Monday, January 4, 2010

how Sunday went

For me, Sunday meant waking up late after a decent night's sleep. Two friends and fellow congregants from our church, Mr. and Mrs. Doe, arrived at our door with food: a hearty soup, Italian bread, a salad mix, and cookies. Our thanks to the Does, whose food we ate (along with the food from Mrs. Burns and the Morrisons) later in the day for dinner. I regret not seeing our guests: I was downstairs, probably showering. Dad was the one who greeted them.

Our goal for the day was to see Mom, so Dad and I shoved off around 2PM. I had nearly emptied the van's gas tank after (1) driving home from New York, then (2) driving back into DC to pick Dad up. Before Dad and I struck out for Walter Reed Medical Center, we drove to Fort Belvoir to gas the van up (gas is usually about 20-30 cents cheaper on base). On the way to DC, we picked my brother David up, and once we got to the medical center, we saw that Sean was there. Sean left soon after our arrival.

Mom's new ICU berth proved to be larger than I thought. I had imagined something cramped, slightly bigger than a closet, in but fact there was enough room for three visitors (plus a doctor) to sit or stand in relative comfort. Mom's room was comfortably dark when we went in. Her poor eyes remained swollen; we were told that she was still receiving regular applications of petroleum-based ointment to reduce irritation and protect the eyes from over-exposure, and we saw for ourselves that, unlike in New York, someone had attempted to tape Mom's eyelids shut. The attempt had been only partially successful; Mom's right eye in particular has now become so swollen that it will probably never completely close again. A nurse came in to re-apply ointment and re-tape Mom's eyes; he, too, was unable to close the right one completely.

Mom herself was as still as death, but her hands remained warm. More to comfort myself than to comfort her, I again sat beside Mom and placed her left hand on top of mine, allowing her inherent warmth to radiate into me. For a while, I could fool myself into thinking that she had placed her hand there-- that it was her will, not merely the pressure of gravity, that kept her hand where it was.

Mom's vital signs were bizarrely good, though: heart rate 114 (high, but better than 140), blood pressure 122/58 (MAP = 78), pulse-ox 100 (David noted that, with the ventilator set for 80% oxygen, Mom might have been over-oxygenated; a respiratory tech later adjusted the machine downward), and best of all, respiration at 16 breaths per minute-- the lowest and calmest rate I had yet seen.

But Mom's serenity and her tranquil vital signs belied the fact that the top of her head had begun to look like the surface of a world that had suffered a global war. The tumor that had begun to rise through the hole in her skull was even more prominent, and red blotches, patches, and blisters were making their way from the top of her head down the left side of her face. Several things seemed to be happening at once: infection, lingering irritation from all those days spent with the helmet on, belated effects from radiation and chemotherapy, and possible enhancement of the tumor in new spots on her scalp. Even the nurse was unsure how to read all the signs, but on a gut level, I knew they meant nothing good.

The ICU is already viewing Mom as a palliative case: they're doing what they can to make her comfortable, but they're not giving her antibiotics or doing anything to prolong her suffering. Both her infections and her cancer are, I suppose, free to work their work on her, and it seems to me that we are, at long last, nearing the end. This is no longer a struggle or a battle with cancer; cancer and the germs have won, and we are merely witnessing the mopping-up.

Dad was, once again, in and out of the berth as he went about gathering information. He wanted to track down the social worker so he could talk with her about hospice options, but it was Sunday, so the social worker wasn't there. Dad did manage to take down some crucial phone numbers; he'll be calling people in the morning, and his hope is to have Mom scheduled to go somewhere-- home or to an institutional hospice-- by the close of business on Monday. Mom's actual move, if Dad is successful in finding and securing a hospice arrangement, will likely occur later in the week.

Dad had also brought along a pile of Christmas cards from various friends. He read the handwritten messages in the cards to Mom, asking me to decipher the Korean messages as best I could. One of Mom's old friends had knitted her a scarf. Mom will never wear it, but David took the scarf and drew it along Mom's right hand, allowing her to feel it.

Throughout our nearly three hours at the ICU, I did little but sit by Mom's side with my hand nestled under hers. Sometimes I shifted position and held her hand. Sometimes I stroked it. My brain didn't know how to reconcile Mom's organic warmth with her corporeal inertness. And the more I thought about it, the more I came to believe that Mom had already left us on the night between December 21 and 22. She had been there, in the office, to hear the death sentence handed to her by Dr. Boockvar from wherever he was in Florida; she had seen the crestfallen looks on Dad's face and mine, and later that evening, she had sat silently in her wheelchair, between spoonfuls of soup, and stared at me as I both sobbed my apologies to her for not having been able to do more, and begged her forgiveness for all my failings as a son.

That, I increasingly believe, is when Mom concluded it was time to look skyward and hitch a ride with the wind. There really was nothing more for anyone to do. With no hope from any medical corner, and with the cancer and the pneumonia raging within her, she may have decided-- at a primal, cellular level-- to stop fighting. For her family's sake.

But after spending eight months by her side, after following her bodily rhythms and feeding her meal after meal, after exchanging ten thousand hugs and going on who-knows-how-many walks in the local park, I feel almost telepathically linked to Mom. Her shutdown is now my shutdown, too. She's dying, and my heart is withering. As I wrote to my buddy Mike, I fervently wish I could magically take all Mom's cancer into myself and perish in her place. If such magic were possible, I'd use it gladly, no matter the cost to me. But that's never going to happen, and I feel there's no longer anything I can do except watch my mother die. When we left, I whispered to Mom what I had told her before in the New York ICU: "You can go anytime you want. It's OK." That was a lie, though: I don't want her to leave when I'm not there to see her off.

We three drove home-- Dad, David, and I. We had tested one route on the way up to Walter Reed; it struck us as rather long and out-of-the-way. The more direct route, which we took in the evening, seemed much shorter, but it also took us through the heart of DC, i.e., through a gauntlet of traffic lights. On a Sunday evening, though, the lights weren't a huge problem; we moved along at a good clip.

The ride back home was quiet. We dropped David at his place so he could pick up his own car and drive separately to our house. Dinner was "every man for himself," a smorgasbord of victuals prepared by others... and perhaps a harbinger of dinners to come as we lose, forever, Mom's savvy feminine touch at mealtimes. The rest of our evening was, as you might imagine, similarly quiet.


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