The Silence – the End

Betty and Calvin in warmer, happier times.

In the very early morning hours I lay next to my husband – we were supposed to be sleeping, but neither seemed to be capable of staying in that peaceful state.  We didn’t speak, each lost in our own thoughts as we drifted in and out of slumber.  We listened to the furnace try mightily to keep up with the frigid December temperature in the largely uninsulated home, and the steady drone of an oxygen concentrator in the next room.

He had a good idea of what was coming, I’m sure.  On the other hand, as nurse, I knew exactly what would transpire.  We held hands under the covers, our toes touching near the end of the bed.  It was cold, very cold in the bedroom of the mobile home that was his mother’s “summer” home – the rest of the year she lived in Florida, in the house I now call mine.  She and my father-in-law usually left for Florida in the fall – when the air became thick with smoke from burning leaves that robbed her of what little breath she could draw.  Her lungs had been damaged from whooping cough as a child, and a life-time of smoking had exacted a large toll on her weakened lungs.

Earlier that fall I had sat with her in a hospital room – she had insisted – when her pulmonologist delivered the diagnosis. Cancer.  Small cell lung cancer.  Rapid-growing and likely to spread if untreated.  She clutched my hand, gasping for breath, but stoic.  She couldn’t bring herself to speak so I asked the questions I thought pertinent.  I was her medical liaison.  She listened as the pulmonologist outlined treatment options and indicated his thoughts on her prognosis.  She left the hospital, armed with referrals, brochures, and faint hope.  She made plans to return to Florida and decided on a course of treatment that involved both radiation and chemotherapy.

To me, though, she didn’t seem at all convinced that treatment was the right choice.  When we spoke, I told her I would support any decision she made and would do my utmost to help navigate the maze of oncology health care and cancer treatments.  Or not.  She eventually decided to remain in Indiana – planning the trip to Florida overwhelmed her and she hadn’t much fight left.  Eventually, she enlisted Hospice care, and made her peace with God.

She continued to entertain visitors from her little desk near her large “window on the world”.   She ventured out occasionally, but every excursion drained her very limited reserves.  Her breathing, never good in all the time I’d known her, became more labored and ragged, and she struggled mightily with even the simplest of tasks.  Eating was such hard work.  Dressing, too.  I helped her shampoo her hair and styled it for her each week – and trimmed it when necessary.

My husband arranged to spend as much time with his mom as he could over the next few months, and I visited on my days off from the hospital.   Her daughter visited before she became too sick, too weak to enjoy the company.  We watched her weaken in body – but never in spirit.  She had occasional bad days but was rarely tearful.  Her weight dropped and she was unsteady on her feet.  On her last outing from her home, she fell and broke her shoulder.

Ten days or so after her fall we had a tremendous blizzard.  I was stuck at the hospital and worked an 18 hour night shift before a replacement could make it in to relieve me.  I was too exhausted to try to drive home and unsure if I could make it there, anyway.  I stayed at my son’s home a few blocks from the hospital and it was after just a few hours of sleep that I received a call – the hospice workers had determined that the end was near.  She had asked for me to come.  So I did.  The highways had been mostly cleared but the below-zero temperatures were brutal.

A hospital bed was set up in the living room, near the window she loved so.  She was exceptionally weak, but lucid. Over the next 24 hours she became too weak to get up to use the bathroom, so I contacted Hospice to see about getting a catheter for her – it was too painful to turn her to put her on a bedpan or change her bed linens because of the broken shoulder.  I impressed my father-in-law with my ability to completely bathe a person in bed without spilling a drop of water and my ability to change the linens with my mother-in-law still in the bed.  But mostly I tried to see to her comfort.  Morphine and Ativan.  Placed under her tongue because she could no longer swallow.  Ice chips, and vaseline for her parched lips.

My husband and his step-father (her husband, my father-in-law) stayed by her side.  Her older son was on his way, due in the next day or so, and a steady stream of friends and neighbors called or stopped by.  It was evident to see that she was much loved.  Even her physician stopped by on his lunch hour – the kind of thing you only find in small-town America.  The hospice nurses were wonderful – loving and respectful to her and utterly dedicated to her comfort.  Her older son arrived as expected.  She continued to stubbornly, and bravely, cling to life.

But after three days of hanging on, in those early morning hours, we were not surprised by my father-in-law’s knock on the door.  “It’s time,” he said.

We got up hurriedly.  I listened to her lungs – no breath sounds throughout most of her chest, and only gurgling noises up near the collarbones.  Her lungs had filled completely with fluid.  Her breaths came irregularly – long, agonizing silences in between.  Her limbs were mottled and blue.  And oh, so cold.

I sat by her side and held her hand – she looked at me, gasping, eyes clouded but seemingly focused.  She turned to her husband.

“I’m ready” she whispered.

Her husband leaned in close and spoke softly in her ear.  “I’m here.  Right here.  I can fix almost anything” his voice caught. “But I can’t fix…this.  I love you”.  A tear slid from his eye.  He placed a kiss on her forehead, then rested his forehead on hers.  His tears fell on her face.

I leaned in and whispered in the other ear.  “I’m right here.  You go ahead.  We’ll be all right.  We’ll take care of each other.  You don’t have to worry about us.  We’ll be fine.”  My own tears flowed onto her pillow.

She breathed a few more shallow breaths then slipped quietly away.  We held onto her for a while, then wiping our eyes, hugged each other.  When the oxygen concentrator was turned off – then, and only then, was she truly gone.  The silence made it official.

I now live in the Florida home that had been my mother-in-law’s.  Every day I am surrounded by her spirit, which was mighty.  I was always glad that we had come to love each other because, after all, we both loved the same man.  And I was honored to care for her at the end.

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32 Comments

Filed under General Mumblings, Uncategorized

32 responses to “The Silence – the End

  1. I hope some day I am blessed with such a daughter-in-law.

    • Thank you. I am glad that people do not find it morbid, but perhaps they are too polite to say so. I really wanted to show that it was a tender, loving, time and the exchange between the spouses was probably the most romantic, heart-wrenching moment I have ever seen.

  2. all the women i know, and have known, are so strong, so caring, so able to do what must be done…much as your mother-in-law, much as yourself. this is as much a tribute to your husband’s mom as it is a to the idea of “woman.” lovely. continue

    • Thanks, Tony. Women are incredibly strong, and doing what needed done was the easy part of it. I was blessed to witness such love, such tenderness, and such strength.

  3. Thank you for sharing this part of your life. It must have been hard.

    • Actually, I felt completely drained when I was finished, and couldn’t even look at it again until today. The part that was hard was capturing the tenderness, and trying not to make it about me (because really, it wasn’t). I hope I was successful at that, but I couldn’t write about it without putting myself in the midst of it.

  4. Thank you for sharing such a personal story.

  5. Thank you for sharing your mother-in-law’s incredible spirit and your strength. It is beautiful.

  6. Your post brought me back to my mother’s hospital room 15 months ago. She also died from a lung condition and fought bravely until she couldn’t anymore. Your mother-in-law was blessed to have such a strong, smart, loving supporter like you in her life.

    • I am sorry for your loss. My mother has been gone for more than 30 years now. She is in my thoughts daily. As is my mother-in-law as I move about “her” house and live amongst her things. I am quite okay with that. Quite.

  7. Thank you. That was beautiful and inspiring.

  8. Oh so lovely and well-told. Thank you.

  9. It’s so rare that any of us get to read such a tender yet honest account of the end of a person’s and family’s struggle with terminal illness. Your essay is so full of vivid and personal details that it gave me goosebumps and bleary eyes.

    Dying by inches is so difficult on everyone, but so is a sudden death when no one has the chance to say their final farewells. Death is a tough topic to write about. You did it masterfully.

    • Death is, indeed, hard to write about – especially one in which I was so intimately connected. The “caring for” was as easy as the “caring about”. I had lost my mother already and knew the loss my husband and his siblings would experience. It was, as you noted, dying by inches. And those that mattered made the most of the time left to them. For that, I was very grateful.

  10. And I was honored to care for her at the end.
    People kept saying, “You kids are wonderful, to all be around her right now, instead of just forcing your mom into someone else’s care!” My siblings and I were baffled by this. Who would do that? How were we were doing something good? As you said, it was an honor to care for her at the end. It’s so hard to explain why, so it touches me to know there’s someone for whom no explanation is necessary . . . and whose heart is, as evidenced by these words, so beautiful.

    As I go to get a new box of tissue, my heart is full. Thank you for sharing this touching piece of your history, and soul.

    • No explanation needed at all. She asked me, I promised, and anything less would have been inadequate in light of her faith in me. I am glad that your heart is full. I pray it is full of loving memories of your mom and gratefulness for your time together.

  11. Wow-nothing more to say.

  12. This is a loving story and trubute to someone so very strong. You did a beautiful job of writing this with much respect and care for all involved. I was touched on many levels. A box of tissues at my side helped me get through the words. The second to line made the most impact and says it all – “I was always glad that we had come to love each other because, after all, we both loved the same man”.
    Outstanding,
    Isadora

  13. This was beautifully done; thank your for sharing it with me as so much of it parallels what we just went through with my friend’s mom – -also lung cancer. I was OK till I got to read the words you and your father-in-law had to say and then I lost it. So, so touching.

    You are right, it is an honor and a privilege to be able to offer end-of-life care. Not something I had experience in but it has forever changed me now that I have.
    Thank you K8.

    MJ

  14. Oh, thanks for stopping in, MJ. Your post about your friend’s mother also had me in tears.

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