It seemed as though I had just settled into my new teaching position in a baccalaureate nursing program. After three months of intense work and adjustment, I was really looking forward to the two week Christmas break and to seeing my mother and father some 900 miles away. With the holidays only two weeks away, I decided to do a little shopping. When I returned home that evening, my dad called and said, "You better come home, NOW! Your mother was just admitted to the hospital and she is very, very, sick. I took her to ____ [his internist] this afternoon and he took one look at her and said we needed to get her to the hospital right away. Her stomach is really swollen and the doctor said she may have a hernia but I don't know, you better plan to come home early."
I called the Dean and received permission to leave two weeks early. I threw the Christmas gifts in the back seat of the car along with a few pieces of clothing and rushed to get on the interstate. While on the road, a number of thoughts crossed my mind. i.e., This was not a good time to have a hernia!; What if it is something more serious? What if mother dies? Suddenly, thoughts of losing my mother came back. Since my mom and dad were getting older, I had often thought that one day, but not now, I would lose them and at these times I would try to imagine what my life would be like without either one of them, sort of a mental rehearsal. As the only offspring of our family unit and with few relatives, compounded by my impending divorce, issues of loss were more frequent. I coped by pushing these thoughts out of my mind and on this day, was quite successful in doing so once again. I thought to myself, "Mother has always been so healthy, it must be just a hernia. Dr. ____ would not have said hernia if he suspected something more serious. I'll get home and mom will be in the hospital a few days and everything will be alright as always.
When I arrived at my hometown, I thought it would be a good idea to stop by the hospital to see mom first. After all, I was driving by the entrance anyway and I thought maybe I should check out the situation first-hand. I remember passing the unit desk where I had worked years before and thinking "where are the nurses?" [No one had on a nurses cap!] I quickly sauntered down the hall with what mother use to describe as my "nurse walk"--fast forward! Her room was empty. A woman in white uniform with mop in hand informed me that she was in X-ray. I quickly went to the front desk, looking a bit frantic, I asked, "Where is the nurse?" A young woman in white came forth and explained mom was in X-ray and the doctor left a message for me to call him [I had worked with him in the past as a staff nurse in this hospital]. She handed me the phone and I was quickly able to talk with the surgeon. "I am 99% sure it is ovarian cancer. I wanted to tell you before you spoke with your mother or father." I stood there in a state of shock. It felt like a thunderbolt of lightening went through my body. I was speechless. I quickly travelled home to see my dad. When I walked through the door, Dad was on the phone with a family friend telling her that mom probably had a hernia. Dad looked up and saw the expression on my face and his smile quickly turned to grave concern. When he hung up the phone he turned and said, "What? What is it?" I explained what I had just learned. I have never seen my Dad so hurt. We sat together and cried uncontrollably. We were stunned, caught off guard. We sat clutching each other not able to say a word. We pulled ourselves together and decided to get to mom's beside as soon as possible. My mother was in surgery when we arrived at the hospital. After about two hours, the surgeon came walking toward us and opened his mouth to say, "It's ovarian cancer, it's so bad, she's just eat up with it" [a not too uncommon cultural slang]. I could not hear anything else. My dad looked dazed. The only other comment I heard was that they could not remove all of the tumor and they would be starting chemotherapy after Christmas. I asked, "Does my mother know?" He replied, "Oh yes, I talked with her after the X-rays." My next thought was, "Oh gosh, she was alone--without us--when she was told." I was horrified at the thought of leaving the hospital before my mom returned from the X-ray department. I slept on a chair next to her bed that night waiting for her to fully awaken from the anesthesia. Mom sat straight up in the middle of the night, wide awake, calling out, "Where am I?" After a few minutes, while sitting on her bed, we began crying. "Mother, I am so sorry I wasn't here for you when the doctor came to tell you." My mother replied, "Oh, I wasn't alone. The dearest young nurse was here. She held my hand the whole time and comforted me. I cried the entire time and she was so gentle. She put her arm around me and held my hand and said, 'You know Mrs. ____, none of us knows when our last day will be. I could leave here tonight and be hit by a car while walking across the street. No one knows for sure except the man above when our last moments on earth will come.'" My mother explained that the nurse stayed with her until mom was able to gain her composure and that they sat silently, hands clasped for some time. Mother said that without the kindness of the nurse, she didn't know what she would have done. I will never forget that nurse, whoever she was, and will always be grateful for the fact that she was there and she knew exactly what to do and what to say at the most difficult time of my mother's life.
Over the next 18 months my mother survived two more surgeries and many ups and downs. She mostly remained close to home, although she was well enough to take a trip at about 13 months after this ordeal. At my mother's insistence, I remained in a nearby state due to many reasons, and travelled home frequently. During the whole period, I often grieved. I would be sitting in my living room and all of a sudden, burst into tears at the thoughts of losing my mother. I also grieved the loss of my mom as a confidant. My divorce would soon be final and I could not share my feelings about this loss with my mother. Her focus was on day to day survival and a struggle for hope just to get through each day. It was the most difficult time of my life. I can remember being distracted at work, having difficulty concentrating and having colleagues remark about my inattention. I remember not having an appetite, losing weight, and joining a number of organizations in order to avoid thinking about all the losses. I remember the trips home when mother seemed distracted at times, pulling away from us. I remember that she was always hopeful, or at least seemed to be around us. It wasn't a false hope, but a hope for each day. At one point she was planning to try a new experimental treatment and remarked, "If this doesn't work, we all know what that means." I can remember trying to comfort her but never openly talking about the end of her life and I have mixed feelings about that. I do not know whether we were trying to protect her, ourselves, or whether she was unable to discuss the inevitable or feared hurting us. I do know that she was determined to "beat this" and struggled every day to be brave and hopeful. It did not seem fair to discuss the end when she was struggling to be positive on a daily basis. Right or wrong, we managed the situation the best we knew how at the time although it was some time before I came to this realization.
I was called to come home when my mother entered the hospital lethargic, some 18 months after the initial surgery. She was in a coma when I arrived the next day. My father, my aunt and I sat up around the clock for five days, dozing off here and there. I remember not wanting to let go, needing to be there at her side. I remember her groans of pain as her obstruction progressed. I remember impatiently pressing the call button asking for pain medication. It seemed that the nurse was always late coming with the medication. I realized later after timing the nurses response, that five or ten minutes was the actual time, however, to me it seemed like an hour. The agony I felt watching my mother move about in the bed in pain was indescribable. Helpless is what my dad and I felt. Helpless to relieve her discomfort. All I could do was talk to her and tell her I was there and how much I loved her and what a wonderful mother she had been while constantly holding her hand. I cleaned her dry mouth with lemon glycerin swabs, placed cool washcloths on her forehead and taught my father how to do this as well. It was some comfort to be able to do something for mother. It helped to relieve our feelings of helplessness. Exhausted, we held a family meeting in the waiting room, a quiet room that looked just like a living room (what a comfort). The doctor offered another experimental drug that may temporarily shrink the tumor. We had a very long talk and decided it was now time to let her go, that God would take care of her and we needed to care for ourselves as well. This was a pivotal moment. We decided to go home and sleep in a real bed and sit together for our meals. I requested that the nurses promise to call us if there was any change for the worse. I said goodbye to my mother two days later and returned to my then home base out of state. Five days later I received a call from my father. Mother died in the night--alone, without any of us.
Looking back, the most vivid memories I have concern communication. As the years went by I often felt guilty about not confronting my mother and attempting to force her to talk about her impending death. I regretted leaving the hospital that December day rather than waiting for her to return from tests. I was angry at the insensitivity of the surgeon and of one of the IV nurses who splashed blood all over the sheets when changing the IV and failed to replace the spotted sheet with a clean one. I was upset for a long time because the nurses failed to keep their promise to call my father when mother's condition worsened. I thought if only they had called, mother would not have died alone. I was consumed with thoughts of abandoning my mom. I thought I should have moved home and given up my career even though my mother asked me to go on with my life and to stay where I was at the time. These thoughts persisted for a number of years until finally, I realized that we managed the situation the best we could at the time and that although we were not with mother when she actually died, God was with her and I know that he held her close and that she was protected.
To this day, fifteen years later, my father remembers the perceived harsh words of the surgeon as he explained the extent of my mother's cancer. From time to time Dad remarks about that moment as though it happened yesterday. I urge my dad to forget the insensitivity of the surgeon, explaining that he is really a good doctor and a good man, who unfortunately, had no idea regarding the impact of his words. He was a general surgeon, it was a long time ago, and it wasn't until recently that medical schools include very much didactic on communication, death and dying. He was a country boy, and rather than using a more sophisticated approach, he used regional slang. Unpleasant thoughts are overshadowed by my mother's story of the nurse who was there for her and held her hand. I have great comfort knowing that my mother was not alone when she was diagnosed and that a compassionate professional made up for whatever was said to her by the surgeon when he chose to break the news without any family members being present. It is unfortunate that I will never know who she was and never be able to thank her. Somehow I suspect she knows the extent of our gratefulness.