Archive for November, 2011

Specters and Human Angels

November 27, 2011

Sometimes when Howard slept, I could sense that much of his essential nature—his soul, if you will—slipped out of him and stayed out until he awoke again. One evening, the sense of it was so powerful, I felt he was already gone, already dead, even as he lay sleeping in the next room.

Late in November, I awoke in the middle of the night and sensed that the entire upper level of the house, the bedroom level, was filled with spirits. I could identify some: my council of guides, my mother, what I sensed were his guides and some of his ancestors. Others I could not identify. These specters returned, again and again, over the coming weeks. When I first sensed my father, I was surprised. While my mother had adored Howard (and he her), my father had died long before Howard and I met. They hadn’t known one another. Then I realized the sense to it. Like Howard, my father had been in the military. Like Howard, he had been an intellectual and a writer. Like Howard, he’d enjoyed chess. Of course he was there. They were going to be great friends on the other side. I was eventually able to discern what I thought were Howard’s parents and his cousin Jack among the ghostly visitors. It was comforting, and it was also telling. I knew that they were all there to help him with the process of leaving his body.

I was happy to take comfort in whatever form it came. After years of bucking up, I cried every day, multiple times a day. I mostly kept it from Howard, but not always. He didn’t question it. He knew his time was short. Some nights, I crept into bed with him, put my arms around him, and just lay with him. Sometimes we talked; other times we just soaked up one another’s presence. And sometimes we wept together. Those were sweet times, those nights. There was a deeper level of intimacy than we’d had in years—maybe a deeper level of intimacy than we’d ever had. It wasn’t about words and it wasn’t even really about physical proximity. It was about the partnership, the unstated contract between us to be partners during this pilgrimage to his death. The unstated understanding that we were what we had been saying for years: best friends. And best friends sometimes just witnessed one another’s lives. I was his witness.

He slept most of the day every day. He could no longer get up and down the few stairs from the bedroom level to the living level without a struggle. He only struggled to do so once or twice a day, mostly to get to the kitchen. I was happy to bring food to him, but he needed to demonstrate to himself that he could still make the stairs. He made one effort to sit in the living room, then asked for a chair in the bedroom. Antonio helped me move a comfortable one from the journey room (the room in which I did shamanic work with people) in the lowest level of the house up to his room. He used it only a few times, but just having it there made him happy.

Everything was beginning to make me nostalgic. I turned on the television to find an episode of Globe Trekker on Fiji. We had been married in Fiji. Another day, the movie When Harry Met Sally was on. I smiled and cried because it was one of many movies he liked a good deal. And while Howard often referred to the house as my house—an accusation more than anything else that I’d arranged it according to my own tastes and needs—everywhere I looked in it, I was reminded of Howard and our life together. It was as if he were already gone. And in some ways, he was. He was slipping further away from me every day.

Yet, a few days after Thanksgiving, he asked if we were going to see the new Harry Potter movie. He had almost died days earlier and he was completely unable to get down the series of stairs that led outside. Still, he seemed to have told himself that he could do this. When I finally got ready to return the borrowed oxygen tank to the cancer center, he said, “I’d like to go with you.” Again, it was a physical impossibility for him. Did he sense that he would never again see the nurses and doctors who had been so kind to him? Perhaps, though it did not occur to me at the time. What did occur to me was that he was becoming farther and farther removed, mentally, from his physical reality. Getting to the bathroom was a major undertaking. Leaving the house? No chance.

Finally, in the last days of November, he agreed to hospice. But even here, he insisted on doing it his way. He slept until he had just enough time to get himself up and together before they came to the house to meet with us. He dragged himself to the shower, dressed, and struggled his way downstairs to the dining room because he did not want them to see him as an invalid. He did not want hospice to see him as an invalid.

The meeting was a negotiation. The hospice staff quickly determined what he was made of and that he would need more than their respect, he would need their agreement to participate in the hallucination that he was not the dying man they saw before them. They stepped up. They’d done this before. He had feared that bringing in hospice meant he would no longer have access to blood transfusions. I knew that he’d already had the last one he would need in this life, but it was an important consideration in his mind. They assured him that it was not beyond the realm of possibilities and that it could, in fact, be done at home.

At one point, during the discussion with hospice, he said, “Maybe I’ll just disappear . . . leave the house, drive away, and not come back.” It was a threat. He wanted them to know that he was still in charge. He wanted them to know he’d already had enough of his body betraying him, before signing on with them, and he didn’t want nonsense from them (or me).

Of course, he would have needed me and a couple of strong men to get him downstairs, outside, and into his truck by this point. Still, I had no doubt he could still drive if he could be helped to his truck. Where would he drive to? No question about that. He would be off on another adventure. Maybe the trip to Alaska he’d been sorry to have never made. No Thelma and Louise action from him. Never.

Unbeknownst to him, hospice and the nightly cadre of spirits were preparing him for his next adventure. No escaping to have an adventure on his own. Not this time.

Copyright 2011 by Melanie Mulhall

Cheating Death One More Time

November 18, 2011

If Howard wanted to be the inconspicuous recipient of a blood transfusion, collapsing at the hospital entrance was not the way to do it. The medical staff crowded around him like a pack of vampires on a warm body. I could do little to help. He was already annoyed with himself and with them. I did not want to say or do anything to make matters worse. I stood back while they attended to him, wondering what the split in their attention was between fulfilling the Hippocratic Oath versus mitigating hospital liability.

He was taken to the emergency room, as opposed to the ambulatory care unit where he was to receive his transfusion. We were in for a long day. There is irony in coupling the word “emergency” with that particular unit in a hospital because there seems to be little urgency to the treatment received there. But on this day, the emergency room was bustling. On our way to the hospital, we had passed a serious looking accident, not half a mile from the medical center. If you’re going to have an accident, being close to a hospital is genius. By the time Howard was ensconced in a treatment room, the human wreckage had arrived at the hospital.

Still, they were living up to my expectations, at least as far as my husband was concerned. He was not a priority and we were mostly left alone for long periods of time. Ultimately, the medical staff wanted to admit him and keep him tucked away in a room at least overnight, thereby providing me with an opportunity to demonstrate that I could be trusted on the “no ambulances, no hospitals” pledge. He and I were a united front: no admission.

Hours—and endless frustration—later, he was placed in a private room in the ambulatory care unit and they were beginning preparations for his transfusion. Even as an outpatient, he was going to be there all night. The transfusion would take that long, not only because they were going to give him four units of blood, but because he had to be given saline infusions after each unit of blood. This would, of course, put a demand on his already overworked urinary track. Fortunately, there was a bathroom right outside his room. Unfortunately, he was hooked up to a monitor because of the earlier incident. In theory, that meant he would need to buzz an attendant every time he needed to go to the bathroom. In practice, I knew he would simply rip the sensors off, thereby setting off alarms, and struggle unassisted to the bathroom.

It didn’t take him long to prove me right. It was not only going to be a long night for Howard, but also for the ambulatory care unit staff. After helping him order some food, I made my escape. My presence all night would be of no help, and I was not keen to be an observer to the paces he was going to put the staff through. It had been morning when we made our way to the cancer clinic and it was now past sundown.

In a moment of stress induced practicality, it occurred to me that I should make a stop at Gretchen Minney’s house on the way home. She had some of my canning jars and I needed to collect them. I called to see if she was home. She was. I told her I would swing by to get the jars on my way home from the hospital. Hospital—the magic word. That was all I needed to say. By the time I reached her house, she had a plate of hors d’oeuvres and a bottle of champagne waiting for me, along with an open heart and a willing ear.

Every once in a while, a friend not only proves herself, but demonstrates her keen understanding of your precise needs. Even the best of friends do not often manage that, but this was one of those moments. It had taken me ten minutes or so to get from the hospital to her house, yet all was waiting for me when I arrived.

Awards are given for all manner of heroic acts, but never for an act like this. How would it be submitted? How could it be described? I couldn’t say that she had saved my life. Technically, she did not save my life that night. But I would argue that a glass of champagne, some nibbles, and the simple act of bearing witness to a story of crisis are highly underrated as life saving measures.

I was gravely worried and with good reason. When I brought my husband home the next morning, he went to bed immediately and slept most of the day. The following day, which happened to be the day before Thanksgiving, he was no better. In the past, transfusions had perked him up and brought color back to him. This transfusion had done neither.

That night, he was uncomfortable to the point of admitting it. His entire body was rebelling and in pain. Breathing was especially painful. He had been prescribed Ambien to help him sleep and oxycodone for pain, but had taken little of either. Now he asked me to bring him both. My husband, the stoic, was moaning and I found it unsettling. I couldn’t imagine how bad it had to be for him to be moaning. This was the man whose pain measurement was based on the level of pain provided by a gunshot wound. I gave him the requested medications, climbed into bed with him, and held him. After an hour, he felt no better and he looked scared.

I knew I needed to act and I knew whatever actions I took would be further demonstration—or the lack of it—that I could be trusted to follow his wishes. I asked if he wanted an ambulance. He was adamant that he did not. I had to honor that, but I also had to do something. I told him I was going to call Antonio. He fought against it, wanting no one to come, but it was either an ambulance or Antonio.

Antonio, the shaman to whom I had been apprenticed, was not only a shaman, but a nurse. He had urged me, over the last few months, to call him—night or day—if I needed his help with Howard. It was after 11:00 p.m. and I was ready to take him up on his offer. I called to find that he was still awake. I explained the situation and I think he must have been getting his clothes on, preparing to leave, before he hung up. I knew, from years of driving between my house and his, that it was a thirty-five minute drive. He arrived a good ten minutes earlier than it should have taken him. He had clearly ignored the posted speed limits all along the way.

I crept into Howard’s room to tell him that Antonio was with me. Howard was delirious and nearly incoherent. He muttered, “No, no. I’m asleep. I’m asleep,” thinking, in his confusion, that I had called an ambulance. I explained that it was Antonio, no one else, and that he had come to see if he could help.

I had never witnessed Antonio’s work as a nurse and was stunned by his ability to gain Howard’s compliance and trust with little more than a few well chosen, calm words. Well . . . that and summoning up the kind of energetic power few but those of us who practice shamanism can muster. He took Howard’s vitals. Blood pressure: 60/40. Pulse: forty beets per minute. Respirations: almost undetectable.

Antonio met me outside the room and told me it was unlikely Howard would make it through the night. In fact, he thought Howard would pass very soon. We sat, side by side, on the cedar chest at the foot of my bed in the master bedroom. And we waited. I had some Jameson’s I’d bought to make hot toddies with and I got each of us a slug of it. He might not have needed it, but I did. Years of treatment and months of declining health had skidded, abruptly, to a stop early Thanksgiving morning.

But after an hour, Howard was still among the living. Weak vitals, but still alive. Antonio went home, expecting that the next call from me would be the call to say that Howard had passed. He had no sooner left than the moaning began again. I called his cell and asked what to do. He suggested I give Howard another small bit of medication.

Sunrise found me exhausted and anxious . . . and my husband still alive. Thanksgiving Day. It was not clear to me if I should be grateful that Howard was still alive—my immediate instinct—or sorry he hadn’t passed during the night. And there was no way to know if he would make it through Thanksgiving Day.

What I did was so predictably Melanie-in-survival-mode that I saw it for what it was, even then. While Howard remained semi-conscious, at most, I made stuffing, baked the twenty-two pound turkey, and otherwise carried on as if there would be someone other than me to eat Thanksgiving dinner. And I gave thanks for everything good and true in the world.

Copyright 2011 by Melanie Mulhall

The Beginning of the End

November 1, 2011

There are pivotal points in life. Life is often compared to an hourglass, our days like the sand dropping one grain at a time until all the sand runs out. Maybe, but the sand does not trickle at a constant rate. Certain events speed things up. Like the pebbles in a rain stick, there is a point where the trickle that sounds like raindrops becomes a flow that sounds like a downpour.

The radiation treatments were coupled with a regimen of steroids. The steroids made Howard a little cranky. Then they made him easily annoyed. Then they gave him the kind of short fuse he’d had twenty years earlier and which he’d gotten over as age and life softened him. At first, I didn’t like the transformation. Then it scared me. He accused me of trying to control him when both of us knew that neither of us could actually control the other. That had been worked out years earlier. When he became instantly angry over something trivial and actually raised his arm, as if to strike, he frightened both of us. He didn’t know what was happening to him. Neither of us was sure it was the steroids, but I suspected as much. He called his doctor and quickly went off them. Within a couple of days, he returned to the kind of equanimity we were both more comfortable with.

In only a couple of weeks, the radiation treatment was complete. In a matter of speaking, Howard was fully cooked and he was weakening before my eyes. I had become proficient at determining when he needed a blood transfusion and I was sure he needed one. For a couple of weeks, I nudged. He wasn’t ready. Then I pushed. He still wasn’t ready. Finally, I asked him what was going on, why he seemed reluctant to call for an appointment to have his blood tested. He’d had blood transfusions when he needed them for months. Why was he dragging his feet now?

Something in my tone, combined with his weakening state, broke through the defenses. He admitted that he was putting off having his blood tested because his radiation doc had told him that if there was a reoccurrence of his symptoms, he should have his wife drive him to the hospital. I was certain that his doctor was referring to the symptoms related to the cancer having spread to the dura—the numbness in his face, for instance—and not the weakness associated with needing a blood transfusion. But it was the word “hospital” that had brought him up short. He feared that all of the doctors were giving up on him and he would now be consigned to hospitalization. And that was the last thing he wanted.

It took him a good minute or two, after dropping this bit of information, to add that he did not want to complicate his life—meaning the hospitals and everything that went with it. He was near tears. I bust out laughing.

“Complicate your life? Do you realize how ridiculous that sounds? Complicate your life? Could it get more complicated than it already is?”

And then I invoked the Gretchen Principle. Gretchen, meaning Gretchen Minney. The Gretchen Principle was a reference to something she had done when her husband, Bill, was dying of a brain tumor and found himself in the hospital. He wanted out. Gretchen understood the implications of doing so, but broke him out anyway. She commandeered a wheelchair and they escaped.

I told Howard that I would not allow anyone to keep him in the hospital against his wishes. I added that I was in agreement with him to stay out of hospitals if at all possible. I promised to break him out, as Gretchen had done for Bill, if necessary. He was relieved and seemed to relax a bit.

It was a good agreement. We would need it soon.

The morning he finally decided he needed that blood test, he slowly made his way from the upper level of the house to the lowest level and took a seat in my office, where I was busy editing.

“I need you to drive me,” he said.

I turned to face him, raised my eyebrows, and told him I would drop what I was doing and take him. “I need you to drive me” was code for a lot of things.

I had been concerned about his driving. His doctor had not forbidden him to drive because he hadn’t had a seizure, but driving seemed risky at best. He’d fallen more than once coming to or going from the truck when he felt particularly weak. He’d made it into Newsland on one occasion, only to fall once inside. An ambulance was called. He was mortified and talked his way out anything but a quick check. That he’d actually told me when he returned home was a surprise because he had been embarrassed and it was exactly the kind of thing he might have kept to himself. Apparently, he had come to the conclusion that he needed a confidant about such things and I had proven myself trustworthy. Not an easy decision for a former Marine and Chief of Police.

When I’d expressed my concerns about his continuing to drive, he had promised me that should the day ever come when he felt he could not drive himself somewhere, he would ask me to drive him. I hadn’t believed him, but he was doing just that—right in front of me. I was not so much surprised by the fact that he was too weak to drive as I was him admitting it.

He was so weak that I’d told him, wryly, that he’d be dead soon if he didn’t go for a transfusion. It was that critical. I had seen him in need of a blood transfusion before but I had never seen him this weak.

Slowly and with care, we got into my car and made our way to the cancer clinic. It was only my second time there. He had insisted on going alone for all the time he’d been treated there. I’d gone with him when we discussed the matter of radiation treatments, less than month earlier. When we arrived, the nurses immediately saw what I had seen. They took a blood sample and assured him that even without seeing the results, they could tell he needed a transfusion. I offered to place a bet with them on the number of units, knowing it would be at least three. That told them pretty much all they needed to know about the wife. They could see that I was neither naïve nor weak spirited. They could also see that I was not going to be placated or assured. I was calm, I wanted answers, and I wanted to know what we needed to do for my husband—right then, right there.

Three was an underestimate. He needed four units. The nurses were very concerned. He was used to having the blood work done one day and the transfusion the next. There wasn’t going to be a delay this time. He was going to get that transfusion as soon as we could get him to the outpatient unit at the hospital and he was going with an oxygen tank in tow. His blood oxygen level was 82-85%. No compromises, no leaving without the tank.

He objected. They persisted. He growled. They were adamant. He did not want to be seen as an invalid. Didn’t matter. They rigged him up with a tank while they made arrangements for the transfusion. Arrangements made, we left the clinic with an oxygen tank trailing us. I got him settled and the tank settled. Just as I was about to drive off, heading for home to grab a few things before continuing on to the hospital, he said, “Be careful,”—meaning that I should take care with my driving.

I left the car in “park,” turned to look at him, and said, “Are you kidding? Be careful? We can’t get into an accident. We have an oxygen tank in the care. If we’re hit, we’ll blow up.”

The absurdity of it was so funny that it was verging on Monty Pythonesque. It wasn’t quite . . . but we would be all the way there shortly.

At the hospital, I swung around to drop him off at the door. He was not going to let me help him in and he was not going to let me get him a wheelchair. The best I could do was drop him off, snag the closest parking spot I could, and sprint back to him. I found a spot very close and was away from him for less than sixty seconds. Too long. As I approached the hospital doors, I could see that he had never made it inside. He was on the ground with a flock of people around him. To make matters worse, the automatic doors kept opening and closing on a woman who was also on the ground. I soon found out that she was a nurse assistant who had been in the wrong place at the wrong time. She was coming in as he was and when he began to go down, she tried to catch him. She was a small woman. Even ill, he was a large man. The doors thwamped and thwamped on her until someone finally stopped the beast.

Howard was on the ground, conscious and annoyed. Doctors and nurses were gathered around him. That part was good. Someone called for a neck brace and a board. That part was also good. But numerous people kept asking him the same questions, over and over. “Are you conscious? How long were you out? Did you lose consciousness? Can you move?” And on and on. One time would have done it as far as Howard was concerned. He wanted to answer the questions and get the heck out of there. He was embarrassed, unhappy at being prone, and becoming increasingly annoyed by the mantra being murmured by the medical staff in the form of questions.

If there was any chance that Howard might get a glimmer of understanding that he had waited just a tad too long to go in for a blood transfusion, it would happen right there as he lay on the cement in front of the hospital doors. It was alarming, but it was so . . . so . . . Howard. There was something just a bit funny about it. The thwamping doors. The fact that I knew some version of “Just shoot me” was being muttered just enough under his breath as to be imperceptible to anyone but me. The surreal quality of it all.

Not funny at all was my internal radar. It was on alert and sirens were going off inside. I knew that this was the beginning of the end.

Copyright 2011 by Melanie Mulhall