Oct 21, 2012

my mother

On September 21, 2011 I found out my mom probably had liver cancer.  On September 22, 2011 it was confirmed. On October 21, 2012 at around 6:00am she died.

I've been lucky to avoid the experience of death on a personal level for my whole life. My grandparents are dead but I was young, they were in Wales, and I hadn't seen them in years. My grief was more centered on seeing my mother cry for the first time.  Watching her try to remain composed in the kitchen after she hung up the phone.  She told me my grandmother, Elsie, had died. She continued to serve me lunch. Silently. And every now and again she became overwhelmed with grief.  Put her hand to her face as I stared at her. Not quite knowing what to do. I acted like nothing unusual had happened. But I could see her trying to continue with the mundanities of life while dealing with the difficulty of mentally absorbing the reality of the death of her mother. Today was my turn.

My Mother
My mother specifically asked for no wake, funeral or ceremony or any kind involving anyone other than the immediate family. No obituary posting. Nothing. Just a cremation. I'm going to break slightly with that request.

Part of what helped me come to terms with my mom's death is that she had a good life. Because it started out remarkably badly. Both my parents were poor on a level I find hard to comprehend now. They had nothing. My mom's parents were kind and easy going but eccentric and completely irresponsible. They never had enough money at the end of the week. And to be poor in mid-20th century Wales was a feat in itself. While a driver for the industrial revolution (coal), its services were no longer needed at that point. My mother was often hungry. To compound the situation, WWII was on. Food was rationed. Whirlybird bombs would fly over and sometimes blow up nearby. Child refugees were sent from bombed out London to live at my mom's house. Putting a further strain on the expenses. My mother at the age of 10 actually took over the family finances. She would take the dole and ration it out to her parents so there was something left over at the end. Worse Wales was a trap. There was no way out of Wales. People were born, worked in some capacity for the coal industry, and died. Usually young.  My father's dad died when my father was 12. Life expectancy wasn't good.

And yet to hear all of this from my mom you'd never view it as bad. She loved her crazy parents. She didn't mind taking care of the finances and laughed about it. She loved having kids from London stay with her. She kept in touch with many of them until the day she died. She bought used clothing for the rest of her life. She laughs about the whirlybirds and how she hoped they would blow up the school. In her own words, "we had a grand time."

And everything after that was uphill.  She married a man who loved her dearly for more 54 years. She eventually had more money than she would ever need.  She moved out of Wales and got to live in London, Paris and America. She raised a nice family and had two decent kids who got along with her and didn't give her too much grief (except the flooding incident. Sorry Mom.). She travelled all over the world. Saw all the things she wanted to see in life.

And she was able to have a year of knowledge that she was dying to prepare herself. Lots of support from her family and friends. Relatively little pain that was easily manageable with painkillers. And a rapid 1 month descent from being fully healthy and mobile to dead. And a quiet peaceful death in which she was mentally fully accepting and ready to die.

Cancer gets a bad rap. It's not a bad way to go. Especially when I think of the alternatives. A sudden death would have been far harder for our family to deal with. A death can also have extreme misery and suffering. Many diseases end badly. By suffocating as your lungs fill with fluid. Or as your mind begins to fail and you are staring at someone who is no longer your mother. My mother didn't have to deal with any of those things. I think if you had given her the option to have that kind of life back when she was 10 she would have jumped at it. It probably would have seemed an impossibility. But that's how it turned out.

My mother was defined by the fact that she never complained. Not because she kept things to herself. But because she never felt that way. I can't think of a time when I saw my mother mad. When someone asked her, she herself said that she never really hated anyone. Everything just rolled off my mom's back. Her one key talent was that whenever someone in the family was mad it would just make her laugh. It was a remarkable talent really. No one could ever stay mad in our family because she would be laughing. Not just a small laugh but the kind of laugh that would inevitably cause my mom to pee in her pants as she ran to the bathroom.  It defused any situation and in some sense made her the most important member of the household.

My mother also had no rules for me. Ever. She just didn't care for them. If I wanted to get drunk before I was 21 or stay out late on a school night she was fine with that. And oddly as a result I never did. I guess it took all the reason to do stupid things away. In other words she was the perfect mom for me.  I could focus on accomplishing things instead of being rebellious. When I was very young I sucked in school. She never cared. C's were fine with her. I eventually got my shit together but I'm not sure that would have happened if she had forced me to.

The Dying
It wasn't supposed to happen this way of course. My mother has been a health nut her whole life. She's been doctor and medication free for all of it.  One September 20, 2011 she was as spritely and alive as any 79 year old lady could be. Like my father. But my father was supposed to die first. Because that would have spared him the reality of going on without my mother. Even though my father was a serious hard working man, she was the real manager and arbiter for the family. A power wielded with a feather sword.  But that wasn't how it turned out. She was going die first.

When the news came in it was of course a shock. Liver cancer is like pancreatic cancer. At a certain stage and a certain age you are lucky to get 6 months. Regardless, I went through, and I'm sure everyone in my family went through, the process of figuring out how to get more information and how to cure her. I had visions in my head of writing a blog post on how I did it. I read lots of research reports. I wrote to doctors in Asia and the Middle East. And on some level I thought maybe I had found a way out for my mom. A chance. But my mom is not a 'hardcore' person. And my remedy required hardcore.

She went through the medical system. A local hospital and then eventually the Mayo Clinic. They ran tests. They administered chemo. And then an experimental chemo. My mom I think instinctively knew that really she didn't want to do that. She had a death sentence. Why make herself miserable? And thankfully she backed off the first chemo and the experimental chemo very quickly. Because they weren't going to do a damned thing. We all knew that. Luckily it didn't degrade her to the point of being chemo-sick. I think for anyone with cancer the decision to undergo chemo is one that should be done with serious thought. Looking back my mom should never have taken dose one. It was never going to change anything. Luckily she stopped early enough that she didn't spend her last year recuperating in a hospital.

After that, things were easier. She just went about her life with no real side effects other than some tiredness and a need for afternoon naps. But she was fine. And able to see her friends and enjoy herself. At that point we were all waiting for something to change to let us know death was coming. Because while she was fine we all held fingers crossed that something good would happen. My rational brain knew that wasn't the case. But my emotions clung to that hope.

And that call came from my sister when she had begun to change. She was becoming more tired. A little pain but aspirin managed it. But mentally she was a little more spaced out. As the liver dies it can't process toxins out of the blood as well.  A key toxin is ammonia which is created from the breakdown of proteins in digestion. Ammonia buildup has the ability to reduce short term memory and to cause hallucinations. Both of which occurred in my mom.  She weaved in and out of lucidity during this time.

I was able to chat one last time with my mother when she was fully lucid. The last real coherent call I had with my mother was perhaps the perfect call.  We were both talking about health as we always have and she was driving me crazy because she just couldn't comprehend what I was talking about. This was a common conversation between my mother and me. My mom isn't super smart. Nor does she care to be. She just doesn't care about things like that with the intensity that grips me. So her lack of understanding the nuances of the science I was discussing with her drove me batshit insane. This often happened. And of course this just made her laugh. Laugh like I hadn't heard her laugh in ages. It was just hilarious to her. And then of course I started laughing to as she ran off to the bathroom to pee.  It was a nice conversation. The one I'll think of many years from now as I look back at her in memory. How she was in that call was how she was to me. A funny slightly eccentric woman who I enjoyed talking to.

In the end I was happy that she died. She was not living anymore. And life was just one series of indignities after another. There was no point in holding onto that. It would have been selfish. It was time.

The Emotions.
The impact of learning your mother is going do die is obviously a powerful one. Think right now how you would feel if that call came in. It's a call we all know is coming. And yet there is no preparation for it. No class in school. No discussion with experts. And not a topic one generally reads about. This is a new experience when it happens. And emotionally you'll never quite be prepared for it. It will hit hard like a sock to the gut. And it will hang over your for the remaining months like a heavy weight on your shoulders.

You forget about it from time to time. And then it rears its head at unexpected moments. The emotional strain is tiresome and tiring. There were times I just wanted to get away from the reality of it. To not have to hold back emotions around people.

At some point if you are lucky you come to peace with it. As I did probably about a month before my mom died. It was going to happen. Nothing could change it. I'd miss her. But she had a good life. There are worse things that could have happened to her and our family. I should be thankful on one level. It's a mantra of sorts I had repeated during the whole ordeal. But at some point I came to peace with it. And my mom did too. She was ready to die at the end. She was awake for very little of the last few weeks. Some pain. The bathroom was an ordeal. Eating and swallowing had become more difficult. There was nothing for her to look forward to. She knew we loved her and that we would miss her for the rest of our lives. What point is there to go on at that point? It wasn't living.

And yet oddly when I finally accepted it I was at my most emotional. Sudden moments of grief would bring me to my knees.  There wasn't the despair from before. Just an overwhelming sense of grief for my mom.

I remember during these moments that I tried to figure out if there is something you can say to someone who has a loved one dying. What would make me feel better? It turns out there is nothing. Nothing makes you feel better. And nothing makes you feel worse. Someone could insult my mom and it wouldn't register. I wouldn't care. That thought would be meaningless. Similarly nothing helps. It just is.

The Husband
As worried as I was about my mom in some ways I was more worried about my father. He has been a devoted husband for 54 years. Every day he has woken up beside my mother. They do everything together. But for all the seriousness and toughness of my father, he is the weak one. My mother was the perfect wife for him because she took all the social aspects of life off his back. He has no real care for or ease with most social activities.

Tomorrow he will have to get up and there will be no one in the bed next to him. He will get up and make a cup of tea like he has for decades. But only one this time. And he will sit and read the paper. And at moments he will realize he is alone.

Spouses have a way of dying shortly after they become widows. And I think my dad is at risk of that. Most of the year has been spent engaging him. Making sure friends come by and making him understand he has a family outside of his wife. He has grandkids. He has friends.

I'm sure the transition will be difficult. But I have some hope that he can do it. He's not a man without hobbies or friends. But it is something my sister and I will need to remain diligent on.

The Aftermath
I'm not sure how the next few months will be. I have family and work and lots of distractions to keep me preoccupied. I will fly out now and see my family. And perhaps later this year we will take a trip to Wales with the grandkids as well and scatter the ashes somewhere meaningful. But I'm not sure how it will play out.

But as of now, my mom is just a memory. But a good one. I had a wonderful mom. As a friend said, "I always liked your mom. Everyone did." I'll miss her dearly.
Do not stand at my grave and cry,
I am not there; I did not die.

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