The Thing About Mom
I feel like I should write about Mom here, but I just don't know that I have the energy. All updates about her condition thus far have been via social media, although I have included them in all the daily morning "My tweets" posts, even though the Mom updates have really only been on Facebook—Facebook is what those posts link to in the digest posts.
In summary though, Mom woke up Thursday morning with slurred speech and respiratory distress, prompting Mary to take her to the ER, from which she was transferred to Kootenai Health, the hospital in Coeur d'Alene. They took her to the ICU for oxygenization and kept her overnight. According to Christopher—as told to Dad on the phone on Sunday, when he called to wish him a Happy Father's Day while Shobhit and I happened to be there in their backyard—Mom was otherwise alert and normal, at least for her, when she left. The told Christopher goodbye like she expected to see him again.
But, then she had a massive stroke while in the hospital on Friday morning. They asked Bill for the go-ahead to give her a treatment for blood clotting, which they had to inform him carried a 4-6% risk of causing hemorrhaging. This was where some terrible luck came in: Mom became one of those 4-6%, and she suffered massive bleeding, for which there is no surgical option, on the side of her brain that had not already been affected by her 2014 stroke.
She has actually been on a respirator since Thursday. I have spoken to one doctor or another every day between Saturday and yesterday: two ICU doctors and a neurologist. I asked the neurologist on Saturday what he thought Mom's chances were, and he said, "Forty percent chance of a good outcome." I failed to ask him to define "good outcome." Just, not dying? Christopher told me a couple of days later that, after they surprisingly let him and Bill visit Mom together on Monday (even though their current policy is one visitor per 24 hour period, because of COVID-19 precautions), he asked what would happen if they took her off the ventilator. He was told then that "She would probably pass pretty quickly."
Dr. Murphy, the ICU doctor who had been there until yesterday, clearly felt really bad about the hemorrhaging happening, and Bill had been so upset about that the day before that he hung up on her. My first phone call with Dr. Murphy, she actually broke down and cried a little herself. I don't blame her for anything at all, though. I mean, would Mom be any different now had they not tried to treat the blood clotting? Clearly not.
That said, Dr. Murphy tried to be optimistic at first. She told me at least two days in a row that Mom seemed "better than expected," and at least once, on Saturday, she wiggled her toes when prompted to—but has not responded to any such commands since. Dr. Murphy also told me more than once, "She won't come out of this without significant disability," which I am beginning to think was a euphemistic way of saying "She's fucked." The only thing that would even indicate she's "still there inside" would be for her to respond to commands, which she has not done. She is probably not likely to.
The new ICU doctor on rotation as of yesterday, Dr. Straight, was a guy who seemed, well, a little more straight with me about it. Shobhit even asked him what he would do in the same position, and even though he didn't outright say "pull the plug," he might as well have. It was after the conversation with him yesterday that I let go of whatever hope Dr. Murphy seemed to have, and finally settled on the opinion that she should be taken off the respirator. I spoke with Christopher for a few minutes on the phone yesterday and I said, "I think it's time to let her go." And he agreed with me.
The real issue now will just be getting Bill on board. Bill does not have the emotional maturity, capacity or bandwidth to handle any of this, but we are stuck in a scenario where it has to be his call—he's the husband. Mom actually asked me a couple of years ago to be her Medical Power of Attorney, for just this reason: she wanted me to be the one to make this call, because she knew Bill would not want to. Also, Bill is understandably devastated, confused and frightened. Stupidly, I kept putting off making sure this Medical Power of Attorney thing got done, assuming I still had time. And then I let a couple of years go by along with my usual twice-a-year visit going down to only one last year. I should have done this during our December visit last year.
Not that it makes any difference dwelling on regret now; all that matters in this moment is that it's Bill's call. Shobhit said multiple times yesterday that he feels this was better, as he doesn't think that burden should have been mine, and now when the call is made the results won't be something I can be blamed for. That's just the thing, though: if we were honoring Mom's wishes, which are actually what are most important here, then I would have done what she asked for long ago. But, whatever. This is the reality we are facing now, and I can only hope that Bill doesn't drag his feet too much about it. Dr. Straight told me some kind of decision will have to be forced in the next couple of days, as they can't just keep her in the ICU. Either take her off the ventilator, or transfer her to a nursing care facility where she will still just be kept on a ventilator indefinitely. And we all know Mom was adamantly opposed to such a thing.
Christopher did tell me yesterday that Mom "did make a more recent change" in her wishes, where she would want to be kept alive if there were any hope of recovery. But even Christopher sees that there really isn't any such hope. Shelley, their close friend who had been their PSR worker but moved to Whidbey Island a couple of years ago, is considering a trip over there next weekend. I have already told her that whether she's there in person or not, she may be uniquely positioned to talk to Bill about doing what's best for Mom, as he is likely to listen to her.
Anyway. Nikki visited Mom on Sunday. Christopher and Bill were allowed in together on Monday, and Becca actually drove from her and Tyler's home in Lake Stevens (near Everett) to see her yesterday. I had phone calls with both Nikki and Becca yesterday while Shobhit was driving us back from Long Beach, and they were so devastated by what they saw when they were in the room with Mom, they in effect both told me I have made the right decision not to see her in this state. If she were conscious and alert, and the prognosis were still dire, I'd be over there already. But I'm seeing no hope for recovery, and no sign of her waking up, in which case I truly don't see the point. Becca, who spoke to me literally minutes after leaving the hospital, said, "I hated seeing her like that." I said, “I’m not sure I even want to see her like that,” she replied, “Trust me, you don’t.”
When Nikki called me shortly after I posted yesterday's update to Facebook—and Shobhit and I were still in the middle of our drive home—she effectively said the same thing. She told me when she entered the room on Sunday, she was absolutely not prepared for what she was about to see, an immediately started bawling. She even mentioned another family member whose open casket funeral she had attended, and she had gone to look at the body. "Now whenever I think about that family member, that's how I see her," she said. In other words, she was totally on board with my not wanting this to be my final memory of my mom.
For just a little further detail, you can read my daily Facebook updates as indicated:
Thursday
Saturday
Sunday
Monday
Tuesday
My stance now is just: I'm waiting. For the inevitable. I really don't want that unnecessarily drawn out, and that part's going to be up to Bill. Christopher said he and Bill were hopefully going to visit again today, and I have encouraged him to have a frank discussion with the doctor and talking to Bill in particular about how stark their options are. I've been getting updates from doctors daily, but haven't spoken to one this morning. Shobhit and I both agree there's really nothing new we can learn anymore. Mom won't be going home again. We need to let her go, and what's done is done. I've held it together pretty well so far and am still working today, but I don't know how well I'll do once the deed is actually done, or how long it will take—how many days, if any, she will last after being taken off a ventilator. The first step is just getting her off the ventilator, and I don't think even that has happened yet.
[posted 12:23 pm]