Part One: The Prognosis
I am sitting here in front of this computer screen with my fingers on the keyboard and I can't think of anything to say about the death of my sister. I realized this morning that I have done just about everything to avoid writing about this, but when I took my journal notebook out of my purse and began to read what I had written over those few days before Kim's passing, I knew I would have to put all those thoughts, feelings and events together if for nothing else than to ensure that I will never forget those precious last moments.
Sometimes it was horrible; sometimes it was hard; sometimes it was sad; sometimes it was beautiful, touching, even humorous, but it was almost always overwhelming. But, I am glad I was there. Had I not been there I would have missed the most beautiful gift my family has ever given me.
I arrived in Las Vegas Thursday afternoon, April 10th. The day is sort of a blur. Everything runs together in my head and I'm not sure precisely what happened when. All I know is that too much happened and I was on complete overload: anticipation, hesitation, fear, sadness, regret, love.
Karen picked me up from the airport and said Robin's flight was due in later that night close to midnight, but she would go straight to the hospital when she arrived, so we drove straight to the hospital to see Kim.
Kim was conscious, but sleeping. There were tubes every where. A tube from the respirator went into her lungs; smaller tubes connected to veins in both arms and her neck; larger tubes drained her lungs, abdomen and bladder. There were countless bottles and clear plastic bags of medicines and nourishment hanging on three poles and connected to the tubes that ran to her body. She was receiving two pain medications with a third one ready, if needed; drugs to keep her blood pressure stable; drugs to keep her heart rate stable; drugs to reduce swelling; and on and on. The combination of the tube to her lungs and her sheer physical weakness left Kim unable to speak. She had been using a pad and pen to communicate, but looking at the pad she used to write on, it was clear she was becoming weaker and her handwriting was becoming almost illegible.
We spent a little over an hour with Kim, holding her hands and talking to her. At times, when she would open her eyes they'd flash recognition. She even tried to smile. Then, when she became uncomfortable, the nurse gave her more pain meds and she drifted off to a deep, peaceful sleep.
I was able to catch one of the doctors in the hallway. "She's very ill," he said. "She will not go home from the hospital."
"I know you can't give me an actual time frame, but she has a son in Virginia. Is it time for him to come home and say good-bye to his mother?" I asked.
"Yes," he said. "I'm very sorry."
I took a very deep breath, but I couldn't keep the tears back. I thanked the doctor and turned and walked back to Kim's room. I took another deep breath, wiped the tears and blew my nose and walked back in the room. I reached over and took Kim's hand and held it for a long time while she slept. She was so heavily medicated, I don't even think she was aware that I had returned to her side.
Karen and I left the hospital and headed for Kim's house to drop off my suitcases. On the way, she called Robin and conveyed the doctor's message. Robin said Tobey would be on a plane the next morning, Friday. We arrived at the house so I could get settled for the duration, but what transpired was an ugly altercation between the two sides of Kim's family ~ blood and in-laws ~ with poor Kimmie in the middle and that nearly sent me back to the airport in complete exasperation at the display of the usual family drama, drama, drama. The words, death brings out the worst in some people and what the hell were you thinking??, kept racing through my mind. But Philip, Kimmie's older step-brother (Tony's son by a previous marriage) was there. And if it weren't for Philip, a loving and kind man, I probably would have walked away, left Las Vegas on the next flight bound for Little Rock and missed the emotional and spiritual connections I made with my sisters and Kim's in-laws.
That evening after dinner, the Kimmie, Philip, the in-laws and I drove back to the hospital and visited with Kim until about 10:30pm. Although, barely aware, Kimmie spent time with her mom, talking to her quietly, stroking her arm and holding her hand. My heart just ached for her. What a huge burden for such a young person, I thought. But, through her grief over her father's recent death and her mother's impending death, she is so strong, so mature, so willful. I am so proud of her. I am so proud of my sister and brother-in-law. They did a good job of raising her, as well as Philip and Tobey.
Karen called me Friday morning. She had visited with Kim during the dinner hour the night before. Kim had been fairly lucid and asked for the writing pad and pen.
She wrote one question. "Am I dying?"
"Yes," Karen replied.
The rest of us drove back to the hospital Friday morning, visited with Kim for a short time, greeted Robin (who had spent the night sleeping in a chair at Kim's bedside), and later we spoke with the doctor and nurse concerning Kim's prognosis. She was not breathing well enough on her own and medications were keeping her artificially stable. She would not survive.
We heard those words over and over in every euphemism possible: will not return home, will not survive, will pass, will expire, will end her journey. No matter how many times you hear them, it's devastating...even when you already know it and believe it. I cried. Robin cried. Kimmie cried. "What would happen if life support was removed," I asked. "She would eventually pass," said Paul, the ICU nurse. "This is not an easy decision for a family," he said, putting his arm around Kimmie's shoulder. Kimmie, Philip, Robin and I just looked at each other. Then we hugged and comforted each other. No one was alone unless by choice. No one would have to go through this without support and love unless by choice. We were there for each other, individuals, some of whom barely know each other, whose lives are thrown together by this profound tragedy, loving, feeding, nourishing, grieving, offering prayers and caring for one another.
Kimmie wanted to wait for Tobey, her brother, to arrive from Virginia that afternoon, and then Kim's children ~ Philip, Kimmie and Tobey ~ would make the final decision with the full support of the family.
I kept wondering how we, the older, supposedly wiser, more experienced family members, could make this easier for Kim's children. We couldn't. Because no matter what, no matter how much love they're given, no matter how much support they receive, no matter how many prayers are said, no matter how many facts they're presented, it will probably be the hardest thing they'll ever have to do in their lives.
Thursday, April 17, 2008
What greater thing is there for human souls than to feel that they are joined for life, to be with each other in silent unspeakable memories. . .
Part One: The Prognosis