Telling myself I'm not a monster

This post is extremely personal.  While I first wrote these words to my husband, I realized that I need the support of everyone far and near to help me support my family.  Seeing scenarios like this almost daily in my work does nothing to ease the internal conflict.  Somehow putting things out into the universe, to my husband, then to a close friend, and now to you, helps me be honest with the clarity needed at a difficult time.

I am sitting awake in my hotel room at 1:00am after trying but failing to sleep. On Thursday my Grandma was in a car accident, spinning out and then rolling her Jeep on the ice.  Firefighters got her out, but she came out of it with just a small bruise on her shoulder, and checked out fully okay at the ER.  The next afternoon she was playing cards, then found down two hours later.  Massive stroke.  Was taken to Dubuque, IA, the closest hospital, and then transported to Iowa City.  I flew out Saturday afternoon.  Today, Sunday blending into Monday morning, was my first day with her and with my family.

It's harder tonight than it has been so far.  I think I stayed up too late in the first place and I'm now riding a mean second wind of emotions.  I flew out with the gut feeling that this was it, now or never, and that my Uncle would need help acting as the medical power of attorney since he is foreign as to interventions, their meaning, and the legality behind it all. Dad brought his copy of her paperwork, stating no interventions - do not resuscitate/do not intubate, no big tests, no antibiotics, no percutaneous endogastric tube or nasogastric tube for feeding.  Since she cannot swallow and has no mode for nutrition, reading that paper line by line with Uncle and Dad this morning made the gravity of the situation all too real.  But the task of assuring compliance with her wishes is suddenly making me feel like I am being preemptive, even though I know with all my heart that she does not want any bit of her current state.

I had a hard time leaving her at the hospital this afternoon. At 4:00pm or so she became tachycardia from 110-150 bpm and had elevated blood pressure of ~160/130.  This is the grandmother who had a pacemaker put in not many months ago. The nurse tried giving her a med by IV in a small dose to no effect, gave a bit more before we left.  A priest also came by upon request between med doses to forgive her of all sins.  uncle and Dad were ready to go for the day, more so Uncle.  Dad knows he has a pattern and respects that it is a part of his coping strategy.  It was almost like a time clock thing for him, in at 8 and out at 5. 

Mom, who was still KC in constant correspondence, had suggested verbalizing to her that we are there for support but it's okay for her to go, that we respect her wishes and seek to abide by them.  I might have held off until tomorrow were it not for the sinking feeling in my gut.  How do you tell your grandmother that you love her and want to follow her wishes without sounding like you are purposely pulling the plug??  I told her it was okay to go, that Grandpa and my Aunt M were waiting for her, because that is in line with her beliefs.  Grandma was more awake and looking at me as I said it and held her hand, but I didn't know if the tear from her eye was there before I started talking.  I found myself wishing for a cardiac complication that was clearly beyond acceptable treatment that could help solve the whole thing.  Every time my emotions swell my fingertips go numb for a second. 

I went to Target for a few things that hadn't fit on the plane or ended up being empty once Dad and uncle were at the hotel. I so very much needed New York City tonight, with constant lights blazing and wide sidewalks, just to roam for a few hours with the city chaos as a blanket.  Target is connected to a mall here.  I started wandering the mall only to immediately get denied by store closures. Back to Target, make myself buy dinner on the way, and back to the hotel.  Watched the late game, Pats at Indy, with Dad and Uncle.

At 10:15 I opted to retreat to my room to sleep, but instead found myself in front of the bathroom mirror.  For a half hour I looked myself in the eye repeating many words I already said today but will have to repeat tomorrow.  I needed to practice saying them, to reassure self that I am indeed saying the right things - that assuring all interventions be withheld is, in fact, not only her wishes but also the right thing to do.  Trying to reassure myself that I am not being a monster.  

And suddenly my heart sank thinking of my brother, helplessly stuck on the other side of the world.  His job sent him first to China and then to Australia.  He called when he woke, both of us in tears trying to figure out if he had a chance to make it in time to say goodbye.  Even though I know time tables are impossible to establish for death I had to ask the nurse and doctor for my brother's sake, because otherwise he probably couldn't forgive himself (or me) if he didn't at least try to make it work.  In reality, if a ticket was somehow available he probably would not get to the airport in time.  He almost immediately had to leave for northern Australia, basically going off the grid to another mine, and will be back to the Midwest on Thursday barring weather. My mirror conversation became me defending the question of a timeline as not stupid because of its purpose for Brother's peace of mind.  I was making up arguments with imaginary docs about something that won't be an issue tomorrow.  When I caught myself saying "Don't you fucking dare talk down to my family!" I realized what I had been doing unknowingly for the last half hour.  Time for bed.

When sleep didn't come I laid there wondering if the nurse would call Uncle if things changed, if we will walk in tomorrow to find her still snoring away like a true Irishwoman from a long line of snorers, or if she will pass overnight during one of the moments like this that it hits me so very hard.  I think the difficulty Dad and Uncle had making decisions during previous admissions is less for them since I am here, which was a major part of my decision to come so quickly.  But this is quite literally the hardest thing I have ever done.  Not only am I holding the finality of someone's life in my hand, she is my frail and helpless grandmother.  I don't know what I believe in when it comes to death, but to have signs of life around me helps remove the existential crisis and supplant it with the wonderment of reincarnation, of the principle of conservation of energy, of a continuing world that had an impact from your footprint.  I suddenly feel trapped by my hotel room, by the icy ground outside, by the single digit temperatures.  

My plan is to walk in the morning amid the college students, working my way around the town and campus before heading to the hospital.  I guess you could say to wander in the cold, so that as my face burns I can tell I am still alive and in reality.  To be surrounded by the familiar beeps and sounds and smells of a hospital, so familiar after two and a half years of working in acute care, but to not have access to her chart or the docs or equipment... It is a very confusing place to be.  

Music

Morning walks during the last month of Daylight Savings were solidly in the dark.  I was listening to music and looking up more often, with a sense of calm and of fun during my break from running.  No pressure, no training goals.  Monsoon season was also nearly gone, so few if any clouds existed.  Orion was to the southeast, the big dipper to the north, and thousands upon thousands of smaller starts filled in all the gaps between.  How many of these are visible because of minimal to no interference from human habitation, or does the thin air of elevation allow better vantage?  It is not as many as visible from the rural coast of eastern Nova Scotia, but otherwise it is the most to which I have ever been privy.  I though of Mrs. Barr's astronomy class during PEP (2nd or 3rd grade).  The green sheets with pictures of constellations.  The nightly moon calendar we were to fill out - I over appropriated the degree of each phase; Mom offered nightly discerning observation.  Three potential Ws also filled the pre-dawn sky, but I couldn't recall its name or which was correct, if any of them.  The particularly crisp mornings offered a thin film of the Milky Way.  And daily - daily! - I'd see at least one comet shooting across the sky, most often to the east. 

October brought my year anniversary of moving to rural Colorado.  Only now did I realize how much of that year was spent adjusting to the deeper cold, the huge difference made by the sun, and how to dress for the valley's easterly winds that give half of my runs a headwind and cause drool and snot to freeze in stripes and globs on my face.  I have also learned to trust the moon, to use its light instead of automatically defaulting to a headlamp even when a mere crescent.  (I still always wear a headlamp when on the road.)  I came to trust the moon so much its absence during Bear factored into my meltdown and my need for a human voice and presence. 

I had also trusted the simple sound of my environment since 2007.  While walking I often listened to talk radio news, but I was so conditioned to relative silence that the conscious act of packing my iPod as a backup for races like Bear was wasted.  Not once did I think of donning my ear buds, even upon suggestion from my husband.  In hindsight, October also became my experiment with music.  It was the exact playlist used for Bear and for Pine to Palm the year before (where I also never used music). 

That first walk with a soundtrack illustrated the power of tunes.  Half of them did not work, even when walking in the dark with my dog and within the safe proximity of a warm house filled with kittens and a spouse.  Being alone in the dark with a gaping sky can bring peaceful meditation but also existential questioning.  Albums that normally can fill in a day's gaps with artistic humanity, like Mumford and Sons, suddenly were being skipped, and skipped, and skipped.  Broken Social Scene for the most part survived except for its melancholy contextual interludes.  David Bowie was half good but half hokey.  All but two Bob Dylan songs became annoying.  Gnarles Barkley and Talking Heads became a refreshing relief.  I was itching for Sharon Jones and Raphael Saadiq, but my iPod Shuffle apparently like to focus on all the songs I wanted to skip.

After my month off I continued to use music while running, now with a parsed out playlist.  Running itself felt much more effortless than before, but the music perked up my pace even more so that easy runs were a minute faster per mile than September.  Since Daylight Savings ended my mornings have regained sunrises of prismatic morphology to add to my music.  It is a much different experience, even with wind chills already into single digits.  I think back to Bear and laugh at myself.  At least I know I can complete challenging tasks when cognitively fried.  The morning light will only stay for a month at the most, so I am enjoying it as much as I can before the dark also brings sub-zero temperatures that regulate me to a treadmill.

Yesterday marked two weeks of having returned to running.  I still used music, though it was hard to hear over the headwind.  While trotting along forest roads to the Natural Arch I heard a horn, turned to find an SUV filled with hunters, so moved over and exchanged waves as they passed.  Turns out they had been behind me for a third of a mile, slightly farther back but still honking to pass.  Nathan, attempting to run according to heart rate, started to sprint in attempt to catch up and alert me.  In my own defense I have only encountered perhaps five cars total on that road within the last year, and there was lots of shoulder room that would allow passage of anything but a little sedan.  But they may have been amused by the few times I jammed out with my arms, oblivious to their presence.