2010 April 28

Created by Tom on 08/05/2010
. Dear friends, Late Wednesday, April 28, 2010 Late last night Meg and Les talked to Dr G who gave permission to take Karen to the hospital, which they did at 10pm. The outcome of all this is uncertain. But Dr G wanted to give Karen a chance to stabilize before deciding how to proceed. Hospice will meet Karen at the hospital on Thursday with papers for her to sign removing her from hospice. She could go back on hospice once more, but not more than that (i.e., she couldn't switch back and forth indefinitely). Dr. G suggested that Karen could receive morphine in the hospital to relieve her suffering if she was willing, which Karen was open to but wanted to see what it was like when she was hydrated and had had some sleep. Les (who spent a quiet day sharing stories with Karen while she sucked on ice) confirmed that Karen has her full cognitive capacities now, even much more so than when I left Tues night (a dramatic improvement since her emergence from coma Monday). She told Les she feels she was still under the influence of last Thursday's death-with-dignity drug and was "acting on automatic" when she decided on Monday night to take a second dose on Tuesday. As the time to take it approached (probably in the quiet time from 3-6 pm Tues when Les and Karen and I all tried to nap -- with me squeezed onto the home hospital bed next to Karen -- not much was happening to distract her) Karen began to realize she was not actually ready to go. Her small bowel movement at 6:30 pm gave her a rationale (is the bowel blockage gone?) to stop the forward motion to suicide. As I reflect on this now from a distance, I can have a bit more empathy with her decision than I could in the moment when it seemed to come out of the irrational blue (even if the bowel blockage is gone, which is highly unlikely, it will pretty surely recur again soon in the natural course of the cancer with horrible consequences) as a unilateral U-turn with no conversation or consideration for the whiplash, emotional turmoil, and life-consequences it could have for everyone else. I still wish she had talked about what she was thinking and feeling in ways that included us, rather than just announcing 20 minutes before the death-with-dignity cycle was due to begin that she was calling it off and wanted an X-ray in the emergency room to see if her bowel blockage was still there. As Martha noted, a lot of emotional work (to say nothing of physical logistics, financial cost and future planning) was done by us to arrange ourselves around her plan to die. It is not so odd for some of us to feel disoriented and discounted, especially those of us who were "running on fumes" after days, weeks, or months of following her (often changing) wishes. [Later I compared this turnaround to a bride who, at a large wedding, says, when asked "Do you take this man as your lawful wedded husband?" says, "Well, on second thought, No, I don't." She'd have a hard time convincing anyone to come to her next wedding, that's for sure!] After a day in bed at home and many conversations with friends and relatives, I feel less burned out, closer to normal physically, but with no particular motivation for anything, poised between several worlds. I participated a bit from a distance in thinking about Karen's scene with Les (who I am very interested in supporting; thank god/ess for Les). I am concerned about my sense of break with Karen which I need to address with her while she is alive (which means, in my estimation, soon). It will haunt me for a long time if I don't resolve it (I can feel the truth of that; our relationship was too long, deep, and nuanced to simply walk away after an upset, no matter how major). I have a hunch I will go to the hospital to see her today, but that I will do some reflection about all this (probably with an I Ching reading, which I often find useful in intensely confusing times like this) before I do. I really don't know what will happen next (as usual, I guess...) Coheartedly, Tom