Category Archives: death and dying

Live Blogging — My Mother’s Death Bed

It’s been many hours since she last spoke, but her breathing is steady, loud and labored.  My sister and are sitting in a shit-smelly room in the Albany Medical Center, 5th floor, neurology unit.  My sister is reading her kindle by the light of the patient’s bathroom.  I am writing this backlit by my mac.  The music is something Bach-like via Pandora.  It’s not exactly a softly lit, pastel colored hospice room.  There was no room at the hospice, but at least they got my mother out of the “stroke room” where an eager neurology resident made idiotic statements about an 89 year old woman with advanced CHF and coronary artery disease making “a full recovery” in 6-12 months.

When confronted with the information that she’d had a heart attack as well as a storke and cardiology had told us they couldn’t treat the blockages because of the stroke risk,  Doc Bollywood didn’t blink.  He just said, “Well, that was cardiology. I’m talking from a neurological standpoint.”
To which my brother-in-law replied, “Are you saying she can live without a heart? Who do you think she is, the Tinman?”

That actor had it wrong.  Comedy is easy; dying is hard.

Physical therapy also stopped by earlier. We sat  astounded.  “I guess she’s tired.  We’ll come back later.”

Yeah, tired.  She’s just resting.

Not everyone who works in a hospital is crazy.  Only the doctors and the physical therapists. The nurses get it.  Comfort care when nothing else can be done.

My mother hasn’t said anything in the last six hours or so, and hasn’t said anything we could really understand since yesterday. — though there was a moment earlier  today when I thought she understood me perfectly and I imagined I understood her grunted, garbled reply.  I was telling her how great Jack — her husband, my father was and how much he loved her, how I still felt his presence, and the caring never dies.

She looked at me, and mumbled something, which I imagined was, ” He was a great husband and father.”

I agreed.

Now my sister and I just sit in a dark room and wait.  My mother gasps for every breath.  She was gripping our hands hours ago — holding on for dear life.  Holding on to dear life. But that’s stopped.  Her knees are bent up, the way we remember our father’s being.

On the phone to my friend, a nurse practioner in New York, my friend overheard the 9 PM announcement telling all visitors to leave.

“That doesn’t apply to you,” she said.

“I know,” I told her.

They finally gave her morphine.  A tiny bit.  My sister was worried.  My mother once had a bad reaction to it.  It was after a fall.  She was in pain, but the drug made her paranoid, hostile.  “I don’t want her to go out that way,” my sister said.

But finally my sister agreed it was time.

1 miligram to start.  It’s already quieted the breathing.

We’re staying the night.  Maybe in shifts.  I used to work a night shift in a hospital.  That was years ago, psyche, not medicine, but still it seems familiar to be here and odd, watching the woman who gave birth to me, contracting into herself, becoming smaller, smoother, more fetal.

Her strangely unwrinkled face.  Dying has a beauty too. It is as elemental, fundamental as birth, but not celebrated.  Still, there’s nothing tragic here.  We are not meant to be too long lasting.  None of us gets more much more than a century, and no one gets out alive.

The morphine is helping.

Old Man Walking in Winter

Spring 2004, they told him the cancer was back, hiding in places it hadn’t been before. Inoperable but treatable, the doctor said.

“No, thanks,” he replied. “I’m eighty-six. I’m not looking to draw things out.”

Three to six months without chemo, he was told.

Nine months later, winter 2005, despite the prognosis, he had only slowed down, a little. The ache in his leg kept him up some nights though he wasn’t sure if it was the pain itself or the knowledge of what it meant. The waiting was harder than he’d expected. He’d read obituaries of people who died in their sleep and feel a twinge of envy.

One afternoon the sun was bright, and he was restless.

“I’m going for a walk,” he announced.

“A what?” his wife said grappling with the concept. “It’s freezing. There’s ice.”

“I’m going.”

“But we don’t need anything,” she shouted.

He dressed warmly and stepped outside, moving slowly at first. Then realizing the streets were dry, he quickened the pace. His lungs were clear and he’d learned to live with the dull throbbing in his thigh. He said hello to a neighbor who asked after his wife. He passed the playground and wondered when he’d last been inside. Could his oldest really be pushing sixty?

He walked by stores, mostly new in buildings mostly old, not as old as he was, though many had been up when he’d moved to the neighborhood half a century before.

Half a century. He remembered a parade he’d seen as a child, men as old he was now, civil war veterans. How was that possible?

He was not in denial, but it seemed hard to fathom that he could feel so physically well while his body was in the process of shutting down.

He found himself in the industrial area of L.I.C. on a quiet block as yet undiscovered by artists or developers. Facing southwest, before him was the lower Manhattan skyline — that gap between buildings filled by the sun. He stopped for a moment and took a deep breath, suddenly aware of the beating of his heart and the realization of when he had last stood on that spot. Fall, 2001. There had been an acrid smell, and all he could see across the river was smoke.

A voice said, “This too shall pass.”

No one was there. A life-long agnostic, he did not believe it was the voice of God. Still, it was something.

As he walked home he noted everything as though seeing it all for the first and final time.

When he returned, his youngest daughter was waiting. She’d stopped by after work as she often did in those days.

Lately, even she, who dealt with suffering on a professional basis, had developed a catch in her voice when speaking to him.

“How are you, Dad?” she asked.

“Great,” he replied, without a touch of irony.

About a car…

_1990-1991-ford-taurus__180-1Jack’s car was not exactly pampered, having a maintenance schedule that consisted of an oil change prior to inspection every August. Most of the time, the 1990 Taurus remained in the heated garage below and in back of the tidy two-family house in Queens — its only companion the Volvo kept lovingly by the garage tenant who lived in Manhattan but visited most weekends. Thanksgiving, Passover and maybe some other times when the weather was good, Jack and Dora took it up to Albany to see their daughter Anita and the grandkids. Occasionally, he’d use it to chauffeur Dora (who’d never learned to drive) and her Hadassah friends to some special event although as the years passed there were fewer, and Dora, easily winded, barely left the house.

Jack had kept his optometry office on the first floor of his home, so the Taurus had never known the rigor of the morning commute. The practice had stayed open long after many of Jack’s patients had died or moved away or been enticed to try the big schlock houses — Cohen’s and Vision Center — with their designer frames and fancy window displays. In the end, the rising cost of malpractice insurance outweighed his desire to keep busy, and so he closed up the shop. He and Dora had talked about traveling, but she’d complain that her neck bothered her after long rides. The grandkids were getting older too, Matthew off at college. The Albany trips became less frequent.

Anita hinted that maybe he didn’t need a car. After all, she pointed out, the grocery store and movie theater were down the block, and they were still capable of getting on a bus though Dora had trouble with the stairs on the subways. Trains to Albany ran often, and now that Andrew had a license, there’d be no problem with his picking them up at the station. Jack replied with an edge to his tone that was rarely heard, that he was not yet “decrepit.”

One spring, he found himself with even less energy than his wife who finally convinced him to see a doctor where he received the bad news with the quiet rectitude that characterized his generation. Soon after the diagnosis, he decided to visit Albany. His youngest daughter, Marion, a childless Manhattanite who didn’t own a car, offered to drive him, but he insisted on doing it himself. A few months later, came his granddaughter’s bat-mitzvah, and he allowed Marion and her husband to drive the Taurus as he sat with Dora in the back, offering instructions on the best route and reminding his son-in-law that this was not a NASCAR event.

He didn’t leave the house much after that, and a few weeks later, he died in his bed. The Taurus though it was 15 years old, still had under 55k and was needed as Dora had made a hasty transition to Anita’s home while on the waiting list for an assisted living facility close by, and many things still needed to be transported. Marion thought she would hold on to it at least until the house was sold.

It turned out that street parking in her uptown neighborhood was less of a chore than she’d anticipated, and the car came in handy especially for the visits she was obliged to make almost monthly to see her mother. Finally, a reasonably priced parking space at her co-op complex became available, and the car no longer needed to be moved thrice weekly to accommodate the alternate side parking rules.

While they did not mean to treat the car badly, Marion and her husband were not experts on its care. On a trip to Vermont, they were sideswiped by a truck resulting in a dent and some damage near the trunk. Due to its age, the insurance payout wouldn’t cover the repair, so they spent the money elsewhere, and only months later noticed that water had leaked into the trunk, pooled inside the wheel-well and froze solid. As it thawed in the spring, a mildew odor pervaded the inside of the vehicle. They drained the water, dried out the inside and used tape and plastic to prevent future occurrences. While this shouldn’t have caused mechanical damage, things began to go wrong. The car stalled on the road. The alternator and battery were replaced, but a week later it stalled again on a busy street apparently due to a corroded wire. They didn’t trust the Taurus after that and felt it would be better off with an owner who knew more about its needs.

On Mother’s Day, they took it for a final trip to Albany, joking that that was what Jack would have wanted. They stopped by Dora’s little apartment and she proudly introduced them to the new desk clerk as she signed out for the afternoon and they all went to Anita’s. When they dropped her back off, Dora — never one for sentiment — said, “Well you’re better off renting for all you use a car.”

The ad went out on Craigslist. $299 OBO. Despite its still low miles and relatively good condition, only one respondent – a teenager in Brooklyn — wanted it for other than its parts. His offer of $200 was accepted. He didn’t need a test drive, was willing to take their word that it ran, and would be by to pick it up on Saturday.

The day before, Marion walked over to the space to get out the last of their things which included all of Jack’s insurance cards stuffed in the glove compartment, along with a few old wrappers for the Nips candies he and Dora had liked, and a couple of pieces of paper faded, with handwritten directions in Jack’s familiar scrawl.

She went back to the apartment and searched for something on the Internet, printed it out, returned to the vehicle, sat in the passenger seat and began, “Yit-ga-dal v’yit-ka-dash sh’mei ra-ba b’al-ma di-v’ra chi-ru-tei, v’yam-lich mal-chu-tei…..

When she had finished the prayer, she said, “Jack, I’m sorry we didn’t take care of it as well as we should have,” she paused then continued, “but you were never much about things anyway. You know where we all are. You don’t need the car to get there. You need to leave it, now.”

She waited a few more minutes, and then feeling a subtitle difference that could have been entirely imaginary, she left.