Life Goes On: October

October

And on and on and on.

We expected Gail’s Mom to pass away any minute. Gail, her Dad and I all knew and expected it was going to happen soon, no matter how many teaspoons of protein broth Albert managed to get down her throat.

While Gail and I had outright rejected Albert’s visitation schedule the previous month, her condition had become so grievous and the hospital care so poor that the family was there twenty-four hours around the clock.

Albert was still doing the day shift, Gail was doing late afternoon to evening with Alma taking over in between.

On the first Sunday of the month, her mom was so bad that Gail didn’t want to leave. We sent Alma and Albert home for a night of much needed sleep, and we stayed in the room.

At midnight, I held her Mom on her side while Gail changed the dressing on the large bedsore in the small of her back.

It struck me as really perverse that this undressed woman I was holding at the hip and shoulder, never allowed me to call her by her first name, and I would never accept calling her Mrs. —. It was too formal given my relationship with Gail, but especially when one considered that Joanne called her by her first name and Alma called her `Mom’.

I felt really uncomfortable knowing how upset she would be at my seeing her so helpless, and upset that I was helping in her care. I felt like I was somehow violating her privacy. But there was no one else to help. To be more honest, I wasn’t sure how much my own squeamishness was playing into being concerned for her feelings.

I tried not to look at the black area, the size of a tea cup saucer, on her back. But the only place I could look and maintain my grip was out the window; which the dark of night turned into a mirror surface. The worse part was the indescribable and unforgettable odor.

I could not believe how calm and matter of fact Gail was swabbing the wound and spreading fresh ointment. I guessed her past experience working in nursing homes gave her a shield, the need for the work to be done overriding the horror and nausea.

When I looked closer at her, I could tell she was fighting tears. I guess it’s harder to shield yourself when the patient is someone you love dearly.

She almost slipped from me several times. Her body was hard and heavy. There was no muscle play at all, and if it hadn’t been for the heat of her fever and the sorrowful, pain choking moans she made with every exhalation, I would have sworn I was holding a corpse.

I became afraid that if I pulled too hard on her, that she would rip apart, starting at the wound Gail was dressing. Gail had to remind me several times to maintain my grip. I was fighting the urge to flee as much as Gail was suppressing tears.

But it wasn’t exactly Gail’s preferred way to spend and evening, and I could hardly abandon her after all the support she continued to give me for my Gramma, Dan and our joint pal, Patrick.

After we changed the dressing, we rolled her on her right side. She’d lain the last four hours on her left, and we had to make sure to shift her to maximize circulation. She was not to be left on her back because of the bedsores.

I escaped temporarily to check on our truck and to get some sodas and juices from the store.

Gail and I sat, watching her Mom steam up the oxygen mask and listening to the pain-filled moans of her laboured breathing. Every now and then, she’d shifted the iced clothes that a nurse told us to put on her to try to bring down her temperature.

The resident doctor on shift had ordered an intravenous anti-viral drug course, but the nurses had not been forthcoming. In fact, so far, all they had done was close the door to the room so that they wouldn’t have to listen to her chain-stoking breathing. (Chain-stoking is the final breathing stage prior to death.)

After three o’clock, Gail demanded that the drug course begin. The nurse refused, citing a lack of doctors to observe for the hour it would take for the medicine to start to take effect.

Gail forced the issue and made them phone to confirm the doctor’s written instructions. The nurses’ already cool attitude and callous disregard for their patient now became positively arctic.

After reluctantly hooking up the bag of drugs, the nurse gave Gail a lecture that they were doing their best to save her Mom, and they didn’t appreciate the family’s interference.

I suggested to another nurse that the family’s version of events was quite different and that our experience was that some members of the staff had been not only callous, but outright cruel. I told her of the nurse telling Gail to not bother to get her Mom to eat the second week of her hospitalization.

I explained that the family had valid complaints. She was supposed to have been taken right to dialysis the first moment she arrived in early August, not kept in Emergency for over an hour, then wait in the Renal ward for several days before getting her first course of treatment.

The feeling was that the staff was waiting to see if she’d die so that they wouldn’t have to bother with her.

The nurses still avoided us, but it wasn’t as chilly after that.

 

I had a bit of an advantage over the family with the nurses. Sure, they had dealt with the nurses the whole time of her hospitalization, but during the first week, I discovered that I had gone to college with one of the nurses.

Deborah and I hadn’t talked about Gail’s Mom, but we did catch up. I asked her what had happened to her plans of being a stewardess. She told me she did the next best thing and had married a pilot.

But in the later weeks, she confirmed for me the feeling of the staff that Gail’s Mom was beyond the help of even heroic efforts. They were entitled to their opinions, but as long as the wishes of the family was that every measure of effort be continued, the unsubtle ways with which they let their opinions be known was inappropriate. And, in my view, negligent.

 

The remainder of the night passed with difficulty. The resident doctor returned to check on us and see how Gail’s Mom was. He was horrified to see we were using cold clothes.

He explained that by cooling her exterior, we were trapping the heat in her body core. In effect, on the advice of a nurse, we were actually increasing her temperature, not relieving it.

Gail almost burst into tears. It was really more than anyone should have to bear. After the doctor confirmed that the drug course had had no effect, and that her temperature had steadily climbed by tenths of degrees all night, he went home.

We found out later that he had taken several pounds of flesh off of the nurses for advising us to ice Gail’s Mom.

At 3 am, I was teary from fighting sleep. I knew I would not be alright to drive home, so I curled up for a nap in the lounge.

Gail woke me just after five am. She needed a break. She was wild eyed, frantic and completely frazzled from lack of sleep and listening all alone to her Mom’s horrific breathing.

I was surprised, in a way, that Gail had woken me to give her a break instead of waking me to tell me that her mother had passed away. I had gone to sleep with the feeling that Gail was thinking of ending her mother’s suffering.

I sat in the room for almost half and hour, my own breathing beginning to sync with the rasping moans. I considered how easy it would be to put a pillow over her face, but I was not able to even reach for the one Gail had been leaning against, never mind walk near her Mom’s bed.

I knew that if it was me, I would have wanted someone to do it to me much sooner than this point. My own Dad had made me promise him when his Mom died that I was never to allow him to be hooked up to machines.

“The machines are to give the living comfort, not to ease the passage of the dying,” he’d said to me. And, crying, I promised him that I would unplug him myself if it ever came to that.

 

Just before six am, Gail could take it no longer, she phone Albert to come to relieve us. He was due at 9 am, but we couldn’t even blink anymore. We were sleep deprived and the sound of her breathing had frayed our nerves and reasoning abilities to tatters.

 

The phone woke us at 8 am. Part of me hoped that we would be told she had passed away, but I knew that Gail would want to be there. We headed back to the hospital.

 

The doctors called the family in for a consultation meeting that Monday morning. Gail’s Mom had not been coherent since her birthday and she was no longer responding to any treatments that they could give her.

As we pulled up to the hospital, we saw the `Lot Full’ sign. It was a bit of a shock, we’d been regulars for almost two months, and had never seen the sign before.

I dropped Gail off in front of the hospital, I had a secret free parking space where I usually parked, but this morning we were in a hurry.

I only went a half block when I found a very easy to get into street parking space. It was after 9:30 so it was perfectly legal for me to park in front of the gas station. The woman driving behind me wanting to turn right did not rejoice at my lucky find.

I sat in my truck to calm down from the frantic drive from North Vancouver, but also to hear the OJ verdict. I was stunned that anyone would believe that the jury could reasonably agree on a verdict in less than an hour.

I entered the hospital and headed for the 5th floor. Everyone seemed stunned. Everywhere you looked, people where whispering `Can you believe it? Not guilty!’

I caught up to everyone sitting in a lounge, drinking coffee that Alma had brought, waiting to go to the consultation meeting.

Albert, Joanne and Gail’s Dad went to check on the meeting room and time. Gail went to her Mom’s room. Edward and Alma followed, leaving me to try to collect the unfinished and mostly full coffees. Some practical side thought that they’d still want them.

However, my trying to collect the coffees resulted in my being too late for the meeting. The family was all inside and the door was shut.

Not that I felt I had anything to say or contribute. Edward and Albert would object to my presence, never mind my actually speaking. I wanted to be in there for Gail; I had no intention of speaking. No one came out to get me, either.

From the moment the door closed, the warfare became open. Edward and Albert demanding their Mother be placed in the Intensive Care Unit (ICU) and Gail and her Dad wanted her to pass away when her spirit chose.

Angry remarks and accusations flew, clear words could not be heard through the door, but every now and then the nurses at the station would look at the door.

The two doctors emerged, giving the family time to talk and jointly decide. They were unaware that I was part of the group, so they spoke well within my hearing range.

Both doctors agreed that the case had become hopeless, it was just hours or days now. They could not halt the infections or heal the bed sores and nothing could be done about the Calsaphalaxsus, the diabetes or the end stage renal failure.

They commented on the hostility of the two brothers, and that the Dad and daughter seemed to have a better understanding of the real situation. They seemed to me to be genuine sorry for what the family was going through.

I could only guess how awful it was inside that room for Gail and her Dad. A few moments later, they both emerged from the room.

Gail walked past me to the elevators. I followed after her, leaving the coffees at the nurse’s station.

“They want to code her and put her in ICU.” The tears on her cheeks were more of anger and frustration, than grief.

I was stunned. Were they that blind to her condition? Or that selfish in their denial? Both?

Gail paced at the end of the hall. I watched her, helplessly. She clenched and unclenched her fists continuously.

“I’m so angry,” her voice was low and controlled, a sure sign of imminent explosion. “How dare they, how fucking dare they!”

“What happened?” I was sure I didn’t want to know, but Gail really needed to vent.

“I’m glad you weren’t in there. Dad was going to get you when Edward pitched a fit. Him and Albert must have had an initial consultation meeting, because it was fascinating how well their arguments meshed.” Gail started to control herself.

Her voice normalized as she continued, “Of course Joanne and Alma sat there, mute little puppets…They want the doctors to put Mom on a machines. Edward thinks that if we just keep her body alive, they’ll find a cure. Albert just can’t accept the fact that the part that was Mom is gone. I know she was afraid of dying, and I know she wanted every thing done to save her life, but she is already gone. There is nothing left but a failing shell.”

“I heard the doctors talking when they came out of the room,” I said tentatively.

“What did they say?” Gail asked.

“Mostly what you said. They said you and your Dad were right and that the boys were being difficult, that they did not seem to understand how far gone your Mom is.”

“Code blue 6C, Code Blue 6C.” the intercom crackled.

“That bastard!” Gail almost screamed. We raced back to the room.

She was being removed to the Intensive Care Unit, and they had already put an air line in her. Gail was unable to even kiss her Mom goodbye.

We didn’t go to the ICU. Gail began a systematic packing of her Mom’s things from the room. After a few minutes Albert returned, and began packing the items he was going to `hold’ for her.

It angered me that he had taken away so much from Gail that he couldn’t even leave her this one thing for her. Gail was hysterical with grief.

We left, but we stopped by the ICU before leaving the hospital. Seeing all the ICU machines clustered around the bed like some SM outtake from Heavy Metal was almost worse than the night we had just spent.

I think that it would have been easier for Gail to have walked in on me with the pillow on her Mom’s face.

 

By the end of the week, Gail’s Dad could no longer take seeing his wife of forty years, shy only a few months, trapped in a body unable to sustain it’s own respiration. It was tearing him apart more deeply than the rifts that had formed between Gail and her brothers.

The doctors asked to stop the body-sustaining procedures that, given the hopelessness of her condition, must have passed the line from heroic effort to needless torture. Her Dad did not refuse the request.

 

I was visiting a friend for a few hours of normalcy, when Gail called me and asked me to pick her up from work and take her to the hospital. It was the call we had been waiting three days for — they were turning off the respirator. My friend hastily sent regrets, and I ran out the door.

 

We remained by her bedside from 3 pm until 7 pm, when the laboured breathing stopped. Gail was holding her right hand while I stood behind her. Albert had her left, Joanne was behind him.

Edward, Alma and their Dad were outside smoking. They had only just walked through the threshold when she did not draw another breath.

“No!” Edward screamed, running forward and crashing into the bed. The heart monitor, which had flatlined, briefly flashed back with the heart beats.

“She’s coming back!” Albert refused to let go.

But it wasn’t her heart trying to maintain, it was just the bump and jiggling of the machine.

The room exploded with the pent up grief and frustration, everyone crying and moaning at once.

Albert began baby talking, promising no more pain, no one was going to hurt her again. He began to remove the sensors taped to her chest. He was reaching for the IV when Joanne stopped him.

“Let the staff do that,” she spoke soothingly, “Let them do their work.”

“No!” he was hysterical, madness flashing through his eyes, “Get your hands off of me! Get them off! Leave me alone! No one is touching my Mommy!”

Everyone took a step back. Albert slumped into a chair, crying.

The family all touched her, kissing her face, squeezing her already icy hands, then slowly drifted out into the hall to give the staff room to remove the tubes and needles and prepare her for her move to the basement.

 

Albert and Joanne has already purchased their crypt at a mortuary in Burnaby. Their Mom had had a fear of being buried or cremated. Albert decided that since it was a double crypt, his Mom could be interred now and he would be interred in the other half when he died. Joanne and their Dad could be cremated and the urns placed in the appropriate half of the crypt.

It was too creepy for me to even think about. It makes sense in a way. It’ll be cheaper to buy burial space now than when property in the Lower Mainland is at a higher premium given the current rates of immigration and general population expansion. No less creepy though; too much like asking to die.

 

Everyone agreed to the idea since there really wasn’t time to explore the alternatives. And it fit with her wishes of being above ground, we just thought that she should have been in North Vancouver, preferably near her son.

Albert, Joanne, Gail, her Dad and I trooped down to the mortuary to select a coffin and a capstone for the outside of the crypt.

The salesman took us into the show room. We were feeling creepy and ghoulish, walking around coffins displayed like sports cars. Oddly enough, we all picked out the one we’d want for ourselves first, but I guess any shopping trip is like that.

We had to stop ourselves from spending too much time shopping for ourselves, we still had the capstone to arrange. Everyone glanced around, thinking about Gail’s Mom. Immediately, we all converged on the tackiest, brightest and generally the gaudiest coffin in the place. It was white with a neon-ish pink interior, the large ornate gold handles were the crowning glory on this monstrosity of white and hot pink that even Elvis would have been embarrassed to own.

“This is the one she’d want,” their Dad said in his understated Jimmy Stewartish way. No one could honestly disagree.      The salesman said that this one would not do, it was a child’s coffin. There would not be time to have it made in adult size.

None of us thought it was smaller than the rest; maybe he would have been embarrassed to sell it to us.

We ended up selecting a powder blue with a paler blue leaf pattern. It was as classy as a coffin could be.

We headed downstairs to the capstone room.

By this time, we were all feeling a little punch drunk. The capstone saleswoman was horrified by the suggestion that we’d cremate their Dad and inter him in a coffee urn. But then, we knew him and she didn’t.

He suggested that a large ashtray would be more appropriate.

 

Albert wanted to go the cheap route and have their Dad’s name cast on the capstone at the same time. Gail and I objected, that was too gruesome and fate-tempting. Their Dad wasn’t comfortable with it either.

The capstone was ordered, the funeral arranged and we returned later that week to the mortuary chapel with guests in tow.

 

The family had selected and arranged all the flowers, Albert had designed and printed the program, and Gail had called and invited all the family and friends.

The service performed by the Salvation Army Major was much easier to listen to than the static inflicted Pastor at my Gramma’s funeral. The Major spoke eloquently and only of Gail’s Mom.

A friend of Albert’s performed Amazing Grace and two other traditional funeral hymns. She had a clear, beautiful voice and accompanied herself on guitar.

After the service, we milled about, a bit at a loss. My Mom asked me quietly what was supposed to happen now.

“I dunno,” I whispered, “I think we forgot to plan anything.”

 

Later, Gail’s Dad looked around his apartment, at his grieving kids and their spouses and the platters and bowls of food.

“I guess we weren’t thinking straight. Mum would have liked a party,” he said not quite loudly enough to carry across the room. “I guess we should have had people back here.”

 

Should haves, would haves, could haves, and life goes on…..

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5 Responses to Life Goes On: October

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