Another day dawns, after a challenging night. Another call in the wee small hours, nurses tending to mum as her breathing became more laboured and difficult. More drugs, more pain relief.

I am pondering this morning on the way we deal with the final labouring towards death. This morning she is sleeping, verging on unconsciousness. She is certainly no longer in physical distress, which is undoubtedly so much easier for us both.

We discussed her end of life wishes a few months ago. It is something I’d recommend everyone to do. As mum is no longer able to make decisions, knowing her wishes has allowed me to guide her care with confidence. Without that conversation, that gentle questioning, the teasing out what is important to her, I would have been floundering more. Now I know we are doing as she would want – choosing comfort over lucidity.

And yet, as an observer, I question the process. We are treating her body, keeping her pain free and symptom free as best we can. This is the wonder of modern medicine, that even as our body shuts down, we can remain comfortable.

But what of her soul? Do these layers of opiates and sedation deaden down the soul’s bid for freedom? Each dawn we are all surprised she has made it through another night. What started as a swift decline has slowed and flattened.

Are we showing kindness in dulling physical pain, or are we hampering a natural process of struggle?

A butterfly needs the struggle to emerge from a chrysalis (and if it is assisted out, will never fully form wings). Just as childbirth needs this same labouring to progress, does death need the same?

The times when I’ve been most aware of this liminal point, the times when the sense of spirit loosening from body is strongest, or the sense of veils being thin, these are the times of struggle, not of rest.

Are we masking a natural process, sanitising it to avoid witnessing struggle? I have no answers of course. This time has raised so many questions for me, about what life and death really is, about how we as carers hold, yet also let go. About how we as a society do that too.