Article Content

I stepped into room 3014 and smiled at the familiar, loving face. My mother, her aged body looking vulnerable in the hospital bed, grinned in response.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

"I'm back," I said, reaching down to kiss her cheek. "I see you've got lots of company," as I acknowledged the presence of my nieces and nephews.


She must know she's dying, I thought. Relatives show up like this when you're dying. She hasn't had this much company for over a year. She knows something's up.


"Dad phoned me," my niece explained. Tears filled her young eyes as she turned away from the bedside.


I gave a quick professional assessment of my mother. Color slightly jaundiced, respirations steady, pulse 84 and strong, deep, non-productive chest cough. Her untouched dinner tray indicated she had eaten nothing.


A day earlier her housekeeper had phoned 911. "Your mother had a spell," she later told me.


"Bronchitis," the doctor pronounced upon emergency room admission.


But somehow I knew this was serious. This was in God's perfect timing. He had arranged for me to travel from another part of the country for a different reason because God knew I would want to be here now. My mother knew, and so she had waited for me to come.


Earlier in the morning, God had given me the gift of a precious half hour alone with her. "Are you in pain?" I had asked.


She shook her head in denial.


"Will you tell me how you feel?"


"No," she said, closing her eyes, shielding me from some unpleasant reality.


"The Lord is my shepherd, I shall not want." I spoke the familiar words. Her voice picked up the verses of the twenty-third psalm, proclaiming her assurance of God's presence. Her eyes remained closed, so at first she did not see the tears flowing down my cheeks.


"Even though I walk through the darkest valley, you are with me." My fingers gently curved over hers. "And I shall dwell in the house of the Lord my whole life long." Clasping her bony, arthritic hands, I wept.


These were the hands that had held me as an infant, had wiped away the hurt tears of my childhood, the hands that had lovingly and lightly spanked the naughty child, the hands that had stitched and knitted my clothes, the hands that had baked and cooked to feed me, the hands that wrote cards and notes of encouragement, the hands that waved as we said frequent goodbyes. These were the hands of my mother.


"I love you, Mom," I whispered.


"I know you do," she said, looking directly into my tear-filled eyes, her mouth drawn into a loving smile.


Yes, I told myself. She knows she is going to her heavenly home.


Now, as I looked at the relatives crammed into the small hospital space, I silently thanked God for those earlier moments of intimacy with my mother.


She sat propped in bed, pillows supporting her frail body, like a reigning queen greeting her subjects. She graciously smiled at the photos shoved in her face and patiently listened to all the family news.


A nurse's aide popped into the room. "Time for your test!!" A broad, toothy smile flashed across his face.


"What test?" I challenged, blocking his way.


The charge nurse appeared at the door. "We've scheduled a special lung test. This is Sunday. We were fortunate the specialists could come. They're waiting for her now."


"But she signed an Advance Directive for Health Care two years ago. She filed it here at the hospital and also filed it with her doctor. She does not want any extreme measures." I spoke with quiet resolve.


I gradually moved out of the room, away from my mother's hearing.


"Why are you doing this?" I asked.


The charge nurse explained. "The doctor ordered a special breathing test to see if your mother has a pulmonary embolism."


The nurse's aide stood awkwardly, uncertain whether to proceed with his routine assignment of patient transport. He slowly edged his way down the hall. Another nurse wheeled the medicine cart toward us. The charge nurse motioned for her to join us.


"Look, I'm a nurse myself," I explained. "I realize you have your schedules. But my mother does not want any special life-saving measures. My niece just finished telling me that my mother returned a short time ago from having a CAT scan. Why put her through any further discomfort of any kind? Any test is a trial for a lady who is almost ninety-three years old. Besides, what will the doctor do if she does have a pulmonary embolism?"


"Well, then, he'll probably put her on heparin."


"Why? Is that really going to prevent her from dying? Why try to prolong her life?" I pleaded. "It's all right to let her die. She's lived a wonderful, long life. She's not afraid to die. Don't you understand? She's a Christian. She knows where she's going. Please, just leave her alone. Just let her go."


I stood in the hallway, surprised at hearing the calm in my voice. I faced the nurses and read compassion in their eyes.


"Don't you understand?" I repeated. "She's not afraid to die. That's why she wanted to sign an Advance Directive for Health Care. Can't you find it in your records?" I challenged the nurses. "Last night I brought the one she had on her refrigerator and had a copy put on her chart. She wants a peaceful death. She does not want people jumping on her chest. She does not want tubes and life support. She's lived a full, wonderful life. And she knows that when God calls her, she is ready. A Christian, like my mother, knows where she's going."


I paused. The two nurses listened, their eyes locked on mine. They did not protest, so I continued.


"I'm her daughter," I emphasized. "And I'm not afraid to let her die. That's what she wanted. She always wanted to die with dignity. We talked about it."


Finally the charge nurse spoke. "I wish more families had your faith and peace," she said simply.


"Thanks," I said.


Their compassion disarmed me. I struggled for composure.


"But," I continued as my emotions threatened to consume me. "I do have to share something with you. I've cared for a lot of people during their dying moments." I swallowed and forced my voice to remain steady. "It sure is different when it's your own mother." My vision clouded.


"You're very strong," the charge nurse wrapped her arms about me. "I know. I went through this with my own father-in-law last year. Believe me, it's tough."


The med nurse squeezed my hand. "You are an inspiration to me. Thank you. Most people we see here are afraid to die. I can see you and your mom are different."


"Let me see what I can do." The charge nurse turned and walked down the hall to the nurse's station.


She returned a few moments later.


"If you'll come with me, the doctor will talk with you. I have him on the phone."


I followed her down the hall, shaking my head in frustration. I don't believe this, I thought. We went to all that trouble two years ago to draw up an Advance Health Care Directive, and now I wonder if those directives mean anything. My mother has been transferred to three different units in this hospital, and I have had to remind each health care team of my mother's wishes. Are hospitals that afraid of litigation? Why can't health care professionals recognize that we all will die? Is it an insult to hospitals that people actually die? It's as if we Christians have a wonderful secret and the title is, "I know that my Redeemer lives!!" Christians are not afraid to die.


I picked up the phone. "Yes, this is her daughter. My mother signed an Advance Health Care Directive two years ago. Basically, she does not want any undue measures. That's because she is not afraid to die. You see, she's a Christian, and she knows where she's going."


Suddenly I realized the entire nursing staff had zeroed in on my phone conversation. I continued.


"Please just let her go. No more tests. Please, let her die with dignity."


I waited. I heard the doctor take a deep breath.


"Am I correct in saying you choose no further medical intervention?" the doctor questioned.


"Yes, that is correct." I responded. "Please, no further medical intervention and," I paused, "please give an order for No Code."


"If those are your wishes, that's fine. We'll arrange for her to be discharged tomorrow morning. Please put the nurse back on."


I handed the phone to the nurse. So that's the acceptable phrase for today, I wryly concluded. No further medical intervention. And tomorrow, the lawyers will demand other terminology.


I strode back toward room 3014 with agonizing questions bombarding my mind.


If I were not a Christian, if I were not a nurse, I don't think I would have known what to say or do. What about families who are not familiar with medical language? What about those who do not have a strong Christian faith? How do they handle these situations?


I knew the answer. Their loved ones end up on life support for months or years, stretching the dying process to a painful, expensive siege. I began to realize that it was a horrifying way to use our medical technology.


"The doctor says you can go home tomorrow," I announced as I reentered my mom's room.


"Thank you," she rasped. Then with eyes closed, she added, "Yes, I'm going home soon." She sighed, as her facial muscles relaxed. "Yes, very soon."


She knew. Her appointment approached.


Later that afternoon, my mother gently exhaled and slipped into unconsciousness. Then, as the flame of an antique lamp slowly dims, her life slipped away, and she entered into the waiting arms of Jesus.


I caressed her hand while the pulse in her wrist slowly weakened, then finally stopped. The pink of her transparent skin turned to a waxy glow, and she was gone.


The doctors, the nurses and the hospital had allowed her to die with dignity. They finally let her go.