Friday, May 13, 2011

Not these clothes, not this soon

My mother-in-law, Dorothy Lillian Gandell, died on April 9, 2011. She had celebrated her 96th birthday at the end of March and had told people that she was ready to go be with the Lord. She had a massive stroke on the evening of March 30. On March 31, my sister-in-law Ruthie (pic of me and Ruthie here) began to reschedule her patients (she’s a psychiatrist) and went from her home in Evanston to Eureka, IL to be with her mother.

Now technically, Dorothy was Ruthie’s stepmother. Her mother, Clara Gandell, had died shortly after giving birth to my husband, David. Ruth was six and a half when her birth mother died and was put into foster care for almost two years until her father married Dorothy. But Dorothy was Mom to both Ruthie and David. And she was Grandma to Ruthie’s two sons, David’s two children by a previous marriage, and the two daughters that David and I have.

Dorothy had had an advance directive on her health care. She was clear that she wanted no intervention other than palliative care. Her wishes were respected. But I couldn’t stand the idea of Ruthie keeping vigil by her mother’s death bed by herself and wanted to go be with her and provide whatever support I could. As I was packing my suitcase and trying to figure out about what I should pack and what clothes I would probably be wearing to my mother in law’s funeral, I was awash with memories about packing to go home when my own mother was dying. It was tough.

I ended up going to Eureka on Tuesday, April 3. Ruthie told me that she was glad I came and it was good for me to be there. I was touched at how gentle Ruthie was with Dorothy. She would stroke her hair, kiss her cheeks, rub lotion on her arms and legs and feet. She and I would sing to Dorothy and I would read passages from the Bible. Dorothy was Apostolic Christian, I’m an Episcopal priest, and Ruthie is a Reconstructionist Jew. We made for quite the ecumenical gathering.

Dorothy lived for eight days with no food or water. It was incredibly difficult. But during that time, Ruthie and I had some precious conversations. I don’t remember all the content but I remember feeling very close to her because we were sharing a sacred experience. In the end, Dorothy lived until David arrived with our daughters. They flew in on Saturday, April 9 at 12:30 p.m. and Dorothy died at 2:06. She died peacefully, with David and Ruthie on either side of her and her favorite nephew and his wife singing in the background. It was exactly as it should have been.

Ruthie was scheduled for an aortic valve replacement soon after Dorothy died and decided to postpone her surgery for a couple of days so that she could make sure her patients were covered during her recovery. That was the plan. Ruthie would have her surgery, she would recover, and she would go back to work.

But that’s not what happened. Ruthie had her surgery on May 3. She was transferred to a regular patient room on May 5. Early in the morning of May 6, 2011, Ruthie went into cardiac rest. And even though the medical team was able to restart her heart, there was a period of time when her brain was without oxygen.

I was at a meeting in Cleveland when this happened and got the information via a text message from my husband. He was devastated. The idea that he could lose his mother and his sister in a month was unfathomable. So we prayed for a miracle. My meeting was going to finish early Sunday, so we decided that he’d stay with our kids until he got a call from either my brother in law or our nephews asking him to come to Evanston.

That call came on Sunday morning. David booked his flight and left Sunday afternoon. I arrived back home late Sunday night. David called me a little after noon on Monday and told me he needed me. The decision was going to have to be made to take Ruthie off of life support and he couldn’t do it without me being there with him. I got out the same suitcase I had unpacked earlier that morning and went into my closet. Since I’m a priest, I’m used to wearing clerics. I don’t often attend funerals as a family member and I have one appropriate black outfit to wear. All I could think of as I packed was “Not these clothes. Not this soon. God help us.” I arrived Monday afternoon. On Tuesday morning, the neurology team did a repeat EEG to see if there were any changes from the EEG they did Friday morning. There weren't. On Wednesday morning they did a repeat CT scan. No changes. Cardiac surgeon, neurologist, intensivist and palliative care doctors were unanimous in their prognosis. The Ruthie that we had known was not going to come back because the part of the brain that made her Ruthie was dead.

On Wednesday afternoon, Leo, Ruthie’s husband, Myles and Michael, her sons, David, Rabbi Rosen and the Cantor gathered with me around Ruthie’s bed. I said the prayers at the time of death and anointed Ruthie. We recited the twenty third Psalm. Her wonderful Rabbi and the Cantor from the Synagogue said their prayers and sang in Hebrew. And then the nurse removed her breathing tube. We stood around her bed and told her we loved her and cried and stroked her head and hands and feet. But Ruthie’s body continued to breathe. Part of her wasn't ready to die.

On Thursday we moved to the palliative care unit. We have discontinued everything except medicine for pain control. The palliative care unit is good. There are “family lounges” where small groups of us can hang out while others are visiting in Ruthie’s room. The staff is trained well. And we’re learning, too. When they ask us if they can close the door “to respect another patient’s privacy” we know that someone else has died and they need to wheel out the body.

We have already met with the funeral director and we picked out the coolest casket! When Ruthie and I were at her mom’s deathbed, we were discussing funerals and one of her mom’s nieces told us about “green funerals” where the caskets are made of sustainable materials and the vaults are bottomless so that the body can truly return to the earth. Ruthie said that she was going to request that some day. I never imagined that day would come so soon. We picked out a wicker casket but it really looks more like a basket. Ruthie is only 4 ft 6 inches tall. Once they dress her in the muslin shroud and put her in that basket, she’s going to look like Baby Moses. Or so we joked.

It’s now Friday evening. Shabbat Shalom. Many family friends have come to visit and bring us food. Other family members are flying in tonight and tomorrow morning. We take turns at her bedside. We tell funny stories. We cry. We laugh. We make jokes about zombies and vegetables. We play music we know she loved. We play music we know we love. Sometimes we dance a little. It’s hard to believe that Ruthie is in a place we can’t reach. So we tell ourselves that maybe there is part of her that does hear. Maybe there’s part of her that is well aware of the love that surrounds her. Maybe there’s part of her that can still roll her eyes at our inappropriate jokes, even if we can’t see it.

I know that God is here because that’s what I believe. But this is hard. I grieve for my husband. I grieve for my nephews. I grieve for my brother in law. I grieve for the rest of our children who will shortly say goodbye to their wonderful Aunt Ruthie. I don’t understand but I trust that all things work together for good.

So we wait.