“I’m Mrs. Carter’s son, Drew. I grew up here and was raised in the house that my mother and father built fifty-two years ago. They were married for fifty-nine years when he died in 1996. My mother made a decision seven years ago that she would stay in their home until the end, no matter what. She has had a live-in caregiver, Deb Elson, with her there for the past five years.
“Mama’s fall was unavoidable. The cat, Big Boy, simply ran between her legs coming to say hello. And so, she fell. Ironically, I had a visit with Mama the week before. I only left this past Monday. Mama fell on Tuesday. And I’d like to tell you what her life was like just seventy-two hours ago, when I said goodbye to her at the airport.
“Mama was a farm girl at heart and rose early every morning. She relished her time alone, so she was careful not to wake Deb. On days like today, she would make a cup of strong coffee and open the doors and windows to let the cool morning air into the house. Afterward, she would step out on the back porch to watch the birds feeding in the side yard or bathing in our dog’s old water dish. If the birds needed food, she’d walk out and add a few scoops to the feeder. By this time, Big Boy would be rubbing her legs, eager to be fed himself. After feeding him and giving him a long chin rub, Mama would cook herself one fried egg and a piece of whole wheat toast.” I glanced around to see Karen standing in the doorway, smiling.
“Following breakfast, she’d clean up the kitchen, put her dishes in the dishwasher, and retrieve the morning paper from our front porch. Still enjoying the early morning silence, she would read the Times & World News from front to back and then dig into the crossword and other word puzzles. By now it would be almost 7:00 a.m. Most mornings she bathed and dressed and combed out her hair by herself. She had—has beautiful hair.” I stopped, wiped my eyes, and continued.
“Most days, at least twice a week, Mama had a bridge game, usually at the country club. They started at ten in the morning, broke for lunch at twelve thirty, and played until exactly four p.m. Mama usually won. That’s not bragging, just a fact.” The group released a barely audible laugh. John laughed, too.
“Mama’s caregiver, Deb, would drive her home, help her up the front stairs, and start dinner. Mama would mix herself a cocktail that consisted of two jiggers of bourbon and a teaspoon of fresh lemon juice topped off with Clamato juice. I know it sounds awful, but she loved it. After dinner, she and Deb might go for a walk down her street and back, returning in time for Jeopardy. Mama could answer questions in most of the categories, but was particularly adept at ‘World Geography’ and ‘Shakespeare.’ Wheel of Fortune was next. She thought Vanna was so pretty. Bedtime came soon after. And she woke the following day to do much of it over again, gratefully.”
I took a moment to collect myself. I was aware that my audience of doctors would have to go soon, so I got to the point. I felt compelled to make it on Mama’s behalf.
“Oh, and one more thing. The night before I left, we were sitting up talking and I asked Mama, ‘Are you happy?’ She turned to me with a smile and said, ‘I get to wake up in my own home, have a good breakfast, tend to my birds, read the paper, and spend time with friends. So, yes of course, I’m happy. Who wouldn’t be?’
“So, now I put it to you: if any of you can honestly tell me that my mother, should she ever wake up again, can enjoy even half the quality of life she had before, then I’m all in. But I appreciate Dr. Ellis’ candor and truthfulness. Mama’s life will never be the same. And she never authorized life support. She never wanted this. So now you know. She couldn’t tell you herself.”
I sat on the edge of Mama’s bed and held her hand. No one moved for a few moments. Several of the interns were wiping away tears, as was Karen, who seized the moment to briskly inform the room that it was time for Mama’s bath. Her words seemed to break the spell, and the room emptied.
“We’ll go, too,” I said.
“That was just to give you some time with her alone this morning. I’ll be back later. Take your time.” Karen left, closed the door, and left John and Mama and me together.
The EEG later that morning showed no measurable brain activity. They repeated the test the following morning with the same results.
The next morning was Friday. According to the bank of TVs in the visitors’ lounge, the stock market had taken its largest plunge since October 1929. The stock market, the news, and the world outside of the ICU seemed surreal.
Kit and I asked for a meeting that afternoon with Mama’s doctors and the hospital Ethics Committee chair. It was standard procedure when considering a decision to remove a patient from life-support. Kit and I had talked and were each certain this is what Mama would want. She had told us this specifically, both together and separately, as recently as the past summer. If there had been any doubt, her Medical Directive spelled it out in writing.
The meeting took less than thirty minutes.
Dr. Ellis was there. “Thank you for supporting Mama’s decision. I was a little worried the hospital might put up a fight.” I smiled and added, “We’ve never had to do anything like this before.” As Kit and I stood to leave, he came over and shook our hands. He said, with steady eyes and a sincere voice, “I’m so sorry. And I’m glad to have gotten to know a little about her. Thank you.”
Karen was on the afternoon shift, and we met her at the door of Mama’s room. “I thought you were off at three today,” I said. I could only offer a sad smile.
“I decided I’d like to be here, tonight, if that’s ok.”
“I think Mama would like that.” I wasn’t able to find any more words.
We were told that it could take minutes or hours, perhaps days for Mama’s body to give up its fight to survive. I hadn’t been prepared for this, and hoped they were wrong. Kit, a former nurse, seemed to understand all of this better than me and gave me a perfectly timed big-sister hug.
I was suddenly and acutely aware of the buzzing and humming of the machinery in the room and of the harsh fluorescent lighting and cords and tubes. In a hard moment, it all seemed barbaric. It was not the ending I had in mind. I sobbed.
Karen gently took charge. “If you’d like to step out for a moment, we can make your mother more comfortable. It’ll only be a few minutes.”
Numb to her words but grateful to get out of the room and delay the event before us, I left, accompanied by Kit on one side, John on the other. In a few minutes, Karen invited us back in, but John nodded, held me, and whispered, “I just can’t.”
I held him tightly. “I understand.”
As Kit and I entered, Kit smiled. “Wouldn’t she like this?” Mama’s room had been transformed. The curtains were open with a view to the beautiful Blue Ridge Mountains that had been the backdrop of Mama’s childhood. Warm, late-afternoon sunlight had replaced the fluorescents above. Mama was draped in crisp, white bed linens, and tubes and lines no longer tethered her to machinery. The machinery, save a smaller heart monitor, had been removed.
The room seemed lovely and still.
I realized at that moment that Karen, and all the nursing staff who had attended Mama, were truly angels. Kit on one side, and I on the other, we each held Mama’s hands. Karen had wrapped my mother’s shorn head in a beautiful scarf and secured it with a piece of jewelry that my sister had brought from Mama’s dresser. Mama looked peaceful, breathed slowly, and began to leave us.
Kit leaned over and whispered goodbye through her tears. I remembered Karen’s words from a few days earlier and leaned close and began my goodbye. “Mama, we’re going to be ok, We love you. It’s ok to let go.” I held her hand, hoping for any last minute squeeze or sign.
It’s hard to describe the passing of another life from this realm to the next, but a feeling of peace gradually replaced my sadness, readying me for whatever was to come.
Just like her own mother, Mama was never one for long goodbyes. Her breathing slowed, but there was no struggle. The only sound was the heart monitor, punctuating the slowing rhythm of a heart that had loved so many so well. There was no drama, only an overwhelming feeling of privilege for getting to see Mama off. And then, only quiet.
Comments