Facing the inevitable

I was at my dentist’s office waiting for a root canal treatment, loaded with lidocaine. I had sent my chauffeur (In India around my friends we call them drivers) to be at my mother’s place when the palliative care specialist arrived, sent by Dean Foundation ( A Charity Organization) with their entourage of nurse, SW and their employed physician. This was the second time. The driver has been a part of the family, for ten years, young in his early thirties and treated like a son by my mom and others in the family. He could fill in details apart from what the caregivers tell the specialist and I was just a phone call away.

My mom got seen by the Specialist and they had a short conversation. It was around 12.30 PM. The driver’s wife I had employed for this month to help the day caregiver as my mom entered the end of life care a couple of weeks ago. Her medicines were stopped and symptomatic relief was given be it pain or sleep. Mom had been to the hospitals thrice in the last one and half months and was told to me by the Physicians that we had to make a choice of what we wanted as outcome for her. I was struggling with my emotions, spoke to my brothers and my family and all of us had decided on palliative care. Still I was not comfortable with the decision we made as I had to carry out our decision. Then my mom one day during my roller coaster ride with the emotions told me that she just can’t do it and wanted me to pray for her to go. With tears flowing down, I listened. She said it. I was calm and repeated the question. “Mom, are saying you want to go?”. She said she was.

My wife and daughter flew down to spend time with my mom and my wife’s dad who had a pacemaker put in place. They had a week's time. My daughter would crawl next to her in bed and keep talking to her. When I was procrastinating to bring in the palliative care specialists, I was given an ultimatum by my daughter. Either she stays back and risks her job for which she worked hard and reached a position I am very proud of or get the specialists care in the next 24 hours. And I did. I approached, Dean Foundation, doing the very nature of work my mom needs. I was surprised by the humble work, Staff at Dean foundation carried out for the past 17 years. The Specialists came, spent nearly 2 hours with my parents, discussed with my wife and me about their nature of work and their recommendations. All medicines were stopped except the insulin and diuretic. Form ten to two appeared to be a drastic cut. But their explanations satisfied us. They were knowledgeable and empathetic.

My mother had the best sleep in a couple of years. She for once never complained about pain which was 24 hours before the pain patches took effect. She smiled. She slept for the first 72 hours with little wakefulness. The support staff I had employed took care to give her a sponge bath, change diapers, checked her blood glucose three times a day, used the oximeter to record the pulse and oxygen content, made sure the oxygen mask was in place for every four hours with a break of two hours and recorded the input and the diapers changed per day. They took care of the bed sores focusing sharply to get them healed as I have warned them that it was a sign of neglect. They were good and I am extremely grateful for a job I couldn’t get myself to do and they had being doing this for the past year and half.

My daughter and my wife left in a week’s time. Her speech, orientation was slowly getting better. But she was less expressive and getting tired very often. Her intake was getting to 650-750 ml of liquid, with some idlis (rice cakes) broken down and mixed with milk to make it easy to swallow. She identified people with the same alacrity, asked for people who didn’t show up, questioned whether I showed up everyday ( Here she feigned ignorance), She smiled more than I have seen in the past year and half during my stay. She was for once never complaining which was odd though to the liking of the caregivers. She thanked everyone for a change. Did she have a premonition, I don’t know. Whether the light was shining too brightly. Probably but I didn’t get the cue.

On August 11, 2015, she woke up as usual. No sign of difficulty noticed by the caregivers or expressed by my mother. At 1PM, my dad left the room with his walker to have his lunch. My mom questioned whether my dad was going to have his lunch. One of the caregivers went to her and asked whether she would like something to eat. She complained her throat was irritating and would wait to have some liquid. My driver’s wife went to check on her in the next ten minutes. She saw her eyes closed and assumed she was asleep. And as she was about to leave she noticed that my mom’s abdomen was not moving and she checked her breathing.

She couldn’t feel any air and put her hand on her chest which was not heaving.She told her husband, my driver. He called me and said that he was on his way. I told him to take his time as I was yet to get my root canal done with numbness spread to my side of the lip and gums. I have not felt the urgency in his voice before. He said he was coming to pick me up and my mom was not doing well. I called my friend to come home.

I checked my mom with oximeter, BP apparatus which was battery operated. and with my hands checked her carotids and it slowly dawned on me that my fears were coming true. I called in for a Physician from a neighboring hospital who confirmed my fears with an EKG that had straight lines. She was gone.

The next two hours my friend and my wife’s uncle organized to get the cooler to preserve the body. My dad was watching TV which I had bought and got it fixed in their bedroom, just a couple of weeks back. He was oblivious to the people walking in and out as it was the norm to do things for his wife. I looked at him and expected to see him turn his head as she was in a bed separated by a few feet and ask what was going on. But he didn’t. He dozed off around 3 PM. I took my wife’s uncle around 3.30 PM. Woke him up and said with a straight face-”Dad, mom has passed away”. He asked “What…?” I told him she was dead in my Tamil language. He continued in disbelief-” What?”. I said slowly. “She is dead, dad”. And there was a scream. I walked out. I stared at the kitchen door where the caregivers were instructed to stay and not cry. I was numb, spaced and with no tears. I opened the door for them to go and comfort my dad. I just couldn’t do it.