A change of plans
Rio’s Big Grandma isn’t actually very big at all. She gets her title from rank, not size. She’s the matriarch of Deb’s family and is actually Rio’s great-grandmother. Deb had called her great-grandmother “Big Grandma” too. But the time Rio came along the original Big Grandma had passed on so the next Grandma in line took the title.
As we pulled out of the driveway after dropping Rio off we got the call that changed the day. It was a nurse in ICU. Things had taken a turn for the worse. The Doctors wanted to meet with Debbie.
We dropped the CRV off at Midas, who were kind enough to give us the use of a battered Nissan for the day. We went straight to the hospital.
Big Grandma has been in a rapid decline for the last six months, from semi-independent and fully functional to frequent flyer discount at the hospital. The medical team’s prognosis: it would take heroic action including feeding tubes, etc. to keep her with the living. It was up to Deb. Grandma was DNR, which means Do Not Resuscitate. She had chosen this herself a number of years ago. That means the Docs can’t restart the heart or lungs if they fail. Below that it is a slippery slope. Where does the feeding tube fit in? Are massively aggressive antibiotics on the fence or over the line? She had been on “pressors” for days. This class of IV drugs brings very low blood pressures up to normal levels. Usually they are more in the spirit of one shot use. Not intended as a maintenance drug. When they tried to back off, her blood pressure would crash. Had the line already been crossed?
My wife, the last of her line and Grandma’s only living blood relative was left with the agonizing decision. Intervene “heroically.” Stay the course of aggressive treatment. Or back off and late nature take its course. She was faced with trying to balance her own desires, her sense of what’s right, her knowledge of what her grandmother had wanted in the past and what her grandma was saying now in her diminished capacity.
With great difficultly and great courage she made what I think is the best, most humane, and only right choice to make in this situation. Let her die with dignity. Go no further. In fact, get some of this crap off of her, keep her comfortable. Let nature take its course.
Once the decision was made things proceeded in a uniquely New Mexico way: nothing happened until the priest arrived. Once the Father was in the ICU the man of God and the women of Medicine both began their assigned tasks. The priest was a Dominican, I think, with a long chocolate brown hooded robe. From a hidden pocket in his over-sized sleeve he took out the Caesar-purple ribbon emblazoned with crosses. He kissed it and placed it over his shoulders. The dialysis technicians clamped the holes pulling deep red blood from Grandma’s arteries into the filters. One of the women was about 8 months pregnant. I was struck with the circle of life. One life was drawing to a close, another was about to begin. The Priest got out his well-worn pocket prayer book and absolved Grandma of her sins while the “pressor” drip was stopped and the IV tubes were removed. As the priest anointed her with oil the nasal oxygen cannaula was removed.
And then it was done, both the church and the hospital had prepared her for her journey to the next world.
In only a few hours her blood pressure dropped to 39 over 11. Her breathing began to slow. Her cataract fogged eyes were closed and she was resting peacefully.
I stood by the bed and looked at her beautiful, regal face. 86-years-old and not a wrinkle. While I gently stroked her hair her breathing slowed, slowed, slowed. Four times per minute. Twice per minute. Once per minute. The pulsing vein in her thin neck slowed. Weakened. Faltered. And then…. she was gone.
Now she’s on the other side, with her three children who died before her. With her husband, most of her friends, her parents. With our first child.
In loving memory,
Grandma Mary, a.k.a. “Big Grandma”
04-05-21 to 04-20-07