Thank you, the living and enduring King. Who has, in His great mercy, returned my soul to me. You have a lot of faith in me.
That is how a Jew start his waking hours. Making a declaration that waking up was a gift and we have gratitude for another day of life. But that is not the end of the declaration; we also acknowledge that we have things to do, and G-d has faith in us.
I awoke earlier than usual this morning -- 3:00AM. I usually get up early. I try the get up before 4:00AM and I have a series of alarms to prod me. My poor wife... I almost always catch the first alarm at 3:45AM on my watch, and remember to disable the 4:00AM alarm on my alarm clock, and and downstairs before the 4:10AM alarm on my palm pilot starts beeping. But some mornings I don't...
In any case, this morning I awoke at 3:00AM and tried to turn over to sleep another 45 minutes or so. No use; so I finally got up around 3:30, figuring I might as well use the extra time (since I wasn't getting any more rest anyway). I think I was brusing my teeth when I realized the significance of my disturbed sleep. Mom had passed away seven days ago; just at 3:00AM this morning. She left this world a week ago, and I awoke this morning... to a new day, still (apparently) with jobs to do.
I got to bais medrash (a large room dedicated to torah learning and prayer), and went to make the coffee. Oops... kitchen locked, erev Pesach... ok, lets see if I can learn without my morning coffee. My first chavrusa (study partner) arrives and we start learning about the trait of mercy. Real mercy sometimes requires being stern... real mercy is to be concerned about the person's soul. Sometimes the needs of the body have to take a back seat to the needs of the soul. Sometimes we need to put our smile aside to help a friend who is not going on the straight path. And sometimes that friend is ourself.
Next is learning gemara with my next chavrusa. Then davening followed by a special treat -- the daf yomi group is making a siyum on masechta eruvin. Next a haircut in honor of the upcoming holiday. On the spur of the moment I decided to go to the mikveh before going home. So now it is 8:00AM and I have learned torah, prayed, fulfilled the precept of loving HaShem by taking a haircut in honor of this great holiday of Pesach that He has given us, and gone to the mikveh for a physical and spiritual purification. Not a bad way to start the day!
One thing about this blog... it rarely goes where I expect it to. Last week I said good bye to Mom for the last time. I can't tell her I love her anymore. And, sadly, I didn't tell her enough when she was in this world. And, worse, I didn't always act toward her as lovingly as I should have. If you love someone, tell them. Let them know... you might be surprised how much love there there is around you. You might be surprised how much difference your love can make to someone else.
I love you, Mom. Thank you for waking me up.
Wednesday, April 12, 2006
Tuesday, April 11, 2006
Almost a week.
It has been nearly a week. The surreality (is that a word?) of being is stating to wear off. I am very glad I started this writing. I couldn't write for a day or so after my mother's passing. The next day my wife encouraged (so to speak) me to stay home. I spent a lot of time writing that day. As I felt the tears well up, my natural reaction was to stifle it; but I forced myself to let the tears and weeping come. When I talked to others -- on the phone or in person -- I was able (with effort) to maintain myself. Alone I could let the feelings come, and the writing seemed to open doors. I am not cried out... but I think I can now allow myself that luxury when I need it.
At the same time I am planning a wedding. Well, to be honest, I am consutling occaisionally on the planning of my daughter's upcoming wedding. And, oh yes, Pesach is also coming. Trying to keep my head on work is verging on impossible. I am choosing tasks that are more mechanical... require less creative thought.
One more interesting turn... I am talking more with my extended family more. This morning I accidently called my niece. I apologized for waking her, as it was only 5:30AM for her. "Don't worry... the sun is almost up anyway", she joked. We ended up talking for nearly 20 minutes. Conversation that was much more than just "hi, how are you". My sister and I have exchanged more email in the last week than in the previous two decades. Mom constantly wished for her children to be closer, and we all had excuses why we weren't. We let the excuses and past hurts die with Mom.
It has been nearly a week. The surreality (is that a word?) of being is stating to wear off. I am very glad I started this writing. I couldn't write for a day or so after my mother's passing. The next day my wife encouraged (so to speak) me to stay home. I spent a lot of time writing that day. As I felt the tears well up, my natural reaction was to stifle it; but I forced myself to let the tears and weeping come. When I talked to others -- on the phone or in person -- I was able (with effort) to maintain myself. Alone I could let the feelings come, and the writing seemed to open doors. I am not cried out... but I think I can now allow myself that luxury when I need it.
At the same time I am planning a wedding. Well, to be honest, I am consutling occaisionally on the planning of my daughter's upcoming wedding. And, oh yes, Pesach is also coming. Trying to keep my head on work is verging on impossible. I am choosing tasks that are more mechanical... require less creative thought.
One more interesting turn... I am talking more with my extended family more. This morning I accidently called my niece. I apologized for waking her, as it was only 5:30AM for her. "Don't worry... the sun is almost up anyway", she joked. We ended up talking for nearly 20 minutes. Conversation that was much more than just "hi, how are you". My sister and I have exchanged more email in the last week than in the previous two decades. Mom constantly wished for her children to be closer, and we all had excuses why we weren't. We let the excuses and past hurts die with Mom.
Sunday, April 09, 2006
Please no more, "well, the main thing is to make her comfortable".
This post is very politically incorrect; you have been warned. I really didn't want to hear one more time, "the main thing is to keep her comfortable". Comfort in this world is *not* the main thing; it is not even a goal. Comfort is sometimes a means to a desired goal, but sometimes being uncomfortable is the appropriate means. In fact, sometimes the discomfort itself *is* the only way to get where you want to go. When is that? When you want to grow, become better, stronger, more than you were before. That effort can never be anything but uncomfortable.
Therefore, my conclusion is that the drive for comfort is motivated by an underlying hypothesis that this particular life is no longer worth living. I reject that hypothesis without reservation. No moment of life, not breath, is ever a waste; it is always worth it. Life is not always comfortable; in fact, it rarely is. How dare hospice or anyone else tell me that my mother's life is no longer worth living.
Moreover, how do they know that constant doses of morphine is making anyone comfortable anyway? Because the body is not moving and no groans are heard? That "goal" can be achieved with duct tape and cotton; but few would agree with that treatment of a sick person. You'll tell me we can study brain wave activity, or ask people who have awakened from anesthesia. I assert that line of reasoning is hopelessly flawed. Brain waves? When they can tell me what the person is thinking, feeling, or dreaming by looking at those squiggles, then maybe I'll pay attention. Reports by patients who have awakened from anesthesia? Who knows if the waking process produces a retrograde amnesia (as it seems to).
I am not saying that morphine doesn't make the patient comfortable... I am only saying I don't know and neither does hospice nor anyone else. Lets just stop being so confident that you understand the dying process or what is going on in the dying person's mind. My sister and I were holding Mom's hands when she died. You can't tell either one of us it was a mechanical, physical process. There was a decided change slightly before the body died, and it wasn't physical at all. One thing I do know; I wish I could spend more time with Mom.
This post is very politically incorrect; you have been warned. I really didn't want to hear one more time, "the main thing is to keep her comfortable". Comfort in this world is *not* the main thing; it is not even a goal. Comfort is sometimes a means to a desired goal, but sometimes being uncomfortable is the appropriate means. In fact, sometimes the discomfort itself *is* the only way to get where you want to go. When is that? When you want to grow, become better, stronger, more than you were before. That effort can never be anything but uncomfortable.
Therefore, my conclusion is that the drive for comfort is motivated by an underlying hypothesis that this particular life is no longer worth living. I reject that hypothesis without reservation. No moment of life, not breath, is ever a waste; it is always worth it. Life is not always comfortable; in fact, it rarely is. How dare hospice or anyone else tell me that my mother's life is no longer worth living.
Moreover, how do they know that constant doses of morphine is making anyone comfortable anyway? Because the body is not moving and no groans are heard? That "goal" can be achieved with duct tape and cotton; but few would agree with that treatment of a sick person. You'll tell me we can study brain wave activity, or ask people who have awakened from anesthesia. I assert that line of reasoning is hopelessly flawed. Brain waves? When they can tell me what the person is thinking, feeling, or dreaming by looking at those squiggles, then maybe I'll pay attention. Reports by patients who have awakened from anesthesia? Who knows if the waking process produces a retrograde amnesia (as it seems to).
I am not saying that morphine doesn't make the patient comfortable... I am only saying I don't know and neither does hospice nor anyone else. Lets just stop being so confident that you understand the dying process or what is going on in the dying person's mind. My sister and I were holding Mom's hands when she died. You can't tell either one of us it was a mechanical, physical process. There was a decided change slightly before the body died, and it wasn't physical at all. One thing I do know; I wish I could spend more time with Mom.
Thursday, April 06, 2006
Life after death.
My sister grabbed my mother's lifeless body. I told her it was time to go. She wouldn't let go; "If I let go, it's going to be real!" I had told her earlier that the body nourishes the soul in this world like the placenta nourishes the baby in the womb. "It's a placenta... Mom let it go, now you need to." She reluctantly let go. "But she is still warm!" "We need to go." "But..."
My sister-in-law asked if my sister and I wanted a few minutes alone. We looked at her and said, "She is your mother just as much as ours; you are our sister." My brother had been called away, but he was with us on the phone. "I thought I was prepared.", he said, "I thought I had said my good-byes." We cried together on the phone. We had all thought we were prepared. But there is, apparently, no preparation for this. What we would give for her to take even one more labored breath. There is no way to describe this feeling... except that it is a feeling that defies description. There is no way to prepare for this, except to prepare to feel unprepared.
We had things to do. First was to call hospice to send a nurse to "make the pronouncement". We didn't want to leave my mother's body alone; the nurse's aid offered to stay with her. (We found out later she had been assigned specially and over-and-above the usual staffing to care for us and my mother.) I called hospice; she'd be over in about 45 minutes. We went to the kitchen/dining room area. I brought out a beer so we could toast "l'chaim" -- "to life". I told them that when the Torah describes the events after Sarah's death, it begins with the words, "This is the life of Sarah". We now needed to move from helping Mom through her transition to remembering and living up to her life.
I had a sudden thought, and I turned to my sister and sister-in-law and said, "I was not always the best son. I didn't always have patience, or speak to Mom respectfully. You weren't always the best daughter-in-law, were you? You weren't always such a good daughter, were you?" We all agreed that we had been lacking many times. "Good", I said, "now we have finished with that part of our mourning. We have admited our shortcomings and are sorry for them. Time to move on; to focus on the positive." I was fiddling with the faucet and all of the sudden a stream of water shot about 10 feet across the room, hitting the refrigerator. We all laughed hard.
The hospice nurse came, confirmed there was no heart beat. We called the mortuary to come pick her up. My brother, who had had power of attorney, had signed all the papers and made all the arrangements. Thank G-d, because none of us were in any shape to make decision; we were just moving and acting according to plan. The man arrived from the mortuary. My sister asked him if he would be gentle; he said he does this a lot, don't worry. Then she asked, "Can we move her to the gurney?" This was unexpected. He agreed. My sister and I worked together to move my mother's body to the gurney, cover it, and strap it down. That was it, the remains were taken.
My sister wanted to sleep in my mother's room, and the aids made up the bed for her with fresh linens. I went to my room and slept for a couple of hours, then got up to pray and finish packing. We had decided that thre would be no memorial service; we were all there was and we had spent the last few days together reminiscing. My niece and nephew took the day off. We drove to the airport together and talked about road trips we had taken with our respective families. We all felt closer than we had in years. Any past hurts forgotten -- unimportant.
The flight home was uneventful; but one noteworthy detail bears telling. I had changed my reservation at the last minute to stay an extra night when I saw that my mother had a little time left in this world. Of course the flight was practically full and I got a middle seat in the rear of the plane. When I checked in they asked me if I would like to move to an aisle. So I was moved from 22B to 12C. More than that, the only empty seat in the plane (I checked) was the middle seat between me and a young lady who didn't speak english. I needed to be alone for a while, and I was granted that.
I am home now. My family is being great. My friends are being great. We are planning a wedding. I wish I had a wise and powerful ending; but I don't. Maybe that is the point, this is the beginning of a new phase in the middle of my life.
My sister grabbed my mother's lifeless body. I told her it was time to go. She wouldn't let go; "If I let go, it's going to be real!" I had told her earlier that the body nourishes the soul in this world like the placenta nourishes the baby in the womb. "It's a placenta... Mom let it go, now you need to." She reluctantly let go. "But she is still warm!" "We need to go." "But..."
My sister-in-law asked if my sister and I wanted a few minutes alone. We looked at her and said, "She is your mother just as much as ours; you are our sister." My brother had been called away, but he was with us on the phone. "I thought I was prepared.", he said, "I thought I had said my good-byes." We cried together on the phone. We had all thought we were prepared. But there is, apparently, no preparation for this. What we would give for her to take even one more labored breath. There is no way to describe this feeling... except that it is a feeling that defies description. There is no way to prepare for this, except to prepare to feel unprepared.
We had things to do. First was to call hospice to send a nurse to "make the pronouncement". We didn't want to leave my mother's body alone; the nurse's aid offered to stay with her. (We found out later she had been assigned specially and over-and-above the usual staffing to care for us and my mother.) I called hospice; she'd be over in about 45 minutes. We went to the kitchen/dining room area. I brought out a beer so we could toast "l'chaim" -- "to life". I told them that when the Torah describes the events after Sarah's death, it begins with the words, "This is the life of Sarah". We now needed to move from helping Mom through her transition to remembering and living up to her life.
I had a sudden thought, and I turned to my sister and sister-in-law and said, "I was not always the best son. I didn't always have patience, or speak to Mom respectfully. You weren't always the best daughter-in-law, were you? You weren't always such a good daughter, were you?" We all agreed that we had been lacking many times. "Good", I said, "now we have finished with that part of our mourning. We have admited our shortcomings and are sorry for them. Time to move on; to focus on the positive." I was fiddling with the faucet and all of the sudden a stream of water shot about 10 feet across the room, hitting the refrigerator. We all laughed hard.
The hospice nurse came, confirmed there was no heart beat. We called the mortuary to come pick her up. My brother, who had had power of attorney, had signed all the papers and made all the arrangements. Thank G-d, because none of us were in any shape to make decision; we were just moving and acting according to plan. The man arrived from the mortuary. My sister asked him if he would be gentle; he said he does this a lot, don't worry. Then she asked, "Can we move her to the gurney?" This was unexpected. He agreed. My sister and I worked together to move my mother's body to the gurney, cover it, and strap it down. That was it, the remains were taken.
My sister wanted to sleep in my mother's room, and the aids made up the bed for her with fresh linens. I went to my room and slept for a couple of hours, then got up to pray and finish packing. We had decided that thre would be no memorial service; we were all there was and we had spent the last few days together reminiscing. My niece and nephew took the day off. We drove to the airport together and talked about road trips we had taken with our respective families. We all felt closer than we had in years. Any past hurts forgotten -- unimportant.
The flight home was uneventful; but one noteworthy detail bears telling. I had changed my reservation at the last minute to stay an extra night when I saw that my mother had a little time left in this world. Of course the flight was practically full and I got a middle seat in the rear of the plane. When I checked in they asked me if I would like to move to an aisle. So I was moved from 22B to 12C. More than that, the only empty seat in the plane (I checked) was the middle seat between me and a young lady who didn't speak english. I needed to be alone for a while, and I was granted that.
I am home now. My family is being great. My friends are being great. We are planning a wedding. I wish I had a wise and powerful ending; but I don't. Maybe that is the point, this is the beginning of a new phase in the middle of my life.
My Mother's Death
You may want to skip this; it is intentionally graphic. I am writing this because I think it would have helped me when we were going through that last few days and hours of my mother's life to have known what others had experienced and what to expect.
My mother had been difficult to get along with for years. It now turns out that a lot of the problems were caused by the many pain and psychiatric drugs she was taking. Several different doctors who were not talking to each other were all prescribing medicine/drugs for her. My brother and his wife (to whom I owe a debt of gratitude I can never hope to repay for the care they gave our mother the last few years) finally got her into a geriatric psychiatric hospital, Senior Bridges. After spending almost two weeks there (a place she referred to as "prison") she came out with her medications cut in half and was a new person. I wish people wouldn't be so squeamish about the title and just get the needed help for their loved ones, whatever it may be.
Unfortunately, it appears that the ups and downs of her life, the drugs, the pain, and G-d knows what else was just too much. The best description of her condition I have heard is simply "failure to thrive". Nothing could be found to be medically wrong with her... her body was just shutting down and dying. Hospice was actually unsure of whether or not to take Mom because they couldn't put down a diagnosis. I was originally upset with my brother... how could he just sign a death warrant like that? Ultimately, though, they did take her and managed her care the last couple of weeks of her life. Was it the right decision? Could we have extended her life? I don't know.... I can't say it was right or wrong... but that is irrelevent now.
I arrived on Friday morning and told me brother that maybe we could get Mom out to the mall as I could use a pair of pants. He said that would be great, but it is really hard to get her out. We arrived and I spoke to Mom for just a few minutes. It turns out that was her last conversation in this world. A few times she tried to express a thought, but after a couple of words came out... it was gone. Someone brought a tiny little puppy by. Mom loved dogs and she petted it; the puppy was practicaly jumping out of the basket to get to her. (Later one of the aids would remind us of that... and add that the puppy had been really shy before that.) She closed her eyes and went to sleep. After a few hours my brother remarked that with this good nap, she might be really rested and be able to get around a little more the next day. My sister-in-law looked at him and said, "You're swimming in that river again; Duh Nile." That became a catch phrase for us all over the next few days.
"Maybe I better call our sister", my brother decided later Friday night. I had mixed feelings about that. I knew he should, but my sister and I had not spoken in years and I was afraid of confrontation. He called her, she said she would be up late Saturday afternoon. She walked in, and the most amazing thing occured... we were both so focussed on Mom that we rose above ourselves. I am pretty sure Mom hung on as long as she did to enjoy her children all together. She was acheiving something with her dying that she had not been able to have for years. I am sorry, Mom... we thought we had such good reasons for our difference. And the truth is, we did and we do; but they were not good enough. I wish we could have given that to Mom before she died, I am thankful we were able to give it to her now.
Sunday, Monday, and most of Tuesday continued pretty much status quo. It became apparent to us that Mom was not going to awaken in this world. We got used to the idea slowly... started talking about it. We never talked about that in front of her. Even though she never showed the slightest response, we knew she could hear and didn't want to cause her any undue distress. We tried shifting her to a more comfortable position a couple of times. That was almost always a mistake; we were "treated" to pitiful groans of pain. We realized we were trying to ease our discomfort, not Mom's; so we stopped all adjustments to her position except absolutely required -- either to help her retain her pain medication under her tongue or to change her. The bed sores were also getting worse; her skin was paper thin.
Mom was mostly breathing though her mouth. The one thing we could do that seemed to give her some comfort was give her a little liquid on a sponge for her to suck on. That was really the only reaction we got during those last days. We joked with her, "Mom! Give it back so we can give you more." We took turns, and I am sure Mom appreciated her children working together and getting along.
Here is a terrible admission... we were getting bored a lot of the time. I have heard that battle is like that; long periods of boredom punctuated with moments of terror. That pretty much describes those three days. We put on Moms's favorite channel, the cooking channel. Now I know name about Rachael Ray and sugar sculpture contests and other things I don't care about. We took Mom's pulse and blood pressure, we checked her temperature. We read the little blue pamphlet that hospice had given us. We had several false alarms. Her pulse went up to 130 and repirations to 27; then back down to 100 and 20. Her fever went up to 103; then back down to normal.
And a worse admission... we each secretly wondered why she was hanging on so long. We "gave her permission to leave", we asked forgiveness and gave forgiveness. But every time there was a hesitation in her breathing, we felt terror and panic... and guilt. How could we be trying to hasten her leaving? How dare we feel bored, with our mother there dying? I am sure these feelings are normal; and G-d forgive me for feeling them.
About 4:00PM on Tuesday afternoon, Mom started making a horrible gurgling sound. I had heard of "death rattle", and I looked it up. Amazingly, the residence had wireless internet, I had been able to do some work, email, and blogging right from her bedside. The information I found said that it was due to phlegm build up in the throat and there was really nothing to do for it. Any treatment would only be for the caregivers comfort, not the patient. We called hospice and confirmed the infomation, so we opted to do nothing. Hospice also confirmed that this usually signaled that the end was near, minutes to hours -- "I've never seen anyone go more than six hours." they told us. Mom gets the record; seven hours or so.
The gurgling was so bad we really couldn't understand how she was still able to breathe. We knew we couldn't do anything and that she was in her last hours. We felt helpless and Mom sounded so pitiful. Her mouth was filling with fluid and it was hard to get her pain medication to stay in. They told us to try swabbing her mouth and then giving her the medicine in four doses, five minutes apart. We asked if we should give her the medicine, but because morphine (and oxycodone) are narcotics the aids couldn't give it to us to administer. Amazingly -- and I plan to write a separate entry about this -- the aids said they were happy to spend as much time helping Mom as we needed. They loved her. Many aids came early, stayed late, or even stopped by on their day off to check on Mom. Most of them kissed Mom after administering her medicine. That in itself was a tremendous comfort -- to see how much they honestly cared for her and were grieving right along with us.
I don't remember the exact timing, but at some point we called Mom's brother and a close friend of hers. We put the phone to her ear so they could say their good-byes. We wanted to give Mom and closure we could. We put on music for her; sometimes 50s Rock & Roll, sometimes country, sometimes classical, sometimes show tunes. It was a bit anachronistic -- Mom laying on the bed close to death and my computer (thanks to internet radio) belting out show tunes, Chuck Berry, or Johnny Cash. Oh well...
My mother had lit candles when each of her children had suffered different crises in their lives. My brother suggested we do the same for her. He and I went to the store to get scented candles. The three of us lit them; one each. We joked with each other... "I get to light first." "Mom likes mine best." "No I want the cucumber melon one!" We wanted to make sure Mom knew it was us.
About 11:00PM things sounded very, very bad. My sister and I sat on opposite sides of Mom and held her hand and stroked her arm. Her hands, which had been almost colorless, became mottled with red. Her body was becoming colder. We sat and held her for almost an hour. Then we relaxed. Another crisis passed. I showed her some funny google videos. We were in the middle of "Matrix Pong" when we both turned toward Mom with a start. "Something changed", my sister said at 12:50AM. We took our position at her sides. The breathing changed to gasps. One eye opened and was not glassy for the first time since Friday afternoon. She could see the candles. Then at 12:58AM the breathing stopped... but her mouth kept opening and closing for almost another two minutes. Mom was dead.
You may want to skip this; it is intentionally graphic. I am writing this because I think it would have helped me when we were going through that last few days and hours of my mother's life to have known what others had experienced and what to expect.
My mother had been difficult to get along with for years. It now turns out that a lot of the problems were caused by the many pain and psychiatric drugs she was taking. Several different doctors who were not talking to each other were all prescribing medicine/drugs for her. My brother and his wife (to whom I owe a debt of gratitude I can never hope to repay for the care they gave our mother the last few years) finally got her into a geriatric psychiatric hospital, Senior Bridges. After spending almost two weeks there (a place she referred to as "prison") she came out with her medications cut in half and was a new person. I wish people wouldn't be so squeamish about the title and just get the needed help for their loved ones, whatever it may be.
Unfortunately, it appears that the ups and downs of her life, the drugs, the pain, and G-d knows what else was just too much. The best description of her condition I have heard is simply "failure to thrive". Nothing could be found to be medically wrong with her... her body was just shutting down and dying. Hospice was actually unsure of whether or not to take Mom because they couldn't put down a diagnosis. I was originally upset with my brother... how could he just sign a death warrant like that? Ultimately, though, they did take her and managed her care the last couple of weeks of her life. Was it the right decision? Could we have extended her life? I don't know.... I can't say it was right or wrong... but that is irrelevent now.
I arrived on Friday morning and told me brother that maybe we could get Mom out to the mall as I could use a pair of pants. He said that would be great, but it is really hard to get her out. We arrived and I spoke to Mom for just a few minutes. It turns out that was her last conversation in this world. A few times she tried to express a thought, but after a couple of words came out... it was gone. Someone brought a tiny little puppy by. Mom loved dogs and she petted it; the puppy was practicaly jumping out of the basket to get to her. (Later one of the aids would remind us of that... and add that the puppy had been really shy before that.) She closed her eyes and went to sleep. After a few hours my brother remarked that with this good nap, she might be really rested and be able to get around a little more the next day. My sister-in-law looked at him and said, "You're swimming in that river again; Duh Nile." That became a catch phrase for us all over the next few days.
"Maybe I better call our sister", my brother decided later Friday night. I had mixed feelings about that. I knew he should, but my sister and I had not spoken in years and I was afraid of confrontation. He called her, she said she would be up late Saturday afternoon. She walked in, and the most amazing thing occured... we were both so focussed on Mom that we rose above ourselves. I am pretty sure Mom hung on as long as she did to enjoy her children all together. She was acheiving something with her dying that she had not been able to have for years. I am sorry, Mom... we thought we had such good reasons for our difference. And the truth is, we did and we do; but they were not good enough. I wish we could have given that to Mom before she died, I am thankful we were able to give it to her now.
Sunday, Monday, and most of Tuesday continued pretty much status quo. It became apparent to us that Mom was not going to awaken in this world. We got used to the idea slowly... started talking about it. We never talked about that in front of her. Even though she never showed the slightest response, we knew she could hear and didn't want to cause her any undue distress. We tried shifting her to a more comfortable position a couple of times. That was almost always a mistake; we were "treated" to pitiful groans of pain. We realized we were trying to ease our discomfort, not Mom's; so we stopped all adjustments to her position except absolutely required -- either to help her retain her pain medication under her tongue or to change her. The bed sores were also getting worse; her skin was paper thin.
Mom was mostly breathing though her mouth. The one thing we could do that seemed to give her some comfort was give her a little liquid on a sponge for her to suck on. That was really the only reaction we got during those last days. We joked with her, "Mom! Give it back so we can give you more." We took turns, and I am sure Mom appreciated her children working together and getting along.
Here is a terrible admission... we were getting bored a lot of the time. I have heard that battle is like that; long periods of boredom punctuated with moments of terror. That pretty much describes those three days. We put on Moms's favorite channel, the cooking channel. Now I know name about Rachael Ray and sugar sculpture contests and other things I don't care about. We took Mom's pulse and blood pressure, we checked her temperature. We read the little blue pamphlet that hospice had given us. We had several false alarms. Her pulse went up to 130 and repirations to 27; then back down to 100 and 20. Her fever went up to 103; then back down to normal.
And a worse admission... we each secretly wondered why she was hanging on so long. We "gave her permission to leave", we asked forgiveness and gave forgiveness. But every time there was a hesitation in her breathing, we felt terror and panic... and guilt. How could we be trying to hasten her leaving? How dare we feel bored, with our mother there dying? I am sure these feelings are normal; and G-d forgive me for feeling them.
About 4:00PM on Tuesday afternoon, Mom started making a horrible gurgling sound. I had heard of "death rattle", and I looked it up. Amazingly, the residence had wireless internet, I had been able to do some work, email, and blogging right from her bedside. The information I found said that it was due to phlegm build up in the throat and there was really nothing to do for it. Any treatment would only be for the caregivers comfort, not the patient. We called hospice and confirmed the infomation, so we opted to do nothing. Hospice also confirmed that this usually signaled that the end was near, minutes to hours -- "I've never seen anyone go more than six hours." they told us. Mom gets the record; seven hours or so.
The gurgling was so bad we really couldn't understand how she was still able to breathe. We knew we couldn't do anything and that she was in her last hours. We felt helpless and Mom sounded so pitiful. Her mouth was filling with fluid and it was hard to get her pain medication to stay in. They told us to try swabbing her mouth and then giving her the medicine in four doses, five minutes apart. We asked if we should give her the medicine, but because morphine (and oxycodone) are narcotics the aids couldn't give it to us to administer. Amazingly -- and I plan to write a separate entry about this -- the aids said they were happy to spend as much time helping Mom as we needed. They loved her. Many aids came early, stayed late, or even stopped by on their day off to check on Mom. Most of them kissed Mom after administering her medicine. That in itself was a tremendous comfort -- to see how much they honestly cared for her and were grieving right along with us.
I don't remember the exact timing, but at some point we called Mom's brother and a close friend of hers. We put the phone to her ear so they could say their good-byes. We wanted to give Mom and closure we could. We put on music for her; sometimes 50s Rock & Roll, sometimes country, sometimes classical, sometimes show tunes. It was a bit anachronistic -- Mom laying on the bed close to death and my computer (thanks to internet radio) belting out show tunes, Chuck Berry, or Johnny Cash. Oh well...
My mother had lit candles when each of her children had suffered different crises in their lives. My brother suggested we do the same for her. He and I went to the store to get scented candles. The three of us lit them; one each. We joked with each other... "I get to light first." "Mom likes mine best." "No I want the cucumber melon one!" We wanted to make sure Mom knew it was us.
About 11:00PM things sounded very, very bad. My sister and I sat on opposite sides of Mom and held her hand and stroked her arm. Her hands, which had been almost colorless, became mottled with red. Her body was becoming colder. We sat and held her for almost an hour. Then we relaxed. Another crisis passed. I showed her some funny google videos. We were in the middle of "Matrix Pong" when we both turned toward Mom with a start. "Something changed", my sister said at 12:50AM. We took our position at her sides. The breathing changed to gasps. One eye opened and was not glassy for the first time since Friday afternoon. She could see the candles. Then at 12:58AM the breathing stopped... but her mouth kept opening and closing for almost another two minutes. Mom was dead.
Tuesday, April 04, 2006
Faith and a sense of humor, that is what you need to make it in this world -- R' Henoch Leibowitz, shlita.
We put on some music for my mother... Country Western via internet radio. All of the sudden we heard:
from "Believe", by Brooks and Dunn. And that was followed by, "send me an angel and show me the way".
Whew... some times that sense of humor is a bit sharp.
We put on some music for my mother... Country Western via internet radio. All of the sudden we heard:
I can't quote the book
The chapter or the verse
You can't tell me it all ends
In a slow ride in a hearse
You know I'm more and more convinced
The longer that i live
Yeah, this can't be
No, this can't be
No, this can't be all there is
from "Believe", by Brooks and Dunn. And that was followed by, "send me an angel and show me the way".
Whew... some times that sense of humor is a bit sharp.
Monday, April 03, 2006
One breath at a time...
כֹּל הַנְּשָׁמָה תְּהַלֵּל יָהּ הַלְלוּ יָהּ:
(תהלים פרק קנ פסוק ו)
King David chose to end his opus to the gamut of human emotion, the Book of Psalms, by declaring, "Every living thing shall praise G-d; Praise G-d!" King David chose to use the unusual word "neshama" to mean "living thing"; and our Rabbis of Blessed Memory tell us that King David's intent in using this word was to also express the message "with every breath (n'shima) I will praise G-d".
I am sitting in front of my mother. The skin on her face drawn and sunken. To be honest I have never seen live person look like this. Hospice tells us that she has hours, not days. The little blue pamphlet they gave us told us her breathing would become more irregular as time goes on. I hold my breath every time Mom hesitates... then I breathe when she does; and I thank G-d for that breath (mine and hers).
She seems to be past the pain now. She seems to not even like the medicine sitting in her mouth. Is she trying to spit it out? Can't really tell. I am guessing that as her soul becomes less attached to this world, the pains that have racked her body for so long are just too far away to be a concern.
I have music playing for her -- 50s Rock 'n' Roll -- seems a bit out of place, but she likes it.
Saying good-bye to Mom.
I really thought I could wait till Sunday. I talked to Mom on the phone on Thursday... she was a little confused, but lucid. Our very close friend had lost her father the day before. She pushed me... offered all of her airline miles to me... just go. My wife was scheduled for a procedure on Friday... Shabbos away from home is never fun. In the end I was convinced... American has a compassion fare... new problem: no compassion seats for a return trip... ok, come back later, fly back overnight. My wife and kids ran around getting my packed, buying food for me, making arrangements.
I arrived Friday morning and was met by my brother, his wife, and my Dad. We spent a couple of hours visiting and letting my brother get a little work done at his Reno store. One the way to see Mom, I got a quite unexpected phone call. "Mr. Allen? This is ....; I want to ask your daughter to marry me and I would like your blessing."
We arrived at my Mom's room. She recognized me and I was able to tell her about my daughter's engagement. My daughter was the first grandchild and Mom always had a special place in her heart for her. Mom tried to talk, but could not really get more than two or three words out before the thought would leave her. She had some juice and then closed her eyes to sleep. I didn't know that would be her last verbal communication. Her eyes opened a few times that day... but there was no vision in them. The only thing we have heard from her in the last couple of days is her increasingly rattly and irregular breathing.
My sister arrived late Saturday afternoon. I haven't seen her in 20 years, but nothing is really important now except that Mom has her three children together. We are waiting together. Deciding together how to handle things as the situation progresses. We do not agree on everything, but on two points we are in complete harmony. The first is that we each want what is best for Mom. The second is that my brother makes the final decision. My brother and his family have literaly dedicated their life to caring for my mother these last few years. I will never be able to adequately express my gratitude for all that he and his amazing family have done for our mother.
The goal is now to keep her as comfortable as we know how.
I arrived Friday morning and was met by my brother, his wife, and my Dad. We spent a couple of hours visiting and letting my brother get a little work done at his Reno store. One the way to see Mom, I got a quite unexpected phone call. "Mr. Allen? This is ....; I want to ask your daughter to marry me and I would like your blessing."
We arrived at my Mom's room. She recognized me and I was able to tell her about my daughter's engagement. My daughter was the first grandchild and Mom always had a special place in her heart for her. Mom tried to talk, but could not really get more than two or three words out before the thought would leave her. She had some juice and then closed her eyes to sleep. I didn't know that would be her last verbal communication. Her eyes opened a few times that day... but there was no vision in them. The only thing we have heard from her in the last couple of days is her increasingly rattly and irregular breathing.
My sister arrived late Saturday afternoon. I haven't seen her in 20 years, but nothing is really important now except that Mom has her three children together. We are waiting together. Deciding together how to handle things as the situation progresses. We do not agree on everything, but on two points we are in complete harmony. The first is that we each want what is best for Mom. The second is that my brother makes the final decision. My brother and his family have literaly dedicated their life to caring for my mother these last few years. I will never be able to adequately express my gratitude for all that he and his amazing family have done for our mother.
The goal is now to keep her as comfortable as we know how.
Sunday, April 02, 2006
I am starting this blog in response to the last few days of my life. This many jarringly different and powerful events in such a short period of time demands a response. Since last Wednesday, I have experienced (in order):
I do know that I cannot possibly hope to understand the entire meaning of anything that happens in my life. Of one thing, however, I am certain. The events do have meaning. The least I can do is acknowledge that fact and put the effort into drawing the lessons I can; for I believe that that effort itself is one of the puposes of these events.
- The celebration of the completion of a major tractate of the Talmud -- 11 years in the making.
- The death of a dear friend's father, preparing his body for burial, and laying him to rest.
- My mother slipping away from this world; and traveling to spend her last few days together with her and my brother and sister.
- The engagement of my oldest daughter to a wonderful young man whom we welcome into our family with open arms.
I do know that I cannot possibly hope to understand the entire meaning of anything that happens in my life. Of one thing, however, I am certain. The events do have meaning. The least I can do is acknowledge that fact and put the effort into drawing the lessons I can; for I believe that that effort itself is one of the puposes of these events.
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