Kennedy savored life as death drew near

WASHINGTON —

Sen. Edward Kennedy was in a wheelchair at the end, struggling to speak and sapped of his energy. But from the time his brain cancer was diagnosed 15 months ago, he spoke of having a "good ending for myself," in whatever time he had left, and by every account, he did.

As recently as a few days ago, Kennedy was digging into big bowls of mocha-chip and butter-crunch ice creams, all mixed together (as he liked it). He and his wife, Vicki, had been watching every James Bond movie and episode of "24" on DVD.

He began each morning with a sacred rite of reading his newspapers, drinking coffee and scratching the bellies of his beloved Portuguese water dogs, Sunny and Splash, on the front porch of his Cape Cod house overlooking Nantucket Sound.

If he was feeling up to it, he would end his evenings with family dinner parties around the same mahogany table where he used to eat lobster with his brothers.

He took phone calls from President Obama, house calls from his priest and — just a few weeks ago — crooned after-dinner duets of "You Are My Sunshine" (with his son Patrick) and "Just a Closer Walk with Thee" (with Vicki).

"There were a lot of joyous moments at the end," said Dr. Lawrence Horowitz, Kennedy's former Senate chief of staff, who oversaw his medical care. "There was a lot of frankness, a lot of hugging, a lot of emotion."

Obviously, Horowitz added, there were difficult times. By spring, friends said, it was clear the tumor had not been contained; new treatments proved ineffective and Kennedy's comfort became the priority.

Kennedy raced to complete his legislative work and his memoirs ("I've got to get this right for history," he kept saying), leaned heavily on his Roman Catholic faith, enjoyed (or endured) a procession of tributes and testimonials, and recently petitioned Gov. Deval Patrick of Massachusetts to push for a speedy succession so his Senate seat would not be vacant long.

The knowledge that death was approaching infused Kennedy's interactions with special intensity, his friends say.

"I'm still here," he would call colleagues out of the blue to say, as if to refute suggestions to the contrary. "Every day is a gift," was his mantra to begin conversations, said Peter Meade, a friend who met Kennedy as a 14-year old volunteer on Kennedy's first Senate campaign.

Some patients given a fatal diagnosis succumb to bitterness and self-pity; others try to cram in everything they have always wanted to do (sky-diving, a trip to China). Kennedy wanted to project vigor and a determination to keep on going. He chose what he called "prudently aggressive" treatments.

"He always admired people who took risks, like Teddy and Kara did," said close friend Sen. Chris Dodd, D-Conn., referring to two of Kennedy's children, who both beat cancer with bold treatments. He also vowed to work as hard as he could to lead a legislative overhaul of the nation's health-care system.

Kennedy deputized Horowitz, who lives in the San Francisco Bay Area, to research all treatment options before deciding on an aggressive regimen of surgery, intensive chemotherapy and radiation, not a clear-cut choice with an almost inevitably lethal disease and a patient of Kennedy's age. Some physicians assembled at Massachusetts General Hospital considered his tumor inoperable and measured his likely survival time between six weeks and a few months after diagnosis in May 2008.

Before he traveled by private plane from Cape Cod to Duke University Medical Center for surgery in June 2008, Kennedy put his affairs in order: his will, his medical directives and his legislative instructions, relatives said.

Kennedy took no comfort, friends said, in hearing how missed he was in Washington or how in his absence he had been becoming something of a "spiritual leader" on issues with which he is identified, such as health care. He kept in close touch with his staff and colleagues, and he was engaged in a running conversation with Sen. Harry Reid of Nevada, the majority leader, on the delicate subject of whether Kennedy would be available to vote.

Reid assured him he would not ever ask him to come to Washington unless his vote was essential. (His disease and treatments made Kennedy vulnerable to infections, so wading into crowded areas was risky.) When a crucial Medicare provision came up last summer, Reid asked Kennedy if he could make it down.

Kennedy's family and staff debated the issue until the senator ended it. "I'll be there," he said, according to an employee involved in the decision. He received a standing ovation when he returned to the Senate floor, and the bill passed easily.

Vicki Kennedy guarded her husband's privacy, but the senator's illness had an undeniably public component. His setbacks and hospital visits often drew news-media attention. After his emotional speech at last summer's Democratic Convention in Denver, it was disclosed that he had been suffering from kidney stones and had barely been able to get out of his hospital bed hours earlier.

He had to memorize the text of his speech because he struggled to see the teleprompter (his surgery left him with impaired vision). The seizure Kennedy had at an Inauguration Day luncheon at the Capitol led his son Patrick to joke that his father was trying to overshadow Obama on his big day.

He left Washington in May, after nearly 50 years in the capital, and went to Cape Cod, where he would contribute what he could to the health-care debate via phone and C-SPAN. He would sail as much as he could, with as little pain and discomfort as his caretakers could manage.

He also told friends he wanted to take stock of his life and enjoy the gift of his remaining days with the people he loved most.

Starting in late July, Vicki Kennedy organized near-nightly dinner parties and singalongs at the Kennedy compound in Hyannis Port. The senator was surrounded in the dining room by his crystal sailing trophies and a semiregular cast of relatives that included his three children, two stepchildren and four grandchildren. Jean Kennedy Smith, Kennedy's sister, rented a home down the street and became a regular, too.

In recent years, friends said, Kennedy had come to lean heavily on his faith. In eulogizing his mother, Rose Kennedy, in 1995, he spoke of the comfort of religious beliefs. "She sustained us in the saddest times by her faith in God, which was the greatest gift she gave us," Kennedy said, his voice breaking.

He attended Mass every day in the year after his mother's death and continued to attend regularly, often a few times a week.

The Rev. Mark Hession, the priest at the Kennedys' parish on the Cape, made regular visits to the Kennedy home this summer and held a private family Mass in the living room every Sunday. Even days from his death, Kennedy led the family in prayer after the death of his sister Eunice on Aug. 11. He died in no apparent pain, friends said.

His children had expected him to hold on longer; Kennedy's son Patrick and daughter Kara could not get back to Hyannis Port in time from California and Washington.

But his condition took a turn Tuesday night and a priest — the Rev. Patrick Tarrant of Our Lady of Victory Church in Centerville, Mass. — was called to his bedside.

Kennedy told friends recently he was looking forward to a "reunion" with his seven departed siblings, particularly his brothers.