Three yahrzeit candles flicker on the mantel in front of a black and white photograph taken sixty years ago. The past few days have been a whirlwind of activity punctuated by fits of grief that seemingly come from nowhere and strike without warning.
I’ve been hit by these fits too, and I’m amazed. Over the years I have become so cold to the world, so disappointed by the way Evil and the stupid profit while the Good and the intelligent suffer, that I thought my skin was thicker. But there I was in the room of a dying old woman who honestly would have been appalled to know that I was at her bedside, turning away to look at the office buildings outside the window as I struggled to hold back the tears. “If you’re going to blubber I don’t need you here,” the Wife had threatened. I was supposed to be her rock, but my tears were quickly eroding it.
So I turned an objective and clinical eye to the proceedings instead and found comfort in Science. The “tree” of instruments and machines keeping her mother alive were accomplishing their task -maintaining her condition – and could have done so seemingly indefinitely.
Her body was racked with cancer. The metaplastic breast cancer that had been excised six weeks ago had been thought to have been contained; the metastatic work up on her had been negative. But the surgeon had seen a “few nodules” on the scans of her lungs, and we knew that this particular type of cancer really “liked” the lungs – as well as other viscera. Her surgeon and oncologist were confident they had caught the cancer in its tracks, but the Wife and I weren’t so sure. The mother-in-law began to experience gut pain, and her doctors felt that this could have been caused by a bowel obstruction brought about by the pain medications she was on. She was brought into the hospital and two weeks ago had a laproscopic bowel resection. They pulled out a fist-sized bezoar that “didn’t look like cancer”; of course a few days ago the pathology came back and it was.
During the scanning in the interim the “few nodules” became “numerous nodules” on her lungs, and were deemed “consistent with metastatic disease.” Up to this point God had merely winged her; He finally hit His mark – and it was up to the Wife to decide her mother’s fate.
The tree maintained her bodily functions. It fed her milky-white nutrition through a tube. It extracted her urine and feces from other tubes. Another tube filled what looked to me like a coin sorter with fluid from her lungs. Other tubes pumped in vancomycin, fentanyl and other drugs. Then of course there was the ventilator that every few seconds pumped her chest up with oxygen and made her head jerk backwards. Her eyes were slightly open but it was clear that she was gone. The tree of life kept her body alive, but my Wife’s mother was gone and nothing was going to bring her back.
The old woman had plans. She had planned a trip to the Copper Canyon in Mexico with the Wife in November. She wanted to stand on the Great Wall of China, and the Wife had struggled to find just the right tour package that could make her wish come true. In the days before her mastectomy she had insisted on getting her nails and hair done, and while in the hospital fretted about the condition of the bushes surrounding her house. We assured her that Fall was not the time to be trimming bushes, but she never seemed to believe us. She planned to see Beverly Hills Chihuahua with the Kid next week when it opened. But these plans like so many others of the dead simply evaporate with their final breath.
On Thursday there had been a change in her condition; the ventilator settings had to be increased and her blood pressure was falling. The Wife called me at work, and I came home to get her; we then stopped by the Kid’s school and pulled him out of class. “I knew this early dismissal wasn’t going to be good,” he said as we drove to the hospital.
The Wife met with the team of doctors assigned to the Mother-in-law’s case. There conclusions were undeniable. Her mother had metastatic cancer of the metaplastic variety – one of the rarer forms out there that’s so rare Medicine doesn’t know how to treat it. The fungal pneumonia which infected her lungs was not responding to treatment, and her prognosis was poor.
How long could she stay on the “tree”? The Wife learned that some patients in the ICU had been there for months with no hope. After awhile family members stop visiting, and they completely avoid the tough decision as their loved one lays entwined in the roots of the tree unable to escape on their own.
As as a doctor the Wife has seen death up close numerous times; I had not. I’ve reached an age where hiding from death is not an option and to support the Wife while her mother died.
An angel of sorts, a physician’s assistant named Carmelina, had attended to us throughout the ordeal. She took the Kid with her down to the cafeteria on break as the Wife and I stood at the mother-in-law’s side watching her draw her final breaths and our eyes glued to the heart monitor.
An old friend asked why the old woman disliked me. I wrote
I haven’t figured that out. When I first met (the in-laws)
in 1994 on the way to Africa I think I struck them as a bit of a
rube; my manners weren’t the best. The first time I ate brie was at a
restaurant with them and I made some stupid comment comparing it to
cheese-whiz. Her mother never liked the fact that I’m basically a shy
person; she often would force me to look her in the eye when I talked to
Truth is I wanted to like them. Since my father died when I was a kid and
the Wife’s read science fiction, was a scientist and historian and liked
computers – interests that I shared – I hoped to make some kind of
connection with him; but I never did. The conversations we had were
forced, and I always felt uncomfortable during them.
I cut their grass and did minor repairs around their house. When her
father came down with pneumonia, I was the one who drove him to the
hospital. I skipped work to take him to his chemo. Every crisis I was
there for them. But her mother would always claim that I did nothing for
them. When you would point things out, she would be surprised and not
remember them – or impugn my motives. Her belief that I did nothing was so
deeply ingrained that it struck me as pathological.
On top of this I proved that I was completely devoted to their daughter
and our son. She wanted to go to medical school, and I supported her
decision. Every scrap she got into with anyone I would always take her
side. “You always take her side,” her mother often told me – as a freaking
Meanwhile, slowly invisible lines were being crossed. On the Kid’s sixth
birthday we were at the in-laws house. Wife’s sister was at the time in
Cincinnati with her family. Wife and I were convinced that she was an
alcoholic and tried to convince the in-laws. She happened to call while we
were there, and the Wife refused to speak with her. This led to a huge fight
with her father screaming at me and kicking us out of the house. “This is
the worst birthday ever,” our son cried in the car. Her parents finally
realized that her sister was a drunk soon after, but the line had been
Wife’s mother was an emotional sadist. She would get into moods where it
seemed she took pleasure out of making the Wife unhappy, and that made me
bristle. You could watch her press the Wife’s buttons, probing her weaknesses
until she got a reaction. She seemed to take pleasure out of inflicting
After awhile I stopped volunteering to help. If the Wife asked me to help
them I did, but you can’t keep kicking a dog and expect him to run to you
when you come home.
Things worsened after her father died; her mother became extremely
negative and never really emotionally recovered from the loss. She also
became jealous of our relationship. “You have Scott,” she would
say to the Wife, “I have no one.”
I’ve shed some tears over her death, but I’m not sure why.
Why they didn’t like me? I don’t know.
She would have been horrified, but as I stood beside her and watched her agonal breaths I felt a deep sadness. This photograph had been slipped in a baggie and rested on her abdomen, a reminder of the life and vitality of the dying old woman. The fact that she had lived a full life did little to take away the sting I felt, and provided no comfort at all to her daughter that placed cool washcloths on her head and spoke gently to her, “It’s okay. Go to dad. He’s waiting for you.”
The heart monitor showed a rhythm over 90 beats per minute, but then it began to dip into the seventies, and surely but slowly it began a gentle descent. It reminded me for some reason like an aircraft coming in for gentle landing as it plateaued in the seventies for a few moments then glided into the sixties, then the fifties. The gradual descent continued and I noted the last vestiges of humanity leave the old woman’s body – what little there was left after all the suffering it had experienced over the prior weeks.
And a deep realization struck me. Whatever my rational mind tried to explain, my instincts told me that I was missing something. This was Death but it wasn’t the end for the old woman; there was something else that existed beyond it that was as real as the machines and tubes before me. It is an innate knowledge – something so visceral that I really can’t explain it.
All I can say is that I may deny the existence of a God, but it’s getting harder for me to state that there is nothing beyond death. Granted I have no proof of this beyond a feeling, and recognize that feelings can be viewed as the results of uncontrolled emotions, hopes and dreams. But when I objectively consider this feeling, the rationality seems almost as childish and empty as an atheist considers a belief in heaven to be.
The mother-in-law is dead, but I feel that she isn’t gone. It doesn’t make sense I know, but then again so many things don’t. Wrap your mind around the wave/particle duality and tell me afterward if that is any less stranger than the possibility of life after death. But I have no proof beyond pure instinct; there’s no double-slit experiment that can conclusively prove it.
Science and Faith. Both have their faults, both their strengths. Blend them together and I think you have a better more accurate representation of reality than either alone. At the very least the combination strikes me as more humane.
The heart monitor descended into the thirties than glided in for a landing at 0. A nurse came in and turned off the monitor. I hugged the Wife and we turned and left the room.
The photograph sits on the mantel and the yahrzeit candles burn into nothingness.