Denver Post article published Sunday, November 14, 2004
A Fort Collins woman made cancer a companion instead of an adversary, reaping rewards for herself and her partner
Story by Joe Lewandowski, a freelance writer and editor in Colorado.

Fort Collins - Kris Rempfer was weak and unable to talk, but as her partner of 24 years approached for a morning embrace, a last surge of energy entered her body. She pulled Sally Juday close and smothered her face with kisses.

Juday simultaneously smiled and cried, gaining comfort in the emotional Eden that is home to a full range of human emotions—sadness and joy, fear and relief, pain and wonder.

Early the next morning, the couple's 11-month battle against cancer ended.

After colon cancer spread throughout her body, Rempfer decided not to wage a traditional fight with the disease. Instead she surrendered to the day-by-day journey leading to her own death, joining a growing number of people who refuse treatment and plan the details of their passing.

She offered all the love she could and accepted what was given to her. She became an unlikely teacher to friends and family about how to live, and how to die.

"Those last months were God's gift to me," says Juday, 56. "I've never had anything like that in my life. I saw a whole new side of her. Her death and dying was such a graceful, honorable process."

Flowing with the experiences of life was not always standard procedure for Rempfer. She was tenacious and hardworking, but she also was controlling, always believing she was right, and carrying a deep-seated anger. When she was diagnosed with cancer in May 2003, Rempfer, 56, realized it was futile to hold onto that part of herself. She dropped her rough edge and softened to the rhythms of life.

Late that same month, Rempfer experienced severe abdominal pain and was rushed into emergency surgery. Part of her colon was removed, and the cancer was discovered. Doctors said chemotherapy probably could hold the disease in check, but they ordered more tests.

The couple, shocked by the news, turned to their longtime therapist and confidante, Judy K. Underwood. She agreed to research information. What Underwood, 58, didn't know was that she would soon become a personal guide on Rempfer's end-of-life journey.

Initially, Underwood learned that the cancer was treatable. But when secondary test results were delivered, Underwood found no encouragement. The cancer had spread to Rempfer's liver, and Underwood learned that she probably would live only six more months - with or without treatment.

"The doctors recommended chemotherapy - they always do," Underwood says. "That's their job; they believe it gives patients hope. But Kris wanted to know the truth. I didn't hold anything back. I didn't try to influence her in any way."

Rempfer quickly decided she didn't want chemotherapy. She told Underwood: "I'm going to die a good death, and I want you to help me make it happen."

Neither quite understood what that meant. But Underwood examined her role and decided it would change significantly. "I thought, 'What would I want in this situation?' So I became a guide in the process; I became a coach," Underwood says.

Underwood researched end-of-life issues and found that most people naturally resist dealing with issues that portend death. She worked with Rempfer to develop an ongoing list of everything she wanted done. The list made the tasks appear manageable and kept her rooted in the present moment.

Early in the process, Underwood helped Rempfer write an obituary. Rempfer and Juday took pictures together to preserve images of Rempfer while she was still in relatively good health and looked good. Rempfer started a list of the people she wanted to talk to.

She also listed the things she wanted to do, including eating out. Dining always had been a big part of the couple's life together. Rempfer was adamant that they continue to eat breakfast and lunch out every day, even though transporting her became increasingly difficult. She also insisted on regular servings of her favorite desert: Mud Pie.

Accomplishing some of the other tasks on the to-do list, however, proved more painful. Rempfer wanted to die at home - a decision that requires a significant physical and emotional commitment. Underwood arranged for the three of them to have an initial meeting at a hospice together.

At first, Juday resisted the hospice meeting because she knew it would be a stark symbol that her time with Rempfer was ending. In the end, "the meeting was traumatic for me," Juday says. "But it pushed me out of denial."

Juday also was apprehensive about visiting with friends. She wondered how people would react and what they would talk about. But Rempfer made sure the meetings weren't morose and awkward. She spoke openly abut dying, provided all the details anyone wanted to know, and told them how much fun she was having. People left Rempfer and Juday's home feeling at ease.

Underwood watched the progression in near disbelief. All of the therapy work seemed to pay off at the most important time in Rempfer's life. While Rempfer long had struggled with old demons, the cancer diagnosis brought a sudden and unexpected shift from many of her inner battles. Regarding Rempfer's past, Underwood would only say that her childhood experiences had been "challenging."

"The change in her was dramatic and wonderful," Underwood says. "She told me, 'This is the best time of my life.'" She wrote letters of apology, explanation and encouragement. She called people and visited those she could. She gave away money, jewelry and possessions to friends and family. She contributed money to a Restorative Justice program and to another program that helps single mothers learn self-sufficiency.

Because of her lifelong fascination with knives, she decided to give her three-bladed pocket knife to someone who would truly appreciate it and asked Underwood to find a worthy recipient. Underwood contacted the Larimer County chapter of the Boy Scouts of America and was told about a boy in a Cub Scout pack who had been recently diagnosed with a tumor on his kidney. At the time he was going through chemotherapy and radiation and was quite ill.

It was a perfect match. Rempfer also bought official Boy Scout pocket knives for the nine members of the pack. Rempfer sent the knives with a letter that said: "Please accept these in the spirit in which they are given. That spirit includes joy, caring, compassion and the opportunity to make a positive difference in the lives of others."

The 12-year-old boy, whose parents would not allow him to be identified, is healthy, and the cancer has been in remission for eight months.

As Rempfer prepared to die, she worried about what would happen to her soul in the moments immediately after her death. Rempfer believed in an afterlife, but worried about "getting to the other side," Underwood says.

Rempfer knew about the "white light" described by people who have had near-death experiences. Yet she was scared about how she would react when she saw it. She feared taking a wrong turn and getting lost in the ether of some imagined purgatory.

"She believed her time on Earth was complete. She didn't want to have to come back and do it all over again," Underwood says.

They talked about the topic for months. Underwood found books and tapes about what is known and what is speculated about the moment of death. The literature suggested that a person create an image of a soft place where wounds can be healed, and to visualize a guide leading the way into the tunnel of the white light.

Underwood helped Rempfer practice exercises from a tape series that prepares people for the dying process. "I kept saying to her, 'All you have to do is follow the light, just follow the light.' That helped calm her fears."

Throughout the months, Underwood guided the couple in making decisions. Rempfer chose cremation over burial, chose a funeral home to host a celebration service, wrote and planned the service, and selected the food.

Rempfer even decided on the day that she would die. She told Underwood that by dying on a Wednesday there would be time to invite people to a service Saturday.

Ultimately, she went unconscious on Wednesday, April 14 - exactly 57 years after she had been born, and five months longer than she was expected to live. She died about 2 the next morning. And her celebration service was held, as planned, on Saturday.

For Juday, the last year was one of the best of their relationship. But she acknowledges that she was relieved when her partner finally died.

"I knew Kris' work was done. She was tired. There was relief on both of our parts," Juday says. "I miss her, but now I'm focused on my life."

For Underwood, the experience was a spiritual adventure and one of her deepest life experiences. She has set new goals for her life, and she's comfortable with the prospect of her own mortality.

Working with Rempfer helped demystify death and the dying process, Underwood says. Instead of something to be feared, Underwood says death can be welcomed and enjoyed.

"I've learned the dying process is much like the birthing process. It's a graduation; you're completed here," she says. "How Kris did that was beautiful. And I know now that everyone can have a beautiful death."