March 1992, Huntington, West Virginia

By Shawn Ayers

The plastic tube attached to the respirator forces air into and out of her lungs 12 times a minute.

The plastic clip attached to the middle finger on her right hand is connected by a beige wire to an instrument that monitors her pulse. The red digital readout blinks with constant, reassuring updates.

The air pad underneath her groans and sighs as pockets separated by thin walls of vinyl fill with air and are emptied. This is to prevent bed sores.

The IV unit dispenses saline solution and antibiotics at a steady pace through the slender tube, to the needle taped to her left hand, and then into the vein in her arm.

Another needle in her right arm is connected by a thin vinyl tube to a small blue box that is programmed to dispense small, precious doses of morphine, though this drug will soon become ineffective.

Each morning, they roll her onto a vinyl stretcher with metal rods on either side. They attach cables from the portable scale to the rods on the sides of the stretcher, and they winch her into the air by pumping the handle — much as one would jack up a car to change a tire — each jolt another blast of agony that causes her to cry out and moan. The purpose of weighing her is to measure her kidney function.

Three times a week, they move her to a smaller, portable bed, a gurney, by which they take her downstairs to the dialysis unit. There, they connect more vinyl tubing to a piece of surgically implanted vinyl tubing in her chest, a shunt. Over the next three and a half agonizing hours, the machine drains her blood, filters it of impurities (a function that her kidneys used to perform) and return it to her. The room reeks of bleach and misery.

Back in her room, the fluorescents emphasize her unnaturally yellow, jaundiced skin. Her silver-white hair, so long when she was healthy, is now cut short for ease of maintenance. She is rarely conscious, though just a few days ago, I remember having conversations with her. Now she just sleeps, and moans, and suffers.

From the hallway, I hear nurses laughing. For the most part, they have a grand time of things. Their gossip is repeated daily and occasionally updated. I hear their hates and fears. Their exasperated sighs when a patient alarm is sounded. Theirs is an island of normalcy in an ocean of tiny personal tragedies.

From where I sit, I can see out into the hall. Roughly four out of five passersby will look in. It is the same curiosity that causes motorists to slow down when driving by an accident. Nothing draws a crowd faster than the suffering of others.

Perhaps I shouldn’t feel this way, but I long – no, I burn – to inflict her suffering on them. My suffering. But as quickly as the anger comes, so does understanding wash over me, extinguishing the flames. I know that someday, they likely will suffer.

I wouldn’t dare pull the plug on any of the machines keeping her alive. But I think of almost nothing else.

She was almost at the end of the various diabetes-related medical conditions: she had renal failure, partial blindness, diabetic neuropathy (the loss of feeling and sensation due to nerve damage), nigh-untreatable sores on her feet and bottom. She could barely walk and was deeply depressed. She was an active, vibrant woman when she was younger. The disease had nibbled away at her over time.

When we first arrived at the hospital this last time, she could talk to me. She had reassured me with her voice and her words that everything was OK. Even though we both knew that it goddamn well wasn’t OK, I held on to her reassurances, and they were precious to me, and we both wanted so much to believe in them.

So, when all hope is gone, why do we still hang on? I know she wouldn’t want to go on like this. I sure as hell wouldn’t. I know she feels nothing now except pain. I know this because she does not return my grip when I hold her hand. There is no reaction when I brush her hair, when I kiss her cheek.

I want to pull the plug, but I can’t.

I don’t want to the pull the plug, but I must.

When it happens, I am not unready for it, but I am still paralyzed for that first moment. Coughing into the respirator, twisting and writhing as her body fails her, this isn’t the gentle movie lie I had come to believe by watching a thousand Hollywood deaths. This is true horror, real, and happening to her. To me.

I snap the call button to summon the nurses. They spring into action and usher me into the hallway, but I am all too aware that my last moment with her is to see her in complete agony. I rush to the pay phones to summon family that would not arrive in time to see her still alive.

Afterward, I am left alone with her for a time — too much time and not enough. My thoughts race. There are arrangements to be made. People to tell. Then a cold numbness settles in, one that the warmth of many years, much laughter, love, and good times since are not able to completely unthaw.

In the end, she saved me from making that horrible, damning decision.

It was only after I had time to reflect that I realized that she did not take the decision out of my hands. I had chosen life, and I have never forgiven myself.

Shawn Ayers is a technical editor for Northrop Grumman IT and resides in Fairfax, Virginia. He was born and raised in West Virginia, and his rural upbringing is the inspiration for much of his writing. This story is about his grandmother, who passed away due to complications from diabetes.

Posted by Elizabeth Armstrong Moore on Monday, June 25th, 2007 | Email This Post

This entry was posted on Monday, June 25th, 2007 at 12:01 am. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.