April 21, 2008--Snowbirding: Mothercare

Though you hope that when your time comes you will be ready, there is in fact nothing that can adequately prepare you for when your mother has a life-threatening illness. As did mine two months ago.

All your experience with your mother and sickness is from when you were stricken and she was selflessly there and, you thought, would be, eternally to care of and protect you from treat and danger. So my first sight of her in the emergency room and then a day later in the Intensive Care Unit to which she had been transferred shook me at the center of my mortal being.

There were four phone messages from my brother when we returned from breakfast. This is never a good sign. We of course feared the worst. The last time there had been so many voicemails in such a short period of time was three years ago when my cousin Chuck died suddenly while exercising in the gym. We are not a family that does that much telephoning or leaves messages unless . . .

In actuarial terms, my mother, just a few months short of 100, is the last survivor from her generation and is thus, by every expectation, euphemistically next in line. Though Chuck’s premature passing disrupted that protective sense of security and unleashed shock waves of anxiety among all the grieving and surviving cousins.

It was thus with fear for some version of the worst that I returned my brother’s call.

He is a cardiologist in South Miami and, though he is used to medical crises, I could tell from his voice that he was calling as a brother and not a physician. “What is it?” I managed to ask. “Something bad I assume.”

“I just got a call from the paramedics. They have mom and are taking her to the Florida Medical Center.”

“Is she . . . ?”

“Yes.” He knew what I was asking. “But I don’t know her condition. From what they told me I think she had a heart attack or a stroke. But she’s conscious. Which is good, but at her age . . .”

I knew enough about medical emergencies for someone of her age not to need to have my brother complete the sentence.

“We’re on our way there right now. They’ll take her to the ER.”

“We’re on our way too. We’ll see you in about half an hour.”

I didn’t need driving directions. I knew how to get there. My father had died in the same hospital more than ten years ago. And I thought, Isn’t it a good thing we’re here snowbirding in Florida. Next I thought, I hope I see her before . . . And, even more personally, What will I do now if . . ? This latter thought was the first fearful inkling I allowed myself to feel of what ultimately, if after Chuck we returned to “proceeding” in order, what my life would be like if . . .

* * *

We arrived at the entrance to the ER just as the ambulance that had brought my mother to the hospital was about to pull away. I peered into the faces of the paramedics to search for any hints that would yield about the status of her condition. I was neither calmed nor made more anxious by their noncommittal look. They had obviously seen worse. And, I tremblingly imagined, better. They were busy changing the sheets on the gurney, readying themselves for the call that would summon them to their next run; and by professionally ignoring me they signaled that it was not their responsibility, or in my best interest, for them to share or for me to receive medical information from them. It was probably that bad.

They had completed their job—they delivered her there alive (how alive is what I was desperate to know) and in one piece. Still I leaned beseechfully in their direction. But before I could approach them, knowing they would have little to offer beyond what my bother had reported, still eager for any shred of news, their radio crackled and, as if liberated from me, they jumped into the front seats, pulled the doors shut, and raced off. For them another day at the office. For me . . .

And then the first of the waitings began. First to be admitted to the ER itself. They had a strict policy that only two family members at a time are allowed to visit with patients. Since we were told to take seats among the parents with small children, most of whom appeared to have the flu, we knew that my brother had already arrived. And since he was the doctor in the family, this was good news. It would assure that my mother would be the beneficiary of whatever professional courtesy was offered in even a rough-and-tumble ER. And, truth be told, I still needed more time, after the wild drive down the Turnpike, to collect my thoughts and prepare a face to present to my mother that would communicate concern and love and strength she could depend upon while masking the anxiety and fear I was experiencing.

My brother came out through a side door and said that it would be all right for us to bypass the rules—things were quiet in the ER and we wouldn’t be in the way of the staff (the first of the small but welcome courtesies)—and could therefore come in to see mom. Though they still hadn’t run all the tests that they would through the next few hours, he reported, to our great relief, that she was indeed conscious and, by his assessment, because of the symptoms he had observed—a slight slurring of speech--had more than likely had a small stroke. Again saying, “But at her age, no stroke, if it turns out to be that, is ‘small.’” And added, “So don’t dawdle.” With his trained and experienced eye he had undoubtedly noticed I was lagging behind Rona. “She’ll be comforted to see you.”

I took that as my mantra during the next two months. Lacking any medical expertise, I came to learn that what comfort I might be able to bring as she moved from ER to the ICU to a regular hospital room to rehab, as she worked her way up the chain of care and restoration, could also be restorative. And so I did my best to do so—to bring comfort. And came to feel, which she confirmed in many subtle and direct ways, that this kind of involvement is an essential complement to all the testing, medications, and other treatments others were well trained to administer.

But I’m getting ahead of myself, though I do so intentionally in order to remove any false drama from this account. I want you to know that my mother is well, back home, living independently, and has no lingering effects of what in fact turned out to be a “small” stroke. So much so that she is right now taking an active lead in planning the ways in which she wants in late June to celebrate her centenary.

Having said this, trying to offer comfort to a mother who for some weeks was dangerously ill was not as benign for me as I had imagined it would be when my brother in effect said—You will bring her comfort.

One of the frequent side effects of a stroke is depression. Not just for the obvious reason that one had just had a potentially life-threatening physiological event (doctors I learned called these things that—“events”), and who after that wouldn’t feel depressed; but there is clinical evidence that the depression also can be just as physiological as the stroke itself.

Thus the first kind of comforting I was able to bring involved trying to help raise my mother from her understandable or metabolic depression while she was still in the ICU—she needed to be there for the careful monitoring it provided—so that she would agree to eat something. This was extremely important, I was told, since the IV feeding was insufficient to help maintain her weight, which would be subsequently important if, in the felicitous words of one of the nurses, “She makes it [i.e., lives long enough] to rehab.”

To Be Continued . . .