As a critical care nurse, I had ‘the conversation’ with hundreds of my patients and their families. Sometimes several times with the same family member until they are ready to hear what is being said. Because I have been in the profession for over 30 years, I started trying to make it a priority way before it was popular to even broach the topic, and encountered hostility from co-workers, physicians and family members who thought it was inappropriate that I was bringing up death when the patient/family member was “fighting for their life.” That has always bothered me.
Fighting implies there is a battle you are able to win. And that if you don’t win, you are somehow a failure. News flash–Death always wins. It is how you allow death to take place that is under your control, and you should take it while you still are able. My mother was dying of Pulmonary Hypertension, a less popular, less known disease caused by over 50 years of smoking and lack of exercise. My brother and sister were initially unwilling to accept that, despite being in their 60s, their mother was going to die. They resisted the ‘conversation’ I tried to have with them for several months and I knew they were not ready.
But, I had the conversation for the final time with my mother one day, very shortly after her 86th birthday. Her lips were the color of her purple sweatsuit due to lack of oxygen and blood supply. She was on oxygen that was being increased steadily, and still remained short of breath. We had discussed many times her quality of life or lack of it, but she was not ready in earlier discussions to ‘give up,’ as she had been taught the battle cry must be answered as well. This morning, she decided to listen to her youngest daughter, the nurse. And, in the end, she said, “Ok, sweetie, I’m done.” I knew what she meant–not done talking or done with her lunch, but done with Life. And that was perfectly ok.
I told (didn’t ask) my siblings that I was putting our mother on Hospice and the intake nurse was there by the end of that same day, which was a Sunday. My mother passed the following Tuesday. It was almost as if, having been given an ‘out,’ or permission, or with her acceptance, she had decided it was time to go. She passed away with all three of her children surrounding her bedside, with my sister and I giving her last manicure, with big band music playing and we three telling stories of our memories. It was a beautiful, peaceful, painless death and I believe every human being deserves that from the people that love them. It was a gift we gave a woman who gave us life—-because we had the ‘conversation’ as many times as it took.