The Devil is in the Details

The gas tank is a quarter full.  Save a drive home from the airport and a second round trip, that’s 300 some miles of back and forth to the hospital.

There’s a “gentleman’s club” between Mom’s house and the hospital.  I think about going in.  This makes sense in a world where the player piano in the lobby plays “O Christmas Tree” when I walk through the doors at 5:30 in the morning and I have to really think about where I recognize the song from and what it is called.  The parking at this hour is great.  But that’s beside the point.  I figure the strippers are probably just as tired as I am right about now, just as frustrated waiting on someone else’s flesh to decide what “enough” looks like.  I’d take a lap dance just to pretend for a minute that I’m about the business of living right now.

In the four hours I’ve been asleep, I’ve forgotten what the hospital smells like.  It’s only offensive 10 days after arrival, and then not because it is bad, exactly.  But for what it represents.  I woke up just before my cousin texted me to let me know she’d arrived at the airport.  In my dream I had collided head first with another swimmer.  I heard the text notification and thought “well, this is it.  It’s over.”  The lady is a hard one to kill.

It isn’t her dying that has become so awful.  It is her living.  The nurses say the strong ones take a long time to give up.  I don’t know so much about strength.  I think she’d appreciate it if I could sneak into the medicine stores and find a little extra of what they’re giving her.  Not for me, though I think the generally bludgeoned feeling in my head would justify some narcotics right about now, but to speed her along to whatever’s next.  If not that, a minute with the pillow over her head would do the trick.  But I’m not strong enough for that.  I wonder how many people do it in these last hours, particularly when the last hour was predicted 12 hours ago.  I wonder if a nurse walked in and saw me attempting to release her, if they’d tackle me and take me off to jail.  I’m not kind enough to risk it.

You think you know awful.  When it was becoming obvious that this death watch would be mine, we all knew it would be difficult.  My sisters were reluctant to leave me, but equally obligated to the living.  So they left.  I am not unhappy about their leaving.  Everything in its right place.

But the awful is such a detailed territory.  Every where you look, there is some new and exquisitely wrought nuance.  When your circulatory system slows down, your body puffs up.  They put a band on her arm to notify the nurses that her right arm wasn’t to be used for drawing blood, taking her blood pressure, or placing an IV.  Her wrist got so swollen that the band was beginning to make an indentation in her wrist.  Not that she’s technically there to notice such things.  We’re at the part of this process where the drugs flow free and fast.  But there it was, a hot pink warning wrapped around her arm and compressing the skin around it.

My cousin cut it off.

My cousin also slept here last night before a return to whence she came.  Four hours of sleep in a hospital room awaiting the lady’s last breath seems like enough to earn the woman sainthood, but what are you going to do?  My mother had two major fears: intractable pain and being alone.  She is safe in the arms of the narcotics, so the intractable pain is not so much of a concern.

At 11:00 last night, at a point when I was way beyond the ability to be socially acceptable or even civil, my sister and I had the beginnings of a philosophical discussion about consciousness.  The nurses, in a wisdom that I wouldn’t dare attempt to discredit as it is won by years and years dancing with Lady Death, know that some patients won’t let go if they have family with them.  Other patients wait and wait for the last person to arrive before letting go.

My mother is 100% unresponsive.  Her forehead wrinkles up sometimes, and we’ve decided that means it is time for more pain medication.  Other than that?  She doesn’t react to having her hand held, she doesn’t react to voices, she doesn’t open her eyes.  Her eyes don’t move around as they would if she were dreaming.  She’s not there.

So what happens between her being 100% unresponsive and the reality that some part of her may very well know when she’s alone or not.  Is it the reptilian brain at the core of it all, the one that manages breathing and our startle reflex, the bit of us that is all crocodile?  If one were to get reductionist about it, then sure.  Does that part of the brain process things like lonely, or scared, or abandoned?  Or is it a binary system: move or don’t.  Breathe in, breathe out.

At WTF in the morning, I’m sitting here instead of sleeping.  For what?  For the crocodile in my mother’s head that is heartbeat and breath and a twitch at an unexpected noise?  Is she there anymore?  And what does “she” even mean when her body is a wreckage and she’s beyond caring what her hair looks like?

A friend of her sent a card which we read to her when she was responsive.  She ended with this quote from Ovid:

Omnia mutantur, nihil interit.

Everything changes, nothing perishes.  Matter cannot be created or destroyed, only transformed.

What does that mean for you?  I mean the parts of you that aren’t mechanics, chemistry, and electricity?  We are all made of basically the same stuff, but yet even twins are not interchangeable.  What is the thing that my body carries around for me?  Is it a kind of matter?  And where does it sit in this hospital room, when it is so clearly not in her anymore?

I’m here instead of throwing back $3.50 drinks while a beautiful (or not) young (or not) woman gyrates on a stage to a song I actually kind of like because someone should do it.  Not for her.  This is the paperwork now.  We said goodbye on Tuesday when the Doctor told her that there was nothing left in the fight but to surrender.  For my grandmother.  For the idea that dying alone, even in one of the best hospitals insurance can buy, is kind of rotten.

This is the problem with trying to move tomorrow’s rocks around before the right day arrives.  That boulder looks kind of manageable.  You write up a notional plan for how you’re going to use leverage and intractable will to make it happen, you walk over to pick it up and it falls apart in your hands.  It’s never one big stone.  It’s a thousand little ones, each with their own precise topography.  Yes, it is a test of endurance.  Yes it is awful.  But it isn’t one big awful.  It is a collection of little dreadful details that are each awful, and hilarious, and twice as awful for being funny.

A Florida cockroach upside down and dead on my mother’s bedroom floor.

A house that smells of lilies even though no lilies are there.

Picking the right pants to send her to the crematorium in, because that will come, just on her schedule.

The macabre and ridiculous notion that there might be some escape to be found in a gentleman’s club.

O Christmas Tree, and the way that one song makes you want to giggle fit for the straitjacket.

The gagging stench of dying flowers.  Carnations last longer than lilies.  FYI.

And that’s just the easy stuff.  Some of this will just be between my cousin and me.  She’s due to be in the air in another 25 minutes.  I was glad to have her.  I am good with doing the last of this alone.  It would seem that this part of the procedure is for her and me.   It’s easier to be left alone to endure.

Anyway, I think The Boss will be here in an hour, and The Boss is a formidable ally.  She knows how to make sure the right thing happens in the right order at the right time.

The Devil is in the Details

One thought on “The Devil is in the Details

  1. Audrey,

    You’re another tough lady with a decent streak of Boss through your middle. This process is less about a single patient and more about the family than any other situation in healthcare. With the right tone and select words…you can advocate for your Mother to be a little more comfortable…just skip writing about it.

    The Nurses are right, take your tea in the garden once in awhile.



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