Saturday, April 19, 2008

Giving up doesn't always mean you are weak; sometimes it means that you are strong enough to let go. ~ Author Unknown

Part Two: The Decision

On Friday, it took several hours for all three of Kim's children to finally come together to discuss their mother's prognosis and decide whether or not to remove life support.

Robin went to the airport first to pick up Tobey. He was on the flight, but had somehow managed to avoid Robin and disappeared in the airport. We were all certain that he was terrified at having to face another tragedy in his young life and guessed that he had called a friend to pick him up. Avoiding Robin was avoiding what was waiting at the hospital.

Two hours later, when Philip went to pick up his wife, Mary, they also searched the airport for Tobey. They didn't find him.

When Robin, Philip and Mary all returned from the airport, all of us congregated in the hospital lobby just a few feet from the ICU entrance. We took turns spending time with Kim. Robin continued to reassure everyone that Tobey would show up. She was right. After almost six hours Tobey called her. He was at the park near his home.

When Robin brought Tobey back to the hospital, Philip and Kimmie took him into his mother's room. Those of us remaining in the waiting room (Robin; Sandy, Tony's sister; Mary, Philip's wife and me) gave the three kids about an hour alone with Kim, then we all went back to her room.

I felt so bad for Kimmie and Tobey. Kimmie's only 20 years old and Tobey's only 17 years old. They lost their Dad just two weeks before, and at the memorial service Tobey stood up and professed that his Dad was the only person he thought really understood him. Now, they were losing their Mom, too, and they had to decide whether or not to remove their Mom's life support. How much can these kids bear before they crumble right before my eyes, I thought. They cried... often and freely...but they never did crumble. Instead, they reached out for support ~ to each other and to the rest of us. There was hardly a moment when they weren't holding hands or embracing each other or one of us.

Philip suggested dinner in the cafeteria. Take a break. Take a breath. Nourish themselves. They need to take some time. They agreed and we all went to eat.

We returned to Kim's room about 8:30pm. She was still sleeping peacefully. Kimmie approached the subject first. She looked at me and said, "What do we have to do?" I knew what she meant. "Let me find out," I said.

I went out into the hall to find our nurse, but saw that he was in with another patient. There was another nurse in the hall and I approached her.

"Kim's children have decided to remove her life support. What do they have to do to do that?"

"Oh." Pause. Long pause, with deer-in-the-headlights look. I thought, You work in ICU, for crying out loud. I'm sure you have been asked this question before. "You need to speak with your nurse and with the doctor," she finally replied. "Your nurse is in with another patient right now, but I will tell him and send him in to your room."

"Thank you," I said and turned and walked back into Kim's room.

About 15 minutes passed and the nurse I'd spoken with walked by the door to Kim's room and stopped. "Oh, by the way, I haven't had a chance to tell your nurse yet."

Great!, I thought. Kimmie was getting a little distressed. She kept looking out the door waiting for Bill, Kim's nurse, to appear. They'd made the decision and the waiting for the next step was becoming very unsettling.

A few minutes later, Robin glanced out the doorway and saw Bill walk into the nurse's station area and took off after him. When she came back to Kim's room, Bill was just a few steps behind her. He was holding a form and a pen.

Bill explained that we didn't need to speak with the doctor after all and then began to read the form aloud. I don't remember much of his recitation except the words "Category 3". A couple of times, Kimmie asked, "what does that mean?" and Bill would explain in detail. He was so patient, so kind, so compassionate. When he finished his explanation, I asked, "She will continue to receive enough pain medication to remain pain-free throughout, right?"

"Yes," Bill said. "We will make sure she is comfortable and pain-free."

"Kimmie, do you have any questions?" I asked. She shook her head "no".

Bill handed the form to Kimmie and said, "Take your time. There's no hurry. Just let me know when you've decided." He left the room.

Kimmie looked at Philip, then Tobey, walked over to the counter and laid the form down on the flat surface. She wrote her mother's name on the top of the form, made an X in the box next to category 3 to remove all life support, signed her name and dated at the bottom. When she was finished, she handed the form to me. I put my arms around her and hugged her for a long time.

It was done. They had decided. They were ready to let their Mom go.

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