My brother Jack was leading Jen and I through an endless maze of hospital corridors. I knew where he was taking us, but I didn’t bother paying attention to how we got there. I knew we walked on beige and then maroon carpet. And I knew that we went through a few sets of doors and past a bank of elevators. Mostly, I knew that the further we walked, the quieter people got.
We turned again and walked through another set of doors. On one was a red sign prohibiting cell phone use.
Until tonight I’d never been in an ICU.
Jack led us through the lobby and into the waiting room. My dad stood up and gave me a hug. Then he hugged Jen.
Then he asked if I wanted to see her.
Like every room in the ICU, room 28 was nothing more than a sterile, brightly lit white box that smelled of disinfectant and was full of machinery. It was a room in which everything had wheels. There was no TV. The only things that never changed were the walls.
In the middle of the room was a bed, and somewhere behind all the wires and tubes lay a sedated figure that was supposed to be my mom.
Except it wasn’t.
Not how I remembered her anyway.
This wasn’t the same woman I’d seen just a month ago.
This woman was too small. Too vulnerable. A helpless victim.
Mom was anything but.
She was a goddamn rock. She survived a cheating husband and the small-town divorce that followed. She survived single-parenthood and asshole bosses who wouldn’t give her a raise because she’d spend the money on toys for her kids. She lived through two blood clots and the deaths of her parents and only sibling. She got through all that shit and emerged a better woman. And she was rewarded with a man who loved her as much as we did. She got her life back. She got the happiness that was long overdue.
Now it was about to be taken from her.
And she was to be taken from me.
I watched as dad walked over and grabbed her hand. He delicately brushed the hair from her eyes and kissed her on the forehead.
“You can come closer if you want,” he said.
I looked at him but didn’t move.
“It’s okay,” he said again.
Jen grabbed my hand and led me to the side of the bed. Dad moved away and put Mom’s hand in mine.
“Her skin’s so soft,” I said. Immediately I could feel the emotion threaten to overtake me and in a desperate attempt to suppress it, I looked up and studied the machines. Then I looked at dad and asked, “what are we looking at?”
“She’s very sick,” he replied. “They don’t know how, but she came down with an infection that wound up getting into her bloodstream.”
“Organ failure,” I asked.
He looked at the dialysis machine. “Kidneys and liver.”
“And that’s it?”
He nodded. “For now.”
“But?”
“The doctors say we’ll know in a few hours if that’s working.”
“And if it’s not?”
“Then we have some decisions to make.” He turned around to leave. “I’ll leave you two alone.”
Jen started to leave with him.
“You don’t need to go,” I said.
She wiped a tear from her cheek and smiled. “It’s okay,” she said. Then she left too.
I was alone. We were alone.
“Goddammit Ma.”
This time there was no blinking back the tears.
I willed her to wake up, but the only response I got was the rhythmic sound of her respirator.
“Say something.”
This was not supposed to be it.
“Please.”
But it was.
I tried to smile. “You’ve got too much left to do.”
Harder tears.
“And our dance. We have our dance.”
Nothing. She couldn’t do anything. The machines spoke for her and all they said was, “deal with it bro, she ain’t coming back.” But I wanted to her to know I was there, that she wasn’t alone, so I leaned in and gave her a hug. And that’s when I lost it. The ostrich with no choice but to pull his head from the sand.
There was no point in holding back. My pride and self-consciousness had evaporated as soon as everyone left her room – replaced by the realization that I was going to lose her; that the day I’d fleetingly acknowledged would come, was in fact here. Four years of Pollyanna thinking. Four years of “you’ll beat this,” positive thinking forced to yield to a reality that I couldn’t accept.
Didn’t she know how much I loved her? How much I needed her?
Did that cocksucking piece of shit God know it?
What if she was trapped inside herself, screaming “I’m not ready, I don’t want to die.” What if she knew all she needed was more time, that she’d get better if just given the chance?
Then again, maybe she was ready. Maybe she knew that this death was better than the one she feared above all others.
Or maybe she wasn’t thinking anything. Maybe the drugs were doing their jobs.
I stood up and wiped my tears from her cheek.
“Don’t leave,” I whispered. “Not yet.”
For some families, death comes without warning. A late night knock on the door by a police officer, a phone call from the hospital. Car crashes, strokes, aneurysms, sudden infant deaths – accidents and the unexpected ripping off the most painful of band aids. Husbands, wives, sons, and daughters here one moment, gone the next. No time to prepare. The luxury of a goodbye, non-existent.
For us, death came slowly. It teased us with false starts and feints.
We allowed cautious optimism to infect our thinking and we squeezed hope from the most harmless of comments.
“She’s responding to treatment,” would become she’s getting better.
“Her heart is strong,” became we’ll be laughing about this in a week.
But it was all an illusion. Delusional thinking from those clinging to hope, however thin it may be.
And two days after we arrived the doctor extinguished it.
He walked into the waiting room, his youthful optimism replaced by weariness and resignation. A resident followed him in.
That can’t be good, I thought.
The doctor made a pointed attempt to look at all of us before speaking.
“Your Mom is a fighter, but as you know, she is very sick.”
He paused.
“While she initially responded to the treatment, her immune system was unable to fight the infection.”
“Which means,” Dad asked.
“The human body is smart,” the doctor continued. “And it’s tough. It wants nothing more than to stay alive. When it’s under attack it pulls back and focuses its energy on keeping its most important parts healthy. However, in some cases it simply gets outnumbered, so it shuts down.”
“And that’s it?” Jack said. “You’re giving up?”
The doctor looked at him. “She’s tried really hard to beat this. We’ve tried really hard to beat this. But she’s letting us know she’s done fighting. Her body is telling us it’s time.” He paused. “If you so choose, we can keep her alive artificially.”
Again he stopped and looked at all of us. “But she won’t be alive. Not as you want her to be. Not as she’d
“But she’d be alive,” Jack replied. “She’d still be here.”
The doctor nodded.
“That’s right, she would still be here. But she wouldn’t be the woman you remembered. There would be no getting better.” He continued. “Let me say, beyond all doubt, that this is one of the hardest losses I’ve ever had to deal with. I did not know your mom for long, but in the fifteen minutes I did get to speak to her and in the time I’ve been able to spend with your family, I know she was a remarkable woman. A woman of great character, class, and dignity.”
He stopped to let his words sink in.
“Let her leave with that dignity.”
“So what happens next,” I asked.
The doctor sat up and cleared his throat. “If you decide to cease treatment and remove her from life support, the next step is to take her off the sedatives and paralytic so her body can breathe for her. As those drugs wear off, her body will again take responsibility for her cardiac and respiratory functions.”
“Will she be conscious,” I asked.
“No,” he replied. “She will have no cognitive function whatsoever.”
“So she won’t know what’s happening,” Jack asked.
“No.”
“Will she be in pain,” I asked.
“I can assure she will not. The drugs she will be on will ensure she feels nothing.”
Dad looked up. “How long do we have?”
“If you are giving me permission to cease treatment, from the time it takes for the paralytic and sedatives to wear off until we remove life support should be about an hour.” He paused and looked at all of us. “You’ll be able to be with her during this time.” Then, looking at Dad he said, “Once it does, I’ll have everyone but you leave. At that time we will pull her off life support, which means we’ll remove the intubation and take her off dialysis. Once that is done, we’ll bring you back into the room.”
“And,” I asked.
We made eye contact.
“You support her,” he said. “You offer her the love and support she’s always offered you. You let her know she is not alone.”
The doctor stood to leave, but before walking out turned and spoke. “I know this is a horrible decision to have to make…but I believe the way your mother lived – how much she valued life – will help you make the right decision.”
Dad watched as the doctor left. Clearing his throat he looked at us. Tears welled in his eyes and his voice strained with emotion. “As I see it there really isn’t a decision to be made.”
We nodded.
“I love her too much to put her through anymore pain. She’s tried so hard to stay with us, but….” He broke down. “But she’s telling us she’s ready to go.”
More silence.
More crying.
“Each of us will be able to spend time with her alone.” He looked at Jen. “I know you didn’t know her long, but she was so excited to have you join the family. You’re welcome to say your goodbyes too.”
Next to Dad, I was the last one to go in.
The attending nurse smiled thoughtfully as I entered. She was young and for some reason this made me feel sorry for her.
“How do you do it,” I asked.
She looked at me, surprised by the question as much as she was probably surprised that I would be interested in her at a time like this.
“What do you mean?”
“This,” I said as I held out my arms. “How do you deal with this every day?”
She looked at Mom. “Some days are harder than most.”
“It’s pretty amazing if you ask me.” I walked over to Mom’s bed. “I can’t imagine.”
“You don’t think about yourself,” said the nurse. “You think about the patient.” She looked at me. “You think about their families.”
“And that makes it easy?”
“Easier,” she replied.
Someone had put a chair by her bed. I took a seat and grabbed Mom’s hand.
“She was a lucky woman.”
“Not lucky enough,” I replied.
“She was fortunate to be so loved.”
I nodded. “That she was.”
“And she’s clearly leaving quite the legacy.” The nurse continued. “Not everyone has such an impact.”
“You’re right about that,” I said as I looked at Mom. She left a hell of an impression.
The nurse studied one of the machines and looked at Mom’s IV bags – the contents of which we’re close to empty.
“She need more of that,” I asked.
“Not of this,” she replied, then she turned to leave.
I called out to her. She stopped.
“I feel stupid asking this, but can you do me a favor?”
“Anything,” she said.
“When she’s….” I stopped before I could say it. Correcting myself I continued, “When it’s over do you think you could save me a lock of her hair?”
She smiled. “Of course.”
“I know it’s cheesy…”
“It’s not.” She interrupted. “It’s something to hold on to.”
I looked back down to mom and slowly ran my fingers through her hair. “It’s gotten so much grayer…”
I must have spaced out because when I looked up to thank the nurse I was greeted by an empty room.
That’s when it happened.
I buried my head on the side of her bed and let loose the crush of emotion that had been welling up since I first walked into her room. Never had I experienced such raw emotion. Never had I been so consumed with loss. She was leaving. The most important person in my life would be no longer. She would never hug me again. She would never say, “I love you.” No more cheesy birthday presents. No mother-son wedding dance. No experiencing the joy of watching her grandchildren raise holy hell.
It was over.
And I couldn’t deal with it.
I cried as hard as I’ve ever cried. Body convulsing in silent spasms of grief. Mind screaming at her to wake up. To be better. To not die.
I cried as hard as I’ve ever cried and my tears and silent prayers did nothing but give me a headache.
Fucking suck it up, I told myself.
And I did. At least as much as I could. Then I began speaking to her.
“This fucking sucks, doesn’t it?”
My curse filled final goodbye
“Never thought it’d go down like this.”
A one way stream of conscious conversation.
“You know I’m here, right? You know we’re all here? Jen too.”
“Quite the way to bring us all together.”
I paused.
“She’s been great. Real supportive. She just lets me hold her and cry. You should see me…I’m like a goddamn five-year old.”
“You don’t have to worry about me, ma. She’ll take care of me now…I’ll take care of her.”
“Like you took care of us.”
Like you took care of us. Thoughts continued to spill from my mind, different thought. Darker thoughts that should remain unspoken – as if verbalizing them would offend her.
I lied to you. I did try killing myself.
I know, it was stupid.
What’s funny is that I blamed you.
You were full of shit. At least that’s what I thought at the time. That’s what I blamed you for.
You said I could do whatever I wanted. You said I was special.
I’m not.
I’m just average.
I’ll always be.
“But I’ll deal with it,” I said. Happy thoughts replacing those of defeat and blame. “Just like I’ll deal with this.”
I leaned over and gave her kiss on the forehead.
“It’s wasn’t your fault.”
“God knows I didn’t make it easy.”
Another kiss.
“I love you so much, ma.”
And another.
“And I’ll miss you so much.”
And then the last.
“I miss you so much already.”
“We all do.”
I walked back to our private waiting room, catatonic and emotionally exhausted, face bearing the telltale wounds of finality. My step quickened as I entered the ICU lobby. Two families were sitting on opposite sides of the room – each engaged in their own personal melodrama. Their faces turned to me as I walked by. An older woman nodded solemnly and offered a warm smile. I smiled back and directed my gaze at the floor.
I envied them. I envied them and their back issues of Reader’s Digest and National Geographic. I envied the shitty daytime television and late-night infomercials they were forced to digest. I even envied the uncomfortable floral print chairs they had to sit on.
But mostly I envied their hope.
I stepped into our room and was greeted by silence. Dad stood.
He looked at me and knew not to ask how I was. Both of aware of what my answer would lead to. Jen stood up and I walked into her open arms. Letting go, we sat.
Some time later Dad came and got us.
“We’re ready,” he said.
We all stood.
I heard Jack exhale deeply and watched his wife put her arm around him.
Taking a few hesitating steps towards the door, we entered the lobby. The families were still there, only this time no one looked at us. There were no warm smiles, no sympathetic looks. To acknowledge us would be to acknowledge that a similar fate may await.
We filed into Mom’s room and took our places around the bed. Dad holding her left hand, Jack holding her right. I stood at the end of the bed. Absently I grabbed one of her feet and rubbed it. The young nurse was there. She and the doctor stood in a corner of the room.
I heard Dad tell her it was okay, that we we’re all there for her and that it was okay for her to go. “You fought hard,” he said, “just relax.”
Her breathing slowed.We all turned our eyes to the heart rate monitor. Her blood pressure was rising; her heartbeat was strong- almost defiantly so. As if she wanted us to know, “I’m doing this my way” or “I didn’t need any help, thank you very much.” She always had to have the last word.
Or perhaps this was her sense of humor reaching out one final time. After all, here we were, standing around being melodramatic and she’s savoring the moment. All attention on the queen. The last time she’d be late for anything.
We stood in silence and watched as her breathing slowed.
Minutes was all we had. All she had.
Her chest heaved a few times – a last, desperate attempt to stay amongst the living.
Then it stopped.
Her eyes opened just a fraction of an inch and I saw their deep brown sparkle for the last time.
She was dead.
The nurse handed me the locks of hair she had cut and someone handed me the pink pajama top Mom was wearing when she was admitted.
We slowly filed out of the room, I the last one out.
But I stopped. I couldn’t leave. I didn’t want to. Not yet. I turned around and walked back to her.
She was dead, but I didn’t care. She needed one last hug, one last kiss. A final I love you.
But really, I needed it more.
