Last night, 370 days ago

Issue no. 0016, on my last night with my mom

They don't tell you what pulling the plug on someone is actually like, probably for a good reason. On TV, it seems like turning off the TV. It’s not.

If you're an ignorance-is-bliss type, you should stop reading now. 

In my particular case, it starts with a 3am talk from the attending physician, who softly explains that my mom is very unlikely to get better. We might be prolonging her suffering. I can barely hear what he's saying, and the words take a few minutes to sink in. 

We'd been staring for hours at the oxygen monitor, hoping that the numbers would turn around. Sometimes they would, and we'd desperately cling to that thought, but the trend was always down.

The beeping monitors become insistent, and we turn them off. Not new information, and nothing we can do.

We’ve read all the articles about how doctors choose to die. My sister and I know what we have to do, what we agreed to do weeks ago, and the pre-commitment to the decision really does make it easier¹. We take it to our dad, who's in no state to be making any decisions, but he agrees.

When it's my time to go, I want it to be quick. 

We give the order, and the hospital machinery gets moving. They must do this pretty often, because things go a lot more smoothly in the next two hours than in the previous two. They give us forms to sign. Then they swap out the morphine for fentanyl. 

The nurse locks the bag of fentanyl to the IV stand using a transparent plastic box, like a stick of deodorant at a SF pharmacy. I don't take it personally. They add the fentanyl in, but every breath is still a struggle, like it has been for months. For all four of us. The rules say they have to titrate the drugs, but they can increase the dose every 15 minutes.

I wonder what the committee was thinking. Nobody’s worried about an overdose.

We turn down the oxygen. It's like a hair dryer in her face. My sister reaches out, and I put my hand on hers, so we’re doing it together.

The time between each breath, gasping and strained, gets longer. I'm holding my own breath, not sure which will be her last. We hold her hands and tell her over and over that we love her, hoping that's the last thing that she'll hear. 

I took this at the hospital as we left without her around 7am. The sun still rises.

1. If you’re in the situation where you have to think about this, you should have the talk if you haven't already.