ELISSA GREENWALD

The Sand Hills of Cape Cod

If you travel to the end of the continental United States and stop one mile short of the easternmost point of Route 6, you will see a line of cars parked in the sand. I have seen those cars, winter and summer, every year for the half-century I have visited Cape Cod. Thoreau said about Cape Cod that “a man can stand there and put all America behind him.” I never put the world so far behind me until I stopped at the end of the line for the first time.

I always assumed those cars belonged to people camping nearby. As it turned out, the people were explorers, like my husband and me. We followed a trail through pine woods for half a mile. Suddenly a dream-like vision opened before us, of sand hills as big as mountains.

It felt as if we had landed on the moon. The scale changed; the dunes seemed infinite. Moving dots studded the hillside. As we came closer, the dots resolved into a group of teenagers tumbling down the sand hills. If those hills had been white instead of dun, the young people could have been skiing down the enormous slope. They took huge strides, like those I took vaulting down dunes to the ocean as a child.

Though only a mile distant, the ocean seemed far away. The towering sand hills blocked our view. As we toiled up the hills, the going got rougher, the sand looser. After a while, we stopped looking up to focus on the shifting sand beneath us and stopped talking to save our breath.

Halfway up, the path seemed endless. Sinking into sand reminded me of another feeling of sinking: into exhaustion. After a decade of caring for my parents and mother-in-law, I was worn out. I felt as old as they were, as if old age were contagious.

All three fiercely independent elders lived on their own until ninety with minimal help from their children. In their nineties, however, they suffered serious health problems, leading to more emergency room visits than I can count and innumerable sleepless nights.

I remembered dark days and nights. One morning I had to go to school rather than comfort my ninety-six year-old mother before she had major surgery. My father was in rehab after surgery the week before, and I had used up the three personal days a year I could take off from my teaching job.

Later the same year, a month after my father was diagnosed with congestive heart failure, he insisted his difficulty breathing one evening would resolve itself in the morning. While he sat up in a chair all night, sleeping fitfully, I stayed up checking to see if he was still alive.

The next day, my father still struggled to breathe. I took him to a medical center in the small town on Cape Cod where we were staying. The nurse there told me to drive him to the hospital in Hyannis, an hour away. “You don’t need to call 911 unless his breathing gets worse,” she assured me.

Five miles from the hospital, my father stopped replying when I asked if he was OK. Out of the corner of my eye, I saw him crumple as I navigated the road to the hospital, which was jammed in both directions by traffic. Even an ambulance could not have gotten through. It was July in Hyannis, a summer resort community and site of the only hospital on Cape Cod.

Finally, I screeched the car to a stop at the entrance to the emergency room of Cape Cod Hospital. I ran inside, urging my father not to move (he nodded assent), only to encounter a line of people at the admissions desk. “This is an emergency!” I shouted to the lady at the desk. “Well,” she replied. “You’ve come to the right place.”

My father recovered from that experience, but I haven’t. I can still recite the names of every car dealer along the long road in Hyannis to Cape Cod Hospital, because I could peruse the prices on the cars in their parking lots as I inched by, pulse racing as I watched my father decline.

It was now another summer on Cape Cod. I could no longer worry about my father, since it had been two years since his death. As my muscles grew weak, I started to think we should turn back, but my husband was ahead of me and I was too out of breath to shout to him. There seemed no going forward or going back. This, too, reminded me of caregiving. When caring for a young person, generally one trusts that the child will grow strong and independent. When taking care of an older person, though medical care can result in recovery after falls or illness, there is only one end in sight and many possibilities of suffering before that.

I was not the only caregiver who found herself increasingly isolated, unable to call on help from others, in March 2020. Caregiving became infinitely more complicated when the pandemic struck. When my seventy-two year-old cousin died of COVID in April 2020, I felt shock and horror. Then I was possessed by fear. My father, at ninety-four with congestive heart failure, would die if he contracted the virus. I don’t know how frightened he was or how aware of the danger–probably fully aware and extremely frightened. Stoical World War II veteran that he was, however, he didn’t show those emotions.

On March 2nd, 2020, my father was released from a three-day hospital stay after a fall. His cardiologist told my brother and me that he didn’t want to see my father in the hospital again. “Bad things are coming,” the doctor said. A follow-up visit with the cardiologist was scheduled for two weeks later. By then, the world had shut down. How would we manage my father’s care during a pandemic?

Before my father’s death from heart failure a year later, my brother and I managed to get my father two blood transfusions at the height of the pandemic without his contracting the virus. I will never forget leaving him at the transfusion center both times, portable oxygen machine in his lap, mask on his face. His short-term memory loss made the experience confusing for him. The medical staff wouldn’t let me inside while he received hours-long transfusions because they had to protect their patients, mostly cancer patients, from the virus. Now I realize how brave my father was, how willing to hope that he could get better. For a few months, he did.

My father faced the infirmities of old age with his usual grace and courage. He never had to call on those qualities as much as he did in his nineties, when he endured two major surgeries, on his heart and his shoulder. The accumulated experience and wisdom of age enabled him to meet the challenge of his many ailments. He unfailingly treated everyone who helped him, especially the compassionate nurses who tended to him during multiple hospital stays, with consummate courtesy. Once when he was treated and discharged from an emergency room, he waltzed the nurse who helped him out the door!

He called me his “angel on earth.” Sometimes I fell to earth with a thump, though, as caregiving grew more difficult. After I retired early to take care of my parents, weeks of ministering to both of them turned into months when I could not leave their house, since my father’s condition could turn bad in a second. I would stare at my hollow-eyed self in the mirror, feeling there was no one inside.

Exhaustion oppressed me again as I climbed the sandhills. The fear that I could not reach the top rekindled memories of feeling inadequate, especially at the end of my father’s life. Then, as now, there seemed no end in sight.

One Friday night, I stayed with my father after my brother went home after a long work week. My ninety-eight year-old mother fell asleep in another room. At 11 p.m., my father’s breath became raspy. I gave him morphine through a dropper as the hospice nurse had instructed me, then turned out the light. I checked on him every hour after that. At 2 a.m., I once again heard his breath become labored, so I turned on a flashlight and gave him a second dose of morphine. At that point, I fell asleep, worn out after ten days of tending to him. When I awoke at 6 a.m., he was gone.

Once again, exhaustion was my enemy. I had hoped to sing my father to his final rest. Because I fell asleep, however, my father died alone, no one holding his hand to ease the transition from one world to the next.

People say the dead are at peace, but I’m not sure. Though raised in an Orthodox Jewish household, my father was not a believer. Judaism, unlike many religions, has a shadowy idea of an afterlife. It was hard to see his death as passage into a better world. When I gave him the last dose of morphine, I whispered, “I love you, Dad.” I hope those words were the last thing he heard.

As I climbed, I wrenched my mind back to the present, forced to pay attention by the effort required to ascend those hills. My legs ached; my breath grew labored. As we toiled up the endless dunes, I was tempted to give up, to relax into the sinking sand as I had been tempted to succumb to death myself several times in recent years. At those moments, I could see no future, no hope. No matter how hard I tried, I could not keep my father from dying.

Surveying the barren landscape, I remembered something Nathaniel Hawthorne wrote about Herman Melville. When he saw Melville wandering among sand hills, Hawthorne envisioned his friend wandering through the desert of lack of religious faith, for Melville “could neither believe nor be comfortable in his unbelief.”

Hawthorne transformed sand hills into symbols of the search for meaning that led Melville to leave family and friends to travel to the Holy Land. As I traversed the sand hills of Cape Cod, I knew how alone Melville felt. Grief, like death, is isolating, binding you to someone no longer alive.

During the pandemic, like millions of others, I grieved alone. When my father died in April 2021, he, like my cousin, had a Zoom funeral because of the virus. I felt doubly bereaved without the physical presence of my extended family for the rituals of mourning, the week-long period of shiva when Jewish people gather to comfort mourners, sharing food and remembrances of the beloved person. My extended family could not gather safely until November 2021, for the unveiling of my cousin’s gravestone eighteen months after she died. In Judaism, unveiling typically occurs eleven months after someone’s death. By that time, good people are believed to have ascended to heaven. Although my cousin was the kindest of human beings, owing to the pandemic, her unveiling was delayed.

On a cold cemetery hillside, one hundred black-clad members of my father’s extended family gathered in mourning. At first, we stayed distant for safety’s sake, but we soon clumped into one mass of embracing humanity. I remember the dignity with which my cousin’s daughter, holding her own three year-old, greeted everyone.

Thinking of her courage, I summoned my own. I would complete the challenge of climbing the sand hills and any other challenges that lay before me, including facing my own mortality. I thought of my father, whose determination and grace helped me endure his death. The day before he died, I sang him his favorite song, “The Sound of Music.” As I stood by his bedside, holding his hand, my voice broke with tears halfway through. Although he could barely speak, he gripped my hand, urging me to go on. So I sang the song through to the end.

When we crested the sand hills at last, the vast expanse of the Atlantic Ocean shimmered before us in the June sunlight. We ran down the hill, as I first ran down sand dunes on Cape Cod with my father half a century earlier. I fell easily into the long strides of youth, fully restored to life for the first time in two years.

I’ve learned that grief can coexist with happiness, even delight. I remember my father’s delight in swimming in a pond at ninety-four, arms outstretched as he lay on his back and turned his face to the sun. I think of a photograph of a friend who died of breast cancer at seventy. In the picture, she looks back from the head of her canoe, flanked by her beloved dogs, at her sister, with wild exultation. It’s challenging to embrace life, like hugging a cactus without getting the barbed needles of sadness and regret stuck inside you.

Grieving presents a paradox. You want everything to stop so everyone acknowledges that someone important to you has died. The more you turn back to life, the more you leave behind the person you have lost. Two years after my father’s death, I can’t remember what he looks like without a photograph. I keep on my desk a picture of him smiling into the sunlight at Cape Cod, where he found a spiritual home after a lifetime of questing.

We climbed the sand hills lured by the ocean beyond them. At the beginning of Moby-Dick, Ishmael remarks that, even on the crowded island of Manhattan, everyone goes down to the water, because by gazing into it we seek “the ungraspable phantom of life.”

For me, the “ungraspable phantom of life” has become grief, a shadowy but continual presence like the Loch Ness monster. Life depends on both remembering and forgetting. We try to forget the monster of death lurking underneath our deeds, but eventually must all reckon with that murky figure. Unlike the Loch Ness monster, death is no fiction. Living life well with awareness of it, however, is the “supreme fiction,” in Wallace Stevens’ phrase. While Emerson said “I grieve that grief has taught me nothing,” grief has taught me the power of dreams and memories, the forms in which my father returns to me now.

That day, as we neared the ocean, we nearly lost ourselves in the criss-crossed paths through the brush leading to the water, as we can lose ourselves in the confusion and disorder of life. We stumbled on a dune shack, whose sole inhabitant did not acknowledge us as he pumped water from a well. Perhaps in his search for solitude, he wished to remain as if behind glass, sealed in his own thoughts.

In that simplified landscape by the ocean, few signs of humanity remained but the shack slowly sinking into the sand and a rain barrel the color of sea and sky. I wondered how the dune shack dwellers could survive in that bare landscape. I later learned that, though there is a path through the sand wide enough for a truck, most of the time the dune shack dwellers repeatedly traverse the sand hills to the town of Provincetown for supplies. How do any of us survive a life shadowed by mortality?

At the water’s edge at last, we discovered seals cavorting, like the children we saw earlier tumbling down the sandhills. Walking along the shoreline was like entering a time machine bearing us back into the past, on the seventy-mile Great Beach Thoreau walked two hundred years ago. I felt restored to life on the timeless beach, a place constantly renewed by the ever-changing energy of sea and tides.

Accidentally taking a different path back, we found ourselves perched on a narrow peninsula. On one side, white froth piled on the blue Atlantic. On the other, the lighter blue bowl of the bay glimmered in the sunlight. The two bodies of water were connected by the blue of the sky; we seemed to float between them.

Cape Cod, “the Narrow Land,” is a sand spit in the shape of an arm protruding into the sea as if in supplication. I had often supplicated someone, some presence, to comfort me as I sat with my father during his many hospital stays and as he ultimately passed from one world into another. Now Nature itself became my companion.

Gazing at the seas surrounding me, I thought of the way Tennyson describes the death–or temporary departure–of King Arthur: “from the great deep to the great deep he goes.” We stood on that narrow piece of land between two great deeps, as we all stand on the narrow strip of time and space that is our lives.

Under the blue dome of a sky decorated with white clouds, like the ceiling of a celestial synagogue, mosque, or cathedral, I no longer felt alone. Rather, I felt protected, even while I stood on the very edge of the land. My single note of grief blended with “the still, sad music of humanity.” My husband reached for my hand. I saw in him my own grief reflected: his mother died a year before my father. Side by side, caressed by a gentle breeze, we stood and stared at the infinite and were not afraid.

"For a moment in the central of our being, The vivid transparence that you bring is peace." –Wallace Stevens, Notes Toward a Supreme Fiction