Monday, December 13, 2010

Moments We Dread

I'm breaking away from my use of this blog as more strictly professional to bring in something more personal.
My grandma is dying.

That pause was me stopping typing because I couldn't see my keys or the screen.
The tears aren't because I feel sadness about the fact that she will no longer be living in a world marred by her dementia, her rapidly progressing loss of memory of all the people she loves, her inability to care for herself, her existence now as only a shadow of the woman who gave birth to and raised 16 children.
What we cry for is rarely the actual physical death, is it?
More so, I think the fact of loss of personhood, of fading from the world. Whether the fading happens quickly, a sudden and unexpected death, or more slowly, piece by piece as it has for my grandma. The fact is, we fade.
The feeling of helplessness, not being able to stop the inevitable. In my professional world, I have an understanding and acceptance of the dying process. I know it is what we all ultimately face and is the one certainty in life. The helplessness I struggle with today is not being able to be there and doing for her what I have done for strangers. Provide her physical comfort, be a part of a team who escorts her through her last walk of life. I am helpless by not being able to be holding my mother's hand as she watches her own mother slip away. I hold the hands of strangers as they cry. I hold them close to me if they have no one else to hold onto. I try to bring them emotional comfort, or at least the comfort of knowing that all is being done to protect against suffering.
If I knew that my grandma's suffering was minimal, the my family was receiving the right kind of support and care themselves, I might feel a bit better. From 200 miles away, though, I'm afraid that neither can be said to be true. I know there is an effort and attempt, but despite my internal struggle to "not judge," feel myself being disappointed and frustrated and even outraged about some of the care she is receiving - more frustrating because some of this care is being provided by a Hospice group, and I'm finding their interventions frankly medically unsound. From 200 miles away, though, and as one grandchild in a family of 40+ grand and great grand children, in a family with 16 children, each of whom are struggling themselves and floundering along the way - what does the one granddaughter with medical and specialty training for just this kind of patient have to offer?
Or, when what I try to offer is ill-received?
I know the simple answer is this: go there.
I know what I would probably tell someone coming to me with the same questions and concerns: go there.
Travel the 200 miles. Be there.
It makes sense on so many levels, but on so many levels doesn't.
There are the obvious reasons: Work. My own little family needing me here. The fact that my ability to be there wold be so short term, and this a problem whose time frame and longevity is impossible to predict. And the overwhelming feeling that should I go there, I will still be helpless. She will, ultimately, till be made to suffer because I simply will not be able to be there at her bedside or on call until she dies. I will have to leave, and my gut knows that afterward, nothing will have changed.
This defeatist attitude is not typical for me.
I see my family members in various stages of denial. I see them in various stages of grief. I see them in various stages of turning on one another with blame. I see them all claiming that they have my grandma's best interest at heart, and believing they are doing what is best for her - but as we find out with all families in this kind of disarray, there is more beneath the surface. More anguish and hurt than I can expect myself to work through so that everyone can begin to heal and so my grandma is no longer some misplaced pawn.
I can't fix them, either.
Again, defeated.
In the end, one way or another, whether I find an answer to my questions or not, the fact remains.
My grandma is dying.
She is dying and it brings back to mind all of the people I have loved and who have died. The shortness of life. The joy of it all, the pain of it all.
And, selfishly, what I dread most about this is trying to explain it to Henry. My bright little boy. He is old enough and smart enough to realize something is wrong. He knows Grandma Cookie, and I think there is a good chance he will carry memories of her with home throughout his life. So, when she does die, how do I handle it?
You would think someone in my position would have the perfect answer to this question.
Guess what? I do have the perfect answer.
Except, it's a perfect answer for you. Or for a stranger. Or for a room full of people attending a lecture.
The answer is not so perfect when you answer it for yourself.
So, here I am on Monday morning, Facing a week of walking into the lives of strangers bringing them my skills and hoping those skills, in turn, bring them comfort and peace.
I will put on my "Hospice Doctor" name tag and game face and I will fake my way through every encounter, while inside I am calling myself a hypocrite and a faker. I will do unto others as I would have done unto me. Or unto my family. Or unto my grandmother.
And will hope that eventually, it will.