May 21, 2007

 It’s a beautiful May morning. The grass is heavy with dew and the air is filled with an early morning concert sung by a choir of returning birds. They’ll soon build nests in neighboring shrubs and trees where they’ll raise their young, then head south again in the fall, completing another yearly cycle. As I turn the corner into my driveway, a mourning dove feeding on the ground takes flight. I feel a light bump as it collides with the hood of my car. I watch it rise straight up, with wings outspread, surrounded in a veil of white light. When it vanishes into thin air I know something has changed. It’s a clear message that my mother is dead.

As I walk toward the house I hear the phone ringing. My dear friend and housekeeper, Bobbie, greets me at the door and hands it to me. It is the Doctor, calling from the hospital to let me know that Mom has just died. My two dogs, Molly and Sam jump and yip at my feet, happy to see me. I’ve only been gone overnight, but they act as though I’ve been away for a month.

Once I’m alone, I call my husband, Bill, who’s traveling in England. He’ll be on the next flight out of Heathrow. Up in New England my brothers Zed and Reid, with whom I talked last night, are expecting my call. I phone my son, Mark, at school, telling the receptionist what I’m calling about. She kindly takes over his classroom for a few moments so that I can talk to him. When I reach my daughter, Lisa, in North Carolina, she is tearful. She’s planning to be here tomorrow with the family.

I’m in no hurry to rush back to the hospital where my mother’s lifeless body lies. I sit with a cup of tea, and a slice of homemade bread still warm from the toaster. Both dogs are at my feet begging for crumbs. I missed having them cuddled next to me during the night. For the first time in seven years I am free, no longer my mother’s caretaker. I’ve been praying for this day for months, if not years, and these two angel mutts, have helped me through it with their unconditional love.

The doctor and nurses have left Mom in her room, giving me as long as I need to sit with her and say my final goodbyes. Yesterday, with all of its discomfort rushes toward me again. I was with her all afternoon and all of last night, as she began her journey to wherever one goes when they die.

Unbeknownst to me, she’d been admitted to the ER early in the morning. She’d complained to the nurse at the assisted living facility, that her leg was badly swollen and she was in terrible pain. I discovered her missing when I stopped in to bring her fresh flowers and a few other items, after lunch.

If the nurse on duty had done her job properly, she’d have checked my mother’s chart and called Hospice directly. They would have arranged for an ambulance to deliver Mom to the hospital and into a private room, where her palliative pain management would have continued nonstop. Instead the nurse called an ambulance herself. Mom was taken directly to the ER where she was not receiving her regular dose of pain meds. That same nurse, also neglected to read that I was to be contacted if Mom was sent to the hospital.

I became a raging dragon when I was told that Mom had been sent to the hospital around seven that morning. “What is wrong with you people? Why didn’t you call me? It’s right there in print on her chart.” The nurse, still on duty, had nothing to say.

I found Mom in the ER moaning, in intense pain. A week ago, as she pushed her walker out to the pond where she could smoke without being caught, she had fallen, bruising her good leg. She was checked out by a doctor who said she’d be fine. Since then, her leg has swollen to three times its normal size. It looks like it’s about to burst. Why hadn’t the nurse in charge of Mom’s care at the facility noticed?

Because the doctors weren’t giving her the amount of morphine she needs to keep her comfortable, I explained that she’s a hospice patient with untreatable lung cancer. No one seemed to hear me. One doctor told me that Hospice isn’t welcome in the ER and refuses to call them. Even after another doctor called the assisted living home to find out Mom’s needs, they refuses to give her the correct dose of morphine. When I asked why, I was told, “It will kill her.” Furious, I yelled out in the middle of the Emergency room, “She is a hospice patient. She IS dying. Can’t you see she needs more pain meds to keep her comfortable?” It made no difference. One of the nurses told me, “You need to leave. You’re upsetting your mother.” When I asked Mom if she wantedme to go, she says, “No.” My fiery words were not upsetting my mother, it was the nurses and doctors who were upset and want me to leave.

I called Hospice myself and continued to harangue the doctors and nurses to help her. She was finally admitted to the hospital and moved into a private room at around five-thirty in the afternoon. My mother had been in the ER in excruciating pain, without proper care for almost twelve hours.

After making sure that Mom was being given the correct dose of morphine I rushed home to make a few calls. When I returned, she was propped up in bed, breathing in and out of an oxygen mask. An IV slowly delivered pain relief. There were other lines to monitor her heart and other body functions. An uneaten tray of food … chicken soup, a roll, and red Jell-O, sat nearby. On the TV, the Evening News was reporting on the latest investigations into insider trading deals. I turned it off, offered Mom a taste of Jell-o, but she was barely conscious.

Feeling that she would getting ready to make an exit within hours, I told her, “Mom, if you’d like to leave this world, you can go without worrying about Zed, Reid, or me. There is no reason for you to hang around if you wish to leave.” With eyes closed, she nodded her head in understanding. I sat, holding her hand as she moved in and out of consciousness.

Suddenly, she sat up and clearly said, “You could say something, you know. Don’t be afraid to talk.” I answered, “I’m not afraid to talk. I just want you to rest.” She replied “Not you. Them,” pointing at the empty wall she faced. Quickly settling down, she closed her eyes, wandering off into an in-between world of sleep and wakefulness. I wondered if there were really family and friends waiting for her on the other side, as those who have had near-death experiences report.

Throughout the night I dozed off and on in a huge recliner next to her bed. Her breathing was shallow and irregular. She occasionally called out in distress. I told her that I ws there with her. A nurse came in several times to adjust the morphine drip. As the sun roses, her breathing became a bit more regular. The doctor suggested I go home, telling me there is plenty of time and that I really should have some breakfast. She promised to call immediately if anything changed.

I’m now sitting beside her again. Her eyes are closed and she is no longer breathing. Her skin is an ashy gray. When I touch her arm, it is stone cold. The only sound and movement in the room is the still inflating and deflating wrap that was placed around her swollen leg yesterday to keep blood clots from forming. It’s as if she is still breathing somewhere beyond my understanding.

I feel only a touch of sadness. There are no tears. I try to talk to her about how difficult this last passage has been. But the pain is too fresh and I can’t find words to describe what I feel. When the hospitalist comes in with her condolences, I find it easy to smile and thank her for looking after Mom. I can’t allow my bitterness to show.

The following days unfold quickly. I have no time to lick my wounds or to sit with thoughts about the unending days I’ve given to my mother and her dying. As I make final arrangements to have Mom’s body cremated, as she wished, I try to breathe deeply, exhaling the angst and fear, that I’ve been holding in for so long.

Bill, along with our kids, remove Mom’s belongings from her rooms at the assisted living facility. I contact far away friends and family to let them know that she has passed on. My brothers won’t be coming down from New England. They’re waiting for me to tell them what’s next. I’m still doing for Mom, even though she isn’t here. I need some time to unwind and pull myself together, but it doesn’t exist.

When I’m asked when and where Mom’s burial will be, I promise that I’ll let them know as soon as I know myself. There is no way that I can plan a funeral or memorial service right now. My brothers are obviously not willing to take on the job. I call them asking for help, but they do no respond. Filled with resentment for being left to carry the responsibility for the remaining arrangements, I stash the brown plastic box holding Mom’s ashes away on a shelf in the back of a storage closet, next to the Christmas decorations and old clothes that no longer fit. I slam the door closed.

But I can’t get away from her. The last seven years replay over and over again in my head, like a old vinyl record that’s stuck. Maybe I’ve missed something. If I move the needle back and start again, perhaps I will find out what it is.