18 February, 2002

One week ago today my Mother died.  On Friday, 1 Feb, she suffered a dissecting aortic aneurism (the same killed King George II of England), and was rushed to Magruder Hospital in Port Clinton.  Here CAT scans revealed possible stroke (although probably an old stroke), and the aneurism, at which point the Life Flight helicopter was called to take her to St. Vincent Mercy Hospital in Toledo.  She was operated on by an excellent open-heart surgeon who, in an extremely difficult operation, which was able to repair her aorta.  It was a difficult decision whether or not to operate: Mother dreaded having to endure after a stroke, and if she had indeed had a stroke, there was a significant possibility that the surgery would exacerbate it.  However, we felt we had to authorize the surgery if there was any chance of recovery.  The prognosis after the operation was poor.

By Sunday evening, the family had all gathered.  St. Vincent Hospital has a facility, called the "home away from home," for relatives attending critically ill patients.  It is an extremely compassionate hospital, in so many ways.  The charge for staying in these rooms, which are in many ways better than most motels, is only $30/night, however many people are in the room, and even with that small a fee, the staff make clear that they only expect the occupants to pay what they can.  By now Mother was in the Cardiovascular ICU (CVICU), with all kinds of electronic and pharmacologic support, and appeared to be sleeping peacefully, while her body recovered.  We brought tapes of classical music for her to listen to, assured that she could probably hear what was going on at least some of the time; and we brought her teeth.  Her last words to Dad before losing consciousness had been "get my teeth and handkerchief."

Many people came to visit her in CVICU; the rules did not allow more than two visitors at a time, and only immediate family, but the staff again were more concerned about compassion than rules.  We were repeatedly told "we are praying for her", and to believe in the power of prayer; but it was hard to know for what to pray: the neurologist confirmed that she had indeed suffered a major stroke during the aneurism.  As the days wore on, her body recovered well; her heart was strong, although at times a little erratic, and she breathed more and more spontaneously.  She was taking food through a tube to her stomach, instead of through an IV.  But, she was not waking up.  She was no more responsive than the day she had entered the CVICU.  This concerned the neurologist; it indicated that she may have suffered quite severe damage to her brain stem.

Gradually, it became clearer and clearer that she was never going to wake.  The staff at the CVICU were impressed at how certain the family was that Mother would not want to be "kept alive" - for her, the only option was to "live".  Of course, anyone who knew her at all knew that that was what she would want, even if she had never said so.  From rural Tennessee to cosmopolitan London, all who had known her confirmed that she could only live if it were on her terms, and with a completely intact mind.  Our decision was made easier on Monday, 11 February, when the neurologist reported that he had performed tests that indicated that her brain-stem was indeed irreparably damaged; she could never wake up.

Again, the compassion at St. Vincent was shown; they have a special section, called Palliative Care, for patients who are terminally ill, and receiving care only for comfort.  The surroundings are less clinical than in the rest of the hospital, more home-like.  Each patient has a private room, which has room for family to stay (even a roll-out bed).  It was a while before everything was ready to wheel Mother up to the Palliative Care area, but finally just before 7 p.m. she made the journey with her many attendants (one to push the bed, one to open doors, one to puff air into her lungs at intervals, etc.).  As she prepare to leave us, the nurse who had most recently been caring for Mother stopped to ask, in floods of tears, if we were "OK" with this decision, to which we replied "we are, are you?".

It will never cease to amaze me how these outstanding professionals, who deal with bodies "on the edge", who must face the prospect of the death of one of their patients every day, still became so very attached to a woman they had never known in consciousness.  There are two explanations that come to mind: First, Mother was a remarkable woman, who could influence people without even being physically present.  For example, the same nurse who wheeled Mother to Palliative Care (whose name is Diane) was also caring for a much younger, male patient who not only failed to look after himself at all (he was overweight, smoked, had diabetes which he did not well control), but was very uncooperative.  As Diane, several days before Mother left,  was going back into the CVICU she caught this patient's son sneaking a glass of water for his father, which she had earlier forbidden him to do.  [I'm sorry if that sentence was worthy of Julius Caesar in its complexity!]  Diane yelled at the son "WHAT DO YOU THINK YOU ARE DOING!", then noticed that friends of Mother's (Bill and Barbara Lane) were coming in just behind her, and felt bad.  We all had to reassure her that, not only would Mother have approved whole-heartedly, but that it was entirely possible that it was Mother's vivacious spirit speaking through the mouth of the normally quiet Diane.

Secondly, the depth of feeling that the nurses who had never truly met Mother felt for her speaks to the power of story-telling.  While Mother slept, with her eyes gently closed, and her own shallow breathing interspersed with the deep inhalations of the machine, the rest of us stood around her telling stories.  From just these, a person and a lifetime was revealed; it's an idea for a short story I would like to write sometime.

And speaking of writing, as I write these words it has now been a month since she died.  There is more that I would like to write, but it will have to wait for another time.  There are links at the top of the page to the obituaries, and to my sister Sandra's eulogy at the top of this page.  Please read the eulogy, it says what we all wanted to say, but it took Sandra to be able to put it on paper.