death and dying

3 weeks ago (this sunday) my aunt fell in the bathroom. she was found unconscious, but breathing. my dad spent the first week at her bedside with her husband and 2 girls when they could be there. last friday i made the trip to albuquerque. pic below is my uncle, giving attitude as only he knows how.

i spent this week watching a woman die. this week has sucked. so as not to bore you with the details, my aunt has had a history of brain tumors. her brain tissue remaining is very little, and her independence and functioning has taken a severe downturn over the last few years. when i met her she was remotely with it, but i was young so we never really got to know each other. her husband has become her sole caregiver, even helping to toilet her these last years. she is very stubborn, always has been from what i've known.

my parents were both there with me, so it was very nice to spend time with them. that's my dad above, somehow with a smile. saturday we all met with the chief of neuro in a family conference. for a doc, he did an excellent job of communicating. essentially he laid it out for us - her remaining shunts from 40 years ago were the source of infection now. her blood/csf cultures were now negative after a week of antibiotics, but he didn't have a doubt that if the antibiotics were stopped, it'd return. she wasn't ventilator dependent at this time, but if we extubated her pneumonia would set in. by day's end we decided to stop life support. it was a difficult situation for my family, my own little 3 person unit. none of us were related to them by blood, so we were walking that fine line of being supportive and educational while not trying to pressure anyone. that's a position i hope never to be in again. yes, she needed to be pulled off life support. but that isn't a fast process, and watching it is very gut-wrenching for anyone. but making sure everyone knew that and was prepared for it was impossible.

my little cousin needed her 2 year old there before we could pull her off, for her own reasons. which meant we didn't get her off the vent until monday morning. the family seemed to think she'd die instantly, even though we assured them it wouldn't happen. the actual act of extubation was done without us in the room, but everyone stayed right outside her door and cried. it was all very weird for me. i understood it, but then i didn't. it was just surreal.

monday night we went out to eat, all of us. to pf changs. 12 people in one of the loudest restaurants to begin with. needless to say, i hit my breaking point. i totally lost it. had to go outside and have dave talk me down over the phone. the dynamics of the family aren't the best. there's tons of catholic guilt floating around at any given time. so much so that it almost becomes a game of sorts. but not a fun one.

by tuesday i'd had just about all i could take. she was still ticking away with an oxygen sat steady in the 70's and HR in the 100-110 range. i made my flight arrangements to come home the next day. by wednesday afternoon the docs at UNMH felt comfortable with sending her to hospice, and she made it there by wednesday afternoon. thursday morning at 6:50 am, she was gone.

this week i saw the downside of nursing. sure it's great to be able to talk to any doctors, to be able to care for just about anyone. but the downside is that same thing. the knowledge. when i got there friday night, i knew she wouldn't make it. yet family was at the bedside all but begging her to wake up. that went on every single day. i've always been proud to be a nurse. this week i saw how it really sucks to be a nurse. knowing what's coming is ok, but watching it happen on the faces of your family blows. no matter what info you give them, no matter how much you warn them, they won't hear you. not in that situation. and then when your predictions come true, they look to you with this look that says 'how could you not have told me this would happen?!'. i did!!!

it was exhausting. i slept hard most nights. i would put on 2 alarms, one to wake me for a run, and the 2nd for the actual time i had to get up because i knew i wouldn't make that run. i just couldn't get up. the diet was rough to stick to. the average diet in albuquerque consists of at least one tortilla a day. which i've missed greatly. but now i couldn't have it. my mom views meals as an experience. this diet cuts out so much of that now, that meals were pretty rough.

i'm still exhausted. the rosary is sunday night, the funeral monday, and the burial monday or tuesday (the services are in Espanola, NM, while the burial is in Clovis, my hometown). i'm not going. i can't go. by the last couple days there, the family was starting to take their frustrations out on each other, and i honestly don't feel that close to most of those people to begin with. i have no desire to put myself back there.

dave and i have built such a cocoon around ourselves. rarely do we venture out of it. we stay home, we go shop, we go to races. we'll even make plans with friends and then cancel at the last minute. wtf is that? i tried explaining to my parents how overstimulated that entire process was for me. my dad didn't get it. my mom seems to.

today i got my first run in in a very long time. it felt good to be out. i think i'm just going to keep moving forward right now, just like in a race. maybe things will begin to make sense at some point...