I am looking at the very old woman in the bed of a private room in a quiet community hospital. This is the community where I grew up and spent twenty years of my adult life. I know some people here, and some of the hospital staff are friends or acquaintences of mine.
My mother has a bandage loosely wound around her head. It keeps slipping off, and I try to put it back, but I see that the sutures on the wound on the back of her head, just above where her neck meets the skull, are clean and not oozing. Her pillow is clean, and she is annoyed with any "fussing." Dad sits on the bench that runs under a picture window with my husband. They are talking about an outside stairway that's under repair at the apartment complex I own. My dad is hunched over, he's not been the same since successful treatment for prostate cancer about two years ago. Whatever the therapy, it's done something to his lower back, and it's easy to see it causes him discomfort. He will not consent to xrays to find the cause.
Mom is looking at me with a hard expression. I sit on the edge of her bed and talk the small talk that works for awhile. I feel I have to be there. Something grim is taking place and at least this visit gives Dad some kind of relief.
"I love you, Mom," I say, trying not to cry. Her eyes soften for just a moment as she says she loves me, too.
A nurse's aid comes into the room. Her tag says her name is Mikki, and I wonder if she's the Mikki I went to high school with, but I don't want to ask and start up a conversation with her. She takes Mom's temperature and says to her, "I hear you're a spunky one." Mikki's affect is cheeful, and she means this as a compliment. Mom is quiet and thoughtful. I can see she is trying to figure something out.
Mom will be climbing out of her bed and falling down somewhere as she always does at hospital stays. She will pull out I.V. lines at some point because they restrict her movement and they were not her idea. When the nurses come to pick her up off the floor or put the lines back into her, she will smile sweetly and say she couldn't get anyone to help her and she really doesn't want to be a bother.
Mikki asks if anyone would like coffee or juice. Larry and I decline, but Dad says he'd like coffee, the regular kind, and Mom says yes, but she only drinks decaf. Mikki says she'll make fresh decaf then, and it'll just be a little while. She brings Dad's coffee about five minutes later, and Mom says to the room, "He's trying to take my coffee away from me. I ought to choke him one of these days." Everyone assures her that is not the case, and Dad puts his cup on the counter out of her sight. His shoulders sag some more.
We've heard the news from the lab is not good. There is cancer present in what was thought to be a wen. A wen is sort of a fatty cyst, fairly common, not to worry. But this is a bit of a surprise. It appears to have invaded the bone in her skull, at least that far, tests in the next few days will tell us more.
Mom had just survived a horrible three month ordeal with pancreatitis. There was a frightening stay at Island Hospital for two weeks at the onset of that, a hellish two week stay at Virginia Mason in Seattle, and then a fairly quiet stay at San Juan Care in Anacortes for three weeks. At home she has had almost daily visiting nurse care, and only a few follow up clinic calls at Virginia Mason.
Through all of the illnesses my father has given up sleep, comfort and peace. Even before the pancreatitis, my mother was fragile and prone to falls (see above), one of which resulted in a broken hip and the recovery from that. There are also cardiac and pulmonary events that have required Emergency Room visitations and brief hospital stays. I have lost count of those, and sometimes I don't even hear about them.
I cannot help her. She won't eat the soup I bring to their house. I tell her, "Mom, you are a fantastic cook, but I know you sometimes don't feel well. This is something I can do. I make it from scratch and load it with good nutrition and taste. Please let me help just a little bit." She looks at me with those eyes I call beady. I don't know how else to describe it. But I know she won't eat the soup. She will eat peanut butter and crackers first. Maybe Dad will have some.
Dr. Sible, the general surgeon, appears and tells us what he found in surgery. He looks a little shaken. He said he started to remove what he thought was an ordinary sebaceous cyst, but then saw bone fragment. There's a hole about the size of a pea and cancer of some type. The dura has not been penetrated, but if cancer does get through, Mom has about two or three days before death takes her. It's urgent that she go by ambulance to Harborview Hospital in Seattle right away, so they can perform emergency surgery of the delicacy they are expert in. This situation is going to be very hard on Mom, whatever the course, even harder than the pancretitis was.
The growth he encountered, he says, is not the source of the cancer. That's somewhere else in her body, and he does not have the expertise to trace it.
I am watching Mom's reaction. Does she want to take the chance of going to a big, chaotic hospital again, just to die far away from home? Does she want to see Dad slide further into whatever is ailing him? She smiles sweetly at the surgeon and says she will make the trip to Harborview. Of course, we all support that. It is her wish, and we all believe life is sacred.
Larry and I go to their house, secure the dog, get Dad's personal stuff and saddle up for Seattle. My brother will meet us down there. I've used Facebook to reach the family members I don't have time to call. Marvelous resource.
Harborview is a huge hosptial on the East Hill in Seattle. We park and find Mom, Dad and my brother, Steve after being shown through a maze by an orderly. It is a haven of human misery and very busy medical staff. One patient is handcuffed to a gurney and I can see by his expression that whatever the reason for his presence, it beats whereever he had been. He has prison tats and a sly expression.
We wait and we wait and we wait. Two hours go by while nurses monitor Mom's vitals and run saline IV. She hasn't had anything to eat all day and it's 3:00. The ER resident stops in and says the neurosurgical team is coming to tell us what they conclude from data sent from Island Hospital. There has been no more than a cursory glance at the surgical wound on the back of her head near the base of her skull.
Three young patients share this room, veiled by curtains. They all appear to be suffering from the misuse of chemical substances. One got high on meth and was pulled out of icy water near Aberdeen, then airlifted here. They are keeping her sedated and bringing her temperature up. One is moaning very loudly and hates to be touched. The other is sitting quietly on his bed, I can see him.
Larry, Steve and I venture down to the cafeteria for survival food. Dad waits with Mom in case she decides to wander. We come back and Steve takes Dad for dinner.
The neurosurgery team appears. There are five very young people standing around my mother, and they each take a glance at her wound. Mom mentions they barely look like they've finished high school. One of them quips, "Our moms dropped us off here."
After they leave, an ER nurse calls them "residents." They had told us that Mom isn't in bad enough shape to be in the trauma care at Harborview, and they'll likely send her back to Skagit County somewhere for follow up. They don't know what's going on with the growth or the hole in her skull, but they can see why Dr. Sible was frightened by it. No, they don't know what it is, but they'll keep her overnight and talk about it some more. She has a room waiting upstairs and they'll move her in about another hour. The ER attending has to admit her, but he's been busy with some other stuff. The nurse hopes he can get to it soon, because now it's 7:00 on a Friday night, and this place really hops on weekends. Keep a close eye on your valuables, she adds.
Mom has removed the oxygen suppliment, the blood oxygen monitor, and the blood pressure cuff. Her head bandage is on the floor. She's fiddling with the cardiac leads.
Larry and I thought we could head back north, to home, after Steve assures us he can watch Mom get tucked in and take Dad home to his house. He can bring Dad back here in the morning.
Goodbye, Mom, I say. I pat her on the arm. We'll see you tomorrow.
Not the last goodbye. Not yet.
