For Mom

I know something is very wrong
The pulse returns for prodigal sons
The blackout’s hearts with flowered news
With skull designs upon my shoes

I can’t give everything
I can’t give everything

-David Bowie
I Can’t Give Everything Away
Black Star

I can’t give everything away. How did Bowie feel when he wrote that line? He knew he had cancer, and that he would, sooner or later, die. Did he know when? Did he have months, days, hours? In his final days, did he feel death coming?

How would I feel if my doctor said I was going to die? Would I believe her? Even if I felt my body slowing down, would I fight it to the very end? How much would I regret not having enough time to give it all away? And in the end, not having any more time at all?

What would it be like to go to sleep each night, after being told you were dying, knowing this might be your last night on earth?

What was it like for my mother, when her doctor told her she was dying of cancer? Did her oncologist, in fact, tell her? Did anyone tell her, before the cancer took her mind and she was unable to respond?

What No One Wants to Tell You
The first time I heard from anyone that my mother was dying was only four weeks before she passed away. Why hadn’t any of her doctors told us before? When a doctor told us, Mom was in the hospital, again. It was clear she had been declining for some time.

This time, doctors found a blood clot in her leg. If it traveled to her heart or lungs, she would die. A specialist told us that she needed surgery to implant a screen in a leg artery to block the clot’s path to her vital organs.

Should Mom have the surgery? Would it improve her life at this point? Did she want the surgery? Mom couldn’t answer these questions for us. The cancer had spread to her brain, and while she spent a great deal of each day awake, she no longer spoke. We tried writing and other forms of communication, but we couldn’t get through. Now her message seems obvious, but at the time we couldn’t decipher her flat gaze and slowly blinking eyelids.

Later, in hospice, she would speak, but only to say, “Thank you, thank you Jesus,” over and over and over in a hushed, fearful voice. It creeped us out.

We – my Dad, sister Elizabeth and I – had to make the decision for her. We didn’t know what she would have wanted.

My Mom’s general practitioner, who had been her primary care physician for more than 30 years, had visited her in the hospital just a few days before we found out about the clot. But now, when we had to make a decision about a life-sustaining surgery, he was on vacation and unreachable.

His substitute, a general practitioner he’d asked to make his rounds, came to Mom’s room, looked at the three of us, glanced at Mom’s chart and said, “Has anyone told you that your mom is dying?”

No. No one had told us. The doctor who had recommended surgery to stop the blood clot had not told us. Mom’s GP of more than 30 years, who had visited days earlier, surely knew but had not told us.

Had someone told my father, and he didn’t have the heart to tell us?

We took a vote. My Dad and I wanted Mom to have the surgery, which we were told was a minor procedure with a high success rate. Dad and I talked about wanting Mom to have more time, how it seemed ridiculous that she might die from a blood clot. But the truth was that we were not ready to let her go.

Elizabeth did not want Mom to suffer any more, and voted no.

I wish I had said no as well. The surgery did not go well. The surgeon said Mom’s veins had shrunk from cancer and multiple rounds of toxic chemotherapy. There were complications. She came back from the OR with bruises. She looked even more sick than before.

The worst part was that Mom had no choice in the matter. I felt guilty, sad and ashamed that I had put her through this. The second worst part was watching my sister break down a few minutes after Dad and I voted for the surgery. She cried so hard that she shook. Her husband Justin held her and said, “It’s OK. It’s your Mom. It’s OK.” I felt horrible.

Later I wondered: Why hadn’t I made the right decision?

A Day in the Sun
After the surgery, Mom went straight to hospice, where the nurses managed her pain with great compassion for 17 days before she died.

One day, early on when Mom was alert, my sister and I rolled her bed down the hall and out into the early summer sunshine. We listened to the birds. Elizabeth and I chatted about wanting to have something other than burgers from a nearby Wendy’s for dinner. Mom looked around, but didn’t speak.

This was her last day feeling the sun on her skin, her last look at blue skies, her last time listening to the birds.

Did she know? If she knew, how did she feel? Was there something she wanted to say, but couldn’t?

Mom, I hope you felt the sun, saw the sky and heard the birds. I hope you didn’t mind that we ate Wendy’s in your hospice room after you started refusing to eat everything we offered. You had always loved Wendy’s chocolate shakes. I hope you knew that we put the TV on Wimbledon for you, since you loved tennis, and played doubles into your 60s. We told you, “Mom, this is Andre Agassi’s last Wimbledon.” I hope you liked watching his last match on centre court.

I hope that I was a good daughter. You were an incredible Mom.

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