The last hours

Here's what happened: My mom had been struggling to breathe, despite our dosing her with morphine and ativan. When we asked if she was uncomfortable she nodded, so we called for a Hospice nurse. He came late in the day, looked her over, and checked her vital signs. He told us her blood pressure was normal, but her lungs sounded pretty bad. He called in a prescription for liquid ativan and said we should give her that every 4 hours, doubled her dose of morphine and said we should give her that every 2 hours, and prescribed a scopalomine patch to help dry up the liquid gathering in her throat and lungs. Mom was barely conscious. She could tell we were there when we tended to her, but she couldn't respond to us very well. She was moaning on each exhalation, and her breathing was rattly and labored. She could only move her arms, and that with effort. The RN said she had only a week left at most--meaning she could go at any time. Mom loved life and had hung on through so many other rough patches that my sister, boyfriend and I figured she'd probably take it to the limit. We set our emotional watches for a few days hence and waited for the Hospice pharmacy to deliver the new meds. Throughout the rest of the day my sister and I kept our mother medicated and clean, turned her from time to time to ease her breathing, stroked her arms and kissed her forehead each time we went in to take care of her.

I had night watch. I was exhausted and knew I wouldn't be able to stay awake for the new medication schedule, so I decided to try to sleep for two-hour intervals. After giving Mom her 11:30 morphine dose I set separate alarms for 1:30 and 3:30, planning to piggyback them throughout the night and early morning until 7:30. I figured after that I'd be able to stay up. But I tossed and turned until 1:25, finally rose before the first alarm and went to check on her. She was still breathing loudly, but she was more relaxed. She was sleeping deeply. I droppered the prescribed doses of liquid medicine under her tongue, kissed her forehead, whispered that I loved her and that she was a wonderful mother, and said I'd see her in the morning. I listened to her gurgling breath for a few moments. Then I went back to bed and prayed, "Please take my mother now. I know I've been asking You to take her soon, but please, please, take her now." I hoped my father was near. After about an hour, I dropped into a dream. I was sitting on a beach that was clouded with mist and smoke. I sat among a group of people I didn't know. We all sat in a circle in chairs on the sand, with the haze all around us and unseen waves crashing behind my chair, and we had thick, hooded, woolen robes on. When it came my turn to speak, something woke me. It was my 3:30 alarm. It took a moment to clear my head, and the hunky scientist touched my shoulder to make sure I was awake and drowsily said, "Your mommy needs you to take care of her." I rolled out from under the covers and padded through the living room where my sister slept on the couch, through the dining room past the chugging oxygen machine, and through my mother's bedroom doorway. I looked down at her, and saw she was sleeping peacefully; the loud gurgling had stopped. I looked more closely, and saw that what had also ceased was her breathing. She'd taken very long pauses between breaths before, so I held my own breath and waited. She didn't inhale. I let my breath out and kept my eyes on her chest. It didn't rise. Relief and pain, happiness, gratitude and more pain flooded through me, and I sat down in the chair beside her bed and looked at her quiet, peaceful face. Her eyes were closed. Her mouth was slightly open. She wasn't struggling anymore. I still couldn't believe it fully, so I reached for her wrist to check for her pulse. Her arm and hands were very warm. Where before her pulse beat regular and strong, there was stillness. She was gone. I'd never touched someone who'd died, but I felt nothing now except tenderness. I slipped her hand back under the sheet and smoothed it above her, and sat for a few moments more. Then I stood and looked down at her, bent to take the oxygen tubing away from her face, then kissed her forehead one last time. I closed my eyes and thanked God for taking my mother away from her torture room of a body, touched the picture of my father that sits on my mother's nightstand still, and went to wake the others.