A minute later we got a phone call from one of my mother’s church friends in Madison. Mom missed her zoom church service that morning, where she had been scheduled to read a Bible passage. Unusual. The rector and a friend intuitively drove the few blocks to mom’s house after church, knocked and called from the various doors, but got no response. They called the police for a wellness check. As one of a hundred well thought-out plans, mom had her garage code on file with the police, so access was easy. As another example of the hundred plans, kind neighbors across the street had a back-up house key and they also stepped forward, noticing the arrival of police and then an ambulance.
Mom was found unconscious next to her small bed, wearing her pajamas. She had likely been unconscious for several hours. She was not responsive and was conveyed promptly to the University of Wisconsin Hospital, the same facility where I had done my PhD work in the mid-1980s.
Mom was in the ER and had received a CT scan. I found the phone number for the hospital and was quickly transferred to the ER desk. Within a minute, remarkably, I was on the phone with the young female physician caring for my mom. I carried my phone back to the table where Laura and Liz sat across from me. Laura handed me a sheet of paper as I took notes. The two women watched my face and listened to my half of the conversation and saw my writing.
Mom had suffered a severe stroke with a large accumulation of blood deep in her brain. There was blood also in the ventricles. It was, clearly, an unrecoverable event.
While listening I felt a mixture of sorrow and resignation. Liz could see it in my face and hear it in my voice. Tears welled up in her eyes across from me.
The doctor and I spoke briefly, and I thanked her. She asked about my mother’s ‘do not resuscitate’ bracelet and I affirmed that mom’s care should not include interventions other than comfort. This direction had been made crystal clear by mom over the years. I was certain about it in my mind, and I knew with confidence that the direction would resonate with all family members and friends. Mom had left no doubt.
Minutes later I got a phone call from a nurse regarding medication to reduce mom’s blood pressure, and I declined it, clarifying to the team that decisions could now be simplified going forward – no medications or interventions or escalations other than comfort measures. The nurse was appreciative of such clarity.
I had one piece of pizza and finished my drink while Laura and Liz packed up our otherwise uneaten food. It was evident that I needed to drive the three hours to Madison. I left a message for my sister in Fond du Lac. Laura helped pack enough for three days. I emailed colleagues for back-up help with my graduate school class, and my faithful lab manager for back-up help with my research lab.
I printed off a special document that created the foundation for the next 3 days. It was 14 pages of digital answers to a list of vital and end-of-life questions that my brother and I had posed to my mom earlier in the year. She had dutifully and accurately assembled all the requested information. I had organized it and shared the compilation with my brother and sister, just in case.
Now, here we were.
The document was perfect. It, together with a file that included memorial service preferences and a pre-written obituary, were all at hand.
Remarkable.
Then I was off.
I love the drive from Rochester to Madison, crossing the Mississippi in La Crosse. Laura let me take her car with hands-free phone, and this allowed me to speak with my sister and brother and make plans to have my sister meet me at our childhood home before driving to the hospital.
The house felt totally normal. One hall table had been moved, presumably to facilitate gurney access. Mom’s bed was unmade, but the room was otherwise normal. Everything felt normal.
Except mom was gone.
It had been an odd few weeks for mom. Things had been fine over the summer except for the need to euthanize her last beloved kitty. Just a few weeks before her stroke, mom experienced a heart event and had received a pacemaker. I had been busy with teaching and mom and friends had managed. My sister had driven down twice to help on weekends. Mom wasn’t happy about the pacemaker, the software connections, the need for physical therapy at home to restore arm mobility after the implant.
But she was improving and back to being herself. The day before her stroke she and my brother had a long phone call. He said she was very much herself. Lots to say. No shortage of opinions, coherent, bright.
Mom’s stroke was a gift of pure grace in that it immediately incapacitated that mind so there was no pain, no anxiety, no distress. It was the blessing she had always sought – the path to a peaceful and uncomplicated death, a death to match her husband’s quiet death in his bed at home. Mom spoke with deep gratitude and frequency about that experience.
Her death turned out to be very much the same.
Grace.
My sister and I met mom’s good friend in the emergency room. The place had entry security protocols and a TSA-like feel. Masks, the usual buzz and waiting patients. Limits on guests. It was late afternoon and mom’s friends had generously been keeping vigil with her the whole time.
Mom was quietly asleep in her bed. She had nasal oxygen but otherwise looked completely peaceful. We and her caregivers spoke to her politely, but in her coma I am convinced that she was already gone.
I asked myself – where is she really? How does resurrection work? When does faith become sight?
My sister and I prayed together as we held mom’s hands. We cried quietly. I found a small box of tissues. The box became a note pad for our time in the ER. I began using my cell phone to take pictures as notes and records.
I spoke on the phone with the palliative care team lead, a perfectly trained and entirely professional physician who clarified everything in just a few minutes.
My sister followed my mom as she was relocated to a quiet and spacious room in the palliative area of 6th floor oncology in the B tower. I met them there after moving our car.
The room was perfect. The view was of mom’s beloved Lake Mendota, the University of Wisconsin campus, State Street, and the state capital. Mom would have loved it. She slept quietly.
There were two striking things about our two days in this room.
Mom was silently asleep. This was a woman who could not otherwise stop talking, and these last two days were kept in silence.
Mom was entirely peaceful. For years she had been struggling with a muscle tremor that affected her neck, making various aspects of life uncomfortable. She never complained about it. Now she slept without tremor, completely still.
The care teams were exceptional. The young nurses shared unexpected connections to Fond du Lac and to a former MD-PhD student of mine. The palliative care residents demonstrated excellent emotional intelligence, rapidly sizing up the room and who in the room needed attention. This was never mom, as she slept quietly. It was often my sister, whose own prior career as a hospice caregiver made these two days easier, and harder.
My sister and I were gifted these hours to work together, to care for each other, and to talk. She would nap or chat with me. I was seated with my laptop working through my list of final wishes and contacts for my mom, sending texts and emails. Had mom died immediately, my sister and I would not have shared this experience.
Throughout my mom’s death, I had the very clear impression that I was reading from a lovingly prepared script, in a play that had been written by grace.
There were no hard moments.
My sister and I decided that we would leave the hospital each night for food and rest. Sunday night and Monday night we returned to our childhood home, now missing its primary occupant. We ate together there or at various fast-food destinations. We slept as best we could.
It wasn’t clear how long this vigil might last. By Monday night I had worked my way through most of the list.
Mom’s breathing was becoming shallow. Her face still peaceful, skin tone changed subtly, mouth slightly more open.
My sister said that maybe this would be the night that mom would die. We agreed to go home to sleep, and that we would not be sad if we got the phone call during the night.
We didn’t.
Tuesday morning we woke and dressed. We had breakfast. We arrived at the hospital just after 8 AM. It was chilly. There had been snow flurries Monday – a typical Wisconsin fall. There were whitecaps on the lake.
We took off our coats and approached mom’s bed. My sister spoke a greeting and gently touched mom’s face. I took mom’s left hand. She was warm and peaceful under the covers.
Peaceful.
At that moment, not one minute after we arrived in the room, mom inhaled gently but audibly, and was silent.
My sister and I looked at each other.
“That might have been it. She waited for us.”
We checked for mom’s pulse at her wrist and neck. There was no pulse. Her body was finished with its earthly work.
It was one of the most remarkable moments of my life.
It was a privilege to be there, and to experience that kind of focused grace.
We prayed again, in tears, believing that Jesus had long ago paid the debt that mom, and me, and everything else that will ever have lived, could not pay.
Jesus taught that heaven’s joys will far exceed the joys we have known here.
That may be.
I thought of the joys of a young high school couple in Iowa in the 1950s.
And I was filled with gratitude. Again.
10/23/22
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