Remembering a Leader and a Friend

The Rush community gathered to remember J. Robert (Bob) Clapp, Jr., the late executive vice president and executive director of Rush University Hospitals, on Oct. 11. He passed away on Aug. 30 after a diagnosis with pancreatic cancer in March.

From personal stories about his love for basketball and public transportation to his passion for diversity and leadership, Bob was remembered in a moving service at Rush. During the service, a special memorial tribute video was shown with interviews from people throughout Rush.

The family requests that any donations be made in support of Rush’s diversity efforts, the Rush University Health Systems Management educational program and/or to the Adopt-a-Family outreach program. Gifts may be made online at Memorial gifts may be sent to Rush University Medical Center, 1700 W. Van Buren St., Suite 250, Chicago, IL 60612. To make a gift by phone, please call (312) 942-6112.

More information:

Remembering J. Robert (Bob) Clapp, Jr., 1958-2012

Coping With Cancer: The Wake

By Margaret Nyman

November 7, 2009

Walking into a funeral home is never easy. Walking into one with your husband in the casket is excruciating. Although Nate always said I would one day bury him rather than him burying me, the picture of that never formed in my mind’s eye. Today I saw what that looked like and felt the pain of it.

After driving the 90 minutes from Michigan, several of us entered the room together. Not wanting to arrive at the front too soon, we lingered to read the cards attached to beautiful floral arrangements. Waiting for us at the end of that line was the casket with Nate lying in it, cold as ice and still as stone. As we approached, I could feel myself getting nervous, shaking as if a shaft of cold air had whooshed into the room.

I remember seeing my dad in his casket, looking as if he was taking a nap. Mom looked natural, too, outfitted in a silk dress like she was on her way to a party. Today Nate didn’t look good. Although I’ve always thought he was handsome, today he looked worn, like a warrior who’d fought a battle and lost. And of course he had. The angle of his chin and set of his mouth made him look like somebody else. Only by standing to the side and looking from the top of his head did he resemble my Nate.

But what did I expect? The cancer had eaten him up, and he hadn’t looked good for several weeks. How would dying of a ravenous disease and being placed in a casket ever improve his appearance? Even so, something in me wanted him to look handsome for his public. Continue reading

Coping With Cancer: The Hardest Part

By Margaret Nyman

November 1, 2009

Life has changed dramatically in the last 24 hours. Nate’s pain has increased at phenomenal speed, and we’ve had trouble keeping ahead of it with the hospice drugs. Yesterday, from around 3 p.m. until 3:30 in the morning, he was extremely agitated, attempting to get out of the hospital bed with energy so forceful we needed the adult boys to “convince” him he could no longer stand on his stick-thin legs.

As we talked repeatedly on the phone with the hospice nurses, we decreased the intervals between medicine doses until we were administering one thing or another every hour. During our struggle to determine how best to overwhelm his skyrocketing abdominal pain, the nurse decided to visit.

Her summary statement was, “He’s shutting down, one organ at a time, and is very close to the end. Maybe tonight, maybe tomorrow. Men hang on longer than women and wait to slip away until their wives are not in the room.”

I told her I wanted to be sitting next to him holding his hand if I could, when he died. “If that’s important to you, then do that, but be sure your words give him permission to leave you.”

She assisted and directed us in changing the Depends and washing him, pointing out the bluish toenails and fingernails, as well as pooled blood at his knees, back and palms. She also changed his white t-shirt. Just as we were wondering how she’d get the old one off without upsetting him, she said, “We have a trick for that,” and pulled out a giant scissors. Even after the soiled shirt came off in four pieces, she continued to use her scissors to cut the clean shirt up the back, leaving the neck band intact to hold the whole thing together.

“Voila,” she said. “As good as any hospital gown.”

Mary offered to stay the night, and we sent everyone else to bed with a promise to wake them up “if anything happened.” Dozing here and there between 3:30 and 7 a.m. in chairs pulled up to his bed, we each kept an ear open toward his gravelly breathing.

As the light of dawn came through the window, his throat and mouth were filled with an ugly grey phlegm causing him to choke and panic. We called hospice again, and the nurse returned, showing us how to place drops under his tongue to decrease bodily fluids including the ones in his throat. She remained calm throughout the process over a 90-minute period, even as Nate struggled, until gradually his body responded to the drug, allowing him to breathe easier.

As I write now, at midnight, oxygen is helping him, and medicine every three hours is holding back his pain. He’s sleeping peacefully, pink-cheeked from a 105-degree fever as his body tries to cool itself down.  We are thankful for his communication yesterday with each of our kids and several others while he was still alert and talking. They were able to give love and receive it, to share hugs and kisses and express gratitude. I’ll never forget how he worked to stretch out his thin arms to receive each child, winking here and there at things they said, using this creative way to stay in the conversation, since he can no longer talk. Today those scenes could not have taken place.

This afternoon as Nate slept, the younger girls and I had a great conversation about what we’ll be feeling when we stand next to Nate’s non-breathing, cooling body. As the tears poured forth, we talked about their father’s point of view. “We’ll all be crying,” I said, “but where he is, he’ll be happier than ever before. Let’s do our best to think about all that good stuff.” They nodded, and we all cried.

As I hold Nate’s hand and watch him sleep, I search for a way to put this heavenly phenomenon into earthly understanding, so have pictured God putting the finishing touches on his dwelling place. Right about now he’s unfurling the rugs and putting fresh flowers on the heavenly tables. Nate’s prepared home (mentioned in John 14) is almost ready.

God knows what he’s doing within Nate’s body and in the lives of the others under our roof. He is perfecting his plans minute by minute, and we are trying to follow his lead rather than usurp it. I am keenly aware that our Lord has a specific moment in mind, planned from before Nate was born, when he will pluck him from this world and escort him into the next. No matter what we do or don’t do, that moment will not change.

As we go into another watchful night of waiting and wondering when and how Nate will separate from his earthly existence, we hover between exhaustion and anticipation. As Nelson said tonight, however it works out, it will all be good.

If Nate could talk, he might say the same thing as Timothy did in the New Testament: “As for me, my life has already been poured out as an offering to God. The time of my death is near.”

Guest contributor Margaret Nyman chronicles the 42 days after her husband Nate, a patient at Rush University Medical Center, was diagnosed with pancreatic cancer. Read more posts by visiting the Coping With Cancer section or subscribing to the RSS feed. Her personal blog is at

Coping With Cancer: Faithful Provider

By Margaret Nyman

October 31, 2009

Nate has always been a good provider. By that I mean every dollar he’s earned, he’s shared. He’s forfeited fancy cars, custom suits and exotic vacations to give to others. I’ve been blessed to be a stay-at-home mom since Nelson was born in 1973, which necessitated receiving money from Nate in the form of a household allowance each week. The amounts have varied over the years with family changes and inflation, but the system has worked well.

I’ve heard of husbands who’ve made their non-working wives plead and beg for each 10-dollar bill. “Why do you need it? What are you planning to buy? I don’t think you have to have any of that. You can wait.” Nate has been the opposite, giving and giving again.

When I’ve commented on his shirt pockets being ink stained, encouraging him to buy a few new shirts, he’s always turned it back on me saying, “You take the money. I’m sure you need something more than I need new shirts.”

Since he’s been sick, he hasn’t been able to follow our usual routine in money matters, although again and again during these last weeks he’s asked me, “Have you got enough money?”

Little by little Nate has lost track of where we stand on our bills, what the due dates are and how much is in which bank account. Even as he’s been losing interest in the things of this world, something deep inside of him still wants to take care of me.

Since he’s been sick, part of getting him ready for each day has been handing him a folded wad of bills to slip into his pocket. He’s never been a wallet man. Since several important things have ended up in the trash or even the toilet recently, I’ve “stacked” his wad of bills with singles, except for one twenty wrapped on the outside. While folded, it looks like quite a fortune.

Yesterday afternoon Nate motioned for me to come into a corner of his tiny room. He was trying to count out his bills, putting them into denominational categories, but of course there were no fives or tens. “I can’t figure this out,” he whispered, fumbling with the money. “I guess I can’t give you as much as I thought.” Continue reading

Coping With Cancer: Out of Sight

By Margaret Nyman

October 29, 2009

Last night had me battling worry over our immediate future. Each day seems to bring a new problem for which I don’t have an answer. For example, today Nate’s hand began having blips of weakness when it would go limp for an instant and then recoup. Because of this, he spilled (onto himself) one glass of water, a whole cup of coffee (lukewarm) and his dinner plate. Hospice is wonderful in their knowledge, experience and willingness to teach me what to do, and our kids are eager to help. But during the night, as I lie alone in bed, the heavy-handed truth is that I’m the one running the show. Although I didn’t want it this way, all the decisions have become mine.

In the daylight I don’t doubt God will point to answers for every new issue that arises and that this will continue unendingly. During the night, however, I worry, hanging onto this truth by my fingernails.

This afternoon I needed encouragement from God, because tears seemed to continually wiggle just behind my eyes. Walking Jack the four blocks to the beach would help, I was sure, since getting a look at that wide horizon and meandering along the wave line has always been calming. I checked to be sure the boys would watch over Nate, then leashed the dog and headed out.

All summer we’d walked to the beach in flip-flops, kicking them off at the base of a small dune on the way to the water. Today it was socks and shoes. I missed the feel of sand between my toes, and as I climbed the dune, I thought of my favorite sandals, a gift from a good friend. They came from J. Crew, a place I never shopped, and were navy blue with “straps” of white and blue seersucker. The part between the toes was hot pink, and they were oh-so-comfy.

In a lifetime of coming to this same beach, I’d never lost a sandal. But last summer I’d returned to the base of the dune one day, and my beloved J. Crew sandals had been missing. I looked everywhere that day, but they weren’t to be found. It was a disappointment, and I credited some creative middle school kid with tossing them into the woods or the nearby creek as a prank.

Today, as I battled worry about what was ahead, my eye caught something bright in the sand. It was a dot of pink, not a natural color at the beach. I bent over to get a better look and got a shock. Peeking out from under the sand was the between-the-toe piece of a flip-flop. Could it be? Continue reading

Coping With Cancer: Medicine 101

By Margaret Nyman

October 27, 2009

Left brain, right brain, I never remember which side does what. One thing I do know, however, is that I’m not a numbers person. I’d rather write a 50-page paper than add a long column of figures, even if I had a calculator. That’s why keeping track of Nate’s pill bottles and medicine doses is almost more than I can handle. The 8½” X 11″ grid hospice gave me today to write everything down was intended to help but has only screamed, “You can’t!” from its place on the kitchen counter.

The hospice doctor and the head nurse of our team spent 90 minutes with us today, examining Nate and talking over his current pains and frustrations. Nurse Gina volunteered to stay an extra half hour to tutor me on the meds. My slow responses to her drug instructions must have triggered anxiety in her as she feared for her patient. She and I lined up all the containers, which included meds we used to use, meds we are currently using and meds we will use in the future. The minute she began referring to the drugs by their real names, I got lost.

Excusing myself to get a thin-tipped indelible marker I said, “You can tell me what and when, and I’ll translate it for myself on the label.”

She chuckled like I was kidding but bravely started in: “Ondansetron is for nausea,” she said, “and he can have up to three pills, eight hours apart, over 24 hours.” I wrote on the container, “Nausea, 1 at a time, up to 3.”

She continued: “ABHR is a gel you rub on his wrists if the ondansetron isn’t working, and he can have it twice in 24 hours.” So I wrote “Break-through nausea, wrist, twice.” Continue reading

Coping With Cancer: Tired

By Margaret Nyman

October 26, 2009

Last night was lively. Although Nate had his usual medications for pain, nausea and anxiety throughout the day, by evening he was restless. As bedtime drew closer, I wondered if he would go to sleep. It reminded me of the feeling I got with a newborn, wondering when I put him/her to bed if we’d have an active night or a restful one. New babies are unpredictable. A man with pancreatic cancer is the same.

The rest of the household drifted off to their various beds and their expected sleep. Once Nate was settled, I sat beside him in the dim light of his room and began the blog, wondering why he didn’t “clunk” right off to sleep. By 1 a.m. he seemed to settle, so I went to bed, too.

By 1:45, I was awakened by Nate checking to see if I was sleeping. I remember the same experience with one of my pre-schoolers tapping me on the shoulder during the night and saying, “Mom, I’m not going to wake you up. I just have one question …” That, of course, was after he’d woken me up.

I took Nate’s hand and led him back to his hospital bed. He wasn’t tired and wanted my attention. “I’d like a drink of water.” After that, he said, “I’d like a drink of milk.” He seemed to be in toddler-mode trying to postpone bed time.

I opened the shade in his room, and we looked out together. “See?” I said. “It’s nighttime. Everyone’s in bed. You have to sleep, too.” He nodded and obediently got back into bed. Continue reading

Coping With Cancer: The Beauty of This Season

By Margaret Nyman

October 21, 2009

Nate is not a nature guy and doesn’t normally notice what’s going on outside his window. Today was an exception. Here in Michigan we had a summery day in late October with temps in the mid-70s and lots of sunshine. The day begged us to “come outside and play,” so the two of us decided to take a short ride. Although I’d planned to drive to our tiny town a mile away, as we were weaving through the subdivision Nate began commenting on the beauty of the colored leaves.

“Wow, look at that yellow one. And the red over there. Are the colors darker than usual this year?”

Instead of driving to town, we drove to a beach lookout with a wooden deck. Since no one was there, I drove right up to the planks so Nate had only four small steps from his car door to the railing. There was a bench on the deck drenched in sunlight, and a warm breeze was blowing off Lake Michigan.

“Could you tolerate that bench for a while?” I asked, hoping he could. And he nodded.

We sat quietly, taking in the beauty of the lake, the sand, waving dune grasses and endless fall color. Some people don’t like autumn, because colored leaves represent a process of dying, and they know bare trees will soon follow.

Our family’s reality is similar in that Nate is in the process of dying. Strangely, though, this season, much like autumn, has a spectacular beauty to it, and none of us wants to minimize that just because we know what season comes after this one. Continue reading