If there were an exam on the caregiver booklet that hospice gave us, titled “Fifteen Signs that Death Is Near,” I feel confident that Charlie and I would both ace it.
It’s almost midnight. We are sitting at the kitchen counter of our parents’ house, obsessively going over the checklist that attempts to break it down by weeks, days, hours, moments. Preparing for the unpreparable. Our mom is lying on a hospital bed in a nearby room.
Her breathing pattern is changing. Check.
She hardly drinks or eats. Check.
Her extremities are cold and possibly tinged with blue. Check.
She sleeps most of the time. Check.
When she is awake, she is restless. Hallucinations are common—she may reach for things you cannot see. Yes: She seems to be working and reworking an invisible cat’s cradle with her delicate bluish fingers. Or playing with Silly Putty. Or poking a hole into another dimension.
When she speaks, it is slow and difficult. She may refer to things you do not understand. “Who can trust the light?” she cries out with a start after hours of silence. Then: “Let’s get out of here!”
You administer liquid morphine under her tongue from a big red bottle. Your criminal defense attorney husband assures you that you could make a fortune off it on the black market. Check.
She doesn’t seem to be aware of you anymore. You are beyond exhausted. Check, check.
Your dad is asleep for the first time in days in his clothes on his stomach the wrong way in the bed next to her hospital bed with the lights on. Check.
“So, what’s your guess?” I ask Charlie.
“I don’t know—a week, a few days?”
We both stare back into the booklet, scanning for something that is not there. Strange creatures: we who try to excel at knowing the unknowable.
Amelia, who is trained as a birth doula, seems to know better what to do. She lights candles and incense in my mom’s room. She changes the water for all the cut flowers, culls the wilted ones. She rubs lotion into my mom’s hands, performs some Reiki. “I’m really feeling her presence,” she says at one point.
I can’t feel her at all. I try to talk to her when everyone leaves the room, but I have no idea what to say. “You don’t have to do this anymore,” I try. She rouses and almost seems to glare at me—bewildered, annoyed. As if I would be doing this if I knew how to stop, she seems to say with her eyes.
Heartbeat and pulse may be irregular. Gurgling and congestion—known as the death rattle—are common and often more distressing for the caregiver than uncomfortable for the patient. She may seek—or demand—“permission” to go.
Three and a half hours later, back at my house, my phone wakes me.
“I think you need to come right now,” Charlie is saying.
“Why?” I ask, my brain stubbornly playing dumb. My toes grope the floor for sandals and I clip my mastectomy drain to a fresh T-shirt and I run out into the warm night.