For Whom the Wedding Bells Toll

Mr. Peterson is 45-years-old, handsome, intelligent, athletic. A desirable batchellor by many people's standards. He is also dying of metastatic cancer.

His girlfriend drove down from their house on a nearby lake to spend the weekend with him. After giving him some medicine for his pain, I stepped out of the room and shut the door to give them some privacy. A few hours later, I returned to take Mr. Peterson's vital signs.

Mr. Peterson: I have some good news.

Mia: Oh, really?

Mr. Peterson: I've just asked Susan to marry me and she said yes!

Mia: Congratulations! How very exciting!

Susan: Yes, we're hoping to have the ceremony in the next few days.

The timeframe of their wedding plans made it apparent to me that they realized the severity of the disease, the expectation of continual decline.

I had a similar experience with a gay male couple, Justin and Mark. The dying partner was hanging on significantly longer than expected. He had become quite confused and aggitated. He kept trying to get out of the bed where he had lain bed-bound for weeks.

Finally, Justin got the words out, "The wedding. The wedding. I must get to the wedding."

Mark couldn't understand. What wedding was Justin trying to get to? Then the idea occurred to him. Prior to Justin's illness, they had spoken of having a commitment ceremony.

"Justin, would you like for us to get married?" Mark questioned. A huge grin appeared on Justin's face.

Mark made all of the arrangements. Friends showed up to the hospital dressed in their finest wedding attire. An officiant came to perform the service. There wasn't a dry eye in the house as the handsome couple sealed their vows with a kiss.

The following days, Justin seemed at peace. He died less than a week later.

Marriage proposals are not an uncommon occurence in palliative care. The threat of death often amplilfies our need to symbolically acknowledge the importance of the people in our lives, the need to somehow make our spiritual and emotional connections official, the need to speak aloud some of the things that are so important during our lives and that become even more important at the end of life: thank you and I love you. Marriage can be healing.