Dignity

Like most people, I have two grandmothers, and each couldn’t be more different from the other. Charlotte, my father’s mother, can only be described as an unstoppable force. Indeed, even after suffering an aneurism and having the doctor tell her that she must stop chain smoking and drinking two pots of coffee per day, she continues to do so, possibly fearing that to stop would result in her dying from boredom. She’s incredibly active, loud, outspoken, argumentative, and sharp as a tack, even if her hearing is starting to go.

Frances, my mother’s mother, is quite the opposite. She was born with a hearing impairment, and as a result, has to be very attentive to follow a conversation. She is soft spoken, and doesn’t like to argue, preferring instead to go with the flow, even if it means suffering fools. She’s fiercely independent, never asking for assistance, and hating to burden her family. Since the passing of my grandfather, her health has deteriorated, and now she is dying.

When I walked into the Cardiac Intensive Care Unit of Massachusetts General Hospital, I really had no idea what to expect. The waiting room was full of people, speaking as if they were at a cocktail mixer. How bad could it possibly be? As I walked down the hall, turning the corner to approach the bays where patients were being treated, I saw a woman in front of me, alone in a room, pale, sunken, lifeless. For a brief second, I thought to myself “I pity the family she belongs to because there’s no hope for her… Now, where’s my grandmother?”

As I got closer to the bays, looking at the areas that had just entered my field of vision, I scanned them for my grandmother. There were family members in both of those bays, none of whom belonged to my family. My attention was drawn again to the woman laying in the center bay, and I could suddenly feel my lungs empty, as if every last drop off air was being forcefully suctioned from them. It was her. She was nearly unrecognizable.

She is suffering from Septic Shock, probably the result of a Urinary Tract Infection. Septic Shock, like its little brother Sepsis, is no fun at all. An infection in the patient’s blood stream causes systemic organ disfunction. In her case, her kidneys failed first, requiring a constant connection to a dialysis machine. Then, her blood pressure began to plummet and her breathing became impaired, requiring intubation and a constant drip of dobutamine, fentanyl, and midazolam to keep her in stable, but critical, condition.

It went on like this for nearly two weeks, during which they feared she may have suffered a stroke. Only two days ago did they take her off of her sedative. When she awoke, she was able to open her eyes in response to auditory and physical stimuli, but she’d look through you, neither recognizing you nor able to discern what she was looking at. The woman I knew as my grandmother never woke from that slumber. She was in pain, both physical and emotional, fearing the unknown, hating the cruel joke that life had played on her.

Yesterday, after acknowledging that her sepsis had yet to be quelled, the doctor finally proposed what we had been dreading to hear. He told us that it may be time to slowly remove my grandmother’s life support and allow her to pass peacefully rather than suffer in misery for the rest of her life. My grandmother, a woman who refused to be helped while crossing the street, did not want to burden her children, and if she could, would never agree to nursing home care. Instead, she’d insist on returning to her apartment, and would hope to quickly return to her walks around the neighborhood. This is not to be.

Tomorrow, the doctors at Mass General will begin to remove the drugs and machines that are keeping my grandmother alive. She will pass in her sleep, without pain, and without ever having to see her children torn apart, watching her wither away in a nursing home. She is Frances Madeline LaCava-Barter, and she will be missed more than she can possibly imagine.