With great power comes great responsibility.

I’ve been writing this in my head for over a week but the words are struggling to get out. I’m finding it difficult even now.

I was asked to make a decision determining whether my mom lived or died. And I was expected to make it quickly. And I froze.

I received a call at work. The voice on the other end said something to the effect of “Your mother was found unconscious in the dining area of the independent living facility. She was unresponsive. Her breathing was slow and shallow, and she was very cold. She had stopped breathing entirely so we intubated her, and the breathing machine is breathing for her. She is still unresponsive. We’re taking her to the Medical City Emergency Room.”

“Did you say she’s not breathing on her own?”
“Yes, ma’am. But we have her breathing on the machine.”
“Is it safe to assume that the facility also didn’t give you her DNR?”
Silence. I tried to help.
“They might not have it on file. And what’s done is done.”
“Yes, ma’am. They, they didn’t tell us, and we can only go with what we’re given.”
“I totally understand. That probably falls on me. I will be up there shortly. No worries. Thanks for letting me know.”

So, as I was driving there, I kept thinking about how I had failed her. She specifically said she didn’t want to be on any machines. Then my masochistic mind started in on all the ways I had failed her, how I have failed everyone in my life. I reeled myself back in and made myself listen to the GPS because I swear the voice had started to whisper.

Whispering Siri managed to get me there but ceased all communication when it came to the parking. If you are familiar with the parking situation at Medical City Fort Worth, you’ll understand why I was in tears and cursing karma for picking now to punish me for whatever thing I had done wrong today.

I was allowed back to see her (mom, not karma). But it wasn’t her. I mean, it was but she looked so different. It wasn’t the woman who always says “Well, finally” when I walk into her room. I suddenly missed Pawpaw who would always sing the Miss America song when I entered. I digress.

The usual intern came in and asked the usual questions. Unfortunately, I have been experiencing memory issues due to a condition of my own and I had come straight from work, so I didn’t have her entire medical history on the tip of my tongue. We fought through it though. Then I mentioned the DNR.

All typing stopped. He looked at me and excused himself so he could get the doctor. During that break, I walked up to Mom and sang her the little song that she had always sung to me. I figured if she was in there that she would pop up and tell me to stop that noise, for Pete’s sake. But no. No popping.

The doctor came in and we sat down, and she immediately wanted to talk about the DNR. She said that had the paramedics known she had a DNR, they wouldn’t have intubated her. But that wasn’t the case. We’re at where we’re at so now what do I want to do?

What did I want to do? Hell if I know. That’s my mom and I’m her little girl. Little girls don’t have to make hard decisions, right? Right?!?

Option #1 – Since she is there, she can go on up to the ICU and they can see what they find and maybe she could come off of the breathing machine if they treat it.

Option #2 – I could request them to discontinue care and they would have to take her off the machine. But they couldn’t do that without your specific request.

“Do I need to know right now?”

“Of course not. Oh, look they got her a room in ICU.”

“Great, I think.” It kind of seemed like they were moving forward with Option 1 by default.

So we moved her to ICU and everyone went on like this was an everyday thing. I mean for them it probably was. But it is definitely not usual for me to be faced with the question of – do I take my mom off of a breathing machine and let her die? Or do I let her wake up, if she does, with a tube down her throat (that will gag her – I know this because I managed to inherit that fabulously sensitive trait).

I realized they were looking at me again, still waiting for a decision. But my mind had managed to distract itself by looking for her clothes that the ER seemed to have lost. I was carrying around her shoes. Then Beth walked in and everything felt better. Not only does she speak “medicine” but she also had a clear head with the sense to ask questions that had totally flown by me. I don’t even know what was said because I was clutching her hand so tightly and my heart rate elevated to the point where I could hear my pulse in my ears (pulsatile tinnitus).

She knows mom’s wishes but also knows how difficult the situation was because the paramedics intubated her and now it “feels” like I’m killing her. She reassured me that I wouldn’t be killing her.

The big deal was that if they removed the tube and she wasn’t breathing on her own, they would not be able to intubate her again (because of the DNR). So if we removed the tube, we were running a big risk.

Mom moved in the bed. It looked like she might wake up. Everyone was looking at me again.

“You want me to decide NOW? How can I decide now? Look at her. She’s moving like a person. She’s all personing over there. I can’t stop the breathing machine just as she tries to open her eyes.”

The nurse and Beth both looked at each other as if they had the same thought at the same time. And they had. Don’t pull the tube out since it can’t go back in again but rather stop the machine and see if she breathes on her own. The nurse ran to get the doctor.

I was a little confused at first but I caught on pretty quickly. The doctor asked me for approval. And, of course, I gave it. While the doctor worked on the machine, the three of us watched Mom in anticipation.

The machine stopped and there was a pause and then she took a breath. She took several and they were getting deeper. She also opened her eyes. And she gagged. The tube was still in her throat. So I held her hands which were trying to grab the tube to pull it out. I told her to be patient and told her everything was going to be okay. Meanwhile, the nurse was restraining Mom’s wrists. I can see that we were probably sending some mixed messages.

Eventually, the tube came out and she gagged just like we knew she would. She was instructed not to speak for a while. But this is my mom.

She looked up at me and managed to utter, “Well, finally.”