No Grieving, Please

No Grieving, Please

My mother was taken away in an ambulance to the local hospital this evening, the first time she’s been there since she was diagnosed with terminal abdominal cancer six months ago. At 87, she had long ago decided against heroic measures in the event of a fatal disability, and she had a strongly-worded Living Will notarized by the local attorney. I had arranged her palliative home care in the small Maritimes town my parents live in.

When I had last seen her, in July, she and my father were being cared for several days a week by a capable and trained home care attendant named Kathie Rose, she had started coming more frequently and was now there daily, walking the dog in the morning and cooking dinner in the afternoon.

The VON nurse, who had been coming once a week, started coming three times a week, then daily. By the time my mother left for the hospital, the VON nurses were dropping by three times a day, specifically to give her a laxative injection to relieve her constipation.

We had found out the constipation was not just caused by the morphine, it was due to an intestinal blockage - the tumour - and was incurable without surgery.

By this time my mother was so weak she wouldn’t survive surgery. Hence, the thrice daily injections. When mother discovered they were $85 a shot (covered, of course), she couldn’t help complaining weakly “$85 for a bowel movement!”. On the phone, I told her “Nothing’s too good for you, Mum”.

She has been on a liquid diet for close to a month, and reference to research on the internet shows that a bowel obstruction is very serious, and usually fatal if not attended to. It ends in vomiting blood.

Well, my mother started vomiting blood this afternoon. My father and Kathie Rose called 911 and the ambulance whisked her to the local hospital, my father following. We have no word on her condition, and won’t know for probably a day, when her palliative care physician visits her in the hospital.

I don’t think my mother will be leaving the hospital. I may be wrong, but she was very weak a week ago, and couldn’t talk on the phone two days ago. I don’t think she has the strength to overcome something as violent as abdominal bleeding and vomiting without clinical care.

This brings us to the heart of the matter. Mother has forbidden any more visits from her children. She has specifically forbidden bedside visits (she used to chortle at obituaries which stated that the deceased had “passed surrounded by his loving family”), and she had made us promise not to hold a memorial, service or gathering. She didn’t want her ashes scattered - we were allowed to have a party later, on our own dime, if we wanted to.

What can I say? My mother is old school. No pity, no regrets, a straight back, and onward into the fog. I think I’ll write a how-to book called “The WASP Guide To Death”. She has left her children in a very difficult spot. We all love her deeply, and we all obey her instinctively. None of us would dream of going against her explicit instructions.

I did once. She was badly constipated at the beginning of the morphine regimen (we found out later it was the intestinal blockage). I had the bright idea of trying Magnesium Citrate, an industrial-strength laxative given before barium scans. Mother wisely suggested she ask her doctor first. I got impatient and called the palliative care doctor, even though it was Sunday. I couldn’t stand the thought of mother being in pain. The doctor wasn’t in, was on vacation and wouldn’t be back for a week. My sense of control was slipping.

I called mother and left a message that I had left a message with her doctor. The next morning I got a phone call from mother and such a tongue-lashing as I’ve never had in my life. I was not to call her doctor. I was not to involve myself in her care anymore. I was not to speak to any of her caregivers, only her and dad. I was mortified.

So it was very clear. They had a small, fragile routine built up around mother’s increasing infirmity, with Kathie Rose and the dog and the nurses and the palliative care physician all pieces on the board, and they didn’t want any grieving children upsetting that. And mother didn’t want to find herself in a hospital bed surrounded by pitying faces. And she didn’t want a memorial of any kind.

We were five children in our fifties, just doing what our mum wanted us to.

But, as my wife said to me “What does that leave? You get a call one night that she’s died, and that’s it? You go to work the next day, you don’t gather at the bedside?”. No, we don’t, that’s not what my mother wanted, but I think, if she is not in command of her faculties anymore, and she’s in the hospital, then all bets are off.

I’m waiting to hear from my father. If mother is still in the hospital tomorrow, and likely to stay there, I’m buying a plane ticket to the Maritimes.

Update. My mother died at 10:45PM  EDT on September 20. She went peacefully, a minister by her side. My mother was a great woman, and she had a rich, full and exciting life. She served overseas in the war, and she traveled to every continent including Antarctica. Now I will learn what it means to care for an aging widowed parent.