Wednesday, August 17, 2016

My Mother's Passing


My Mother's Passing

(Part One)

The first scare I had concerning my mother was about two years ago. That was when I found her slumped behind the steering wheel of her car, as she tried to catch her breath. She refused treatment, but was eventually taken to hospital the next day. She fought like hell with the doctor and nurses. Mom was discharged early then, because she refused all treatment; including a much needed heart catheterization. We don't know why she refused it. Myself and my sisters got on her case about it, but to no avail. She was diagnosed with COPD (chronic obstructive pulmonary disorder) and sent home. With her in tow was various medications, and an oxygen machine. I likened it to the life support systems in sci-fi movies; as it took carbon dioxide from the air, and made it into breathable oxygen.

I set up a list of medications, and what times to administer them. I also keep a close eye on her, to make sure she didn't smoke again. This was in February of 2014.

At the same time, one of my cats was diagnosed with an ear infection. While my Mom was in the hospital, I had to take a cat to a different kind of hospital, and get her on meds. Fortunately, the cat pulled through, and the infection cleared up after about a week of antibiotics. That's another story entirely.

I caught her smoking in the summer that year.

My Mom, not the cat!

I had a fierce argument with her, in which I said to Mom, “Do you want to see your grandchildren grow up? Do you want to see the cats again? Do you want me to be without a mother?”

Mom just yelled back, “I like smoking! I'll be okay with just one or two. It helps me to quit.”

Her words sounded like a petulent child; one that pouts until they get what they want. I caught her smoking a few times after that, and had the same argument with her. I fought with her because I wanted her to live. I loved her, and didn't want her to hurt herself. She may have not seen it that way at the time, but I hope she knows now.

Eventually, around the same time next year, Mom was hospitalized again. It was deja vu all over, as exactly the same thing happened. Except this time it was much worse. It was around Easter, and we weren't sure if it would be her last one.

I blamed myself again for not calling the ambulance sooner. Once again, she refused all treatment. She was cognizant when the paramedics came, and gave them hell. She was fussy with the doctors, but at least she was alert, awake, and seemed alright.

That night, I received a phone call from a nurse.

“We're trying to reach the family of Lonnie.” She said.

It was 11:00 p.m., and I was just getting ready for bed. I knew it couldn't be good.

“Yes, this is her son.” I replied.

My hands were shaking, as I anticipated what the nurse was going to say next. Surprisingly, my voice was calm, as my body was in tremors.

“Your mother is on life support. We're trying to stabilize her, but her blood oxygen levels are low. We'll do all we can. Would you like to talk with the doctor?”

I said, “Yes,” and was referred to a heart specialist.

He echoed what the nurse had said, and added, “Does your mother have a living will?”

“No,” I replied, knees shaking, and in a cold sweat.

“In that case, we'd leave it up to the next of kin; that's you and your siblings. What would you like us to do?”

“Keep her alive by any means necessary.” I told him. “What are her chances?”

“I don't know.” The doctor replied. “I wish I could you for certain, but it's too early to tell.”

I called one of my sisters, who then called my other sister. The three of us went to the hospital that night. I trembled as I walked up to the ICU unit where my mother was kept. My sisters were by my side.

I had this strange reserve of courage inside of me. I didn't flinch or panic when I saw my mother connected to machines, and with a breathing tube inserted down her throat. I listened to the gentle beep of the heart monitor, and found it soothing. It was the lullyby of the heart, and it told me Mom was still alive. They'd successfully stabilized her.

We consulted with the doctor, who discovered she had a fractured rib; possibly from a fall she'd not told us of. They weren't sure how long she'd be under sedation, or would need the ventilator, but her prognosis seemed fair. Worst case scenario is that she may have had to go to assisted living.

As we left, one of my sisters turned to her and said, “We love you, Mom.”

I reached out, and stroked Mom's hair; just as she did to me when I was a child.

That night, my eldest sister drove me home. I didn't make it to class the next day, but I did make it to work. I just needed something to make life normal again. Normal, for that matter, is a relative term. What was normal before her advanced illnes would change. The new normal was more medication, and keeping an even closer eye on Mom.

Once again, I blamed myself. My therapist offered absolution again, and said, “You have no way of knowing how serious this would be.”

But I felt I should have known. I should have seen it coming.

Eventually, Mom was sent to a care facility; a physical rehab center, where she'd need to learn to walk again, and build up her legs. She was on life support for about a week and a half, before being discharged. She had the heart catheter this time, and it was revealed she had a heart attack. She was mildy in denial about this, but the proof was in the ultrasound. She was diagnosed with hypercardio myopathy. I was soon tested for it, as it is hereditary. Thankfully, my tests came up negetive.

That experience is another story as well. The night was going to the heart doctor, I met a girl. Less said about her, the better. We dated for four months. She was very controlling and manipulative, and pretty much made my life a living hell. Again, this is another story; a cautionary tale about who to date, when to breatk up with someone. I mention it here because it was another turbulent situation in my life at the time.

At one point, my ex had said to me, “Your mother fights you all the time. I think you should move out, and sever all ties with her.”

I refused. Soon after, my ex became really abusive, and that was the last straw. I dumped her about a month later. You don't tell a son to abandon his mother with a clean conscience. In fact, anyone who tells a child to do that has no conscience. I stayed with my mother, and continued to take care of her. It wasn't always easy, but I stayed.

Another year passed, and life went on as usual. Summer of 2016 was nearing it's middle phase, and I thought, “No rain on the way. It looks like things have settled for a while.” Mom didn't need another hospital visit during late winter/early spring, so I took it as a good sign.

My therapist once told me, “You can't keep someone alive indefinitely. Eventually, you will lose your mother.”

“True,” I told her. “But I want to keep her alive for as long as possible. I'm not ready to lose her yet.”

Tuesday, July 26 began mundane. I woke up early, and got ready for work, just as I do every weekday. The weekend seemed to zip by in a matter of seconds. Mom had made pork chops on Sunday, after I came home from the movies. Monday was just like any other day. Why would Tuesday be any different?

That morning, as I about to leave for work, I saw that my mother hadn't gotten out of bed yet. This was a bit odd, but not unusual. She normally woke up at sunrise, long before me. Her TV was on, as was usual (she never switched it off, except when she left for the store, or a doctor's appointment.)

As I was in the kitchen, Mom said, “Can you get me a glass of water. I think I'm dehydrated.”

I figured, it must be the heat. Mom hated hot weather. This summer was unusually hot for Pennsylvania. We normally don't have temps in the 80's or 90's until August. Instead, it was a heatwave.

Mom then complained, “I threw up the chocolate bar I ate this morning.”

I then debated with myself, “Do I stay, and make sure she's okay. Or, do I go to work?”

I gave Mom some water, in one of her favorite cups; a plastic rocks glass with a little black cat on it. It's mildy gothy. Tim Burton would approve of it.

I said to her, “I have to go to work. I'll call you when I'm on break. Call me if you need anything.”

As I left for work, Mom said my name, followed with, “Bye.”
She did that every morning, so I didn't think much of it. I sent a text message to one of my sisters, to let her know to check on Mom. I went to work. I called Mom when I was on break, but didn't get a response. I assumed she was just sleeping, as she often did during the afternoon. Later that afternoon I received a voice mail message from one of my sisters, Nicolle.

She said, “I can't get a hold of Mom. I've been trying to get a hold of her since 8:00 this morning.”

“Odd,” I thought. I left around 8:15.

I called her back, and said, “I'm leaving work now. Meet me at the apartment. If you get there before me, have the super let you in. His apartment is across the landing from us.”

I left work, hopped on the next bus, and began a 45 min ride home. I texted a friend about what happened, and then started to contact other friends; informing them of the situation. When I was about 30 mins away, I received another text.

Nicolle: There's vomit everywhere. Mom said she was eating cherries.
Me: She told me it was a candy bar. We don't have cherries.
Nicolle: Oh my God, it's blood.
Me: Blood?

She texted me when the paramedics arrived. They showed up about ten mins after being called.
Me: Is Mom cognizant?
Nicolle: Yes, but she doesn't look good.
Me: Is she talking?
Nicolle: There's blood everywhere.
Me: Is Mom awake?

I was twenty minutes away when I received this text.

Nicolle: They're performing CPR.
Me: What's happening?
Nicolle: No pulse. Pray.

I did just that. I prayed the following mantra, “Please don't let my mom die. I'm not ready to lose my Mom. Please don't let her die.”

I must have said it a thousand times as the bus pulled up to my stop.

My knees were shaking, but I had to run. I ran for a few moments, then had to stop. I thought I was going to throw up. I prayed again, and again. When I saw the ambulance parked outside the apartment, I ran. I ran faster than I had ever before. I threw my backpack onto the lawn, and then ran up the steps. The only thing that slowed me down was one of my nephews, who stood in the doorway. I excused myself, and he stepped aside.
I ran up the steps, and saw Nicolle standing in the doorway. She had been crying.

She said, “Prepare yourself, Mom doesn't look good.”

As soon as she said that, I had already looked.

I saw Mom on the floor of the living room. A group of paramedics were huddled around her. Mom's blouse was cut open, and on her chest was a device like a plastic jackhammer. I expected hands on her chest for the compressions, instead, this piledriver press down on her chest, and caved in her stomach like a stress toy. I almost yelled at the paramedics for this, but then realized it was meant to stimulate her heart. She had an oxygen bag on her face, and one of the EMS guys was pumping air into her.

Around Mom's mouth was blood. Under her head was a pool of blood. I looked over to her bed (which we'd put in the living room for the air conditioning, and her TV) and it too was covered in blood. There were large congealed masses, along with large crimson stains. Yesterday, one of my cats, sat on a recliner, and watched calmly. But I could tell by her body language, that she knew something was up.

I hugged Nicolle, and I said, “This is my fault. I'm a bad brother. I'm a bad son.”

“It's not your fault.” Nicolle said. “It's not your fault.”

I heard a paramedic ask, “Is there more blood?”
Another one replied, “No, she's not regurgitating more blood.”
Another medic walked over to us, and said, “I need to talk with both of you. Are you the son?”

“Yes,” I said.

“This is your sister?”

“Yes,” Nicolle said.

The medic took us onto the landing, and said, “We've put three epinephrine shots into her. There's no pulse. We used to transport everybody to the hospital. Now, we wait to see what happens. We're doing for her exactly what they'd do at a hospital. I don't want you to think we're not.”

I then asked, “This may sound stupid, but is there any brain activity?”

I was trying to ask something medical. It was a lame attempt to calm myself down. I felt that if Mom's brain had enough oxygen she may still survive.

“No blood to the brain means no oxygen.” The paramedic said. “She's lost a lot of blood.”
I watched as a paramedic gave her another epi shot. Still, not change.

“There's electrical activity in the heart.” one of them said. “Let's take her to the hospital.”

My brother-in-law had brought my backpack in, which I then opened to give Nicolle and myself some tissues. I offered to ride in the ambulance with Mom, and Nicolle would follow.

We stepped aside onto the landing, as the EMS guys loaded Mom onto a plastic stretcher. It was this flimsy orange vinyl sheet. It reminded me of something Nicolle and I used to sled ride downhill when we were kids.

As the paramedics were taking her down the stairs, they dropped Mom! She fell sideways, and hit her head on the metal railing.

Nicolle screamed, I yelled. I remember yelling, “Dude!” to the paramedics. Though I probably used another four-letter word. I reached out to pick mom up, but then realized I'd get in the way. The plastic jackhammer stopped. They righted her onto the stretcher, and then restarted the device.

I should point out that her eyes were closed during CPR.

They loaded Mom onto the ambulance, and I jumped into the passenger seat up front. AC/DC was on WDVE on the ambulance radio. I texted some friends with updates, and breathed a sigh. I thought, “We're going to the hospital, she'll probably be okay. If not, they wouldn't bother.” I knew she wasn't out of the woods yet, but still...I had hope.

I turned around, and could see into Mom's eyes. He head hung upside down on the edge of the gurney. She looked at me, and I said, “Mom, I'm here. I'm not going to leave you. We'll get you to the hospital. Mom.”

She then started to cry.

I cried too.

I then said, “Mom, can you hear me? Mom, I'm here.”

Then a paramedic sat in front of her, and blocked my view. I heard a few gurgling noises, and thought, “Mom is drawing breath. Thank God!”

Once we got to the hospital, I stepped out of the ambulance. They unloaded Mom at the same time.

I asked a medic, “How is she?”

“There's been no change.” one of them said.
As we approached the entrance to the emergency room, two young interns commented on the gurgling sound that Mom continued to make.

One of them said, “That's a gurgle, gurgle,” and laughed. A nurse then shot him a stern look, and his smile quickly faded. It took every ounce of restraint my part to not put him in his own emergency room.

I wanted to follow her into the E.R., but was stopped by two nurses. The R.N. Introduced himself as Bill. Then another nurse took my mother's info.

When she asked, “What religion is your mom?”

I blanked, and then thought, “Protestant.”

My mom believed in God, very much. But I wasn't sure how to label her faith. I also wasn't sure of most of what she asked me. I was on autopilot. I gave her my mother's birthdate, address, contact numbers for my sisters, etc. When it came time to ask about insurance, I told her, “Medicare.”

Soon after I excused myself to the rest room.

I actually did need to take a wiz. But the main reason was to pray. It may sound sacriligeous, but I leaned over the urinal, and prayed.

I asked St. Christina, patron of therapists and their clients, for help.
I asked St. Francis, patron of wild animals and house pets; both of which my mother loved.
I asked Mary, the ultimate mother, for help.
I asked Christ himself...well, for obvious reasons.
I then asked God one more time, “I'm not ready to lose my mother. Please, don't let her die.”

As I look back, I wished I prayed to Joan of Arc, who I've always had an affinity for. I'm not sure what she could have done in this situation, but it certainly wouldn't have hurt.

At the end of my prayer I went back to the family waiting room. Nicolle was there, and had been waiting for my eldest sister, Danielle to arrive. Nicolle's husband took their children over to his parent's house, so they'd not have to see this.

Bill returned, and said to us, “She's in the emergency room now. They are doing everything they can for her. So far there's been no change, but I'll let you know as soon anything happens.”

He brought us bottled water, and then stepped out.

I drank a few sips, and talked with Nicolle. I charged up my cellphone, and waited.

A few minutes later, Bill returned. He had a doctor, an intern, and box of Kleenex with him. I knew this wasn't going to be good. The doctor introduced himself, and then sat down.

I sat next to Nicolle, and held her hands.

“What is your mother's medical history?” The intern asked us.

We told them, as Nicolle and I took turns, and filled in Mom's medical history.

She's been hospitalized two years ago with COPD. She'd had a heart attack last year. She has hypercardio myopathy. We also added that she'd not shown any signs of bleeding, or acute illness, over the past few days. She'd seemed normal the day before.

The young intern spoke, “There was tremendous blood loss from the gastrointestinal bleeding. We took her to the emergency room. Her pupils were fixed and dilated. There was no change. We performed an ultrasound on the heart, and there was no activity. We tried to resuscitate her. I'm sorry, but she died in the emergency room.”

Nicolle and I both started to cry.

“She died?” Nicolle asked.

“Yes,” The intern replied. “I'm sorry.”

In truth, she'd died at home, on the living room floor. I believe that when she saw me in the ambulance, she had some life left in her. The epi shots may have jump-started her for a few moments. Corpses don't cry. She had to have been alive to see me one last time. It was then that I realized what the gurgling sound was. It was the infamous “croaking” sound that deceased people make when they exhale their last breath.

In that moment time stopped. I didn't feel as if I was in reality anymore. We all know that at some point our parents will die. It's just that nothing can prepare us for the moment when that happens. I couldn't even rely on fictional depictions of parental loss, because so few of them had it right. I had to feel what was going on as it was going on for real. No one knows how it feels to lose a parent, until they actually lose one.

“This was my fault.” I said to the doctor. “I should have called the ambulance this morning. It was my fault the first time, and the second time.”

The doctor then said, “There are other families I've spoken to that have sat where you are now. If your mother had arrived sooner, could we have saved her? I don't know. There was little we could have done for her. The bleeding was so extensive that if she had arrived sooner, there wouldn't be much else we could do. I try not to play the game of 'what if.' Instead, you need to look to the future, and what happens next.”

“Is is my fault.” I repeated. “I tried to take care of her, and I failed.”

The doctor then added, “There is only one person who knows what could have happend—and you're not him.”

“That's right,” Nicolle added.

I then asked, “Can I see her?”

“Yes,” Bill replied. “You can see her. The nurses will just clean her up a little bit.”

He then added, “We haven't removed the tube from her mouth, because it needs to stay in. That's in case the coroner needs to do an autopsy. Given her age, and her history, he probably won't perform one.”

“What do you think caused the bleeding?” I asked the doctor.

“We're not sure.” he replied.

I then asked, “She complained about back pain, and too ibuprofen for it. Could she have overdone it? Could that have caused the bleeding?”

“It's possible, but I can't speculate on that.” The doctor said.

Ibuprofen is safe in small doses for occasional aches and pains. But if one exceeds the maximum dose (1000 miligrams) over an extended period of time, it can cause internal bleeding and ulcers.

After the doctor and intern had left, Bill the registered nurse, stayed. We waited for a few minutes, and then Bill guided us to the room where my mother's body laid.

I put on my backpack, and headed down the corridor. Nicolle was behind me, and Bill was beside us. I saw the young intern again, who nodded at me, and then frowned in sympathy.

There was a green curtain, which Bill pulled back. Inside the tiny room, which was the first one in the E.R., my mother laid on a gurney, with a sheet up to her neck. The tube was still in her mouth, but all apparatus had been disconnected. I saw a crash cart with rubber gloves next to her. It looked as if the defibs had just been used. There was a small plastic bag on the counter next to the sink, which contained her blouse, bra, and other items. I don't recall any of us collecting it.

I entered the room first, followed by Nicolle.

Mom's face had been cleaned up, but I could still see faint blood spots on her forehead. There was a little bit of blood around her mouth, and in her right ear. There were also traces of crimson on her blonde hair.

“Mom.” I said, with tears. “We're here.”

I kept expecting her to open her eyes. Maybe the doctors were mistaken? She looked like she was just sleeping. She didn't look dead. My paternal grandfather looked really dead at his funeral. Mom didn't look dead at all.

“We love you, Mom.” Nicolle said.

I said to her, “I'm sorry both your parents are gone.”

“Thanks.”

“I liked your dad. He was a good man.”

“He liked you too.” Nicolle said, with a smile.

She then added, “I don't know what to say.”

“Just say anything.” I said. “There's so many memories coming through at once. I remember Mom making me Halloween costumes. I remember trying to play Nintendo with her, and she couldn't hit the 'A' button fast enough on Skate or Die. She used to stroke my hair, and say, 'you need to wash your hair!'”

“She did that to me, too.” Nicolle said.

She then added, “I have to do this.”

“It's okay.” I said. “I don't mind.”

She gave our mother a sort of Protestant “last rites.” She made the sign of the cross on Mom's forehead, and then placed her hand there for a moment, as if taking her temperature.

“May Jesus meet you at the gates.”

She named our grandmother, our Aunt Donna, and other lost relatives; who we both believed she'd been reunited with.

Nicolle kissed her fingertips, and then pressed them to Mom's lips. I reached out to stroke Mom's hair, as I'd done when she was on life support last year. This time, I couldn't. I was afraid that she'd feel cold, and that that'd be my last memory of her; that cold touch.

Nicolle had to step out to make some phone calls, and wait for our sister. I told her that I'd stay with Mom for a little bit. I didn't want to leave, and stayed there for a long time. While I was there with Mom, I talked to her.

What I said to her was sacred, and loving. I won't recount it all here for those reasons. I also couldn't stop talking to her, so I can't recount it all. I just kept talking for as long as I could. I didn't want to leave her.

I said to her, “I really do love you. It's why I was on your case about smoking, and all that other stuff. I wanted you to live. I wasn't ready to lose you. Here I am, with my school backpack. I'm just a little boy that needs his mom.”

At some point, I added, “I was in therapy for several years. I didn't tell you that. My therapist, Julie, said that I accomplised my goal; I became an adult. Maybe this was the next stage, being able to take care of myself? I don't know. I don't know if I can. It wasn't always easy being your son, but I guess that's how it is sometimes. I forgive you for the times when you weren't there for me. I hope you forgive me for the times I wasn't there either.”

I then told her, “I feel like I failed you. I feel that this is my fault. I knew I couldn't keep you alive forever. I just wanted you to stay around longer. I'm not ready to lose you.”

I told her about the trip to England. I told her I'd not give up on school. I told her I'd become a published author some day. I told her I'd one day get married. I told her I'd take care of the cats. Most importantly, I told her I'd not give up.

I didn't feel scared to be in that room with her. She didn't look like some horror movie zombie, other exaggerated form of cinematic death. Instead, she was still my mom; but her soul had been released. At one point, I thought I saw her eyes move under their lids, such as in REM sleep. I'm not sure if it was the post mortem muscle spasms, or if I hallucinated it. I just wanted her to wake up.

She used to say to me, “Wake me up after Teenage Mutant Ninja Turtles, so I can make dinner.”

I always did wake her up at 4:30 p.m., after her afternoon nap. That was back when my parents were still married, and we lived in a house. I thought she would have lived in that house the rest of her life. Instead, she died in a two bedroom apartment, while my sister, myself, and one of our cats looked on. I felt she deserved more.

It was then that I started to call everyone I know. I talked to them, with Mom still in the room. Bill came in to check up on me, but I stayed. I really did not want to leave her behind.

Danielle arrived with her husband. They were followed by Nicolle's husband. The five of us stood over Mom's body, and said our final good-byes. I was the last one to leave the room, and stayed the longest as they'd left.

That night, Danielle drove me home.

She asked me, “Will you be okay in the apartment tonight?”

“I'm going to have to be.” I replied.

She helped me with the mattress, which was soaked with blood. We turned it over, so I'd not have to see it. I did see it, and it was worse than what I'd imagined. One entire side of it was covered with Mom's blood. I then put paper towels over the large pools of blood on the living room carpet.

That night, Eddie, a friend from Phantom, came over. He brought pizza, and we talked late into the night. I think I only slept about four hours that evening. I didn't dream about Mom as I slept. I cried periodically, and then would stop. July, one of our cats, cried, and woke me up. Yesterday, our eldest cat, acted with somber motions. She knew what had happened.

That night, it felt as if time had just stopped. There was me and the cats in that silent apartment. I then wondered, “What happens next?”



Text copyright Riley Joyce 2016

P.S. Special thanks to both Eleanor and Justine, who both kept me company via messenger on the long bus ride to the apartment, and the ambulance ride to the hospital. I am forever grateful for that. And thanks to all the friends I'd called and spoken to that night when I was alone in the room with mom; Dillon, Kethry, Eddie, and various others. 

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