Losing Humanity

September 8, 2010

I’ve been meaning to write this, but I’ve been putting it off for about a week.

My grandmother (paternal) died yesterday morning.  A week ago I got a call from my Dad saying that she was in the hospital because she had a stroke.  He couldn’t give me any more information, but needless to say I rushed into the hospital to check on her.  She was sent home the next day to be put in hospice care “to wait”.  What had happened is that she didn’t have a stroke, but more a brain aneurysm.  A bleed had started deep in her Right Frontal Lobe, the hemorrhage had doubled in size in 24 hours, and despite minimal risk from surgery, it was deemed that little could be done to restore function, much less improve quality of life.  She was sent home with an active bleed.  For those of you who know a little about medicine or have watched at least one episode of Grey’s Anatomy, this means eventual death.

So what happens when she gets sent home with only family to watch her?  They ask questions of the one person who knows anything about medicine.  And I become the doctor, in effect. This is where I began to notice something.  When “playing doctor”, it wasn’t hard to see my Grandma in that state.  I checked her vitals, evaluated her, and did what I could to ascertain her situation.  Clinical distance, or clinical detachment, became a defense mechanism.  As soon as I reached a point where playing doctor would be redundant, everything would hit me again.  And so I delved into the medical aspect of her death more and more.  Looked up answers for family members.  Reassured them using what I know about End-of-Life Care.  Gave a tentative timeline.  It kept me safe.

About this time is when I wondered if I was losing my humanity.  If medicine had made me cold.  What if medicine sucked the life out of me? What if it stole my compassion and empathy?  Maybe instead of Doctors not having compassion or empathy, they had it and it was taken from them by their job?  Dad and I started talking about how we were dealing with it, and he asked how someone could just watch someone go like that.  I started talking about the various times I’ve seen someone is horrible shape, or dying, or even dead, and talked about how in the moment I was able to take myself away from it and focus on what needed to be done.  I said it was a skill that you have to develop to treat people and to not get lost in everything.  This is the moment I really realized what I had been doing, and when I began to feel badly.

On Monday I visited her for about the 5th time, and I was told that her kidneys had shut down.  Well, they assumed.  I confirmed it.  I checked her pulse, and I found that where her blood pressure had been hypertensive the whole week, I could barely feel a radial pulse.  In other words, her systolic (top number) was around 80.  Her brother asked me what I thought, and I told him “It’ll be today, sometime.  Hopefully, for her sake.”

I saw Cheyne-Stokes breathing for the first time.  I had to explain apneic episodes to my family (they thought she might have died the night before because she stopped breathing for about 30 seconds).  I said my goodbyes and left.

My Dad didn’t come home until 5 in the morning.  I woke up and asked him how he was doing when he finally got up.  He told me that she had died around 4:30 in the morning, and that he just couldn’t watch it.  I cried, and not just because he cried.  I cried because despite my knowing that it was coming more than they did, I wasn’t ready for it.

I’m not sure if it’s completely sunk in yet.  But I don’t think I’ve lost my humanity.  At least not yet.  But I worry about it, sometimes.

Since yesterday I’ve been going over mortality in general.  I’ve legitimately thought about what would happen if my parents died, or what will happen when I die.  All of the cliches about death went through my mind, and I just let myself go with it.  Maybe it’s how I ultimately deal with it.

This whole experience is completely new to me.  I’ve lost both of my maternal grandparents already, but I wasn’t close with them whatsoever.  I barely remember my grandpa (the last time I saw him I didn’t even realize it was him until about halfway through his visit, and I barely talked to him), and my grandma was an alcoholic, and I only have a handful of memories of her.  When both of them died, I was sad, but I never felt like I was appropriately sad.  I cried more when my dog died than when either of them died.  And yet this grandma practically raised me.  I spent more time with her than with any of my other grandparents.  She made me the bookworm I am today.  She got me interested in my Family Tree, and always told me stories.  Whenever I hear the word Grandma, she’s the person I think of.  And I actually regret how things have been the past few years.  When I became a teenager, I didn’t want to hear her stories anymore.  My Grandma was the epitome of garrulousness, but when her Alzheimer’s started taking it’s toll, she stopped talking because she didn’t want to give away the fact that she didn’t remember things.  And so I spent less and less time with her because it felt like I wasn’t spending time with her at all.  How I wish that now I could go back and slap the hell out of 13 year old me for not listening to her; she was probably trying to tell me an interesting family anecdote that I would love to know now.  But I can’t, and I have to come to terms with that.  I suppose it’s part of living.

My Mom asked me a few months ago “If you don’t believe in God, then what do you think happens when you die?  I like knowing that my Mom and Dad are in heaven watching over me.”  I replied with something completely off the cuff, because I had never thought about it before, but it still makes complete sense to me.  “Well, a strict scientific view would be that the Carbon atoms that made each of them up are still in the world today.  It’s the closest thing that science has that comes to reincarnation, and it gives me some comfort.  Knowing that what made them is still in the world, and could be in another living thing, that’s comfort to me.  It means they’re still here, in some sense”.  It’s how I deal with it.  I know that that’s a general (and possibly loose) interpretation, but it’s more or less true.  The carbon atoms aren’t going anywhere (for the most part).  And until I see another naturalist way to find comfort in death, this is what I’m going with.

Last thought before I wrap this up: What Sarah Said, by Death Cab For Cutie has one of my favorite lyrics of all time.  The line is “Love is watching someone die… so who’s gonna watch you die?”

After this, and after talking to my Dad, I think it’s more flexible than that.  I would say that sometimes love is not watching someone die, just because it hurts too much to see that person suffer, or to see them go.  Even now, I wonder if I could watch the very closest people to me go.  Let’s just hope that that will remain a mystery to me forever.

RIP Grandma.

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