Lynn Osterkamp - Cleo Sims 03 - Too Many Secrets (17 page)

After they left, Gayle, Paige and I sat pondering our shredded
expectations. Nothing had gone as we had hoped. What to do next?

“Paige, how about you go back into the apparition
chamber and try to get more information from Sabrina.” I said. “This
time maybe she’ll tell you what happened to her.”

“Absolutely not,” Paige said in an unusually firm
voice for her. “I’m not going back in there to see Sabrina again. I can’t
face her. She asked me to fix Moxie and instead it all fell apart. How about
you go, Cleo?”

“I can’t do it,” I said. “She’s never even met
me. Why would she contact me?”

“But if she’s dead, doesn’t she know everything that’s
going on? Wouldn’t she know how you’ve been helping us?”

Now there was a question. One to which I had no answer.
“I don’t know what she knows,” I said. “But I think someone she
feels close to needs to be the one who tries to contact her.”

Gayle had been sitting silently during this exchange, but
getting increasingly restless. “Look,” she said. “I know I lost
a lot of credibility when I pretended I saw Sabrina. I’m so sorry that I did
that, and I promise you it won’t happen again if you let me try one more time.
Please. Sabrina means so much to me. I have to find out what happened to
her.”

I heard her plea and decided to take Gayle at her word. I
believe in second chances, especially when the person apologizes and appears to
be sincerely remorseful. We set up her contact session for the next day.

But unfortunately that was not to be.

When I turned on my phone after the Moxie meeting, I found
six missed calls, all from Mary Ellen at Glenwood Gardens. Panic seized me like
an icy claw. Something must be wrong with Gramma! I had three voicemails, which
I knew I had to hear ASAP—even though I dreaded listening to them.

The first one had come in at 2:00 p.m. Mary Ellen said Gramma
was listless, coughing, had a fever, wasn’t eating or drinking. They were
watching her and had talked with her physician. The next message came at 3:15.
It said they think Gramma has pneumonia. They are sending her to the hospital
by ambulance. The final message came at 4:05. Gramma is in the hospital ICU.
Come as soon as you can.

Tears poured down my face. I could barely see to drive.
Roads, still icy in places, slowed me down. Red lights seemed to last forever.
How could this be happening? My dear sweet Gramma. She’s everything to me. Even
now that so much of her is gone, even though she’s confused and disoriented
most of the time, she’s my rock. I need her. I can’t lose her. I sobbed so hard
I almost hit a car turning in front of me.

I screeched into hospital parking lot, parked crooked, and
ran inside. “Where’s the ICU?” I demanded from the first person I
saw.

“To the right, down the hall.”

I sped to the ICU where I found Gramma, looking tiny in the
hospital bed. She lay unmoving amidst a web of intravenous lines and wires
hooking her up to an assortment of machines whose dials showed wavy lines and
rapidly changing blinking numbers. A tight-fitting clear plastic mask covered
her nose. It was attached with bands around her head and connected to a machine
by a plastic tube. Her skin was deathly white, her eyes were closed and the
only sound in her little cubicle was the beeping of monitors and the whispery
blowing of her facemask.

Chills shook my whole body. It was like I was caught in a
blizzard with horrible freezing particles slamming into me from every
direction. Nowhere to turn. I could hardly breathe. I struggled to remain
upright. I wanted to run away to some place where none of this was happening,
but I knew I had to get past my fear and be there for Gramma.

I closed my eyes and focused on my breathing until the
shakiness stopped. Then I looked at Gramma’s sweet face. I wanted to embrace
her in a hug, to hold her close and keep her safe, but of course I couldn’t. I
leaned down and kissed her. “Gramma, it’s Cleo. “I love you.”

She didn’t respond at all.

After quietly stroking her face for a few minutes, I stepped
away from her bed and called Pablo. “Hang tight, Cleo,” he said.
“I’ll leave Longmont right now and be there as fast as I can.”

I knew it would be at least half an hour before he could get
there. I went back to Gramma’s bed, pulled up a chair and sat next to her,
holding her limp hand and watching her every breath.

A nurse came in. I looked up and to my surprise saw that it
was Lark Dove. “Cleo,” she said. “I saw your name on the chart
as next of kin. Martha is your grandmother?”

“Yes,” I said, trying to hold in my tears.

Lark put her hand on my shoulder. “I’m sorry she’s so
sick,” she said.

In the face of her sympathy, my emotions bubbled over. “She
looks terrible,” I sobbed. “Is she dying?”

“She’s stable right now,” Lark said. “We can
talk more over at the main desk if you’d like.”

I followed her out to the nurses’ station at the center of
the room. “We don’t know what she can hear, so we don’t want to talk about
problems right next to her,” Lark said.

“Does your grandmother have an advance directive—a
living will?” she asked.

“No,” I said. “She doesn’t have a living will.
By the time Grampa and I realized how confused she was, it was too late for her
to consider what she might want.”

“We should talk more about that,” Lark said.

I didn’t want to talk more about that, so I asked a different
question. “What’s that mask over her nose?”

“It’s called a bipap machine. It helps push air in and
out of her lungs. It improves her oxygen level and it’s less invasive than
putting a tube down her throat and having a ventilator breathe for her. Her
doctor can tell you more when he comes,” Lark said.

“Oh, here’s Dr. Bremer, now,” she said, turning
toward a tall, skinny man who had just walked up.

I had only met Dr. Bremer a few times. Gramma’s long-time
physician had recently retired and Mary Ellen at Glenwood Gardens had recruited
Dr. Bremer to take her on. He seemed capable and compassionate and I was
grateful to have him, as it’s not easy to find physicians to take new Medicare
patients. But I didn’t really know him.

He greeted me and I followed him over to Gramma’s bedside. He
listened to her heart and lungs, checked her chart and the numbers on the
machines, then turned to me. “She has fluid in both lungs,” he said.
“We have her on some strong antibiotics. I’m hoping she’ll respond well.
We’ll know more in a day or so.”

“The nurse asked me about a living will,” I said.
“But Gramma never made one. When she got to where she couldn’t make
decisions, Grampa made them for her. But Grampa died eight years ago. Now it’s
all up to me. I’m her power of attorney.” I dreaded the next question, but
I had to ask it. “Are there decisions I need to make for her today?”

“Not right now,” he said. “But that time may
come. It will help if you tell us what you want us to do if she needs a
breathing tube or if her heart stops, things like that. The nurses can go over
the choices with you.”

I didn’t want to go over those choices. I didn’t even want to
think about those choices. I so wished Grampa were alive to help me. I didn’t
want Gramma to suffer, but I didn’t want to be the one determining when she
would die. I felt like I’d be signing her death warrant if I chose not to have
everything possible done to save her. I sank back into my chair in alarm.

Finally Pablo came. I rushed into his arms, sobbing. He held
me and stroked my back softly. Finally I pulled back, got a tissue to blow my
nose and wipe my eyes. “She’s so sick,” I said.

“What does her doctor say?” Pablo asked.

Before I could answer, Lark came in to check Gramma’s
breathing and the numbers on the machines. “Cleo, can you come back out to
the nurses’ station for a few minutes? There are a few more questions I need to
ask you.”

I wanted to jump back into Pablo’s arms and hide my face, but
I got up like a grownup and followed her out.

I knew what was coming. I remembered Lark telling me that
most nurses don’t believe that someone in late-stage dementia who has no
quality of life should be treated with antibiotics.

“Dr. Bremer suggested I go over your grandmother’s
healthcare decisions with you,” Lark said. “You said she never made a
living will or told you what she would want done in this situation?”

“What situation?”

Lark looked at me with kindness in her eyes. But her voice
was firm. “A situation where she has advanced Alzheimer’s Disease and
pneumonia and can’t understand why she’s hooked up to all these machines. A
situation where she might not be able to breathe without a tube down her throat
attached to a ventilator. A situation where her heart might stop.”

“No,” I said. “We never talked about any of
that before she got Alzheimer’s. And after that, she was too confused.”

Lark sighed. “That’s the thing about Alzheimer’s,”
she said. “By the time the patient might want to say she doesn’t want
aggressive treatment for pneumonia, given that she has Alzheimer’s, it’s too
late. Now you have to make her decisions.”

“I have to think about it,” I said. “Right now
I want everything done. Maybe I’ll change my mind after I have some time to
think.”

“Look, Cleo, I’m saying this as a friend,” Lark
said. “Your grandmother is eighty-seven and frail and she has Alzheimer’s.
Her quality of life is very limited. Would she want to live more years with
dementia? Sometimes the most unselfish thing we can do is to release those we
love rather than make them stay to suffer longer.”

Pablo was back in Gramma’s cubicle, but he was looking over
at me. He must have noticed that I looked distressed. He came over and put his
arm around my shoulders. “Hey, babe, how about a short break to grab some
food? I haven’t eaten since this morning and I expect you can use a snack. We
can come right back.”

In the cafeteria, I got a grilled cheese sandwich—one
of my go-to comfort foods. Pablo gobbled up a hamburger and fries.

“I feel like Lark has an agenda, and she’s trying to
pressure me,” I said.

“Lark’s the blonde nurse you were talking to?” he
asked. “You looked devastated. What was that about?”

“About end-of-life decisions,” I said. “She
thinks people with Alzheimer’s have no quality of life, so they shouldn’t get
treatment for pneumonia, that we should just let them go.”

“Does Martha still have quality of life?” Pablo
asked, gently, his eyes filled with love.

“I think some,” I said. “She still recognizes
me some of the time, she still enjoys music and art.”

“So you want the treatment?” I heard sincere
sympathy in his voice

Tears ran down my face. “Yes. She’s still my sweet
Gramma and I love her dearly. And I’m not ready for her to go.”

He nodded emphatically. “Then that’s it,” he said.
“It’s your choice, not the nurse’s choice. Just try to think it through
and be clear about what you want.”

Back at Gramma’s bedside, I tried to clarify my thinking. But
my mind kept slipping back to all those summers I had spent with Gramma and
Grandpa as a teenager and how she had shared her artist’s studio with me and
taught me to paint. Gramma was an award-winning painter—so creative and
productive. It’s hard to accept that she’s ended up like this. Was Lark right?
Had Gramma lost so much of who she was that her life wasn’t worth living?

It’s agonizing to make life-and-death decisions for another
person. How could I know what she would want? Was I just trying to keep her
here for myself?

Lark’s shift ended at 7:00 p.m. and thankfully she left
without bringing up the subject again. Pablo and I sat quietly with Gramma
until about 9:00 p.m. when another nurse insisted we leave and get some sleep.
We agreed to go with the nurse’s promise to call us immediately if anything
changed even the slightest bit.

When we got to my house, we both fell into bed exhausted and
were asleep as soon as our heads hit the pillows. I set the alarm for 6:00 a.m.
so Pablo could get to work and I could get back to the hospital.

But I awoke in a cold sweat at 3:00 a.m. thinking about
Allie, whose mother had been at Glenwood Gardens with Gramma.. Her story kept
running through my mind. When her mother had Alzheimer’s and was in the ICU
with pneumonia, the nurses there pushed Allie to consider withdrawing
treatment. She didn’t agree. She thought her mother was getting better with the
antibiotics, but then her mom suddenly died in the middle of the night.

Omigod! What if that happens to Gramma? Why hadn’t it
occurred to me? There must be something to Allie’s suspicions if the hospital
offered to settle with her. Allie thought Sabrina might have been the nurse
responsible. But Sabrina’s gone so that would mean Gramma is safe.

But what if it wasn’t Sabrina? I sat bolt upright in the bed,
my heart racing. I almost screamed, but gulped down some quick breaths to
stifle the cry. What if it was Lark? That’s hard to believe when Lark is so
kind and helpful. But she is very firm in her beliefs about not treating
demented patients with antibiotics. Is Lark euthanizing demented patients in
the ICU when their families choose to have treatment continued? What if that’s
what Sabrina meant about Lark violating her oath?

An image of Gramma lying there dead in her bed flashed before
my eyes. I shook Pablo awake. “I have to get back to the hospital right
now,” I said, my voice shrill. “Gramma might not be safe with Lark
there.” I threw off the covers to climb out of bed.

Pablo grabbed my arm and shook his head sleepily.
“What’s going on, Cleo?”

I was way too jumpy to sit still and talk, so I pushed him
away and stood up. “Lark thinks Gramma would be better off dead and I’m
afraid she’ll make that happen. I need to get over there to stay with Gramma
and keep her safe.” I headed for my closet to grab some clothes.

“Wait, Cleo,” he said. “I’m not sure why you
think that, but remember that Lark left at 7:00 p.m. last night. She won’t be
back until at least tomorrow morning. So you don’t have to rush over there
right now.”

I grabbed my phone and called the ICU to check on Gramma. No
change. I asked for Lark. They said she was off duty until Tuesday morning at
6:30.

“You’re right,” I said to Pablo. “She’s
actually off until Tuesday morning, so I have more than twenty-four hours.
Oh—and they said Gramma’s condition hasn’t changed.”

He held out his arms. “Come on back to bed,” he
said. “We can talk about this more in the morning.”

I snuggled up next to him, listening to his even breathing as
he went back to sleep. But my mind was active, running through what I could do
to find out more about Lark before she could do anything to Gramma.