Learning to Die #5: practicum

Clara on her 90th birthday, Jan. 2019


On Christmas Eve in 2020, my daughter, Julia and her husband, Colin,, found his mother, Clara, collapsed. She had not activated the alarm, which was hanging around her neck, They had taken her down the mountain to her doctor the day before because she was complaining of severe leg pain. The doctor ordered more blood tests. The urine test came to a sad end. Julia insisted that he prescribe Pantoprazole again to prevent stomach acid. Lack of it seemed to have already caused a bleeding ulcer. (For the past few years doctors had been reading a dire warning that this acid suppressors caused bone thinning. My own doctor, Dr. Joe, had scoffed, citing throat cancer, never mind stomach cancer. My sister cited Dr. Joe to her own doctor.) Clara was very unwell even then at the clinic, couldn’t concentrate, couldn’t see even on her best days and was lying down on the examination table.

The obvious question -is she dying and if so, what choices should be made – did not come up.

On Christmas Eve, Julia got Clara washed and into clean nightwear in a fresh bed. It was then Clara started praying. In Tongues. Although the language was unclear, it was very clear that Clara was talking to God. Very vehemently. Very loudly. All night long, while they sat or lay beside her.

We had had a few family emergencies and always Clara would phone her prayer group, thousands, waiting for the word to start exhorting God. Julia and I didn’t necessarily believe in that kind of personal God. We were more Taoists. But you’ve heard that no one is an atheist in a fox hole. Now Julia told me on Face Time, “We never needed thousands. All we ever needed was Clara.”

In the morning, she asked, “What’s for breakfast?”

So they moved essentials from their place higher up Bear Mtn and settled in, dividing the night in two shifts. Julia who had had persistent insomnia for 9 years took the shift starting at 2:30 a.m., which was when she usually woke up. Colin sat up until then.

Christmas morning breakfast was oatmeal, not instant, bacon, soft scrambled eggs, toast and jam. Clara came to the table and put away some of each and a lot of oatmeal.

“Haven’t felt like cooking,” she said. “I was hungry.”

Indeed, she was a whole size smaller.

On the phone, I went nuts. “You can’t overfeed her,” I protested. You’ll do her harm.”

“She’s burping a little,” said Julia. “She’s sitting in her favourite chair.”

“The one that shot her onto the floor where she remained for 12 hours?” I querried.

“We told her not to use the lever. Anyway we’re here. I think she had a series of small strokes, but the clinics are closed for the holiday and the hospitals are full of Covid. I know what to do now. Keep her blood pressure down. I’ll watch the stool for blood and balance out the need for painkillers.”

“Is she in pain?”

“I think she will have some.”

Julia was an acupuncturist before she had to retire because of her health and she had worked with many elderly people and their primary care-givers.

Christmas got postponed in many family places. A Dallas great-grand-daughter was in hospital with an infection. And here in Toronto, we ate breakfast with a dizzying array of devices beaming in three other households. Usually we were at one long table farther north in snowy Barrie.

On the mountain, they had ordered Christmas dinner from a local, but closed to dining restaurant. They ate it a few days late with 25-year-old Leo up from L.A.

So they fell into a routine, Julia’s breakfast -donuts on Sunday- and yes, we know but last minute wishes and all that – and Colin’s dinners. Lunch was easy to pick up from the generous left overs or Clara had a bagel and cream cheese, The good food along with the acid suppressing meds began to clear up the GI bleed.

When a urinary bleed erupted and the clinics and drug stores were still closed, I said, “Cranberry juice.” Clara hated it. She was used to orange juice but two days later, that too was gone.

My Brussels’ brother, Rob, had had a memorable experience, finding our grandmother locked up in the bedroom of a farm house, where she was patiently stripping the wallpaper and saving it in rolls. First, he made a very angry call to his father, which brought about a quick move to a better Home. Secondly, it made him a lifelong guardian of old ladies, five in all. He put in indoor plumbing -yes, in Brussels in the 2010s, he installed water heaters, he bought roasted chicken at the Sunday market, he got them to the doctor, he bathed them, he found long term care rooms when persistent burglars targeted them. This last involved the mayor. (Oh, by the way, these ladies plunked down a plastic bag containing 350,000 Euros on the desk when they checked in.) And he saw to their burial or cremation. One of these adventures involved pre-dating a document, but that’s what I like about the Europeans … no problem.

Between us, we had lots of advice. Get a baby monitor. Get a commode. Here’s how to prevent falling out of bed.

Every morning after Julia helped Clara to shower and lather in moisturizer, they walked up and down the covered deck and wrapped in her duvet, Clara sat and looked at the mountains until she got cold. Mostly, she slept in bed or in that dangerous chair, waking up to call for tea or toast or ‘any more donuts’. When Colin sat in it, he said he felt like issuing commands.

Clara was getting better but they were exhausted. Colin changed his shifts to the afternoon. Because it was winter, even in California golf courses on mountains were not doing a thriving business. Leo came up occasionally to spell them off. But Leo like Colin was male and, unless Clara was more or less out of it, she was too modest and proud to let them help her in the bathroom.

Gradually the pain was coming back.

A very bad winter storm threatened. And threatened. Two feet of snow. Five in the Sierras. Farther north, I assured myself. Forecasts gave estimates according to altitude. They were at 5,500 ft. The other house up 2000 more. Colin made a run up for heavier outerwear and shovels. The pain got worse.

It was abdominal. It didn’t seem to be a bleed. Julia was too tired to think. Her shift was basically 2:30 a.m. to 9 p.m. Later she learned that if she slept with Clara, her hands on the pain and did Chi Gong breathing, the pain diminished and they both slept 4 hours. But now it was too much and Clara said she had to go to hospital. She had done so before, but after many cardiac tests, the verdict was anxiety attack.

Moreover it was now snowing very hard.

Julia says, “Do you understand that if you are admitted to hospital, we may never see you again?” Damned Covid.

“Yes,” says Clara.

So the paramedics come from the fire hall. The EKG shows heart damage. It always does now, because she had a ‘silent’ heart attack some time that summer she and I had lived in two rooms above the Real Estate Hotel while she was moving up from Vegas.

The ambulance at the firehall can’t transport her because a truck has rolled on the mountain road and traffic is jammed – people fleeing just half an hour too late. It is arranged they will drive her in the Subaroo to the Y where an ambulance will be waiting. Another will wait at the I 5 to take her to Bakersfield. “No,” said Julia, “Santa Clarita. Henry Mayo.”

“Can’t do that mam. The I 5 south is blocked”

The medics load Clara into the front seat of the Subaroo. But no, where are her gloves. Colin sets out, driving around the slippery hairpin turns and along the edges of cliffs until, he comes to a full stop behind a line of cars. Julia gets out and begins to walk. The walking is through foot-dragging snow for a mile or more. She passes the truck on its side. A big delivery truck.There is a tarp over the cab. When she gets to the Y, she asks the CHP officer if he can communicate with the ambulance. “No,” is all he said

She calls Colin and between them, they go to each waiting car and tell them they need to pass to get a patient to an ambulance. They meet, walk back together, get back into the car and Colin pulls out into the even less passable left lane to begin the slow slip back up the hill to the Y.

While the off-loading is underway, Clara is heard to ask a medic how long he has worked at the job.

At Clara’s house, Julia and Colin sleep for ten hours.

This particular dying practice will continue briefly next time -long term care in the age of Covid- and then I will begin to write about the study of theory, including the psychopomp, Tibetan ideas and eventually Roy Scranton’s Learning to Die in the Anthropomycene

1 thought on “Learning to Die #5: practicum

  1. Pingback: Learning to Die in the Anthropocene: reflections on Scranton’s book #2 | 115 journals

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