Thankful

Needless to say it was not a "Merry Christmas" in the Sallee household today, instead it was the last Sallee family Christmas as I know it, the last Christmas with mom. That's heavy, huh?   So my favorite Christmas movie is " A Christmas Carole"  by Charles Dickens, and this year I have somehow seen four different versions of it. And everyone knows the end when Ebenezer wakes up, and discovers he is still alive with the chance to bless, and love and spread Christmas cheer; then he goes running through the streets yelling "Merry Christmas!" Truth be told that I didn't feel like saying Merry Christmas this year, it was more an act of honor, not merriment or happiness.  But I think the happy warm feeling of Christmas Day, with the perfect gifts, carefully placed house decorations and the big feast is just a facade. And a lot of this holiday is distraction from a much holier and more somber day than we give it credit for. Sure we sing Christmas hymns and carols and "O Holy Night" might bring tears to our eyes. And there are so many wonderful Christmas movies to watch that talk around the idea of a winter holiday that involves good feelings, love, gifts and a happy ending. But the real Christmas story isn't glamorous or sparkly or involve trees, tinsel, bows or family gift exchanges, it involved a drafty barn, hay and a feeding trough for a crib as well as flights in the night to flee danger.  And there was certainly no "happy ending" a few years down the road.  There is no warm and fuzzy feeling or a happily ever after at the end of my Christmas story either, instead I'm more dwelling in that end part of the Christ story: His suffering and  sacrifice. And I'm understanding so much more what Christ sacrificed. Seeing the story in a new light I'm realizing this chapter in my family's story is almost done with all its traditions and good feelings. There are new chapters of the book are yet to be written. And now we wait.

Mom's days are drawing shorter and shorter as her consciousness each day decreases. When she is awake she is mostly foggy, not sure if it's the drugs or the liver disease or her body slowly shutting down. But despite that, Dad, Jeff and I have all been able to have wonderful talks with mom in the past days expressing our love for her, telling her how much we will miss her, making sure she knows we aren't afraid of life without her. But beyond those few conversations there is much silence from mom.  She is quite comfortable, but her body is so very tired.  She talks a little and she drinks fluids some, and I was thrilled to get her to eat two Popsicles today after giving her pain medicines. Her breathing is starting to get heavier and more labored, she drifts in and out of sleep more now, and too weak to even stand. Her face is drawn tight for the most part but we can still draw out that classic Janice smile a few times a day, but only if we are goofy enough. So we treasure the smiles and just keep waiting. 

There have been lots of tears shared between dad and I as the reality sets in deeper, but you must know how thankful I am . I'm thankful for these tender moments. I'm thankful for the last months and now weeks to learn to let go. Everyday I have to talk my emotional fingers into releasing their grip that is tightly clasped on mom. I'm thankful for Gods grace to give me 35 wonderful years that didn't end in a sudden stop but have wound down slowly.  I'm thankful for the 10 months she fought so that she could be here for my brother and I. I'm thankful that soon she will take her final breath on earth and close her eyes one last time, and when she opens them again her body will be free. She will take a deep breath and realize that the battle is done, the fight is over and the cancer is gone, and the happiest of  happy endings will find her in the arms of Jesus.

The hardest part

Today is one of the hardest of days in this walk with mom. Just the reality of it all settling in, hopes dashed and crumbled once again, and trying be present as a loving child and caregiver while holding myself together. Its a lot of pressure to bear up under. And it's these days that being a nurse are the most challenging. I have a job where I make people better, and if I can't I find someone who can. ER nurses are tough and we don't take no for an answer, we save lives in a matter of hours. We may lose a patient from time to time but we save so many that we always have confidence and hope that we can do it again.  But this situation is different. This time it's my mother and this time I can't save her. What is a nurse to do?

The hardest part about today is after realizing that things are worse now than they have ever been is trying to find a little piece of hope to stand on. Without hope I start sliding down this terrifying hill that you can't see the bottom of, and the hill isn't bad but it is oh so scary and so foreign. The faster you go the better you can see the fast approaching base of the hill, and terror with it. Finding a little hope blinds me to the fear and helps me find joy in the midst of the fall. Somehow I'm stuck. I know my mothers ultimate hope and my hope for her is getting to pass on from this world into eternity, and into the loving arms of Jesus. But the daughter and the nurse in me cannot find solace there yet. There is so much suffering and illness in the meantime and the path is a long hard one.

There is just so much to consider, so much that my medical brain and spiritual heart run through.  The nurse in me never really stops and I'm constantly assessing mom with my eyes, trying to see ways to help her, weigh out the difference between dangerous new symptoms versus acceptable progression of the disease. I'm so tired of chemotherapy. I'm tired of seeing the fatigue, the neuropathy, the fog, and the compromise brought on by it even though it is preventing advancement of tumors. I hear her wheezing and short of breath and I just don't know if it's tumors in her lungs or if it's because of her low blood counts depleting her body of the necessary oxygen her body needs. 

My nurse brain is constantly trying to fix this very special patient, this most critically ill patient. How on earth do you teach an ER nurse to see altered mental status or wheezing or sheer fatigue or anemia or critically altered lab values and do nothing?  I fix things and I fix people, that's what I do when I go to work.  Even more challenging is trying to turn the assessing off at home and a few hours later turn it back on at work.  I must suddenly value the minute suffering of a headache or a sprained ankle with the same compassion as that of my dying mother. All the while my moms illness process and the questions of her care plan still run through my head. 

You nurses all know we learned to make care plans and learned to hate them. I promised myself I wouldn't make a care plan for mom; but here I am with goals for healthy skin and prevent skin break down and falls and promoting oxygenation and ADL's in the back of my mind while looking in a 2 year olds ear.  I want to let the doctors be her doctors but 10 years have taught me doctors don't know everything and the compassionate nurse often has the wider scope. The reality is setting in that my dear mother will become my most challenging patient. The reality is setting in that I'm not supernurse and I can't fix everyone. Only My Jesus can fix her. And only He is my hope. He must be.

"And hope does not put us to shame, because Gods love has been poured into our hearts through the Holy Spirit" rom 5:5