This is Getting Old (6 page)

“Well, it's
Friday
,” I said. “You said you'd get her off the breathing tube by Friday.”

“She's holding steady,” he said. “I'd like to get her oxygen support down to forty percent, but the pneumonia is slowing us down.”

“Shouldn't the antibiotics have gotten rid of the pneumonia by now?” my brother asked.

“I want to give them a few more days to work. I know you're worrying about keeping her on the ventilator, and I respect that. As I told you, I don't like to go more than two weeks with the ventilator, but it won't be two weeks until Monday.”

We agreed to a third extension.

When we went back into the room, our mother was sitting up in bed, and for the first time since the accident she stretched her mouth into her version of a smile around the blue pipe. We looked at each other in amazement. Did she guess what we'd been saying in the hall?

We called the grandchildren back. We couldn't believe that a couple of hours before, we had decided this was to be her last day on earth.

THE THIRD WEEK

We wanted to help her rally her strength by Monday. I asked my son Noah to come from Texas to cheer her on, and the very next morning, Saturday, he walked into her hospital room. She brightened and reached her tethered hands toward him. He was a tall man now, and he leaned way down until she got her hands onto his shoulders, and she pulled him down into her bower of tubes to give him the fumbling kiss of a bridled horse. He held a picture of his two-month-old daughter, her first great-grandchild, in front of her open eye, and she studied it hard.

On Monday, after morning rounds, Dr. M. called us into the corridor outside our mother's room. “It looks like a good day for an extubation!” he said.

Quite a crowd of family members and medical people
gathered in the room for the big event, including Dr. Z., the one who helped patients die; his presence worried me.

“Hello, Alice,” said Dr. M. “You'll be happy to hear that we're going to take out the breathing tube now. Are you ready for that?” She nodded enthusiastically.

It turned out there was nothing to it. The respiratory therapist pulled the tube out as easily as if she was pulling up a weed with a long root, and Mom was breathing.

The RT put an oxygen mask on her face to give her a little extra help in the transition. It was fastened around the back of her head with elastic, like a Halloween mask. They finally took off the wrist restraints.

Dr. M. had said she probably wouldn't talk right away because her vocal cords would be sore, but she was already lifting the mask and moving her lips, finding her voice after the long mute weeks. She was the diva and we, her eager audience, strained to hear. The words came out, one at a time, hoarse and irritated: “I just want to wipe my chin!”

Dr. M. was proud of her, and he brought a couple of the residents into the room to show her off to. Everybody was jubilant.

“Do you know where you are, Alice?” asked Dr. M.

“I'm not quite sure,” she said. “Am I in the kitchen?”

He told her she was in the hospital. “And can you tell me how many grandchildren you have?”

“Nine,” she said proudly. “I have nine grandchildren.”

Dr. M. looked at me. “She does,” I said.

“And do you remember,” Noah asked her, “that you have a great-granddaughter?”

“Yes,” she said proudly. “I certainly do remember
that
!”

Noah, having seen her over the hump, was ready to say good-bye. “You're getting better, Grandma! I'm coming back to Chicago in the spring, and I'll bring your new great-granddaughter to meet you!”

“I can't wait,” my mother said. “That will be wonderful.”

The day after the tube came out, a Tuesday, she told the nurse she wanted to turn on her side, and the nurse helped her do that. “It's time to get ready for the baby,” she explained.

“You're not having a baby, Mom,” I said.

“I know
that
!” she said, annoyed at my obtuseness. “I have to get ready for my great-
grandbaby
. I have to make a place for her.” She curled up and made a half-moon of a nest in the bed for her great-granddaughter to lie beside her. She patted the spot.

“You'll see her in a few months,” I said.

Dr. M. told us not to worry that our mother was sometimes confused. He said it was normal for a person who's been in the ICU for a while to become disoriented. It would go away, he said.

The next morning she was in a grateful mood. I was sitting in the corner crocheting when she waved her hand at the ceiling over her bed. “I'm giving you that one for a present,” she told my sister.

“You mean that tile right there?” my sister asked, pointing to one of the six-inch square acoustic tiles over Mom's head. I was impressed that she had understood.

“Yes,” Mom said, and turning to me, she continued, “that one's for you, and that one . . .” She gave each of her children the gift of a ceiling tile. She didn't have anything else to give.

On Wednesday, the third day off the ventilator, she seemed to be weakening. “What's going on?” we asked Dr. M.

“I don't know,” he said. “We're delivering as much oxygen as we can through the mask, and she's just maintaining.” He paused, as if gathering himself, and said, “You should think about what you want to do if she gets to the point where she won't make it without mechanical support. Would you want us to do a tracheotomy?”

Once the tube was out, we couldn't bear the thought of putting it back in, and we already had her instructions. Still, people can change their minds, and now that she could talk to us, we decided to ask her.

We waited for one of her brief windows of alertness. Dr. Z., the palliative care doctor, came into the room to support us. He pulled up a chair beside her bed, so he was at eye level with her. The rest of us stood around the bed, and my sister asked her that terrible question again and again: “Do you want us to put the tube back in if it turns out you'll die without it?” She asked in different ways, and our mother said nothing. We thought she didn't understand. Then Dr. Z. leaned in to help. “Alice, would you object if we put the breathing tube back in?”

“Yes, I would,” she said quietly.

“Now listen carefully. If you need it to live and we don't put the tube back in, you'll die. If that happens, we'll make you comfortable. How do you feel about that?”

She suddenly sat up in the bed and exclaimed, “Shit! This is a lousy time to ask a question like that!” Then, as if to explain her loss of temper, she added in a softer voice, “I've already discussed these matters with my children.”

On Thursday morning she perked up a little—she could still be getting better. One of my nieces, visiting from college, brought her violin into the room. “Want me to play something for you, Grandma?” she asked.

“Yes, play me something cheerful,” said my mother.

So my niece played a Scottish tune called “Ships Are Sailing,” and my mother tapped her fingers on the bedrail in time, to show her pleasure.

But that afternoon she became increasingly anxious and agitated, shaking her shoulders, waving her hands, shifting her legs. Her breathing got faster and shallower. “Just breathe slow and easy, Mom, just slow and easy,” I said, and though my words
couldn't put more oxygen into her lungs, they calmed us both for a moment.

Dr. M. relinquished her as his patient to Dr. Z. who put her on a morphine drip to relieve her feeling of air hunger. Dr. Z. said she'd be more comfortable on the palliative care floor, and my sisters and brother were ready for the transition. “But isn't that giving up on her?” I asked.

Dr. Z. said that they could do everything in palliative care to help her live that they could do for her down below, and she would be more comfortable besides. So I agreed, telling myself it wasn't beyond the realm of possibility that she could still get better.

The next day, Friday, a bed became available in palliative care—meaning I suppose, that someone had died—and in the afternoon my mother was moved to a hotel-like room on the sixteenth floor, the top floor of the hospital, closest to heaven, with fabric drapes and upholstered armchairs. She had always held a good view to be one of life's greatest pleasures, and so, even though the morphine had put her to sleep and she seemed to see nothing out of her still-open eye, we wheeled her bed around so that she faced the picture window looking east, over the stone turrets and steel roofs of Chicago to the darkening expanse of Lake Michigan.

Dr. Z. said it could take several hours or several days for her to die. It was a relief to get her out of the technological brambles of the ICU, though the monitor that measured her blood gases was still hooked up, and I was still watching it, as if there was meaning in it.

Out in the hall I told Dr. Z., “Her oxygen level keeps going down to eighty.”

He put his hand on my arm. “Mom is dying,” he told me in the voice of a kindergarten teacher. “Now is the time to make her comfortable.” I knew he was trying to be kind, but I spun away from him and marched down the hall—she wasn't
his
“Mom.”
But it wasn't really his use of the word
Mom
that was upsetting me; it was the rest of the sentence.

There were six of us family members in the room—children and grandchildren—when the palliative care nurse took off the oxygen mask and put on the nasal cannula: “She'll be more comfortable.” I looked back and forth from my mother's face to the monitor, and I saw the numbers drop like an elevator—into the seventies, sixties, fifties. My son Sandy was sitting across the room in an armchair. “Grandma's dying,” I heard myself say, and he jumped up to join us at the bedside. Helpless, we watched her sternum rise and fall like the prow of a ship in heavy seas; helpless, we watched her face turn white as the red blood drained out of the capillaries.

In less than two minutes she stopped breathing. We stood there, waiting for something to happen, waiting for our mother to tell us what to do next. But she had left the room. I don't know how she managed this disappearing act—I never saw her get up and go, and I was beside her the whole time. After a pause, all six of us began to cry. It was ten o'clock on a Friday night.

The nurse slipped out while we wept, and after a polite absence of ten minutes or so, she came back in with some papers for us to sign. “You can stay here with the body for two hours,” she said. “Then we have to remove it.” Time swung around and slammed into a wall. How suddenly the nurse's patient had turned into a body. Now that my mother was truly comfortable, the nurse's job was done.

We took off her neck brace—there was a red sore underneath where it had been rubbing against her collarbone. We sang “Dona Nobis Pacem” and “Row Row Row Your Boat.” I recited a Buddhist chant for the dying, and the ancient sounds we didn't understand held us together:
nen nen fu ri shin
. My sisters and I took her clothes out of a plastic bag, the clothes she'd been wearing in the accident. It seemed strange, though it was a relief, that there was no blood on them. Together we took off the hospital nightgown
and pulled her faded black denim pants up over her dead hips, we put her arms through the sleeves of her blue smock shirt, and we left her bare feet bare. Her face looked suddenly thin, the skin drawn by gravity down toward the pillow. We tried to close her open mouth, but it didn't stay. The same with her open eye. We folded her hands on her chest, and I spread the half-finished shawl with the zigzag blue and green stripes over her legs.

Old Bones

I
TOOK MY ALMOST-THREE
granddaughter to the play-ground, and she climbed
up
the slide on her hands and knees.

“Now
you
do it, Grandma Sue,” she said.

“I can't do it,” I told her. “My old knees can't go up the slide.”

“Just try! You can just
try
, Grandma!”

But I didn't try. “I'm sorry, Paloma, but my knees are too old.”

The next day I was taking Paloma upstairs to have a bath. “Carry me, OK, Grandma?” she requested.

I was tired. “You can walk,” I said. “I'll hold your hand.”

“I can't do it,” she said. “I have old legs!”

As I get older my bones are getting older, too. I have osteoporosis in my lower back. It runs in my family. My mother lost five inches of height from it, and I've lost an inch and a half, but it doesn't hurt and I wouldn't even know I had it except for the bone scan.

The arthritis in my knees and thumbs is more annoying. At the minor-detail end of the scale, I can't open jars very well any more because of the arthritis in my thumbs, and this can
be bothersome when I'm alone with a vacuum-sealed jar of homemade plum jam. A friend gave me a wonderful gizmo, like a potholder, with rubber webbing on one side, which is remarkably effective for opening jars, but if it doesn't do the job and there's no other pair of hands in the house, I have to get through the morning without jam. As for my knees, they don't like going up and down steep hills, they object to the warrior pose in yoga, and I can't squat at all anymore, which makes it hard to pee in the woods. Hopscotch is out of the question.