Friday, April 3, 2026

The Agonal Breath

 


The Agonal Breath

My friend Webster tells me that agonal is related to, associated with the act of dying and occurring just before death. I looked around a bit to get a better sense of the term ‘agonal breathing’, and I see that it is an abnormal pattern of breathing, a brainstem reflex accompanied by gasping and labored breath. I read that the duration can range from two breaths to several hours. As for my experience, it has been of longer duration than two breaths.

Over a seven-year period, I have sat with four people during their agonal breathing: my parents and my parental in-laws.

My mother-in-law was the first. I was not alone for any part of the vigil with several family members present at the care facility. Her breathing, while labored, was quiet and shallow, as though she did not want to make a fuss. After a few hours, I was dispatched to bring food for everyone but before getting to the deli, I received the call that she had passed away. I doubled back to support the family and was asked to pray for Jan before she was taken away.

The next was my dad, followed ten short weeks later by my mom. Dad had been in hospice care at home for four or five weeks, a short time as we were told by the hospice support folks. In a sense, my mom had been his primary care person and was providing unsupported hospice care for him for more than a year. My sister and I were taking shifts watching him through the night. She woke me at 2am when he had begun to really struggle. We made him as comfortable as we could, and I began my 15-hour vigil. Dad had suffered from emphysema for many years, and his agonal breathing was labored to the max even with the pain meds that had been given to him. Bob, my brother-in-law, sat with me for nearly an hour and I will be forever grateful for his company. Denise checked in from time to time, she is an angel. Mom was in her own fight for life recuperating from a fall and a separate surgical procedure. She joined me for the last hour of dad’s life. His final three breaths were the least labored I had seen for him in ten years. He did not want to die.

Mom had a feeding tube put in because of an inability to swallow. I think we were about a year to late with getting her to do that. She had been starving, and all the while, tending my dad, getting him to do his breathing treatments, taking him into his appointments, dressing his wounds from skin cancer, and getting him to eat. My sisters and I took those over but too late. Mom’s body was shutting down. We drove her from Oregon to Quartz Hill so Stacey and I could take care of her better through the winter months. She was here only a few short weeks when she became nearly unresponsive. We had her taken to the hospital where I sat with her in the ER for eight hours. She struggled, and with each hour they tried something new to stabilize her. She wanted to live. Mom’s breathing was shallow and rapid, punctuated by the occasional gasp. Covid protocol did not allow me to accompany her to her room when the doctors decided to check her in from the ER. I drove home. An hour later I got the call that she had passed away. It was as though she wanted to be by herself and save me the agony of being there.

My father-in-law was the latest. He had been in a car accident and bumped his head which eventually led to bleeding in his brain. He went from improving to declining and back, seemingly by the hour. My wife and her three brothers were in the hospital taking turns sitting with him. My son came in to see his grandfather, and he and I took a shift sitting with him. Daniel talked of the great hiking trips he had with his grandfather, and we regaled each other with memories of this beloved man. His breathing was slow with a deep struggle to take in oxygen. It was odd for Daniel and me. We got up at one point and stepped outside the room to prepare for a shift change when Gene’s sons got back but we were called back by a nurse. The last couple of breaths were so quiet, we did not even realize he’d stopped breathing. He was finally at peace.

This is Good Friday, the day Christians remember the day Jesus was hung on a cross and died. I think of the agony of hanging there, nails in his hands and feet, while onlookers jeered and tormented him. With my own experience, Jesus’ agony is real to me. This person, fully God, fully human, chose to be hung on a cross for me. In his agonal breathing, Jesus cried out to his father, “why have you forsaken me.” Jesus was forsaken so that I could be saved, so that I could have access to the father and life.

I can imagine Jesus’ disciples and his mother being present while he gasped and cried out. All this and yet he could offer grace to the thief hanging next to him. The photo I will use for this post shows three empty crosses. I cannot bear to show him hanging there. After all, in three days we will celebrate that he is risen, the stone closing his grave rolled away and that he has risen to be with the Father after having descended into Hell. All so that I will not have to descend but can instead live, and serve, and love.

The scriptures describe this occurrence:

Matthew 17: 45-46…50: 45Now from the sixth hour there was darkness over all the land until the ninth hour. 46And about the ninth hour Jesus cried out with a loud voice, saying, “Eli, Eli, lema sabachthani?” that is, “My God, my God, why have your forsaken me?” 50And Jesus cried out again with a loud voice and yielded up his spirit.

Mark’s account is very much the same with a subtle change to the last part of Jesus’ death. Mark 15: 37: 37And Jesus uttered a loud cry and breathed his last.”

Luke’s version is a little different still – Luke 23: 46-47: 46Then Jesus, calling out with a loud voice, said, “Father, into your hands I commit my spirit!” and having said this he breathed his last. 47Now when the centurion saw what had taken place, he praised God saying, “Certainly this man was innocent!”

He will rise! We should bow.

jj white