom!”

Here are sweet photos from Ellen and Eric’s wedding day in 1994.

Maudlin?

Wed, 28 Sep 2016 10:41:43 +0000

Ellen has always liked to do projects. She’s always had a list of projects going and the most recent one hung out the entire summer on the end table next to where she would sit on the living room couch. Recently, Eric, Kathryn, and I reviewed that list, made in April, and began assigning the projects not yet crossed out. Here’s a sampling:

Buy new spoons – replacements CLF31 by Cellar, plume @ tip, Tools of the Trade
Update the BCD trans.html page
Midwife of the Soul (Eliz)
Eric’s paper

Ellen has called management of her health while living with metastatic breast cancer the “Ellen Project.” What a complex project, with a dozen symptoms, multiple immune-system boosting activities, a dozen health care providers, a dozen medications and another dozen supplements, and over a dozen brain mets to track and manage. As she has become less able to manage the Ellen Project, others have had to step in. We have come to know numerous details about her medical case, including what might be causing what (such as a headache) and how best to address it (need to taper steroids more slowly?). We have not completely replaced Ellen’s brain in managing the Ellen Project (no surprise there), but we are doing okay – maybe we get a “B” while she always gets an “A” (see Ellen's Report Card).

The days are getting more difficult and the nights are no longer very restful. Ellen seems uncomfortable a lot of the time and we’re facing that challenge of balancing enough pain medication (morphine) to make her comfortable with little enough medication that she’s alert enough to interact with those around her. Ellen has said lately that she’s tired and at the end of her rope. And yet, she has not wanted sympathy and certainly not pity. She has not wanted good-byes. She’s expressed discomfort at “this is what you’ve meant to me” letters received in the spring and summer, but also read them with pleasure while thinking of the meaning of her life and her life accomplishments. One thing is for sure – she doesn’t want maudlin* and doesn’t want us doing maudlin things. Whatever you do, don’t launch into the song Dear Friends.** If she had the energy, I could see her creating and putting up a sign such as this one:

Favorite quote of these past few days: Eric says, “I’m going downstairs to get some breakfast and I’m going to leave you with Spee.” Ellen replies, “Can I keep you on retainer?”

We’ve been sorting through hundreds of photos and finding one after the next of Ellen’s beautiful face. Here is one of my favorite photos of Ellen and Eric, taken at Dorson’s Rock above Powell House during a family outing that included not very successful efforts to send paper airplanes flying off the edge of the cliff.

With gratitude today for Ellen’s warm smile, for shared therapeutic Colorku*** with Kathryn and Anne as we accompany Ellen and Eric during this long labor, and for QIVCers coming together at this time to hold us all in our collective hands and hearts.

Definition: Showing or expressing too much emotion especially in a foolish or annoying way, weakly and effusively sentimental ** Lyrics: “Dear friends, dear friends, let me tell you how I feel, you have given me such treasures, I love you so.” *** A game like Sudoku, with colored round balls instead of numbers

Ellen Time

Fri, 23 Sep 2016 09:25:20 +0000

We’re living in what midwife Michelle calls “Ellen time,” floating through each day with each hour calling us to be fully present. For the past ten days or so, Ellen has been speaking with more facility, had longer time periods of alertness, and been quite active physically, getting up many times a day and moving about from bed to couch to chair to bathroom. While she’s more alert, she’s occasionally unclear and confused. Eric, Kathryn, and others around Ellen are appreciating when she communicates a full idea and we often find humor in what she says, which is good for the soul.

Here’s one example: For years, Ellen has been going to peer review each month in Saugerties, greatly enjoying these get-togethers where midwives share resources, discuss concerns, analyze complex cases, and otherwise support each other professionally. At the September peer review gathering, the midwives celebrated Ellen, bringing stories and poems and Ellen’s favorite varieties of chocolates. Then on Sunday, midwife Birdie came to see Ellen to share with her about that special gathering in her honor and to pass along some poems and cards. As Birdie was getting started, Ellen commented, “Just tell me a little bit, because I don’t want to get too jealous.”

Here’s one that got a hearty laugh out of Eric: Ellen said to him, “Would you please get me my … heavy … volunteers?” “Oh,” says Eric picking up her sheepskin slippers, “Do you mean these?” (Yup. How did he know that?!)

This one also brought laughter: Jess came home for a quick visit tonight and caught Eric in the midst of helping Ellen move from place to place. “Spinning around, huh?” asked Jess, and Ellen replied, “That’s what we do all day.”

It’s clearer that Ellen’s busy-ness is the terminal restlessness many people experience during this phase, and we’re feeling grateful that for Ellen, it’s not a frustrated or anxious state but a purposeful and peaceful state, with her going about her business. Today nurse Elizabeth noted a couple of other “transition” symptoms like signs of decreasing blood circulation. She asked Ellen if she has any anxiety about dying and Ellen responded that she does not, which was good to hear.

Here is one of my favorite photos of Ellen, taken one time when we were at the Cunuñacu hot springs in the valley below Quito, Ecuador. Do you have a favorite photo of Ellen you’d be willing to share with the family? If so, please send high-resolution versions by email (don’t worry about MB size) to Ellen’s sister Deb at debra@huntermorgan.com. If you can provide the date, location, and names of others in the photos, that would be helpful.