On my mother's death

It was a very peaceful end. I was resting my hand on her chest in order to check her heartbeat and I felt the last beat of her heart. I had been sitting with her all day and in the evening, after my father had left for dinner, there seemed to be something different about her breathing. Mmyspouse went to get dad and so he was there with her when she breathed her last.

It had been winter when she went into the hospital and it was spring when she died. Leaving behind the deathbed vigil was like emerging from a very long and dim tunnel to find that ordinary life had continued in our absence. At home the grass needed to cut and yard work needed to be done. In just a week my father would face his first birthday without mom in over 60 years.

Sitting day after day and then week after week in the hospital I have learned much about the amount of sadness in the world. The morning before my mother's death another patient on the floor of the palliative care unit died. The man had only been in the unit for 2 days and his family was totally unready for the his death. His daughter was sitting by him, looked away and when she looked back he was dead. She broke down in hysterics. Across the hall was a man who has been on the floor for 18 months. The doctors had given him 5 months to live when he arrived. He went home for a few hours on Sunday to enjoy the Masters with his grandsons. He and his family knew that every day could be his last. Just down from his room was that of a young woman -- maybe 24 or 25 -- who had metatastic bone cancer. Her father told me that "it sounds like a cliche but every day becomes a precious gift to you." And in yet another room a 23 year old was dying of cancer and his mother expected that he wouldn't last more than a few more weeks. And a few hours after the corpse of the man who died in the morning had been removed the room had a new occupant. The man, just transferred down from oncology, was constantly wracked by coughing and gasped as if always fighting for enough air just to breathe.

We walked out of the palliative care ward leaving one set of worries and fears and taking up another. Our  concern was now to look after my father, a man who was both heartbroken at the passing of his wife and ready for it. He loved her and he looked after her to the end. We loved her and the greatest gift we could give to her memory was to care for and cherish the man she had loved so long and so well.

Speaking to death and grief, part 1

The problem isn't that people do not know what to say to you when you tell them that your mother is dying it is that people want to say something wise, moving, insightful or spiritually uplifting.

Perhaps because so many of us are from small families and so few of us have experienced the practical details that attend sickness and death people have trouble understanding the deathbed realities of the grieving family.

The address book

My mother had an old well-thumbed address book. I think she bought it decades ago and over the years she had drawn lines through many of the addresses. In some cases my mother had simply lost touch with the person named but in a heart-breaking number of cases the struck-through addresses had the word "dead" written over them in red ink. But we could not simply pass on because of the red line drawn through the name. That person might still have living parents (unlikely), be survived by a spouse (somewhat less unlikely) or by children and grandchildren. We would search through the ragged address book looking for candidates.

We sat down and made a list of the people who needed to be called and shared the names out amongst us. We discussed what needed to be said and what was better left unsaid. And then we began making the phone calls.

How many times can one say 'my mother is dying?'
How many times times can one politely and patiently answer the questions?

"Are you sure?"
'Yes,' I would say, while thinking, would I call a near stranger to tell them this news were I not sure?"When did you find out?"

'Well,' I would say 'I am fuzzy about the exact day,' while thinking, please please don't be offended that my first response was not to call you.

"Is there anything I can do?"
'No,' I would say, while thinking, if I knew of anything anyone could do for my mother do you not think I would have already asked that it be done.*

You know that these people don't mean to hurt you. They may even think that they are helping you by giving you 'a chance to talk about it.' But talking about it doesn't make you less tired, less worried, less concerned about your father's health, less concerned as to whether your mother is scared or in pain.

Every second talking to someone else is a second you are not spending with your mother. And your mother has very few seconds left. You don't know when she will draw her last breath but you do not want to spend some of those last few precious moments of time telling yet another person 'my mother is dying.'

So you answer the questions with as much speed and as little emotional involvement as possible.

And then you go back to your mother's bedside. Talking didn't help. Sharing didn't help. Answering questions didn't help.

Your mother is still dying.


* There are some wonderful people do don't say vaguely "Is there anything I can do?" but instead make suggestions as to what they could do. This frees you from the fear that you have misunderstood the nature of their offer. "Would you like me to pick up your groceries?" or "Do you need to have any books returned to the library?" are much more useful offers than a vague 'anything.'

Dying isn't easy

They lie to you in movies and on television about what it is like to sit by the deathbed of a loved one. Movies are too short to capture the mixture of exhaustion, boredom, panic, worry and grief that closes in around the people at the bedside.  Television is too episodic to capture the grinding constancy of routinized sorrow. 

A year ago I thought I understood just how wrong are the images of dying we learn in popular culture. I was wrong.

The day after I learned my mother was dying I woke up early. The last I had seen of my mother the night before she had fallen into an fitful uneasy sleep. Since I knew the time of the nursing shift change I wanted to talk to my mother's nurse before she went off duty. A pattern had already been established. I introduced myself to the nurses as they came on shift and if I was not there when they went off shift I called them. 


The speed with which the patterns of hospital time became the patterns of my time was something I had not expected. By the end of the first few days I knew when they gave medications and when they changed the sheets. I knew when they took each patient's temperature and blood pressure and I knew when they gave my mother a bed bath and shampooed her hair. But I didn't know when they fed their patients because my mother would never eat again. 


We don't know exactly how long my mother had been suffering from severe pain after attempting to eat. It wasn't until the night my father found her vomiting blood that he realized how she was ill and insisted that she let him take her to the hospital. Although on the day of her "death sentence" she had been in great pain she was still able to think clearly and discuss her medical situation with her surgeon. Soon the mixture of pain killers and pain left her unable to remember exactly why she was so terribly hungry. 


I quickly learned that tending to a dying person means having to take great care lest you accidentally rip their skin. I learned that tending a dying person means holding their head as they gasp and cough and fight to breathe because they have have accidentally obstructed the ng suction tube. I learned that sitting at the bedside of a dying person meant monitoring their urine bag and their ng collector bag and always knowing the location of every nurse on the floor. I quickly learned that giving comfort and preventing pain was all I could do. 


By the end of the second day of my season of sadness I felt that I had learned much. By the end of that second day I thought I knew exactly how wrong the movies and television were about death bed vigils. I was wrong. There was much more I had yet to learn about exhaustion, worry, pain and grief.

A season of sadness

March 10, 2010. 
@4:30


That was the moment I learned that my mother was going to die.


Of course I had always know that absent a drastic alteration of the normal laws of our universe that either we would die at the same moment or one of us would outlive the other. Unless I took up a career more dangerous than that of an academic  the odds were that I would outlive my mother.

Intellectually understanding something and actually knowing it in your gut are two different things.

I remember being at the dinner table in my house when the phone rang. I remember hearing my father's voice giving me the news. I remember arriving at my parents' home and finding my father in an almost pitch black apartment,  frantically looking through drawers and file folders for a mislaid hospital card. I have no memory of the hour and a half car drive that took place between those two moments of time.

My mother had made the decision not to undergo an operation that she was unlikely to survive. Without the operation she could not live. She had always been a fighter but she had no fear of death. She wanted a chance to say goodbye to those she had loved most and to those who loved her most. As much as it is possible for someone who has outlived most of her friends and much of her family she did so. 

But she did not go swiftly into that good night. She had no fear of death but she had never given up on a fight in her life and she was not about to do so now. The doctors gave her days to live. She lived for more than a month.


So this is my season of sadness as each day brings me closer to the anniversary of her death.