Friday, July 05, 2013

From Splintered to... Shattered

So, there we were, being thankful that the storms that had raked our fair state had (by and large) passed our area leaving no real trace or trail.

We were trying, once again, to settle into a routine - find (yet another) "New Normal" for our family, when I was reminded that any time the phone rings after 10 pm, it is never good news.

S2* was on the phone.  I greeted her warily, knowing that she was typically asleep at this hour, even on a Friday night, and certain that the sinking feeling in my core was justified.

It was.

MIL was very ill, and DIL was trying to convince her to go to the hospital.  S2 had been at their house all evening, and was now summoning our help to try and convince the parents that they should not wait until morning.

But no amount of persuasion would move MIL.  And so wait they did - but not just until the morning.  They waited all weekend, until Monday.  MIL was convinced (by some snippet she had seen on a newscast a few weeks prior) that she would die if admitted to the hospital on the weekend.  There was no moving her until Monday.

Thus we passed a miserable weekend - with no one more miserable than MIL herself.  A smoker for more than 50 years, (and convinced that if anyone ever tried to make her quit smoking she would die) she did not even try to light a cigarette.  She drank little, ate even less, and we learned that she had not had a BM in "several days".  The brothers and sisters (and in-laws) spent most of this time texting one another, trying to find an argument that would move their mother, along with her legendary stubborness, to do something - anything.

She kept saying that she felt like her heart medicine was just "out of whack" and she just needed them to fix it, then she would be fine.  She said she was nauseated, and didn't want to eat or drink - it just made her stomach more upset.

Monday arrived, and we packed them off to the hospital with a sense of relief.  At least now, we knew she would be in the hands of a doctor, and we would all spend a couple of days at The Big Hospital, crammed in to her room - all 14 of us in total, including the grandkids - and then she would come home.  Life would go on.

The relief was short-lived.  S2 called again - this time from the ER at the hospital.  The news was not good, and as the hours rolled by, it became worse.  She was placed into ICU, where she would stay until almost the end.

It was not the heart medicine.  Her colon was obstructed, and by the time she got to the ER, it had begun to die.  They operated - multiple times - each time leaving her open between, so that they could go in again, and again, trying every 24 hours without success to get good, clean viable ends to sew together.  But it was too late, and she literally was decaying from the inside.

The surgeon explained to DIL that her circulation was compromised from so many years of smoking.  That because she had continued to smoke even after being told that it was (literally) killing her heart, it was now also killing her other organs.

DIL was like a wounded animal.  He would stand at the foot of her bed, hands jammed deep in to the pockets of his dungarees with tears in his eyes.  He refused to go home, even though she was being kept deep in a medically-induced coma, saying that he couldn't leave her there alone.  Nearly 80 years old, and the strain was showing on him; even the doctors and nurses were urging him to go home at night, and get some rest.

I've been part of this family for almost 27 years.  Because S1 and S2 both have divorced,  I hold the dubious honor of being the most senior of the in-law children.  MIL and DIL have been my extra parents; since the day that TW brought me to their home to meet them, they have treated me as one of their own.  They gave me so much love and support during those four years of caring for my own Mom.  DIL and I have always been very close especially - I think in part because I was his first "extra daughter".

It was the 3rd day, and DIL was tired - so very tired.  I summoned one of the nurses that DIL seemed to have great rapport with, and talked to him outside MIL's room.  This gentleman had been an Army Medic, who went on to complete his nurse's training after his tours in the middle east.  He was a great nurse - probably one of the best I have ever personally seen in action.  We talked briefly, and I told him that I would stay overnight with MIL, if he could only persuade DIL to go home.  Nurse and S2 and I took DIL out of the room, and talked to him in the hall.  I promised DIL that I would not leave her side, and that I would stay until he was able to return in the morning.  Nurse admonished him to go home, sleep in his own bed, take a shower, eat a good meal, and not to return until the next morning.  He resisted at first, but when I pointed out that I had sat up all night many, many nights with my own mother - and so was uniquely qualified to do this job - he relented.  When he hugged me goodnight, he whispered in my ear "Tell her I love her please".  S2 drove him home.  TW brought me my laptop, a change of clothes (it was freezing in ICU) and a snack.  The brothers and sisters all expressed their gratitude, for they too wanted someone to be with her.

ICU is not a place to try and sleep.  I didn't try; nurses and all kinds of technicians were in and out at least every 15 minutes all night long.  Because she in was a coma and on a ventilator, they could (and would) literally perform procedures and care all night long, while the unventilated patients would be allowed to sleep.  I put the TV on low, and we watched her favorite channel.  I sang the old songs from her childhood to her - the ones that my Mom had taught me as a child, the same one I sang to my own Mom as she was dying.  I talked to her, and in our "conversations" I told her the news of the day, and where everyone was, and what was going on.  And I told her that she was loved, and that we would not leave her alone.

And it was in this fashion that she and I passed through the next many nights; the only time I would leave her room in those small, dark hours would be when they had to bathe her, or the portable x-ray machine was brought in, or some other procedure that would require me to step out into the hall.

Every morning, I would send another group text detailing what happened overnight, and I would wait to be relieved by DIL and one of the siblings, or TW.  I would go home, and try to sleep and typically fail - my phone lighting up with texts zooming back and forth between family members.  We found that DIL could remain calm by playing with TW's iPad, so we loaded it with the apps that DIL liked best and left it at the hospital for him. 

As we went through the days, I tried to explain to TW, his siblings, and DIL that the vent was what was keeping MIL stable.  That they had to listen - and really hear - what the doctors and surgeons were saying about her condition.  That the prognosis remained poor, and that the vent was what was keeping her alive.  

Slowly, one by one, they came to that realization.  TW first, the sisters next.  The two younger brothers took longer; one holding out hope and hanging on to faith that his mother would not, could not leave before he was ready for her to go.  And then finally, on that last day, DIL stood again at the foot of her bed.  The doctors had convinced him that they had to at least turn off the vent - that it was the only way to find out if she now had the strength to breathe, to heal, to try to recover on her own.  It was the kindest way of giving DIL permission to remove the vent; I think they knew that otherwise he would never let her go.  His hands jammed deep in to his pockets, he looked at me and asked me what to do.  It was just he and I and MIL in the room; everyone else was at work.  I remember the way the early morning sun bounced around the room, coloring it a cheerful pink and gold, and thinking that it was too beautiful a morning to talk about this.

We sat together, side by side, on the sofa there in MIL's room.  We talked about all of the possible outcomes.  We talked about what MIL would want us to do for her.  And as the minutes ticked by, and the sun rose higher, DIL was finally comfortable with the decsion.  She would come off the vent, but they would leave her intubated for now, in case she needed it later.  I sent another group text, to let everyone know, and as the doctors and nurses came in to turn off the vent, DIL and I went down to the hospital cafeteria to eat breakfast.

I didn't go home that day.  I stayed all day, sending texts to the family members - all of whom by this point had used up their vacation and PTO.  I didn't want DIL to be there alone; and as the day progressed, and her vital signs waned, the kids began to trickle in to MIL's room.  By 5:00 pm we were all there, except for the grandkids, and MIL had begun to have episodes where she would stop breathing.  Her doctors assembled again, called in by the nurses because of her breathing abnormalities.  DIL stood again at the foot of the bed, this time surrounded by his kids; the doctors explaining that there was nothing more to be done; her body was nearly done fighting.   The group was silent; the doctors and nurses shifted uncomfortably.  S2 looked at me, silently mouthing the word "help!" TW squeezed my shoulder and nodded.  Finally, I took a deep breath and spoke into the void:  "So, Dad, maybe what we need to do next is Hospice". 

Everyone looked relieved that the word had finally been said.  Head bowed, hands jammed in his pockets, shoulders bowed under the weight of his impending loss, he nodded and said "Yes.  Yes, of course."  The doctors agreed, explained the basics of Hospice, and told us that she would be moved to another floor, to a Palliative Care/Hospice unit.  DIL needed to eat - he had refused to leave for lunch, and so B2 and I took him to eat some dinner.  We came back to find MIL had been moved to a new room, and for the first time in two weeks, all of the tubes, wires, and other equipment had mercifully been removed from her.  The nurses had bathed her, and changed her into a soft, pretty gown.  She smelled sweet, and her funny, fuzzy white hair was shining and clean.  Dad entered the room first, alone, and he sat on the bed, and gathered her into his arms for the first time in two weeks, holding her, and kissing her forehead so tenderly that everyone who saw it did it so through their tears.  We all sensed that it was likely their last embrace as well.  As it turns out, it was.

After a time, it was again,  just DIL and I sitting on a sofa.  MIL was actively dying; the episodes of apnea-like breathing were becoming more and more frequent.  He took my hand, and kissed it, and said "You need to go home.  You haven't been home, you haven't slept. Go home.  We can't do anything more".  I told him that I would go home, but we had to talk first.  I told him that it wouldn't be long now - that I had seen this with both of my parents.  I told him that no matter what happened, she was already beyond any pain, that she was going towards her parents and her sister, and there she would wait for the rest of us.  He nodded his head, and then looked at me.  Tears streamed down his face, and he said "You know, we've been together almost 60 years.  I'm not sure what I'm supposed to do now."  I told him the truth - that it will be hard, but we will all find our way through it, together.  The way all families do.  And that no matter what, he would never have to be alone, unless he wanted to.  He told me that they had said their goodbyes to each other just before the first of the surgeries, when she could still talk.  He choked up then, and we sat together in silence, holding hands and counting the seconds between MIL's breaths.

The sisters came back in; they finally convinced DIL to go home, to try and sleep.  We had been told it could be hours, days, even a week before she passed.  I was going to go home, shower, change and go back to sit with the sisters through the night.  They were scared - afraid to be there, but afraid not to be.   I had been with both of my parents when they passed, and so I at least knew what to expect.  The sisters walked down to the parking garage with us, and we all went our separate ways, planning to meet in MIL's room by midnight or shortly thereafter.

I got home, pulled my car into the garage, and laid my head on the steering wheel for a moment.  I pulled myself together, and made my way into our house.  I was going to take a shower, put on clean clothes, drive through Starbucks and go back to the hospital.

The clock in the kitchen said it was 11:45 pm.

My phone rang.

I knew.

She was gone.

She waited until everyone left the room.  Waited until she was alone to leave on her final journey.


Farewell, my other Mother.




*For a quick reference, TW has 4 siblings - two older sisters, and two younger brothers.  Yes, I married the middle child.  For the purposes of this post, we shall refer to the sisters as S1 & S2, the brothers as B2 & B3MIL = Mom in Law & DIL =Dad in Law


6 comments:

Chuck said...

Ugh. Very well told. Nobody lives forever but the end is never easy.

We just made the decision to put my mother on Hospice - hope it goes well.

Suldog said...

As always, you have the gift of telling a touching tale. I'm so sorry it took me so long to come over and read it. I've been a crummy blog buddy, not checking in with my very good friends (such as yourself) often enough. God bless.

Cedric said...

Cool!

Suldog said...

I hope things are going a bit better by this time. If you feel like unburdening, I've got a shoulder for you. Love to all!

Ericka said...

sorry it took me so long to find this.

I so admire your strength, and grace in the midst of pain.

I hope that by now, time has dulled the edges a bit.

xoxo, my friend.

Ericka said...

hey, you.

I hope you're doing well. drop a line one of these days, won't you? I worry.