Chapter 3: Day 2: Dawn (continued)
Route 78 between Newark and the Short Hills Mall is not scenic. Mostly shopping malls, light industry, and sound barriers. But with every mile passed, my anticipation grows. When I was I kid growing up and I did something that my mother thought was special she would proclaim me “Hero of the western World” as if I were a hero returning from battle. I feel that way now. I had, against all odds, by plane and taxi, through pandemic and ignorance, at great risk to myself, managed to travel 6,000 miles from Rio De Janiero to Summit, New Jersey in less than forty-eight hours from when Mom called and told me she needed me. I was unduly proud of myself and thought of the videos I had seen on Facebook, Twitter and YouTube and families who had been reunited after being separated by Covid. The bear hugs. The joyous tears mixed with laughter born of relief. I knew I would not get a hug as Covid protocols were to self-isolate for fourteen days, after travel but I knew Mom would be happy to see me through closed glass doors. A tear would be shed. I would be her “hero of the western world” yet again. I can’t wait to knock at her door.
We leave the highway and enter Summit via River Road. Years ago, my mother told me that the reason she and Dad had fallen in love with Summit was because of the trees that blanket the town. I understand that. It is the reason Nadine and I decided to move to Summit when we married. As she put it at the time, with only a little twinkle in her “You know my darling, I like green. I grew up in the jungle.” A tear trickles down my cheek. I had no idea the emotional release I would feel when I reached this place. It is home. I have made it home A place where you have always felt safe, where nothing bad could happen to you. It makes me even more anxious to see my mother and the last few miles of the trip seem to take longer than the entirety of my trip.
We turn off the main road into the neighborhood my parents have called home for the past half century. It looks the same despite some recent McMansioning and I feel some of the tensions I have been carrying in my neck and shoulders release. I have made it. The prodigal son has returned!
That feeling of well-being is short lived. In front of our home is a blue and gold truck of the Summit First Aid Squad. Its lights are flashing. In our driveway is a black Ford Explorer with a police department logo shadowed on its door. Its lights are flashing as well. I throw a hundred-dollar bill at my driver, grab my bag, and launch myself out of the cab. I fly across the lawn to get to the front door, I am intercepted by a man wearing a white paper hazmat suit, N95 mask, and plastic face shield. He does not touch me but tells me to stop. I tell him he needs to get out my way. II have traveled six thousand miles to be here and I refuse to be blocked.
The man say’s “Danny, I can’t let you in.” He takes off his mask and pulls down the hood of his hazmat suit. H
He is a high school classmate of mine, Daniel McMahon. He has been a paramedic for the First Aid Squad since High School. He says “Danny, everything is under control. Your sister called us. Your mom was having some breathing difficulties and was coughing up blood. She let us know she had been exposed to Covid which is why we are using protocols. “
He pauses for a second and then adds “We have checked her. She is having trouble breathing and he Oxygen level is about 88%. Anything below 90% we are required to transport to a medical facility so we are taking her to Overlook Hospital.”
“Can I see her?”
“It’s probably better if you wait right here. They are getting her ready for transport and it is a little hectic. When she comes out will give you a chance to speak with her.”
Five minutes later a gurney emerged from the front door of the house. Mom is in a seated position with an oxygen mask over her face, her black Ferragamo purse clutched tightly to her chest. She is agitated and simultaneously giving directions to the EMS workers guiding her gurney “watch the door frame,” “Be careful of the flowerpots on the stairs” and telling them how unnecessary this is. “ I can walk you know. I am not an invalid.” It was Mom. Fussy, fiercely independent, and elegant. She had even managed to put on lipstick before getting on the gurney.
I walked over to her and said in as calm a voice as I could muster, “Hi Mom.”
“Danny! Can you tell these people they are being silly? I don’t need to go to the hospital. “
“I know Mom, but they say your oxygen levels are down. They must figure out why and the best place to do that is at the hospital. “
Before she could reply she broke out in a coughing fit, mucus filled and racking. It was hard to hear and even harder not to step away from the gurney to avoid exposure to the infection. I said “Mom, we can’t take care of you here. Honestly, the hospital is the best place for you. I will meet you there. Okay? “
The coughing had left her breathless, so she just nodded and waved as they rolled her onto the ambulance.
Daniel, who had been standing next to me, during my interaction with Mom said in a kind tone. “You know you cannot see her at the hospital. Covid protocols. No visitors in the hospital.”
I nodded. “I knew but I didn’t know. Don’t they make exceptions for frightened old women?”
“The hospital will call you and let you know what her condition is.”
“Daniel, nothing you can do for an old classmate.”
“I am sorry. There is nothing I can do except put in a word with the admitting physician to give you a call sooner as opposed to later.”
“When will that be?”
“Hard to say. It depends on how soon they can make a diagnosis and when a Doc or nurse has time to get to the phone…” He must have seen the horror on my face because he quickly added “It is chaos down there Paul. Everything is in triage mode but trust me they will do everything they can for your mom.”
I suddenly didn’t feel so well. My head buzzed and I felt my knees turn to rubber. I sat down on the front steps of our home and put my head between my hands. I had promised my mother that I would never leave her alone and I had left her alone, she had gotten sick and now she would be alone. Daniel put a hand on my shoulder and asked, “You okay.”
“Yeah. Fine. I am fine. A little overwhelming after traveling for almost two days.”
He nodded and said “Give me your phone number. I will give it to the hospital, and they will call you when they know something.” He handed me his phone and I punched my digits into his contacts list. He reached for his phone but I held and said “Daniel, take good care of my mom.” He nodded and I let go.
A minute later the ambulance pulled away followed by the police cruiser sirens blaring. I wanted to scream, rant, rave, and call god ugly names. What kind of sick joke was it to have a man spend thirty hours traveling only to make it home after incredible difficult journey only to see his mother carted away to the hospital. My grandmother Jenny, a survivor of the holocaust was fond of saying ““Mann Tracht, Un Gott Lacht” which she would tell us in her sweet Hungarian accent. “Man plans, and god laughs.” I didn’t think much of God’s sense of humor. I wanted to find a nice dark place, curl up into a fetal position and suck my thumb.
I was so deep in despair that I didn’t notice when my sister Lotte pulled into the driveway. I only notice her when she is standing in front of me and says, “Welcome home, brother.”
She sits down on the other side of the stoop from me, leaning up against its iron railing and says, “I take it the first aid squad has been here.”
I nod my head and reply “Come and gone. They were taking Mom out on a gurney when I got here.”
“How did she look?”
“Not great. She had a full oxygen mask and she looked very angry. She kept telling the EMS crew what to do and being a bit bossy. She also begged me not to let them take her to the hospital.”
“Did you think about it?”
“Of course. But the guy who was the head of this crew is someone I knew from high school.”
“Naturally.”
“And he said that her blood oxygen levels were in the eighties, and she was spitting up blood. He had to take her.”
Lotte said “Yeah. She sounded like hell when she called me this morning.”
“She called you.”
“Yeah. Called and said did I think it was problem when she coughed, she got a little blood in her tissue. And she sounded completely out of breath. I volunteered to call her pulmonologist and she said had tried yesterday and had not heard back. I told her that then we had to call the First Aid Squad. She argued with me, but I said “Mom, you can’t breathe. You are spitting blood. Your Dr. isn’t returning your calls. What else are we supposed to do? “
“And.”
“She agreed. Reluctantly. And asked me to call. I told her I would and that I would try to get there before they came. But if not, I would meet her at the hospital.”
“That is not going to happen.”
“What do you mean that is not going to happen?”
I explained about the new hospital protocols. Visitors were no longer welcome at the hospital. She would be evaluated and that someone on the staff would give us a call and let us know what was up.
My sister is a fierce defender of those she loves. I saw that fierceness rise in her eyes noe. How dare anyone keep her from her mother. How dare anyone not let us see her and be there for her. But as quickly as that anger grew, I saw it float away like a shout in the wind. These were crazy times. None of the normal rules applied. It didn’t make it any easier to accept but it sucked the wind out of your anger.
For a few moments we sat there quietly on the steps of our home for the past fifty years. A place where we had always felt safe and slept better than anywhere else. A place of family joy and unconditional love. The home my father had chosen to spend his final days so the last sight of this world would be of the trees and garden of the haven he had created with my mother. We knew in that moment that those days were coming to a close and the pain of that realization kept us silent.
After a few moments of silence Lotte said “Was she wearing lipstick.”
I smiled. A family joke. Mom never left the house without lipstick on. I say “Of course.”
“Then there is hope.”
Lotte drove me home and for safety’s sake I sat in the back of her silver blue BMW X4 with the window open. We didn’t hug. We didn’t hold each other close as we both would have liked. I was still under Covid protocols and had no desire to contaminate my sister and her family. Having a sick mom was enough. Instead, we fist bumped. It was the emotional equivalent of putting out a forest fire with a garden hose.
It was good to be home. But it was an empty space. So empty that you could practically hear my thoughts echo. Wife in Brazil. Fenway Rose, my Australian Cobberdog, still at the farm where I had left for a week four months ago. I was alone. Alone with nothing but my worries and fears over my mom. I tried to push them away but going through my normal routine on returning from a trip. Clothes went into the washer. Toiletries placed in the bathroom. The suitcase placed into storage and a long hot shower to dissolve away the remnants of my journey. Finished, there was nothing left to do but wait.
Time was on a different scale that afternoon. Seconds were minutes. Minutes were hours and hours were days. I tried to busy myself with minor chores, but the house was immaculately clean as Zita had come weekly in my absence. Not because the apartment needed to be cleaned but because I knew if she did not work, she would not be able to feed her family. My focus was not strong enough to read a book. I did not have the emotional capacity to even get into a good Facebook argument with someone. I called Nadine several times, but we had little to say to each other as both of us were caught up in our own emotions about my mother. Nadine’s mother had passed long before I had met her. When she had met Mom, she had instantly adopted her as a surrogate. The thought of losing her was like losing her mother all over again. For my part, I found it very difficult to talk about Nadine’s suffering when I felt mine were paramount. I did not have the emotional flexibility to be able deal with both.
The phone finally did ring shortly after six that evening. Much to my surprise it was a physician I knew, Dr. Alice Liddell. She had treated Mom two years previously when, after valve replacement surgery, she developed a lung infection. I had liked her from the beginning. She had a way of being a matter of fact while still being gentle and kind. Most physicians don’t have this gift. After she had saved Mom after her surgery, I was so grateful that I bought her a pair of Wonder Woman Converse All Stars as I had noticed they were her favorite shoes.. A friendship had developed. It was reassuring to hear her voice on the other end of the line.
She got right to the point “Daniel, I have some very difficult news for you. Your Mom has tested positive for Covid.”
“We figured…”
“Because of the way she was presenting and my experience with her in the past I had them run some blood work and took an X-Ray of her lungs.” She paused and then in a softer voice said, “Did your mom tell you she had leukemia.”
“Yes. But she told us it was mild and didn’t need treatment. Just something lurking in the background they may get worse or may just stay the same. It was a wait and see nothing to worry about diagnosis.”
“That’s right. It is not severe. We would not treat it under normal circumstances. Even then, considering her age, we may not choose to treat it all.”
“Okay…”
“But I am far more concerned about what we found on her X-Ray.” She paused again and then said in a very gently tone “I am sorry Daniel, while I cannot be 100% sure without a biopsy, it appears that her lung cancer has returned. That is what has been causing her to spit up blood.”
This news caught me completely off guard. I was expecting her to be diagnosed with Covid. It had seemed almost a foregone conclusion. But for her lung cancer to come back after ten years was not even close to being on my radar. Stunned, I said “Can it be treated?”
There was a long moment of silence on the phone, and she spoke. “In a normal world, a world without Covid, I would say yes. We could try chemo or radiation or even surgery.”
“But this is not a normal world.”
“Right. And more importantly it is not your mom’s biggest problem right now. She has Covid. She is having difficulty breathing. When she came in this afternoon her blood oxygen was in the low eighties. We have gotten them up to the low nineties by using high volume Oxygen, but her lungs are full of disease and that is just exacerbating her cancer. Normally, my course of treatment would be to put her on a ventilator to give lungs a chance to heal and rest…”
She paused, no doubt hoping that I would finish her thought. She knew I could have. I followed the news like some follow the stock market. I knew there were not enough ventilators to support all who had Covid. Hospitals and physicians were forced to triage their patients. Deciding who had the best chance of survival. Who would benefit most from the gift of life these machines would give them? Mom’s age would have counted against her having access to one of these precious machines to begin with but with the additional diagnosis of cancer and leukemia her opportunity for a vent dropped to zero. I could have told Alice that I knew all that, but I did not have that type of generosity. Instead, I remained silent and let her words inform me.
“Danny, we can’t give Mom a vent. There just aren’t enough. We must give them to patients who have fewer issues, are younger…” Another pause. “Patients we think can survive.”
“You are saying Mom is going to die.”
“No. I am saying that her prognosis is grave. That we will do what we can do to make her comfortable. We will keep her on high volume O2. We will sedate her. I have seen nursing home patients come with far worse symptoms and walk out of here a week later. Who knows? I don’t want to give you false hope but also don’t want you to think all is lost.”
“When can I see her?”
“Danny, you can’t. The hospital has a no visitor policy.”
“Even for patients in my mother’s condition.” I say with undisguised anger. My Mom is dying. I need to be there for her. They need to let me in.
Alice replies gently “No. Not even for people in your mom’s condition or should I say especially for patients similar to your mom.” and added in an even kinder tones “Covid had forced us to do unimaginable things including this. It is horrible for everyone. For the patient. For their families and for us who are trying to care for them. You don’t have any…”
She stops in mid-sentence sensing she was about to go too far. She doesn’t want to put her burdens over mine. But I know what she is going to say. I have seen enough Dr’s interviewed on the news. For them, telling patients there is nothing that can do to save them. Telling them that can’t even have the comfort of those they love nearby in the final hours. Explaining to families they cannot be with their loved ones is as cruel to the caregivers as it is to the families except, they go through it day after day. And they have been doing it for months.
I know all this. Under other circumstances I would be sympathetic. But it is my mother who is lying in that room all alone. It is she who is scared. It is she that no matter how kindly Dr. Liddell is presenting it, is dying. I promised her she wouldn’t be alone and now, perhaps when she needs me more than anything, I cannot do a goddamn thing for her. All I can think of is “I promised her she would never be alone. I promised. In that moment, the fatigue of the trip, the frustration of the moment, and the realization we were at the end of times for mom struck me like walking into a wall and I began to sob. First soft welps, then deep heaving snot blowing back arching can’t catch your breath sobs. I tried to stop. I was conscious that Dr. Liddell, no matter how sympathetic she was to me, and my situation did not need or want to hear my despair. But I couldn’t. I tried to apologize for my breakdown, but Alice would not let me. In her kindness he told me to take a moment. She would wait. was to tell me it was alright and to take a moment.
When I finally found the ability to control myself. I said “Dr. Liddell, I can’t let my mother be alone. Is there nothing we can do? Is there a release I can sign? An administrator I can call. What have other people done? “Pausing I then add “Help.”
“There is no one to call. There is no release you can sign. But what other people have done and what we can do for Mom, is put an iPad in her room. If you have a subscription to Zoom or another video conferencing channel you can, and your family can spend time with Mom. You can make sure she is getting the care she needs. I know it is not the same as being there, but it is the best we can do….”
At 11pm I am sitting in my car waiting in the very empty parking structure at Overlook Hospital. Dr Liddell’s had agreed to meet so I could give her an iPad for Mom’s room. I find parking garages creepy. In movies people always seem to find themselves in trouble in them. Not having slept in forty hours, and the energetic thunderstorm outside don’t help make me feel more comfortable. I am waiting thirty minutes before a tiny figure appears out of the gloom. One of the things that had always struck me about Dr. Liddell when we had met in the past was her dynamism. She was a ball of positive energy which made you feel that with her on the case anything could be accomplished. This is not the Alice I see now. This is an altered woman. Every step towards the car is an effort. She is hunched over as if she was carrying a heavy backpack. When she is closer and I can see her eyes beyond her protective googles and N95 respirator. They are dim. As if the light had gone out of them, surrounded by fatigue lines that could not be concealed by makeup. No doubt she had better things to do than get an iPad from a patient’s sons. But she had made the effort for me. It is an incredible act of kindness.
I say “Thank you. I cannot tell you how much this means to me and to my family. It is a debt I can never repay but will always be grateful for.”
“No need to thank me. I am only sorry I can’t do more for Mom.” She takes a deep breath and lets a long sigh. I can tell she is not looking forward to going back inside. As if reading my mind, she says “I have been on duty for the past thirty-six hours and I have twelve more to go. The ICU is full. We have converted the entire psych floor for ventilator patients. And I need to see them all.”
She is on the verge. This is what the disease and the deniers have done to our caregivers. Turned them into the walking wounded. Talk about heroes of the western world. I am ashamed I even considered myself in that class earlier in the day. I say, “I know I can’t give you a hug now but when this is all over, I promise you that I will give you one that will make a python proud.” She laughs, waves and heads back to her personal hell.
On the ride home, I think about Tex and his fellow Covid deniers including Trump. How they lack the imagination, the empathy, or the emotional intelligence to understand what their litany of excuses for not wearing a mask or wishful thinking that this was no worse that the flu had done. Why couldn’t they see they were murdering people? Last moments that should be full of succor and love are spent alone and in fear. Families left inconsolable unable to have a final embrace or kiss. Condemning care givers to a hell of dying patients, they can do nothing to help. I want to scream at them to wake up. To beat sense into them but I am impotent to cure this new social disease and instead pound my steering wheel in frustration.
At home I am greeted by an angry email from my brother Levi. Lotte and I had been in constant contact through text and emails since we had parted company earlier that day. I had left it to her to communicate with our older brother. It is not that I do not love my brother. I do. But there had always been a sibling rivalry between us we were hard pressed to put behind us. It had been exacerbated by his lack of presence during our father’s and mother’s illnesses over the years. He had left the heavy lifting to Lotte and me and when confronted with it had gaslighted us by saying perhaps we “were doing too much.” But before I had left to give Alice the iPad, I sent an email to the whole family letting them know Mom’s situation and how to access Zoom. I wanted to in the gentlest of ways encourage everyone to spend time with Mom before the inevitable.
This was the subject of Levi’s tirade. If I was inclined to be charitable, I would say the tone of his email and the outrage it expressed was sourced from the grief and horror of the situation in which we found ourselves. But I was not so inclined, nor did I have the bandwidth to process his grief and anger with my own. It pissed me off that he felt that he should be included in all medical decisions. Mom had given me her medical power of attorney because she trusted me, not him, to make those decisions for her. I did not have time nor the inclination to herd cats when we needed to make immediate decisions. What angered me the most is that I was including him in all the decision making which is why I sent the email. Instead of being grateful for what it is that I was doing, he was telling me I was doing it wrong.
Poor Nadine she had to listen to me rant, rave and curse my older brother. I was the one who showed up, I was the one who was here, he had done nothing but drive from the backseat and second guess. She calmed me. “My darling just remember this when your mother needed someone to help her, she did not call Levi who lives in Manhattan. She begged for you to travel home from Brazil. Levi did not volunteer to care for her. He only offered to be critical of your handling of things. He will not change. Ignore him. Let Levi be as angry as he wants. Louise trusted you to make the right decisions. She is the only person whose opinion matters.”
My anger is marginally relieved by a medicinal dose of Blanton’s Bourbon. Exhausted, I make my way to bed. Propped up by pillows I log onto to Zoom hoping to see Mom before I stumble into sleep. No such luck. The hospital has not set up her Zoom yet. I try to remain awake until they do but my emotional and physical exhaustion are stronger than my will and I fall asleep without realizing it.
I am awakened by the dawn. I have forgotten to drop the shades and close the curtains and outside my windows the sparrows’ chicks who are nested in the eaves of my townhouse are chirping for their morning meal. My watch tells me that it is 5:23. I glance at my iPad, and I am overjoyed to see that someone has activated the device in Mom’s room. I suspect that have placed it on one of those rolling tables on which patients’ dinners tray are placed as I can only see the top of her shoulders and head. Her pallor is a purplish grey and her lips, now devoid of lipstick, blue. Her mouth hangs open as if her jaw muscles no longer work and she has a large bore canula in her nose. The only reason I can tell she is alive is there is vital signs monitor in the background that show her respiration rate and heart beat.
I take my iPad with me to the kitchen and keep Mom in view as I make my morning pot of coffee. Coffee had always been one of my mom’s things. Each day began with a cup, often taken back to her room to savor in private. As kids, we had been instructed never to talk to her before she had downed her morning fix. I think of this and how she used to reheat morning coffee in a pot for her afternoon jolt before she got a microwave. As I watch I am surprised by, but grateful for, the lack of coughing. No doubt they have pumped a lot of drugs into her like morphine to suppress the coughing reflex. I go to the refrigerator to get a splash of milk for my coffee and when I return to the screen, I see that mom’s eyes are now open. They are unfocused and they are scanning the room with bewilderment and a touch of fear.
I say in the jolliest voice I can muster “Hi Mom. How are you feeling.” She looks at the screen and I wave. She looks at the camera intently and for a second, I sense she cannot comprehend the screen with my face and the sound emanating from it. I see comprehension sweep over her features and she mumbles something that I cannot decipher.
“Mom, what did you say? I could not hear you.”
She looks at me with annoyance, the face she used when she was displeased with something we had said or done. She, swallows, and then says in a marginally louder voice “I said, get me out of here.”
There is nothing more I would like to do. I know how much she hates hospitals. I know how much she struggles when she is not in control. I also know that on some level she knows she is never leaving this place. This tears me apart. And I try not to cry when I lie and say “I will Mom. Just as soon as you get better. I promise but right now you need to get better, okay.”
My words seem to mollify a little. Or perhaps it is just the drugs. Her focus shifts to somewhere beyond the iPad. She mouths words that I cannot hear and for a moment I think she is talking to a nurse or aide. But none appear and she continues to speak, stopping occasionally to let the person she is imagining a conversation with respond. I hear her mention my father’s name and it sounds as if she is having a great conversation with him. While I can hear none of the words, the dialogue comforts her. I hope he is telling her not to be afraid. She is loved. She will be missed.
Eventually, the conversation ends, and Mom closes her eyes and appears to fall asleep. I take the opportunity to walk to my desk. My plan is to watch her as I answer emails and straighten my desk, which is unfamiliar after months of absence. I never get the chance. As I walk to my desk the sound of an alarm comes blaring through the device’s speakers. I open the iPad and can see that it is her vitals monitor that is squealing.
Mom’s heart has stopped. Mine is broken.
It is now full daylight. The sounds of birds singing their morning odes have been replaced by the sound of the resort coming to life.
Like Maui I tried to be a good son. But while he was successful in his effort to make the days longer for his mother, I am haunted by my failure. The months of isolation have only served to make me more comfortable with my ghosts, not quiet them. Which is why I call her every day. I know she is no longer here. That doesn’t mean she is not listening. And calling is what dutiful sons do even when you know your mother won’t answer. And perhaps, just perhaps, one day she will answer and let me know I am forgiven for leaving her alone.
Blame it on Rio 