The Texas Bohemian

Word artist. Jack of all Trades.

Choosing Death

Yesterday I talked with my wife about the question of “assisted suicide” and all that goes with someone deciding to die or for someone deciding FOR someone to die.  Today in a very real way I have to make that decision.

We’re not talking Kavorkian machine here but the decision is the same.

My mom has reached the end of her ability to function without extraneous measures.  Her intestines are no longer functioning.  The doctor said he beleives it is blocked by tumor.  Three weeks ago tomorrow she underwent surgery as a last ditch effort to unclog a bowel.  Four hours of surgery and the surgeon was only moderately hopefull he’d succeeded.  He said he found a collapsed intestine and bypassed it.  “We’ll know in around three weeks.”

It’s been three weeks.  She had bowel function briefly after the surgery, two or three times, but since then not a whimper.  She’s had a few good days but mostly she’s gone steadily downward.  Her life has been dripping into her from a couple of IV’s, sustaining her body, giving us all that hope we want that mom will if not walk out of here recover enough to go home for the holidays.

It ain’t gonna happen.  That’s what the doc’s believe now.  Today we tip over that mountain and start down the other side.  The other side is slippier, steeper, harder to control and far more difficult to deal with.  Today we move from recovery to comfort.  One might say we tip over from hope to despair, too.  Momma ain’t going to go home.  Not this time.

The situation is bleak.  Mom’s intestinal system has quit.  The only way she will survive is through nutritional feeding via IV.  The hospital says it’s time she be discharged since she’s reached her capacity to improve.  Nursing home is out, no way to get a good room for her paid for.  Taking her home with stomach tube, catheter, and IV’s is hardly feasable.  As much as we’d all like to we’re not trained to provide that kind of care.  Not to mention the fact that it’d be care we could not afford.

With the nutrition mom might survive a few months, until her cancer catches up with her.  Without it she’ll not see December.  With the nutrition we can cling to her withered hands a little bit longer, cry more, wish for miracles we know won’t come.  Without the nutrition we’ll cling to her soft fingers for a shorter time, cry about the same, and just figure out how to say goodbye.

With the nutrition she’ll struggle along until the cancer takes hold.  Without the nutrition it’s unlikely the cancer will catch up to take her.

All the help and kindness and care she can get is waiting four floors down in a nicely-decorated room past a window that says, “Hospice.”  It’s the best option, the doc says.  It’s probably the best, my siblings say.  It’s the best for her, too, I think.  But in sending her down there where they’ll remove the nutrition and keep her free from pain we’re choosing to hasten her death.  In sending her down there we’re saying, “mom, it’s time for you to go.  Vaya con Dios.”

Do we have the right to do that?  How will I deal with the decision once she’s gone?  Will knowing we were doing the best for her matter?

I have said often, growing old sucks.  In the “back days,” as my kids say, the miracles of modern medecine were not available to create these dillemas.  Mom has had a no-resusitate order for years.  She’s said she don’t want to live on tubes.  Does this situation apply?  Can we simply say “it’s what she wanted?”

Of course if she clears up enough to understand we’ll ask her.  The problem with that (and gears grate against my head with saying that) is, what if she says she wants to keep the nutrition going?

I am prepared to be with her, three weeks or three months, what ever I must do.  Can I hold up to that?  Is it fair to my family?  If she hangs on with IV bottles how bad will the cancer get before she has pain beyond what drugs will control?  If the choice is to muddle through with the nutrition rather than going with Hospice are we actually choosing life or just prolonging death?

When that little ol’ lady over there drifting in and out of consciensness is gone I’ll be a lot more alone.  I’m selfish.  I want her company.  She, like dad, have been proud of me.  I’ve not managed to get many people proud of me all these years.  My lack of tact, constant trying to change the world, always taking on the badguys and doing what I believed was right even when unpopular has not endeared me to many people.  So honestly, I want to keep her around.  But I’m being selfish.

We’ll decide today.

And then we’ll cry.

November 4, 2008 - Posted by | Blather | , , , ,

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