Wednesday, July 3, 2013

DNR



The world just keeps spinning, even when you can’t spin with it. 
 
As I stepped out of the emergency room to breathe in some hot night air I saw a couple of cars drive by. I thought, “I wonder if they know how lucky they are, I wonder if their life is as simple as it seems?”

My head wasn’t in the mundane which is really the meaty part of living.   All of my focus, all of my energy was on the little monitor above Marty’s head, the monitor that shows her oxygen levels, the monitor that shows her beating heart, the monitor that shows her blood pressure way too low.  All of my focus was on the next blood pressure reading.

That was Friday; we came home from the hospital Monday.  Marty had another infection, an infection that came suddenly, without precursor, an infection that weakened her and pushed her compromised system too hard.   

Marty is feeling better and all signs point to recovery from this latest event.  Guess what, I’m not really ready to dial down the hyper vigilant mode.  

That Thursday Marty had just shown signs of getting back to normal for her most recent UTI.  On Friday things changed, she had been tired all day.  She seemed to feel good when she woke up that morning for breakfast but after that, pure lethargy.  She was tired, sleepy and complained about a bad headache.  It was late in the afternoon that her blood pressure started to drop.

She and I ate supper alone, together, as I watched her every move and quizzed her to get some sense of what was happening and if what was happening was bad enough to ring the alarms.   We watched the news as we ate and watched as the world kept spinning.

I had already been on-line and made a reservation at the emergency room we frequent, “just in case”.  I told Marty I would check her blood pressure one more time after she drank more fluids and ate some supper.  We ate, she drank, I did, and it was too low and the decision was easy, we piled into our van and drove to the ER with me looking in the rearview mirror at Marty too much.

We got in quickly and were in the system immediately, her blood pressure still trending down.  I have to say it never felt fatal; it never felt like Marty was leaving, but maybe I wasn’t being realistic. 

Marty’s blood pressure was as low as I had seen it and her persistent complaints of a really bad headache brought back the nightmares of the ruptured aneurysm.  It had been eight years but here we were in the same ER, it felt like history repeating a very frightening memory.

Tests were done, blood was drawn and urine was procured.  A chest x-ray was clear and best of all a cat scan of her brain was clear save the damage from the previous strokes.  Her blood pressure was awful but she wasn’t bleeding in her brain again, that left a tenuous sense of relief.

The blood tests did reveal an infection and fluids were administered to prop up the blood pressure and dilaudid was given to help with the headache.  Marty slept.

While the world was turning outside of Providence ER, while those wacky Kardashians were setting social standards, while my daughter-in-law whom I love was driving home from Austin, I sat with Marty’s doctor, who is also her friend,  in the ER talking, answering questions, answering THE question.

I hate the question.  I hate the thought of the question.  I think I know our answer to the question, the answer Marty and I have talked about before her strokes and since the strokes.  I think I know our answer.

Great and Wise wanted to know what we wanted to do if Marty’s heart stopped.  It wasn’t a capricious question; it was a serious question from a loving man in a serious situation.  Marty was weak from some unknown infection and her blood pressure was precipitously low.  We were up against it and it wasn’t a theory. 

I gave the answer, I hate the answer.  I started to doubt my answer as it came from my mouth.  “We let her go, “I said quietly.

As the world continued to turn, as people necessarily went about their lives shopping, cooking, kissing, holding each other we were in an emergency room in Waco Texas talking about end of life decisions, this can’t be our reality.

For me, it’s an easy, clinical decision…..if it is someone else we are talking about or we are just sitting around talking and theorizing.  But it’s not theory, it’s not someone else, we were talking about Marty and we were confronting reality once again.  

When they put the purple wristband with the initials DNR on your loved one it becomes a made decision.  Doubt, recrimination, self-criticism was and is almost overwhelming.  How can you say, “Just let her go….”

I have to be reminded that Marty is not afraid of dying, that her words, “It’s just another way of being” are true.  I have to remind myself that it is not about me, that it is about how Marty has always wanted to live her life.

It is not a onetime decision, it is not a spur of the moment decision, it is an evolving decision that stems from 40 years of talking with Marty.  It is a decision I know she would agree with, it is a decision that requires more courage and faith than I may have the next time.  

I don’t really care to think about the next time, I only know that the purple wristband symbolizes my worst fears and my hope that I really do know what is the best path. 
It’s really all about the hope.

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