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.