Death & Taxes

Patriotic to her last breath, Mom used these to celebrate Independence Day on her deathbed.

          I watched two people die last year. I don’t mean I watched them become gradually overwhelmed by terminal illness, although that was certainly part of it. I mean I was in the room with them at the moment they died. The most recent one was my mother. Both deaths were remarkably similar in their physicality—the urgent, rattling gasps, the arched neck, the open mouth—all suggesting a desperate clinging to the last shards of life—the final opacity of lifeless eyes. It is a moving experience for the survivors, and one that seems to resolve itself in peace at the end, possibly just in the knowledge that a loved one is no longer suffering, and possibly because, on balance, dying seems such a natural thing.

          In the aftermath, of course, we still living are left to confront our own mortality. This too is natural. How could it be otherwise? One needs to prepare for one’s demise. There are many paths to this preparedness, and they all have to do with the degree of self-absorption involved.

Mom was prepared. She was 90. She had been getting ready since my dad died 15 years ago. She did it for her heirs. She took care of all the arrangements. She prepaid everything. She left explicit instructions, and even included a few choices for her children to make us feel involved in the leave taking—involved, but not burdened.

          She also saw to the disposition of her soul. I think it was that she had taken care of this that she was able to take care of us. Her faith was a primary thing in her life. In twenty years I have not had a conversation with her in which she did not mention prayer, church, scripture, or the Lord. In that time and to my knowledge she never watched anything on TV that wasn’t broadcast on EWTN, the Catholic cable channel, or read anything that wasn’t primarily Roman Catholic in origin. (For those prone to doubt the connection, this includes the Bible.)

Mom was a woman of unflagging faith, and she had professed her willingness and desire to pass into an eternity with God on numerous occasions. She was ready to go. She stayed ready. It was a good thing that she did, because even though she was 90, no one expected her to go the way she did.

          She had a stroke on a Monday morning. My sister’s husband was with her when it happened. They were at the checkout counter at her regular grocery. EMS was dispatched almost immediately, and arrived within 10 minutes. She was stabilized and rushed to a nearby hospital—the hospital where my sister works, a hospital that is famous for its stroke unit.

She got the best possible care in a very short period of time. By Monday evening, she was alert and responsive. The prognosis for a complete recovery was pretty good—right up until the time that it was very bad.

          The doctors determined that they should give her an anti-coagulant—something to bust up the clot in her brain. They have tests they administer to determine the feasibility of the anti-coagulant. Apparently it’s not an easy assessment. There is considerable risk with the drug, and a lot of factors have to be balanced to determine whether or not the risk is warranted. Mom scored a 20 out of 22 possible points on the efficacy charts. She looked like a good candidate for the procedure. She was not.

          The drug caused multiple bleeds into Mom’s brain. This was the risk—the one the doctors thought was acceptable, but which was not. When the seeping and swelling finally stopped sometime on Tuesday, half of Mom’s brain was gone. I saw the scans. The medical staff was amazed at the amount of tissue involved. They had never seen anything quite like it. Mom had set some kind of record for a medical “bad beat.”

          “Bad beat” is a poker term. Mom didn’t know anything about poker, and probably wouldn’t appreciate the analogy. A bad beat, at its simplest, is a hand that should have won but did not. It is a hand that started out with a statistical advantage, and was correctly bet, but was subsequently beat as more cards were dealt—usually as the result of the winning player making a statistically unsound call and then sucking out a winning hand with the final card.

This is the equivalent of what happened to Mom. She had the statistical advantage on Monday evening, but fate sucked out a spade flush on the river. Mom got screwed. Well that is until you consider that what she really wanted to do was cash out her chips and go home to Jesus. In that regard she made out pretty good.

There was an incident of sorts right at the end. I hesitate to say that it was miraculous because I’m sure there are any number of logical explanations for what happened. Whatever it was, it was special to me. I’d like to think it was special to Mom too, but that would depend on whether or not what happened was actually miraculous.

We had moved Mom to Hospice after the doctors at the hospital determined that there was no chance of recovery. I rode over there in the ambulance with her on Thursday evening. She had not been alert, responsive, or even opened her eyes since Tuesday. She had not acknowledged anyone’s presence in any way although we all talked to her as if she could tell we were there. The doctors felt that was a waste of time, I’m sure, but they had the good sense not to say that to us.

By Friday afternoon it was clear that the end was near, although I think that most of us felt that she would probably last until Saturday. There was a shuffle of family around lunch time. My youngest brother went to pick up his daughter who had got a ride in from college. My other brother went back to his hotel to catch a nap because he had spent the night with Mom in her room. One sister had left with her family to get some lunch. The rest of the family trooped down to a central sitting room to listen to one of my nieces play piano. I took advantage of the moment to have Mom to myself.

I sat next to her bed, held her hand and stroked her forehead. I have no idea if this was a comfort to her or not. It was just something that felt right. Mom would have done it for me.

I gave her permission to die. This is something Hospice recommends. I have no idea about the need for or the propriety of this exercise either. For one thing, Mom was the last person on earth who needed my permission for anything. Mom was the person I had to get permission from...even now. This felt right too, however, in the circumstances, so I did it.

I said, “It’s okay for you to go if you want, Mom.”

Her right eye popped wide open, and she looked right at me. This was the miraculous part. The only thing she had done for three and a half days was breathe, and she had trouble with that. She had not opened her eyes once in all that time. She had not blinked or squeezed anybody’s hand. Now she was suddenly fully engaged in what I was telling her. It seemed I had her attention.

“Really,” I said, “You can go if you want. Go to Jesus. We’ll be okay—all of us. We’ll be fine. I love you.”

She kept looking at me with that one eye the whole time. There was an intensity to her gaze. It took me by surprise. I had not expected it. I didn’t know what to make of it, but I knew it was special. And then, right in the middle of this special moment, in another life-defining instance of incredibly unfortunate timing, a volunteer decided to come into the room to deliver a flag fan and a fact sheet about the Statue of Liberty in honor of Independence Day. He was blissfully unaware of what was going on between Mom and me, although, surely, he understood that people come to Hospice to die, and that he ought to take some pains, therefore, to see what was going on before just barging into a room.

This guy was on a mission. He wasn’t content just to deliver the goods. He felt a lengthy explanation was in order. He felt that Mom and I needed to know who had slapped red, white, and blue construction paper around a tongue depressor to enhance our 4^th of July celebrations. He wanted to point out the highlights of the fact sheet. He thrust it into my hands and started ticking off the various entries on it as if I might miss them. I was flabbergasted.

I guess I should point out that I am used to being interrupted. Interruption seems to be a hallmark of my life. It is an adjunct to the unfortunate timing thing that I discussed yesterday with regard to my hair…among other things of course. Getting interrupted is a pet peeve of mine, but something I seem unable to get under control. No one seems to care what I am doing or saying. Whatever it is they have to say is almost always more important than what I have to say. This happens so often to me that I have come to believe it is more about me than it is about them. It is more than mere rudeness or self-absorption on their part. There is something about me that invites interruption. It’s not that their sense of entitlement is over-developed. It’s that mine is under-developed. My sense of entitlement is infirm and eminently trample-able. It must be my fault else I wouldn’t be interrupted with such frequency and with such unerring inconvenience. I fully expect to be interrupted on my own death bed. It would only be fitting.

I put my head down and willed the guy to go away. I tried to shrink into my shirt and disappear. I tried to fill the room with a sense of privacy. I tried to exclude the guy by sheer force of will. Mom was more effective. She gave him the skunk eye. She’d always been good at it. A withering look was one of her most formidable weapons. It is the kind of thing you have to perfect when you do not curse or swear. She could stop you in your tracks with a glance. She apparently kept this skill to the last. The guy turned and almost ran out of the room.

Mom looked back at me, closed her eye, and breathed her last. She took several more gasps, but she essentially quit breathing at that moment. My youngest sister came in the room with one of my sisters-in-law and our aunt. My sister checked for a pulse and called a nurse. The nurse checked with a stethoscope. She said there was some activity in the heart yet, although it was very faint, sporadic, and failing—not a beat really, more of a gurgle. She said she would check again in a minute. When she did there was nothing.

For some reason I have found joy in this last exchange. I am gratified that Mom had her last moment with me. I am amused and edified that she was still able to wield the full strength of her personality at the very end of her life. It is the kind of thing that defines her existence just as getting interrupted seems to define mine. I have to wonder if there might have been more between Mom and me if the volunteer had not come into the room at the most singularly inconvenient moment in the entire history of my relationship with my mother. I have to wonder what I might have been cheated out of in those few fleeting seconds of boorishness. I wonder what Mom thinks—if she’s disappointed that she wasted the last bit of energy she had for living and loving to shoot some bozo the skunk eye.