“Pittsburg,” is the only part of what he says that I can make out. He sits up, trying to muster the strength to do what I know he cannot: move from the bed to the commode next to it. He has asked a question that I cannot decipher, except for the word “Pittsburg.” I can think of no connection to Pittsburg, no conversation we’ve had about the city—nothing. Either I, in my weariness, am just not putting together something obvious or he has drifted farther away cognitively. I consider the possibility of the former but suspect it’s the latter.
I have given him his morphine and I eventually get him to lie back down, but he sits up again almost immediately. I tell myself that if I could get a bit of Adavan in him, he might be less restless, but he won’t take the Adavan. I call Antonio, thinking that he may be more successful at it than me, but before Antonio can get to the house (a thirty-five minute drive), Howard is down and has taken it. I call Antonio’s cell to tell him that he needn’t come, but he insists on coming anyway.
While Antonio is at the house, Kristen, the hospice angel of a nurse who had helped get him back into bed the previous night (Christmas night), calls. She had promised to follow up and is fulfilling that promise. She manages to convince me that we can get a hospital bed into the room without removing the queen-sized bed and her description of how we’ll manage it makes sense to me. Howard needs the restraint of the sidebars and I need the ability to move the bed up and down.
It is a stroke of luck that Antonio is with me. Kristen has ordered the bed and it arrives in less than an hour and a half. Kristen continues to behave as if she has angel wings. She comes to the house and the three of us manage to move Howard from the guest room bed to the hospital bed—no small thing because even though he has lost a great deal of weight over the past month, he is still somewhere around two hundred pounds . . . of dead weight.
Howard is semi-comatose and cannot help at all in this process. That’s the downside. The upside is that he also cannot fight against it. He has refused a hospital bed up to this point because it represents death to him. But it can no longer be avoided and he is, indeed, close to death.
In a moment of overwhelm, I call my sister Maureen, who has offered to drive out from Illinois to help with Howard’s care, and tell her, “I give up. Come on out.” But after we have Howard settled, I think, I can do this. Nevertheless, I’m glad she will be on her way. I’m not sure she will actually make it before he dies, but I will be relieved to have her there with me.
And now the waiting begins. The next couple of days are a blur. I consider what should be done before Howard dies and call his sister Ann and his three sons, not simply to alert them to the fact that he is close to death, but to give them a chance to say whatever they want to say to him. He is beyond words now, so he won’t be able to talk to them, but I can hold the telephone up to his ear and they can talk to him.
They all want to do this.
With each, I hold the telephone to Howard’s ear and tell him that he need do nothing, just listen. I’m fairly certain that he can still hear, even if he cannot talk, and I want to give him permission to just listen and not struggle to even try to get words out. But he does try to get words out with each of them. He’s unsuccessful at this except with his oldest son, Jim.
Jim makes his peace with his father and it brings me to tears as I hear what he says over the extension. Then, quite miraculously, really, Howard gathers the strength to say what Jim and I later agree is, “Okay.”
Once his closest family have had a chance to speak to him, there is really nothing more for me to do but try to administer his medication and wait. He hasn’t lost the ability to swallow yet, so I am able to give him his liquid medication. I do my best to make him comfortable and wait. I’m restless.
I talk to Antonio on the 28th and he tells me he’s coming over to do ceremony. He and his wife, Helena, come. I welcome their calm strength. Even though I’m a strong woman myself, I can stand outside myself just long enough to realize that the one leg I always have in the other realms, as the shaman I am, has actually pulled more of me into those realms than the part of me that is on this side. I’m unbalanced, too much in an altered state and too little grounded. Ceremony is actually the best thing for me, whether or not it is something Howard would want if he were lucid enough to state his preferences.
The death ceremony we do is so magical and so what is needed that I’m less restless afterwards, more at peace. [The details of this ceremony can be found in my March 28, 2011 post, titled “Death Ceremony.”]
No more than a couple of hours after they leave, my sister arrives. I make dinner for us and, not long after we sit down to eat, I hear something coming from Howard that I’ve never heard before—a gurgling, gasping frustration. I tear into his room with Maureen on my heels. We get there just in time for me to hold his body up as black ooze issues from his mouth. One eye stares at me and the other has rolled back. He has entered a coma.
Maureen and I clean him up, which takes no small effort. The sheets must be changed, all of his clothes must be swapped out, and his adult diaper must be changed. Mo (the diminutive I’ve long used instead of my sister’s full first name, Maureen) has just arrived to be swept into the most difficult kind of help to provide. I had told her, before she came, that she would have to be tough to manage this. She hasn’t even had dinner before she’s put to the test.
We have to cut off some of his clothes because the combined strength of the two of us is not enough to effectively move him. And I’m not about to call hospice. This is sacred duty; I need to perform it and Mo is willing to join me in it. His clothing is insignificant at this point because he won’t be wearing it again and getting him clean and comfortable is what is needed.
Mo and I struggle so much to get the job done. We take sides on either side of the hospital bed and try to manhandle the sheets and clothes without doing harm to my poor dying husband. Eventually, I look up at her, start to laugh, and tell her we’re like the Keystone Cops. We’re clumsy and incompetent, moving about with too little purpose and using too much effort, but we manage.
When we’ve finished and return to the table, Gretchen Minney calls. She’s just returned from spending time with family out of town and I can hear in her voice that she is jet lagged and weary. She wants to know how Howard is doing and when I tell her, she insists on coming over, even though she’s barely put doen her luggage.
Dinner shifts, becoming almost a celebration. It’s an odd celebration, but it does seem like one. I’ve opened a bottle of champagne. I’ve made a good meal. Gretchen, Mo, and I seem aligned in knowing that Howard is about to break the bonds of human form, step out of his body, and step into the mystery. And that is a very good thing.
Finally, Gretchen leaves and I settle Mo in my bed. The only other option is the bed in the guest room and I’m the only person who should be in that room on death watch. She retires, as do I. I lie awake for a time, listening to Howard’s death rattle. The hospice nurse had prescribed drops that sometime eliminate the sound, which she has told me can be quite disconcerting. The drops have worked until now. And I now understand what she means. I’m too weary and too relieved that the end is near for a mere death rattle to rattle me much. I fall to sleep and sleep like the dead until I awake with a start at around 1:35 a.m.
I look at the clock and realize I’ve missed giving Howard his morphine and Adavan on schedule. Then I realize that the death rattle is gone. I leap from bed, go over to him, and can hear that he is still breathing—softly, gently. I give him a small dose of morphine, thinking that it is probably unnecessary, and I pull up a chair and sit next to him, rooting under his covers to take his hand. It won’t be long now. His breaths are so infrequent that I think he is gone more than once, only to hear him take another breath. His sleep apnea over the preceding several years has, thankfully, prepared me well, and I am not jarred by the sporadic breathing.
I have a headache and after some minutes, I get up to take something for it. The combination of stress and champagne have left me with a head that doesn’t quite feel like my own and it is distracting. I want to be clearly focused.
When I return to the room and wait for the next breath, there isn’t one. He’s gone. I look at the clock and see that it is ten minutes of two and I’m startled by the knowing that he’d awakened me so I wouldn’t miss this moment. He knew I wanted to be there and he woke me up so I could be. What a blessing! I thank him, even though I know he’s not actually there any longer. In fact, he has mostly been gone for days. And the death ceremony had helped the rest of him go.
I think about something he’d said, sometime over the last month. “I don’t think we told each other we love each other enough.”
He was probably right, but we had told one another often enough and we’d shown one another in many ways. And he’d given me this last gift of love—waking me so I wouldn’t miss his death. What is enough when it comes to love? There is never enough when it comes to feeling the love, murmuring the words, acting in love. But I’d come to the knowing, years earlier, that any instant of love is not lost, but reverberates on in the universe—onward, outward, past the farthest reaches.
And I feel it, right then.
And I continue to feel it.
Copyright 2011 by Melanie Mulhall