Tuesday, July 14, 2009

A shell

While I was in the no-technology zone on Whidbey Island over the weekend, my sister, RE, was dealing with a new development with Mom.  Apparently Mom's been chewing, then spitting out her medications.  Spitting right at the nurses and aides trying to...well, aid her.  So as of yesterday, Mom's off all her meds, other than one liquid anti-depressant.  The psychiatric nurse told RE that this is the heartbreaking part of her job, because it signals that the end isn't far off.  Three weeks ago, when we were dressing up and taking Mom to her grand-daughter's wedding, Mom was still almost present.  Sure, we had to sink onto our knees in front of her, interrupting her vacant stare in order for her to actually see us.  Sure, she could neither understand our words nor speak in recognizable sentences. Sure, she'd forgotten our names, that she'd ever been married, what a wedding even is.  But she was there, and at moments, her eyes seemed to clear a little, and she broke into a smile.  Now, according to RE, she just seems sad.  A sad shell of her former self.

RE thought Mom might perk up a little if she heard my voice, so she held the cell-phone up to Mom's ear and I began to speak.  "Hi, Mom," I said, then told her my name.  But though she reacted to my name, she didn't get the concept of the telephone, and tried to lean closer to it, as if she might hug or just see me through it.  It was not a successful venture, so RE lifted the phone away from her leaning body, and talked to herself, while Mom slumped back in her wheelchair, staring blankly toward the window.  It's the last time we'll try that, RE and I decided.  I will never talk to my mother on the phone again.  And it's possible that, even if I'm in the room, she won't be able to communicate with me.

Two weeks ago, Mom was still pacing the halls of the nursing home in her wheelchair, propelling herself with her feet.  Now she just sits in her room, barely aware of time passing.  Mom, who once was addicted to chocolate, now grits her teeth against her favorite treat.  She who could read whole stacks of books in a week, now cannot recognize more than a word or two on a printed page.  Oddly, however, she still instinctively adds the words she reads to her incoherent speaking.  For years, I was annoyed at her relentless reading of signs as we drove through town, because it interrupted any real conversation.  "Dissmore's", she'd say.  "No fee ATM. Clements' Chiropractic."  "Don't even think of parking here (this was actually a sign across from the post-office when I was a kid--my alltime favorite sign ANYWHERE.  And Mom had a shirt made with that sign plastered against my chest.  Imagine the response I got when I wore that shirt in public)."  And somehow, that endless sign reading has lasted into this winter of her brainless life.  And what once irritated me is now amusing and even comforting.  It reminds me that she's still in there somewhere!

So now we're in the final countdown.  RE didn't ask the nurse how long this season will last.  It's probably hard to quantify, varies from patient to patient.  But the heart, blood pressure meds she's been taking a long time are gone.  And the thyroid pill she's had daily since long before I was born will no longer regulate her system.  No more Alzheimers drugs either, so the steep descent might actually accelerate.

So we're all holding our breath a little now.  RE told me it's increasingly difficult to visit Mom. Because she doesn't even speak very often now, one has to be ready with a monologue.  For some in my family (like myself especially), monologues come naturally.  Sorry to say.  But for RE, it's excruciatingly difficult.

But what strikes me is that every change somehow becomes the new norm.  About when I got used to filling in the blanks when she couldn't think of a word, she began to use nonsensical sounds.  And just when we got used to her roaming the halls and using her feet to move her chair, she stopped moving.  The blankness in her conversation became a blankness in her very being.  And now, her being a body, a shell that used to house a person, will become natural.  And just about the time we grow comfortable in her living absence, that absence will become a literal one.  All of this shell-time is practice for that.

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