Marilyn insisted on carrying some of the boxes of her Christmas decorations down from the attic to the living room. She was always glad to make Christmas special for the family, but this year was different. Marilyn was fortunate to be on her feet. It was Christmas Eve day and there was much to be done. Marilyn’s children came over and helped trim the tree. The grandchildren put the little decorations Marilyn had collected since her childhood in her living room and dining room. At noon, her daughters-in-law pitched in to make dinner for Christmas Eve and Christmas Day. By midafternoon, Marilyn was exhausted even with all the help. After a long nap, she gathered her family to attend the Christmas Eve service at her church.

Four weeks earlier, I told Marilyn she would likely survive only a few weeks. Either she could spend the time in the hospital with intensive chemotherapy trying to put the leukemia into remission, or at home with hospice. Because the acute leukemia was resistant to initial treatment, I could not promise that additional therapy would benefit her.

I asked Marilyn what was most important to her at this time. Marilyn replied, “I like to take care of my family. It’s Christmas, and I want to enjoy the holiday with my family and pass on to them what’s most important to me about Christmas. I’m not going back into the hospital.” By staying home, Marilyn might accomplish her goal as long as fatal complications did not occur because the leukemia was not being controlled.

Before the very first Christmas, Mary of the family of David, a young virgin in the town of Nazareth, was visited by the angel Gabriel, who announced: “You will be with child and give him the name Jesus. He will be great and will be called the Son of the Most High. The Lord God will give him the throne of his father David, and he will reign over the house of Jacob forever; his kingdom will never end” (Luke 1:31-33). Mary was amazed at this awesome announcement. Because she was aware of the Biblical prophecies about the Messiah, Mary knew of the prophecy that foretold where the Messiah would be born: “But you Bethlehem though you are small among the clans of Judah, out of you will be come a ruler for me one who will be ruler over Israel, whose origins are from of old, from ancient times (from eternity)” (Mich 5:2).

Mary had no reason to go to Bethlehem – more than 100 miles away – and it would have been an arduous journey anytime during a pregnancy. However, in the waning days of her pregnancy, a decree from Caesar Augustus was issued that all under the power of Rome had to return to the family’s hometown to register for a census. For Mary, a decision to return to Bethlehem, the hometown of the family of David of the clan of Judah, would be like walking from Portland to Bangor in December on dirt roads, eating only food carried on a donkey, and sleeping on the side of the road for a week. Such traveling could cause the death of any mother and/or child – then or now.

Both Marilyn and Mary in the Bible risked their lives to achieve what was important to them. For Marilyn, it was dangerous to stay at home to share with her family for the last time what was important to her. For Mary, it was dangerous to travel but to fulfill Scripture that Jesus would be born in Bethlehem.

Marilyn succeeded in her goal, though she required transfusions to maintain her strength and keep her from bleeding. Her children and grandchildren were with her on Christmas Eve day and attended church with her on Christmas Eve. They were also with Marilyn for a full day of celebration on Christmas Day. The actions of her family members preparing for Christmas proved she had accomplished her goal. Later that week, without chemotherapy to deter the growth of the leukemia cells, Marilyn’s condition declined rapidly. New Year’s Eve was Marilyn’s last night alive, but she was at peace with her decision.

I’ll not forget Marilyn’s last words to me in the office before Christmas: “Remember to go to church on Christmas Eve. It’s special. Very special. ” Marilyn was also taking care of me.

Dr. Delvyn C. Case Jr. is a hematologist/oncologist, writer and director, and consultant to the Department of Spiritual Care at Maine Medical Center in Portland.