Mother. Less or More

The phone rings at 6 a.m. on Saturday. It’s the director of the board and care. My mother is having a seizure. Three years ago during high holidays, I met with a team of palliative care specialists and decided to authorize no futher measures to prolong the life of my father, who was a few months shy of 90. The machines were unplugged. It took him about two days longer to die than was expected. My mother will turn 90 in November. I arrive at the board and care just as the paramedics are driving away with her.

Spuds accompanies me to the hospital to see her on Saturday. She is not awake and I sit for a while and watch her sleep. Four days have elapsed and while I call and inquire of the nurse on a daily basis, I do not return. The director of the board and care visits her daily and brings her clothes and fixes her hair and applies makeup. I am ashamed but there is no one available to accompany me to visit, and just like going to see her at the board and care, I am unable to bring myself to visit the hospital alone.

The cause of the seizure is still undetermined but it is discovered she is suffering from pneumonia and that one of her lungs is badly congested and partially collapsed. I am asked to authorize a bronchoscopy which is dually a diagnostic measure and will also serve to suction off some of the mucus in her lungs. Because she is nearly ninety years old and suffers from pernicious dementia I do not authorize the procedure, promising to think about it.

I call Jayne and Mike Goldberg, mavens of all matters medical, dog and automobile. Jayne tells me that nurses refer to pneumonia as the “old man’s friend.” Patients dying from pneumonia can be prescribed strong pain killers which do double duty in slowing respiration, essentially making for a peaceful and painless death. It is possible that my mother will survive this bout of pneumonia but Jayne suggests taking more aggressive steps to cure it, particularly when she has suffered a seizure, might eventually result in a more painful death, as dementia and age are capricious and irremediable.

I send Himself and the children off to Rosh Hashanah services and sit on the couch in a ratty nightgown and wait for the doctor to call. I try to watch live Rosh Hashanah services on the Jewish t.v. network but can’t engage. I watch a cooking show and some reruns of The Office and stare at the phone, willing it to ring. When it finally does, the doctor explains again the possible benefits of the bronchoscopy but when we discuss the actual individual who, while treated with warmth and compassion at the Board and Care, is maintained by strong sedatives and has no quality of life, he agrees with the decision to withhold all but palliative treatment. He arranges for hospice care. She will return to the board and care and hospice staff will monitor her and provide necessary services on a daily basis.

After the doctor and I agree to provide only palliative treatment I call the board and care to explain that my mother will be returned there by ambulance within the next few days and that she will receive hospice services. The caretaker is angry. She doesn’t even know that I haven’t visited my mom in the hospital and I am thankful for this. She says that once the pneumonia clears up my mother will be fine. But fine to her, is the vegetative state she has been in since her arrival at the home. She agrees to cooperate with the hospice service but I can tell she is distressed. The board and care is run by a Filipino family. The house is filled, not ironically, with Catholic kitsch. I suspect the objection to my decision is rooted in religion and culture. I believe that if my mother had foreseen her fate she would have opted to die about three years ago but I still I am stung and wounded by the caretaker’s disapproval.

My mother looks far younger than ninety and is one of those old ladies you can recognize as having been a great beauty but there is nothing left of her anymore. I am disturbed by the thought of her languishing and I imagine she would be disgusted at the picture of herself in diapers and gibbering incoherently. I think she would agree with the decision to discontinue life prolonging measures but the truth is, death for her won’t vary much from her current life. I am the one who stands to be most changed at her passing. Her death will make me an orphan, although perhaps it is tacky for someone in her 50s to wallow in this designation. She has been absent for so long that while her death will be sad, foremost, it will bring relief. The caretaker’s shocked response trips the switch of perpetual guilt and exacerbates my fear that my primary motivation for eschewing life extending measures, towards almost inevitably hastening her death, is that my mother is an inconvenience.

Spuds returns from services which I glean he finds boring and volu

nteers again to accompany me to visit my mother at the hospital. We are stuck in the hall behind an enormous man with a walker being led by a tiny nurse down the hall. He wears pressure stockings. His head is wrapped in a thick bandage and with each tiny step he emits a moan of exhausted pain. It is terrible to witness Spud’s witness of this but I cannot imagine this visit without his comforting presence.

My mother stares vacantly at Tyra on the overhead t.v. Her arms are black from IVs and blood draws. I bring her favorite dark chocolate. The hospital bed tray is cluttered with applesauce and medical food thickening agents. I break off a tiny piece of chocolate and stick it in my mother’s mouth. At the board and care she’d easily polish off an entire bag, regarding each new piece I offer with surprise and delight. She chews and swallows the tiny piece. I offer another. The voracious love of chocolate has been one of the few human qualities left to my mom but now, her mouth clamps shut.

We leave the hospital and Spuds says he is hungry. He deserves a special snack but reports that the hospital cafeteria is yucky. I don’t feel like taking him to a restaurant but I stop at Trader Joe’s hoping there will be a sample of something to tide him over but the offering is pork shu mai. Despite temple, grandma and gnawing hunger he doesn’t complain and even unloads the groceries when we get home before preparing for himself an elaborate snack which I accurately predict, but refrain from pointing out, will spoil his dinner.

Himself deplores the telephone. This will elicit a “duh” from anyone who reads here with any regularity. He answers the home phone in such a tone as to insure that no one ever wants to call again. It is remarkable the mileage that he can get from those two syllables of “hell” and “o.” The phone rings and Spuds identifies “Market Research” on the caller i.d. Himself’s posture stiffens and he rages, “DO NOT ANSWER IT. THEY HAVE BEEN HOUNDING ME FOR DAYS,” and then he segues into his usual rant about the corrosion of personal privacy with some sort of overpopulation subtext. Himself is hunched over his laptop, his back to the phone as the seventeen year old picks up the receiver and stealthily disconnects the call. He answers the dead line, “Hello? John Murphy? Yes, just a moment.” He extends the phone to his apoplectic father and says, with an Oscar worthy deadpan, “It’s for you. It’s Market Research.”

After a summer of sleeping until most people have finished lunch, my seventeen year old forces himself out of bed on the first day of school. He grabs a cup of coffee, ignoring my raised eyebrow. A senior now, this is his last first day of school, at least the kind of first day of school that starts with Mom yelling at him to wake up, a hot meal and a packed lunch box. This is also the first day of school on which car keys are placed next to his vitamin on his breakfast napkin. We make a dry run to the school and scope out the parking situation on the weekend but as I hear the engine turn over I am knocked silly by a huge rush of love, pride, relief and acute terror.

I badger Spuds relentlessly to text me every time they arrive at any destination. I pump him about his brother’s driving prowess. I remember how I drove for the first few years after being licensed and a serious accident I caused. The last time I visit at the board and care my mother eats half a pound of chocolate and jabbers forming no intelligible words. I wipe the smeared chocolate from her face and kiss her goodbye. She calls out “drive carefully.” How indelibly etched that terror is.

I have chewed around for years my mother’s brokenness and the complications of my relationship with her. I was angry for a long time but over the last dozen years I’ve gotten over it. I turned out ok after all so there’s no point in ascribing blame. As dementia peels her down, like a brittle onion, what is left at the tiny sliver of withered core is her love for me and she is, above all things, rightous. Now she is ashen and tiny in a gigantic hospital bed. She gazes blankly at the comically insipid Tyra. My children drive away from me now and I text and call and wait in the driveway for them to return. In the end we can’t even hold on to what we cherish the most but we will fight like mad before letting go.