Tuesday, March 3, 2015

Heart Surgery, However it Happens

Since I've been sitting in my mom's terrace-level apartment for longer than two weeks now while she starves her sturdy old body of food and most fluids I figure I should, after all, be unsurprised at how long it takes for her process to run its course. Many, many people by my age have undertaken one or more death-watch, but this is my first.

It is at a few moments horrible; as often as not it's mundane, in the sense that we're all so equally mortal, on a par with rotting tree trunks. Even the beloved. But it's been gratifying, giving me days and days of opportunity interwoven with a long, dwindling goodbye.

We were a small family headed by mature parents, my sister and I their only two children despite their previous marriages and upheavals and re-beginnings. We thrived on our folks' loving gratitude for one another set against their memories of much less harmonious households. From my mom I feel I've received a lifetime of intentional and inadvertent gifts made most valuable by the remarks and adventures that came with and followed from them. Early in our lives we girls in our sheltered, gently disciplined, freedom-filled years must have sensed that we had a degree of family contentment, along with the trips and holidays we could always anticipate, that most of the kids we met through school were all in all lacking. We certainly had affectionate parents, especially our mom, who grew up missing affection from her mom, and so my mother's unique sweetness to this day pervades the mood of this apartment half-buried in Boston-area snow, like a burrow I have largely disappeared into. Today, again, I felt myself stepping out in the sun.

The harshest parts of this age-appropriate dying that I witness in its progress have been the dunks into bereavement coming after little respites ever since before mid-February when I arrived from Minnesota. It's up till now been as if she keeps dying only to reawaken when I come to greet her next hour at her bedside. My mom chose this destiny months, or even years, before turning 90 because the recommended surgical reconstruction of her heart's main valve would have meant an uncertain recovery, possible death in the operating or recovery room, long and likely incomplete rehabilitation with a short future of narrowed scope afterward not to mention major expense to the family. There was too much risk for too little reward. When she told me her decision in the beginning of winter she said, "I've done everything I want to do." She denied that she had been depressed, instead summing up her recent years and months as a period of contentment. Somewhere in the late fall of last year she wrote the following to share with her community of well-educated retirees many of whom continue to enjoy lives of privilege:


Have you ever noticed how often your days are governed by your  decisions?  Simple choices, such as when you will get up to start the day, activities in which you will participate, or whom you will join for evening dinner?  Gone are the days when we were governed by job or family obligations!  Now we organize our time by which day of the week it is, what times we are due for appointments, for participation in club activities to which we are committed, or for time alone to watch favorite television programs or read interesting books.  Or, if we don’t want to do anything at all, just sit and ruminate, we can do that, too.  We are free agents.

We do, however, have one more obligation, should we decide to accept it.  We need to decide how we want to end our days -- a gloomy subject to contemplate, perhaps, but that’s where we are in life.  We’ve fulfilled our family obligations (or not, depending on the circumstances); we’ve made our financial decisions; now we look to an abbreviated future.  And this is when one item rears its insistent head:  how willing are we to die?  Call it what you will -- meeting your end; going the way of all flesh; passing away -- the fact remains that sooner or later all life ends.  Energy flags.  When a life begins, it will one day end.

So, the question remains:  How willing are we for our lives to end?  If the idea is abhorrent, then we will go to all available means to prevent or extend our lives.  No medical treatment is too extreme; no daily routine too fatiguing; no diet too restrictive.  If, however,  whatever is is, then we become more philosophical. We accept our diminished energy; we perform as best we can the duties and/or activities to which we are committed; and we carry on.  No hard feelings; no extreme life-prolonging measures.  Just acceptance.  So be it. 
by Ruth Katherine Beyer

By now she's lingered in her bed several intervals beyond what everyone expected. As I seize my daily chances to hustle outside for an hour or two I rehearse, again, dwelling in the knowledge that my mom is history, only a living presence I carry inside me, not a live person any more whom I can talk to. Unlike many survivors I've been given a chance to rehearse, since the likelihood has till now remained that I would go back into her apartment to share yet another conversation, if brief and repetitive. I walk in a madcap swinging manner in lug sole boots between the walls of snow and remember the character Prior Walter in the epic movie Angels in America which I was last week watching piecemeal each evening to my mom's amusement (she was no longer able to fix her attention on a movie whether she lay in bed or sat up to see the monitor.) Prior had climbed the flaming ladder to a godless heaven in order to confront death and plead for more life even in the face of all the suffering known in the 20th century and during the AIDS epidemic, to which he had fallen victim. He says of life that for him it's never enough; he can only, despite everything, want more of it. So, looking on the death that's most painful of any yet for me to behold, and most ever feared, do I.

This particular day I am watching her leave our realm of awareness; the nurse said the inevitable transition was coming soon.

To switch to another dramatic comparison, she reminds me of Sayward Luckett, the pioneer matriarch in Conrad Richter's novel The Town, unable to die yet even though she is days beyond being able to see or speak or gesture. She is a huge leftover tree from a virgin forest in territory that's been in her lifetime mapped and named Ohio, but is lying down, breathing, taking no sustenance. Her story was set before the American Civil War. My mom's is now, with upset of our climate set in motion. Live roots of her are tugging and snapping loose in my heart, and that's the heart-ache that's set me wandering between doorways of her apartment as my sister and I keep the vigil with our mom's prescribed morphine and Ativan. Where a root pops free of my own live nerve endings, I console myself--having prayed as I'm skeptically not given to doing--a replacement petrified root will fill the empty socket, because there's no way so long as I live but that she will linger in her own established place in my heart. Devout people are correct: praying softens grief. Something nebulous comes to fill a void and then we merge into hugeness, where we find ourselves adrift but easier in ourselves.

The gifts borne to me via the energy currents of my mom have kept coming through life and through the approach of death. Conrad Richter's trilogy in paperback, The Trees, The Fields, The Town itself was a physical gift that lives on a shelf in Minnesota--I don't recall the year she gave it to me. Since I've come to Massachusetts to see her along I've reveled in the gift of time, to expand a website and set up a marketing newsletter in email, to learn to use this Apple computer for my various purposes that are beyond the uses she had for it. I've sat here by the big window that by comic accident lost its curtain rod and drapes, exposing sky and treetops and neighboring rooftops to my mom's wandering eyes in a way that was quickly a blessing for her, and begun on my third miniature watercolor in just two weeks.

Sometimes now I am for a few seconds afraid that I'll never get over this sorrow, it's so deep and chaptered back into childhood, but after all I'm still sitting here with Ruth, my mother, who hasn't died yet. She has that matriarchal body, with a hardihood that I'm sure she's passed to me. Out these walls I know of infinite unfolding stories that would shrink our particulars all to drops of water. This newest miniature watercolor she saw and enjoyed in the developing; it was a natural piece of work given what the wide window shows of Massachusetts snowpack and what the bed shows of a woman's body shrinking ever deeper into slumber. The birds are a reminder of what has kept making people want to come back.


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