Sunday, January 26, 2014

No. 130 – Hemispheres

Performer: Rush
Songwriters: Geddy Lee, Alex Lifeson, Neil Peart
Original Release: Hemispheres
Year: 1978
Definitive Version: A View From The Palace, 1994. Why? Because I was there.

OK, so I’m cheating a little bit here. This song’s placement is based entirely on the Prelude, which, when you think about it, is pretty much a condensed version of the entire song. My house, my rules …

When I left Columbus in late February 2011, I knew Mom was going to die soon. I just didn’t know how soon.

The plan was she’d take care of herself at home with the regular assistance of a home-care nurse. In two weeks, I’d come back and we’d determine the next step, which I suspected would be hospice care.

Remember that wording about the best-laid plans? Within days, it became clear that Mom was having trouble. She seemed clear, but she was having difficulty speaking. When she could speak, she said she was having a lot of nausea. When I spoke with her on the 27th—less than a week after I’d returned to Chicago—she made her feelings clear: She no longer thought she could take care of herself. She wanted to go to assisted living.

I was on the road the next day to help her make that move. Scott planned to meet me at Mom’s, where I assumed we’d be taking her to Mayfair. Scott and Sally had been working on it over the phone. However, the oncologist had to sign off on it, which meant she had to see her first to satisfy the requirements of insurance. I called Jin and told her to get on a plane as soon as possible.

We also made sure that the home-care nurse would come over after we arrived late in the afternoon. Mom was supposed to have assistance four or five times per week. As I had learned, however, she refused to let the nurse into her condominium out of fierce determination to do things herself.

When Scott and I arrived, Mom’s condition was worse than I imagined. She was downstairs, thinking that she was going to Mayfair. No, she hadn’t been cleared for that, I explained, due to insurance. She couldn’t speak except a series of “yeps” when asked anything. I told her the home-care nurse was coming over soon. “Yep.”

I suppose in retrospect I should have taken Mom to the hospital then. If I had to do it over again, that’s exactly what I’d do, but no one indicated that we were as close to the end as we were. Mom didn’t want to die at the hospital, and I was going to do everything to make that possible.

The nurse, who had seen Mom a few times, as it turned out, took care of Mom as best she could, although truth be told, there really wasn’t much she could do. Then she pulled me aside in the kitchen.

Your mother doesn’t have much time left. I know. Then the nurse told me that she and Mom had a heart-to-heart talk earlier in the week. She said Mom had a lot she wanted to tell us and that tonight was a night to talk.

I thanked her for that, but, really, what was there to say at this point? Mom barely could speak. Scott and I were in no mood to trouble her any more than she already was. Jin wasn’t even there. The things that Mom wanted or needed to say, she said—to the nurse.

The more I thought about it, the more I realized that that was exactly what Mom wanted. She wanted to deliver her valedictory … to someone who didn’t care, who wasn’t there and couldn’t respond. After Mom died, I never contacted the nurse to ask her what was said. It was said in confidence, and that was how it stayed. I’m sure that by now the nurse long has forgotten it anyway.

Instead, all Scott and I said was we’d be back tomorrow to take Mom to see her oncologist. Then we took Mom upstairs to her bed … since her oncologist didn’t believe that she needed a hospital bed downstairs—based on Mom’s insistence—and therefore didn’t approve it for insurance purposes.

The next day was March 1—a bright, chilly day. Scott spent the night at Dad’s condominium with me, so we could take Mom to her appointment bright and early the next morning. The drive to Mom’s condominium was fraught with worry. I figured it was at least 50-50 that we would show up and find Mom dead in bed.

Instead, we again found her downstairs in her rocking recliner, incapable of communication, still seemingly in incomprehensible pain. We bundled her up and drove her to see her oncologist … who made us sit in the waiting room for 10 minutes before seeing us. Yes, that’s despite the three very prominent, very ugly tumors protruding from Mom’s neck.

Finally, the oncologist saw us, and in just a few minutes sent us on our way … not to Mom’s preferred Mayfair but to the hospital for immediate care. “Your Mom doesn’t have much time left,” she said as left. Yeah, I got that.

Scott and I took Mom to St. Ann’s—the last place she wanted to go—and all that was on my mind was to get Mom as comfortable as possible wherever she was. Of course, being in a hospital, it was a lot of hurry up and wait—wait for the next attendant in check-in, wait for a wheelchair, wait for a room in ICU.

Finally, they got Mom into a room and began to work on her in earnest. She had a dilauded drip hooked up, and that gave her a little bit of comfort, but only a little. She still was in a lot of pain. A doctor saw that Mom had a serious infection at her feed tube, which wasn’t a surprise to me considering that she had been allowed to do this herself. He said Mom’s feed tube needed to be replaced.

In retrospect, I should have said don’t bother, but I still had no idea how little time was left, and I thought it would help to ease Mom’s pain. Instead, it only caused her more pain, which is exactly what a terminal cancer patient needs, amirite?

While they swapped out Mom’s feed tube, the staff psychiatrist pulled me aside. He said it was clear that Mom needed to be in palliative care. It was what I wanted, too. Unfortunately, all the beds in the palliative-care wing, around the corner from Mom’s room, were taken. He assured me that he would do everything he could to get Mom into palliative care as soon as possible, and I believed him.

I sent Scott on his way and said I’d stay at the hospital—with The Sea Refuses No River seemingly on endless loop in my head. (Hemispheres was one of the big songs on my computer’s iTunes plugged into my car’s aux jack at this time.) Dad was heading to the airport to pick up Jin and Bridget.

I went in to see Mom. She seemed to be doing a little better, and she expected me to also take my leave as Scott had earlier, but I said I could stay for a while. She said “Sit,” which was the first word that I’d heard from her that day that wasn’t “Yep.” I sat in a chair that I pulled closer to her bed.

Mom hit the pain button on her drip as much as she was allowed, but it didn’t seem to be enough. I wondered whether palliative would be any better, but I kept my doubts—and I had a lot as I’ve intimated—to myself. It wouldn’t do any good bringing that up NOW.

I told Mom the hospital was working on getting her into palliative care. Her oncologist would come by tomorrow and hopefully we’d get her to Mayfair after that. That seemed to cheer her up a bit.

I talked about work and Laurie and Henry—small-talk types of things, really—just trying to keep things as normal as they could be given the circumstances. Finally, there wasn’t anything more to say.

I told Mom that Jin was coming into town, landing even as we spoke and as the sunlight began to fade. I told her that I would be back in the morning with Jin, so I would see her then. “Yep.” Then I told her I loved her and gave her a hug and a kiss on the forehead.

And then I left.

(To be continued)

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