I met Yolanda while she was practicing a headstand on Ocean Beach in San Francisco in the fall of 1988. Late last year, she was experiencing some bloating around her abdomen that was assumed to be normal menopausal issues. When she started to appear pregnant we went to the hospital for tests. On December 14th 2007, a teary-eyed doctor announced the diagnosis: Stage 4 ovarian cancer with a grade 3 cell (the most aggressive), an incurable disease. Nine months later nearly to the day, on September 11th 2008, her soul was birthed from our physical realm. If there can be any consolation for the enormous loss that I’m feeling, it’s that Yo and I experienced a depth of connection during this twentieth year together that I didn’t know could exist. It was a journey of complex options, difficult decisions, and unprecedented emotional and physical distress. It was also the most meaningful and heart-opening period of our lifetimes. Yo would often describe her condition as a “blessing and a curse”. The outpouring of love from our families, friends and community were a constant reminder of the blessing. Her blog postings below describe some of the challenges and joys that we faced. The purpose of this posting is for my own cathartic need to honor my extraordinary wife and to share some of the details of our final weeks together and finally of her passing.
Yo taught her last public classes in January just prior to surgery. Within 5 days after surgery she was on her feet and doing basic yoga stretches. As she continued to recover, she set two goals that seemed attainable at the time. One was to visit family and friends in my homeland of Western NY State. We looked forward to attending a family reunion and relaxing in the balmy weather of the beautiful Finger Lakes Region. The other goal was to drive from San Francisco to New Mexico and visit Yo’s homeland. She and her 4 sisters would be together for the first time in 6 years since their Mom passed. We planned to visit friends and relatives while marveling at the desert vistas, the magnificent Sandia Crest, and our favorite spots like the red mountains of Jemez and the vast caldera of Valle Grande.
Though she was frail after the surgery, Yo adapted masterfully. She utilized her strengths and respected her weaknesses. She never blamed anyone or anything for her condition and she sought out ways to make the best out of her changing body and challenging symptoms. As the saying goes, there were good days and bad days. During the first 8 months there were mostly good days and they made you feel like everything was fine and in time she might even regain her vibrant physical health. The difficult periods were tough but managed with Yo’s remarkable determination. Her practices and treatments consisted of plenty of gentle yoga, acupuncture, massage, hypnotherapy and connection to nature. She also had her daily “receptivity time” which meant resting and absorbing the prayers and positive energy from so many of you. When fluid would build up around her abdomen or pleura (a common symptom of this disease), we would go to the hospital to have it extracted. This relatively simple outpatient routine would become more common as time passed. Her breathing and mobility were affected by the fluid which caused discomfort. Yet she continued to adapt to the challenges that would arise thanks to her regimine and to what Yo referred to as PMA (Positive Mental Attitude).
With regard to the first goal, we kept changing our departure date for NY and there were moments when I didn’t think we’d make the trip at all due to her shortness of breath and increased immobility. We decided to cut our time from a month to 2 weeks. Yo rebounded while in NY and relaxed into the gentle nature area where my sister and her husband live. She got up with the birds to do her yoga by the canal and connected with family and friends with unending love. It was just amazing to be in her presence. Her light was shining brighter than ever.
The flight back to San Francisco was hard on her and she needed another Pericentisis (fluid drained from the abdomen) immediately upon return. Her oncology nurse was always attentive to our requests and needs, setting appointments and continually consulting with us during the process. Yo wanted to avoid being in the hospital except for these outpatient visits for the fluid management. Shortly after our return from NY on August 11th, movement became increasingly difficult and occasionally she needed help climbing the stairs, but most often she preferred doing it alone at her own pace. She found ways to open her body with a gentle yoga practice and acupuncture treatments. She still was able to maintain enough energy and mobility to walk in nature just north of the Golden Gate to special areas that we shared together throughout the years.
One walk in particular which would have normally taken us an hour to loop, now took us 3 hours. It reminded me of a mindfulness retreat we once attended in the Adirondacks led by Thich Nhat Hanh. Walking meditation was one of the practices. One step, one breath. Everything slowed down and present-moment awareness was our focus. This is what living with Yolanda was like in general. She couldn’t be rushed and she had remarkable patience that complimented her graceful nature. Years ago on a hike around Phoenix Lake, I watched in amazement as she very, very slowly reached down in a yoga posture variation and stroked the underside of a tiny lizard’s neck. This is the kind of lizard you see all over California mountain terrain that speedily darts away from the slightest movement. While she slowly came back to standing, the little creature remained motionless except for looking up at Yo after physical contact was made. That was Yolanda. She walked gently through life and connected with nature in an almost mystical fashion. She showed reverence for a resting spot by putting her hands in prayer position and giving thanks before walking away from it. Her deepest passion was being in nature and in the 9 months following her diagnosis we couldn’t be in it enough.
“The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.” - Albert Einstein
When Yo mentioned driving to New Mexico shortly after our return from New York, I inwardly dismissed the notion. I loved the idea early on but I assumed the plan would be abandoned after the last series of challenges. Yet she was determined and when I mentioned the option of flying she emphatically rejected it. Though Yo showed obvious signs of physical decline, her mind was sharp and she was radiating a light and energy that had its own direction and purpose. Rather than complicate the matter with my opinions, I tried my best to get out of the way and happily assist. A plan was unfolding that I needed to trust and follow. She held onto an unshakeable image of driving with me through the Southwest as we had talked about throughout the years. She wanted to be with all of her sisters in her homeland and share New Mexican Enchiladas together as we had done in past visits. Yo’s appetite was always healthy and throughout this illness she maintained it in extraordinary fashion. The only time it waned was when she experienced nausea from an antibiotic to treat symptoms of pneumonia. She loathed taking pills and that included many nutritional supplements. Whatever the side effects, she would have them in the extreme. She declined almost all pharmaceutical offerings including chemotherapy (which she believed would have killed her from the first treatment, see her blog posting from June 5th below). The doctors respected Yo’s self-determination. A new Pericentisis was scheduled and a date was set to begin our trek several days later.
We left for the Southwest on Wednesday, September 3rd in the early afternoon driving my Toyota Sienna Minivan, a comfortable ride that was made more comfortable for Yo’s needs. She loved the reclining seat behind the driver’s side and I fixed it so she could have her feet propped up on pillows atop the ice chest. She didn’t want to lay down flat because she would miss the scenery. Interstate 5 takes a bad rap when compared to the more visually versatile 101 but we enjoyed the open space of the Central Valley farmlands. Our first overnight was in the outskirts of Bakersfield, a dusty town of roughly 300,000 and considered the country music capital of California. We stayed in a hotel on Buck Owens Drive. I brought dinner in the room since Yo’s movement was limited and she was very tired. We ended the evening with massage and prayers. She always felt relief from massage. I had been focusing on her legs and feet several times daily since the beginning as they were prone to swelling. Yo’s idea of God was probably as inclusive and expansive a concept as imaginable and the prayers of surrendering to and trusting this power brought comfort and strength. While she showed obvious signs of fatigue, her determination only intensified. I brought in breakfast the next morning and then we headed out on the next leg of the journey. Her one insistence to an otherwise spontaneous driving schedule was a night in Flagstaff, Arizona. We pulled out of Bakersfield and headed East, driving by colorful flower farms, cotton and sugar cane fields and lots of almond and fruit trees. Then within an hour the landscape started to shift dramatically.
The Mojave Desert in California is one of the most remote areas in the country and possibly on the planet. There’s a stark beauty and openness that offers a welcome contrast from a compact city like San Francisco but you probably wouldn’t want to live there. We kept things pretty quiet during this leg of the journey. I don’t think we listened to any music and our conversations were kept to a minimum. She had to keep verbal communication to the necessities as it required precious energy and breath. Cruising down Highway 40 East, we drove through places like Boron (home of twenty mule team borax) then Needles, then Barstow…places that we passed through when we first discovered the West Coast years before we met. Now we were sharing this highway together for the first time. We pulled off in Needles and it was 105 degrees. I asked the gas station attendant if this was typical weather. He smiled and said that it was cooling off and that it reached 120 not long ago. I felt some urgency to move on since Flagstaff was still a few hours away, but Yo insisted that we pull off outside of town, throw a blanket down and have a picnic. She loved picnics. So we found an ample space under a tree on the dusty desert floor and broke out the cooler that was stocked with all kinds of goodies. It was hot and desolate but we created an oasis for the hour that we stayed. This was another of Yo’s talents; she was brilliant at transforming a space to make it more efficient and comfortable. I’m sure her more crowded yoga classes benefited from this gift.
We pulled into Flagstaff in the early evening and arrived at a hotel nestled on a 300-acre pine forest that I booked online before we left. The air is thinner up there so I was concerned about her breathing but she seemed no worse than at the lower altitude. She loved the hotel and our room that opened onto the nature preserve. We spent the night and she wanted to spend an additional day and night so we could relax in this beautiful setting without driving. I know she needed the rest so we stayed and made the best out of her limited mobility. Much of the time we sat on the large couch and gazed out at the forest with the sliding doors wide open. She wasn’t able to hike so she sent me out alone to bring back a “nature report”. I set out for an hour and crossed paths with a coyote at one point and an elk soon afterward. Yo is super-independent but now she had to rely on me for some of her basic needs. Yet she would always encourage me to get outside and exercise and take time to do something special for myself. There wasn’t much I wanted to do as I felt content just being with her. My heart would quietly break when she would struggle with her condition but I tried to focus on love and not on despair. Being such a loving and loveable person, Yo made this easier than it could have been.. I learned that I need not feel helpless. There’s no end to the amount of love one can hold and it’s a very powerful and stabilizing force.
The next morning I packed the van and wheeled Yo out on the hotel’s luggage cart. We found some humor in that exit as did a few guests, but we were really using the cart as a makeshift gurney. We could have reached Albuquerque by early evening but Yo’s tolerance for driving long distances was low. I was trying to keep my anxiety from her, but I had secretly charted out hospitals along the way from my laptop at the hotel in Flagstaff in case she needed oxygen in a hurry. We drove less than 2 hours to Holbrook, AZ and stayed in a comfortable hotel at a lower elevation. I bathed her and served her dinner in bed. It was there in Holbrook that she confided that she might decide to die in Albuquerque.
We left for our destination the next morning on Sunday, September 7th and traveled through the Painted Desert toward the New Mexican border. Yo asked me to make sure she was awake when we crossed the border. When that time came, I indeed woke her. For much of the remainder of the trip when I looked back at her through the rear-view mirror, she was peacefully gazing in wonder at the rugged mountains sprawling across the enormous desert floor. We had made arrangements to stay in a nice hotel-suite in an area of town near her childhood home but by the time we reached the Albuquerque city limits, I went straight to the hospital to get her some oxygen. We pulled into the ER and within a couple of minutes, Yo was in a wheelchair with oxygen and being seen by several doctors.
Yo’s sister, Claire had previously researched hospitals in Albuquerque in the event that this would come up, and the University of New Mexico Medical Center was deemed the best choice. It’s an enormous complex with a top-rate cancer center though it was never our intention to need anything more than another Pericentisis and some oxygen-to-go. The ER doctors were informed of Yo’s condition and very supportive of her needs and requests. She was transferred to an observation room where we would spend the next 24 hours. Claire lives in San Francisco and Yo’s three other sisters: Phyllis, Madelyn, and Anna live in Albuquerque. Claire was going to fly out the following week for the “big dinner/reunion” after Yo and I made our visits across the state. I called her and she decided to come immediately and took a flight out the next day (Monday, September 8th) with Yo’s dear friend, Elizabeth Kert. Certain that she would be released soon, Yo wanted me to check into the hotel-suite across town where we had originally planned to stay but I opted for a modest hotel very close to the hospital.
We were soon visited by the Medicine Team who wanted to admit Yo to a unit that was one step below intensive care until her oxygen and sodium level were elevated. Her sodium level was low which is another effect of the disease. On Tuesday the 8th they wheeled her to room 438, Unit 4 West where she was subjected to the typical IV’s and monitors and everything else that make hospitals unpleasant. Yo didn’t complain much and made friends quickly with the nursing staff. She would observe someone whose health was noticeably compromised and her heart would bond with that person as she prayed for his or her well-being. She especially took note of the patients who didn’t appear to have a family or visible support aside from the hospital staff. I never knew anyone more sensitive than Yo. She wept frequently throughout the years and cared deeply for many causes. She talks about her sensitivity and feelings of grief on her blog posting from Tuesday, March 4th under the heading of “My Womb Story”. It’s poignant and keenly revealing. One thing that always touched me about Yo’s grieving was how, at a certain point, it would often transform into laughter and joy. I loved this about her and I loved holding her in our “heart-press” as this transition would occur.
The Medicine Team had mostly disconcerting news to share with us. They were blunt during their visits and asked if we had considered hospice. Hospice in San Francisco had contacted me when Yo looked to be fading beyond return, but she would always bounce back and I expected she would make another miraculous recovery. At one point Yo asked the doctors to stop painting such a bleak picture about her condition. Earlier on I had asked them to let me be the buffer and to give me the distressing news and that I would relay it to her. I realize that every hospital or doctor probably has their own policies about this. Still, they all asked the standard question, “what about life support”? Did Yo want to be revived if her heart stopped? She wanted to leave that decision to me but made it clear that if it meant a respirator or other mechanical means she would rather not be kept alive in this way. Based on the grim statistics for this disease, we acknowledged early on that her time on earth could be cut short. Yet while she had any capacity for quality in her life, Yo would never focus on death. Was she in denial? Maybe, but I think it kept her alive much longer and in a way that gave herself and others a sense of completion. We talked about death but never steeped in it. Life was too precious and Yo had a mission to fulfill.
On Tuesday the 9th of September, Yolanda’s 4 sisters, her friend Elizabeth, and her brother-in-law Lawrence were now all gathered to see her. Her energy was such that she could only see them in pairs. However, a plan was settled for a late lunch of New Mexican Enchiladas the following day that would include the entire crew. The idea was to wheel Yo outside into the large, beautiful courtyard of the hospital and the gang would bring in the food from a favorite restaurant. Yo wanted another Pericentisis for the occasion so her doctors approved and took her to ultrasound where they surveyed her abdomen to find a place to safely insert the tube to extract the fluid, which was now accumulating at a faster rate than ever before. This frequency of accumulation is related to the spread of disease but, as far as Yo was concerned, it was a nuisance that needed to be dealt with from time to time. It certainly offered her relief. She could breathe better as the fluid wasn’t pressing into her diaphragm. It also gave her much better mobility as the procedure typically freed her of anywhere from 2 to 4 liters of extra weight and volume. Mobility was less of a concern at this point. Yo couldn’t really walk on her own and the only time she got out of bed was to visit the bathroom, which she still could use. When she was first admitted to Unit 4 West, a nurse talked her into trying a tiny bit of morphine to help with her breathing. Yo relented, but the next day she was slightly constipated. She asked the doctor if the morphine was responsible for this. The answer was affirmative and she refused subsequent offerings.
On Wednesday, September 10th, it was sunny and warm in Albuquerque. A perfect day for a picnic. However, Yo’s oxygen saturation had taken a turn for the worse and she was now wearing a mask instead of the nose application that she had been accustomed to. She wasn’t happy about this. She had a date in the courtyard with her family and now it didn’t look good for her to leave the room at all. I encouraged her doctor to let me take her in a wheelchair to the courtyard with a couple of oxygen tanks in tow. Soon afterward, a nurse was showing me how to change the tanks when one got low. We had enough oxygen for good couple of hours. I wheeled her down and we found a nice table half-shaded from the sun. Her sisters arrived with the food along with Elizabeth and her brother-in-law, Lawrence. He owns and operates one of the oldest family-owned mortuaries in town. The photo below tells the story better than I could ever. Yolanda took her oxygen mask off long enough for a passerby to take the shot.
Left to right…Yo’s sisters Claire, Madelyn, Phyllis, Anna, friend Elizabeth and brother-in-law Lawrence, 16 hours before Yo’s heart would stop beating.
She was happier that day than she’d been in weeks with a glow of affection and contentment that touched all of us deeply. The love was so strong it reminded me of what healing really is. Numerous people were deeply effected by Yo over these 9 months. Some had only heard about her through others. Many described the healing that they felt from her and her journey, and the inspiration that it gave them. Yo touched many hearts over the years just by being herself. She would be the last to realize this. During her journey with cancer, she would talk about healing but the healing she referred to went beyond her own physical condition. Yo always put others first and she brought people closer to each other and to their sense of connection to Spirit. She touched many hearts with her sincerity and inspired others with her courage. In the midst of her illness, she would say that she felt healthier in certain ways than ever before. I think it’s because barriers were breaking down in herself and in those around her. What was left was authentic and pure.
Oxygen tank #2 was getting low so it was time to leave the courtyard. I wheeled her back inside and through the glass hallways and toward the elevators. The rest of the group followed. When we arrived at Unit 4 West they all hugged and kissed Yo goodbye and made plans to visit the following day. As I wheeled her away from the group and toward her room the very last thing they would ever hear her say came like a sweet song, but loud and clear through her oxygen mask, “Goodbye Lawrence, I love you”. None of us at the time realized the gravity of that statement but Yo had just expressed her gratitude to the person who would be managing her body after she would leave it. Once in her room and back in her bed, she relaxed, removed her mask, and locked eyes with me. With a smile of satisfaction and relief she whispered, “We did it”!
Upon our return, Yo now had a roommate (whose name I can’t recall) adjacent to the drawn curtain. She was from the Jemez Indian Tribe, who come from an area an hour or so outside Albuquerque. It was always a favorite stopping place for us on previous visits. The woman was unconscious and seemingly comatose. Yo was concerned about her and struck up a friendly relationship with Jacob who was sleeping in his truck at night and sitting with his sister during visiting hours. He chatted about tribal lore and we shared our connection to their land. Jacob had a warmth about him like an old trusted friend. He was worried about his sister and expected she might die soon. Yo consoled him and we talked for a while. I had my Hang (a melodic steel instrument played with hands) and Yo asked me to play it, another of our nightly rituals. As I played, Jacob started to softly sing native songs and the mood became transcendental. It was soon dinnertime and as with every hospital meal, Yo turned it down for my take-out options, which were generally whatever she wanted. I returned with food and we ate together and shared our meals with Jacob. After dinner, Yo asked me to go to the van and bring back the large envelope in her suitcase. I retrieved the envelope containing bills that needed to be paid. She took over the bookkeeping in our household early on. That was her livelihood before the yoga profession took over, and I was not great at it. She was an impeccable organizer and had an elaborate filing system in her office at home. Before the trip, she walked me through it, carefully explaining the essentials. That evening in her hospital room she asked me to write the checks, address the envelopes, and stamp them (she included a book of stamps in the package). She then asked me to leave earlier that evening to let her rest, and to come back earlier than I had been the following morning. I massaged her feet and legs, we said our prayers and affirmations and kissed goodnight. I left at around 10:00 p.m. and her parting words were, “Mail the envelopes on the way back to your hotel”.
Generally I would leave the hospital after midnight and arrive between 9:00 and 9:30 a.m. I woke up from a dream around 5:30 a.m. In the dream, I was awakened by a loud knock at my door. I was with one of my brothers and I went to the door and some deceased relatives were there but the rest is vague. I tried to go back to sleep and may have dozed but finally got up around 6:45 and got ready for a day at the hospital. It was Thursday, September 11th and the skies were overcast for the first time since we arrived. I was happy to get to the hospital early enough to beat the droves of cars vying for a space in the mega-parking structure next to the hospital. I walked into Unit 4 West at 7:30 a.m. and was surprised by a large group of doctors and nurses pouring out of Yo’s room. The lights were bright and there was a lot of commotion. I ran and in and wrapped my arms around my sweetheart as she was being administered CPR with a respirator tube down her throat. I sobbed deeply, telling her that I love her and it was ok with me if she needed to let go now. The CPR persisted and a voice shot through me that felt like it came directly from Yo. I looked up and said, “Can we stop this now?” The CPR ceased. There were others sobbing in the room aside from myself, yet there was a calmness in contrast to moments earlier. I asked if she was gone, and they nodded yes. Slowly everyone filed out, and the last person turned the lights down. I stayed holding Yo’s body for some time. I felt her Spirit in the room so I spoke with her from that perspective. I felt devastated from the shock yet embraced and comforted by her pervasive love. After some time I called Claire and asked her to contact the others and come to the room. When they arrived, we stood in a circle around Yo’s body, holding hands, praying, singing and expressing our love, grief, and gratitude for her great soul’s passing. Yo’s Doctor told me that her heart had stopped just moments before I arrived and that it was peaceful. I believe that’s why she wanted me to arrive early that morning. I needed to stop the resuscitation and to see her off.
Minutes after Yo’s passing and until I walked out of room 438 for the last time, the Jemez Indian woman had awoken and was lively and chatty.
I stayed in Albuquerque for a few more days to connect with Yo’s family and receive her ashes. The service was completely arranged by Lawrence and his business, Salazar and Sons. Yo was so efficient in life; she even demonstrated this gift in the Great Beyond. She knew where her body would most comfortably lay to rest without creating an additional financial burden. Family connection, enchiladas, and efficiency were only part of why she chose to be here. She loved this land. I felt her powerful Spirit when I set out by myself to hike at the Sandia Mountains on the second day after her passing. It felt as if she had become the mountain itself and was guiding me every step of the way. First through the desert terrain and sagebrush and then into a Ponderosa Pine forest at the base of the craggily crest. There were many mystical encounters with the land and animals along the way and a much needed emotional catharsis for myself. Yo spoke to me all along the way. She was doing great. It was myself who would eventually need to let go of her.
We had arranged a small memorial ceremony in the red cliffs of Jemez for Yo’s family and a few friends. Jemez was always a stopping-off area for Yo and I. We were drawn to the magnificent red cliffs and mini- canyons that jutted through them. There were clay caverns that had beams of sunlight shining through that gave them a cathedral-like appearance. I knew of one that would be a worthy area for the memorial. Claire wanted to get clearance from the Jemez Tribe before we spread any ashes on their land in case they had beliefs that were counter to this ritual. I resisted at first but after a few minutes I realized that Yo wouldn’t want to offend anyone. It also felt like it would preserve the integrity of our ritual. We walked to the visitors’ station and the nice Jemez Tribesman at the desk gave us his blessing. The rest of the group arrived and we headed into the entrance of the crevice that Yo and I had explored years back. Lawrence arrived and handed me the beautiful wooden box with Yo’s ashes and we proceeded with spontaneous sharing, singing, and sprinkling of ashes to the dusty ground. It was a simple and beautiful ceremony that touched all of us deeply. Later, of course, we had a picnic within site of the grounds. Afterward, Claire, Elizabeth and myself drove a couple hours further to Valle Grande. This was another stop that Yo and I had planned to make. We spread a few more ashes and headed back to Albuquerque while the moon was rising over the Jemez cliffs. I got pulled over by a native Jemez patrolman for going 20 miles over the speed limit. We explained where we had been; he let me go with a warning. That was Yo reminding me to slow down and enjoy the journey.
“ Some people, sweet and attractive, and strong, and healthy, happen to die young. They are masters in disguise, teaching us about impermanence.” -The Dalai Lama
This quote was sent to me recently by one of Yo’s longtime private students. I know there are many people who miss her and are deeply saddened by her passing. I can’t measure the depth of emotion that comes through me and I’m only at the beginning of the journey. The realization of impermanence, of Yo’s impermanence, of her passing and not coming back to me is very difficult to fathom. It’s very similar to when I was alone with her body in the hospital room. There are the tears, the sadness, the missing and the confusion. Yet, I feel my heart experiencing love in the midst of it all...a depth of love and connection that is mysterious yet has a familiar quality to it. This tells me that Yo is ok. Her choices were as exceptional and honorable as herself. I now share with her the understanding of the close relationship between sorrow and love. Perhaps this will bring me comfort in my pain.
Another phenomenon that has made this transition and the entire journey with cancer closer to a blessing is the way our families, friends, and community had been with Yo and I from day one. I want to list everyone but I’m afraid I’d leave people out because there are so many of you and some known only to Yo. Your prayers, your generosity, your time, your comforting words, your touch, your treatments, your food, your benefits, your laughter, your music, your artwork, your guidance, your procedures, your honesty, your unending love have made the difference for us on this journey. Blessings to you all. You are awesome.
With love and eternal gratitude,
Matt
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