Several weeks ago, at work, I helped a daughter say goodbye to her mom. There was a bit of sibling drama, but all in all, it was a joy to be there. My patient's grandson, probably in his 20s, asked me a question I have been asked a lot,
"How can you do this?"
It wasn't hard to answer him. I told him,
"This? This is not hard. It's sad, yes, but not hard. Your grandma made her decisions about how she wanted to live her life and we're honoring that. Your family and her friends have surrounded her, told stories, prayed, sang songs. It's beautiful. I'm helping her die with dignity, pain free, surrounded by you, her legacy. This is a death we all dream of. "
He paused for a moment and told me, "I've never thought about it that way. Thank you."
My patient had been on the ventilator for several weeks, but was alert and aware and refused a trach and did not want to live on the ventilator. Some legal personnel were brought in and she got her affairs in order. That Saturday morning, I washed her and helped her sit on the side of the bed. I took a few pictures of her and her daughter - the last pictures they would have together. Some of her friends arrived - beautifully dressed ladies in hats and heels. They laughed with her and teased her and told stories. Some older men - in fancy suits - arrived, too, and everyone in the room prayed together.
Around noon, I gave her a dose of morphine and the respiratory therapist came in. We pulled out the breathing tube and turned off the ventilator. She asked her daughter, "What do I do now?" Her daughter, bless her heart, said, "You just relax, Mama. You keep breathing and you relax and you'll come home with me." Some people, including the grandson I spoke to, read Scripture. A few women sang, there were more prayers, and the stories and laughing continued.
About an hour later, the daughter found me and said, "She's struggling." I had medicine waiting in my pocket and gave it immediately. She was comfortable and less responsive when I left. Within an hour or two after we pulled the ventilator, she was unresponsive. I checked on the family throughout my shift, making sure my patient was comfortable, making sure the family didn't need me. I didn't do a lot of technical care that day, but I spent time talking with my patient's family, helping them process her death and begin grieving. She died shortly after I left that night. As the daughter hugged me goodbye, she told me, "She's waiting for you to leave. She doesn't want to die until you're gone."
It's always sad to take care of a patient like this, to have my focus shift from saving a life to assisting with death. When it's a daughter and mother, I feel a strong sense of kinship. I've made the same decision with my mother. I've let her die with dignity. I've given her medicine to ease her pain. I've held her hand as she's taken her last breath. I've written her obituary. I've gone through her personal belongings. I've closed her accounts. I've sold her house. I've felt like I was erasing her life. I've been there.
I would never say that I know how someone feels, but I have been there. I'll never regret letting my mom go, letting her make the decision to enter hospice instead of trying a new chemo treatment, moving into her house and sharing her care with my sister and brother. I can't imagine doing anything else. She is my mother and she took care of me, so I took care of her.
My mom loved her electric fry pan. She would make grilled cheese, goulash, chop suey . . . any one-dish meal meant pulling out the electric fry pan. She bought me my own electric fry pan when I got married. Over the past year, the screws have come loose or been lost, the non-stick coating has come off in places and probably poisoned us, and finally, I dropped the lid on the floor and it broke. So, yesterday, I bought a new pan. It's bigger - I'm feeding a family of five -and the pan comes off the heating element so it can be easily washed. I'm excited about it because I love kitchen implements, but every time I throw away something my mom gave me, I feel like I'm throwing her away. I know she's still with me in my memories, I know she's not a freaking electric fry pan, but I hate throwing away something that is so directly connected to her. I feel like when I finally throw away everything she gave me, she'll be gone - really gone - and I just can't let that happen.
