My mother died last night. Now all is well, finally.
When Michael and I went to the hospital yesterday at about 10 in the morning, she was located in a critical care unit. She did not recognize me or Michael. She was unresponsive to any voice whether from me, Michael or a nurse. She was quite agitated and moaned a lot as if she were in pain.
I found out that she was on two very powerful medications to elevate her blood pressure, as well as two antibiotics, because the doctors came to the conclusion that she was suffering from some sort of infection. Her pain was likely due to the consequences of that infection. In the ER the day before, they gave my mother 3 L of saline solution. And overnight and during the morning of the day we saw her, they gave her more fluids along with the four medications. So, by the time we saw her, she may have had 4 to 5 L of fluids. Yet she had produced no urine during the past 24 hours. Fluids were building up inside her body. Her kidneys had failed. Her feet were turning blue and were cold.
Finally talked to the doctor after about 1 ½ or two hours waiting, while my mother was in obvious pain. He said they were fighting an infection, and then an infectious disease consultant had been called in and prescribed the two antibiotics they were using. All this time my mother was either moaning or even being more demonstrative in terms of verbal expression of pain. No words, just sounds. Her expressions of pain rattled my entire body. My entire body was filled with tension, and that tension even affected my consciousness, and I felt a sense of urgency to end her pain if the outlook was hopeless.
So, I talked to many staff people while I was there. Not only her hospitalist physician would not make any guess as to prognosis, but only stated she may be able to take oral medications the next morning after recovering somewhat from the infection, then to her nurse, who is very concerned that she had not produced any urine and over 24 hours despite being administered 4 to 5 L of fluids, which indicated major organ failure. I also talked to the hospice worker, Jennifer, a very nice lady, who formally had worked in intensive care units as a nurse, and it was her opinion that my mother was not going to recover.
Then I was given a consult by the palliative care physician and his nurse, because I did not want to have my mother suffer in pain anymore. They were waiting on the results of cultures to see what kind of “bug” and invaded her body but those results would not be available for some time. The palliative care physician said in his estimation she had about a 10% chance of recovery, but even that was probably optimistic. Michael and I talked about this for a while and I talked about it with the various people involved. I also recognized my mother was not there anymore. There was no longer in her any identification with the personality known as Helen, or even with being a living being. It was just a body now complaining, in pain, uncomfortable. It was obvious to me that my mother had finally passed to the other side, that is the identity and person that she was had found a way out from being stuck between worlds, and what was left behind was merely a body wherein the Lifeforce was having great difficulty sustaining life.
I suspect that the perhaps 36 hours had passed from the time she had fallen out of hospital bed, with desperately low blood pressure, may have further affected her brain and had ended any association or identification with her body, or with any of us she was leaving behind.
By this time, the emotional wear was so great on both Michael and I, that my body to was in pain. My left hip pain for which I was seeking surgery, had become intense.
The palliative team gave us several options. One was to discontinue the supportive therapy of fluids and for medications, including the blood pressure medications and the antibiotics, and to immediately introduce morphine to ease the pain. Another was to move her to a hospice facility where they would do the same thing. The third was she was able to live on her own without the blood pressure medications, and she stabilized, she would be moved to the hospice facility next day.
I chose number one. We had been given conflicting information. The first hospitalist doctor who consulted with the infectious disease specialist, seemed a bit optimistic about her chances of living, but said to give her morphine would undermine the treatment they were giving her, and he could not provide any educated prognosis in terms of her survival and what her condition would be. Everyone else was not optimistic at all, mostly based on the fact she had produced no urine and well over 24 hours despite the fact of receiving many leaders of fluids. The palliative position felt that she would die soon after the blood pressure medications were stopped. So, I gave the order to transfer her to palliative care within the hospital, to give her morphine to ease the pain and make her feel comfortable, and to stop pouring more fluids into her, because none were clearing her system. All of fluids were building up inside of her body, and her arms and legs chest and stomach. She was developing bruises all over her body.
So slowly they began giving her morphine, 4 mL at first, until she relaxed, and then gradually removing the medications from the central line. Both medications were supposedly very powerful, and she was at maximum dosage. They raise the blood pressure by constricting the size of the blood vessels. First one was removed and 15 minutes later she was given a second dose of morphine, 2 mL, and the second medication was removed as well as the antibiotics.
Well, my mother’s blood pressure began to drop until it was amazingly low, like 40 or 41/20 or 21, and there she stabilized for several hours. By that time, both Michael and I were so worn out by watching the death process my mother that we had to leave. We left at maybe 4 or 5 o’clock. The palliative doctor was surprised that she was still alive, and said that if she made it through the night we would talk about moving or to a hospice facility the next day. Everyone was very supportive there and agreed with our decision to give her a palliative transitioning, and if she was going to recover, it will be on her own dime, rather than attached to machines pumping are full of medications which had a 10% chance of allowing her to painfully return to an unknown level of existence.
It was not a hard decision. I knew that my mother wanted to live, but I also knew she did not want to go through a lot of pain. She had signed a do not resuscitate advisory when she was in that same hospital two years before and I had been given medical power of attorney. The palliative physician stated that being on the blood pressure medications and fluids was “essentially” life-support, which my mother had sort of indicated she did not want, although she was thinking in terms of being resuscitated from a heart attack in terms of chest compressions etc.
And, I knew my mother was not there anymore and had essentially passed beyond probably the day before when she fell out of the hospital bed. Prior to going to the hospital, Michael and I went to her house to see what had happened. The hospital bed was in the living room, but it had no side guardrails such as we had installed on her bed in her bedroom. The hospital bed was low, but she tried to get up, and fell maybe 2 feet to the floor and had laid there for some hours during the night. When taken to the hospital by paramedics, at the hospital she did not recognize me or Michael. She had already been gone to the other shore for some hours.
Now I feel nothing, but have no regrets. My body is gradually recovering from the tension accumulated from yesterday, and life goes on.
I thank you all for your kind thoughts and prayers, and the visible support you have given both my mother and I through all this. But one thing was made very clear to me was that who my mother was, had nothing to do with her body. That who she was, had left her body at least the day before. And with that I felt in myself almost a bit of disgust for my own body, because I am tied to it, and in a sense dependent on it as a host for the Lifeforce that plays through me. It reinforces the knowledge that I have absolutely nothing to do with anything, that all decisions in all situations really have nothing to do with me as a decision-maker, I just assumed that I am in charge of some parts of this life process. But this is an unnecessary part thrown in, and an inconvenient one that causes trouble all the time of making identifications with the decision-maker within. All is well. All is well.