My hands are raw from Purell and washing them in hot water for as long as it takes to sing Happy Birthday. The length of time preschool teachers tell their students it takes to get rid of germs. My mom was a preschool teacher. Miss Barbara. Purell has become a verb. “Purell your hands before you come in here!” Mostly for her sake. The leukemia from which my mother suffers has suppressed her immune system so we cannot risk infection. Everything in the hospital is a-glow, in my mind, in a germ aura. We move in a bacteria/viral/fungal cloud. We have to protect ourselves. We have to protect her.
We have hope for the former. None for the latter. My mother has migrated from curative to palliative care. Hospice.
She arrived from Florida a couple of weeks ago, on Halloween, to explore treatment options for acute myeloid leukemia, but during one of her doctor appointments to do just that, she is so short of breath that she has to pause every minute or two to gasp. I watch her struggle as she creeps down the corridor in the bright red quilted jacket that she reserved for trips “up north”. Her blood count is too low to risk removing the fluid that an X-ray reveals between her chest wall and her lung, though. One pinprick and she could bleed out.
“You’re scheduled for a transfusion on Monday anyway,” says the hematologist, Dr. Ruskin. “Go home. Rest. After the transfusion we will extract the fluid and you’ll feel more comfortable.”
As will often happen over the next few weeks, the target keeps shifting; we lose sight of the goal. We forget about leukemia treatment and just hope she can breathe through the weekend. She can’t.
Mom, who was staying with my sister Suzanne, knocks on her bedroom door Saturday morning, scared and desperate for breath. Suzanne calls me; they head to the ER immediately and ask that I to meet them there. I rush in, desperate to find them, and I’m met by a Rent-a-Cop reading Rifleman Magazine “guarding” the entrance. Just in case that did not tip me off to the clusterfuck into which we were about to sink, the 3 ½ hours of mayhem in the crowded, blue-curtained ER cubicle left no doubt. We helplessly watch her discomfort escalate while myriad doctors, nurses, and various other unidentified scrub-clad clones poke, prod, and ask repetitive questions while they joke with each other and roll around the floor on wheeled barstools, staring intently into attached computer screens. “Missing Zacky’s soccer game this morning,” one says, making a little pouty face. “That might not be a bad thing!” chortles another, eyebrows raised. “Fuck you,” I think. “Come help my mother.”
Each time the limp blue drape slides open we hope that someone will tell us they know how to make her better, and plan to take immediate action, but the tail-chasing entourage dashes our those hopes repeatedly. We hear “soon,” and “I’m sorry” ad nauseum. To what depths of despair have we sunk when the news that they need to admit her elates us? How sad that we are happy to follow her, in her rolling bed, up to oncology central on six? Little did we know that we would spend the next eleven days here, and she would not leave alive.
The weekend is a bad time to check in to the hospital. The A-Team is at home with family. The skeletal B-Team is stretched. The constant, incessant cacophony of beeping, coughing, whimpering, and expectorating eclipses the details of her diagnosis, condition, and treatment. We get nothing but “I’m not sure,” and “I’ll check,” from the few staff we can snag and drag into the room. The hall fills with the smell of bodily fluids, bad hospital food, and ineptitude.
Mom only seems comfortable when she sleeps, but sleep evades her. The bed shifts at preprogrammed intervals to prevent bedsores. The oxygen tubes irritate her nose. The blood pressure cuff squeezes and bruises her arm. Random people shine lights in her eyes at irregular intervals to check her neurological function. The IV fluids make her need to pee. Which she can’t do alone because she is a “fall risk”. This feels urgent to no one but her, and assistance often arrives after it is too late.
Mom, at 77, even as sick as she is, is upbeat and more worried about us than we are about her. She is also resigned and ready to die. “I’ve had a great life,” she tells us and everyone else that comes into the room. “I have a great family. Thus, we know she is gravely ill. She usually only waxes this sentimental after one glass of white zinfandel. She may be ready but I am not. I cannot imagine the earth without her on it. I am not ready to be the senior generation. I am not ready to lose the one person in the world to whom I matter more than anything.
* * *
Suzanne and I keep ten-hour vigils on Saturday and Sunday. We are closer neither to answers about her condition nor to having the fluid removed. We are obviously exhausted physically, but increasingly, we erode mentally and emotionally. Hospitals are not soothing places; I look toward home for a brief respite; for solace from Cleo, my thirteen-year-old cat. She is my constant and only companion. I head for home to feed her, shower, and sink into the sofa. Which I do, with a glass of mead wine in hand. I glance over to confirm that she is sitting in her customary mysterious pose of simultaneous rest and vigilance, but she isn’t. She is walking in slow circles, head bent at an odd angle, eyes flickering like erratic Christmas lights. Cleo, too, as it turns out, is a very imminent fall risk.
“You’re kidding me, right?” I think for a moment. But she is not joking. The inoperable tumor deep in her right ear canal, which until now has only caused messy, foul-smelling secretions, has clearly grown enough to cause acute neurological distress. Again, I see what I don’t want to see. It is clear that Cleo will not make it through the night.
I feel badly but call a very groggy Suzanne and deliver the news. “You’re kidding me, right?” “I’ll be right over, she says.” We need to get to the vet right away, but I know I can’t drive myself. She’ll have to take us. I text my ex-husband Donald, too, who is always there for me in crises. “You’re kidding me, right?” “Let me know where you’re going; I’ll meet you there,” he texts back. I call the vet, who is alone in his oblivion to the incredulous irony. Dr. Dan directs me to the emergency clinic, conveniently located right next to the hospital that I’ve just left. My boys are both at college. I feel like everyone important is slipping away.
Suzanne pulls up to transport me and a caterwauling Cleo to her end; Donald and his wife Samira meet us at the clinic, rushing into the examination room into which we’ve been ushered. I cradle a shivering Cleo in a thick blue quilt, which hides the hastily inserted IV ports. She moans and shakes until I stroke her forehead and whisper to her. It’s surreal in here, with this small coterie of support. They won’t do the deed until I’ve paid, so Samira slips out to takes my credit card to the receptionist.
“Are you ready?” asks the doctor. I look up at everyone, searching for – what? An alternative? Agreement? Permission? Conspirators, we are, in giving her a gentle exit. They, somber, nod. “Yes, Yes.” Cleo calms and closes her eyes, and all too quickly, dies in my arms, her body going limp and tension releasing as the sedative and heart arrester work their way into her veins. I close my eyes, too, and touch my forehead to hers.
I hold just her softness and sob, not so much for her, as this seems immensely compassionate and kind, but selfishly for the loss of my companion; my aloof but alert and loving friend. And for the knowledge that while we face this same situation with my mother, it’s unlikely that she’ll meet such a swift or humane end.
At home, the wine has lost its appeal. I feel restless and overtired, so I do the one thing I know will settle me and make my mother proud. I clean. I package up or toss every vestige of evidence that Cleo ever existed because I feel my heart will implode if I stumble over and bump into her stuff after waking up without her curled up, purring, on my chest.
In the morning I drop off all of her paraphernalia at her still-closed vet’s office, with a note of thanks and a request to either use or donate her belongings. And then drive right to the hospital.
Back on six, mom looks sad. Sad about Cleo. Sad for me about Cleo. And just sad. Smaller. Sad. I go in to hug her. She looks up at me askance. “Did they save any of those drugs for me?” she asks. We chuckle quietly, awkwardly, but both wish it could be true.