Monday, September 12, 2016

To Die in Modesto

She was born Mary Elizabeth Ray, in Baltimore, Maryland on Aug. 13, 1923. We always called her Libby, and she was my mother.

What little I know of her childhood suggests that it was a happy one. She was the only child of Charles, a banker, and Mary, a homemaker, and though she grew up in Baltimore, she had numerous relatives she called cousins (although I think her use of the term was expansive) in Frederick, which she considered a second home city. She was outgoing and quick to make friends, and kept in touch with many of them for life, and very sentimental.

She was working for Baltimore Gas and Electric Company in World War II, when she met Dad, a 2nd Lieutenant, fresh off the boat in the Merchant Marine at a Lutheran church function. After the war, which ended late for Dad, having been stuck on a ship in the Pacific, whose Captain was reluctant to return, they were married in Baltimore, and shortly after started a near legendary journey across the United States in an old leaky Hudson Terraplane, to meet Dad's family, and ultimately complete his education in music at UCLA.

The details of their movements between then my earliest recollections are obscured; dad may know, but they're not important today. I was their first child, born in the summer of 1951, and my earliest recollections are from our house in Culver City, where we lived until I was 12 or so (we moved between my 5th and 6th grade). While she did not work while I was young, I am aware that she had a job as a buyer in the UCLA Purchasing Dept. before I was born, and which she went back to after we kids (she had two more, Ted and Mark, born 5 and 7 years after me) were old enough to trust to babysitters. She kept working there, rising steadily in rank and authority, until retirement at an early, but respectful age. We just located a 20 year pin from UCLA while inventorying her jewelry.

After Culver City, they bought a magnificent old fixer upper house in very nice neighborhood nearby, Cheviot Hills in Rancho Park, Los Angeles. I remember Mom carefully stripping and re-varnishing what seemed like 100 windows, while dad and I demoed a wall to make the new kitchen/family room.

Dad and Mom were a great couple. He was the dreamer, and she the realist. He had high flying plans for business deals, and she was the worrier. He was the accelerator pedal and she was the brake. He was the entrepreneur, and she was the accountant. They fought some, but never seriously, and while many of his ventures were not great successes, enough were that they contributed significantly to their financial success.

I left home for college at 18 and, except for summers, usually split between Oregon and Los Angeles, never really came home again. Ted sold all my old books and kept the money, and I think he might have sold some of my fish tanks too.  Still, we were all close.

When Mark went off to college at Cal Poly, Dad, ever looking for the land investment opportunity, bought a sea side apartment complex in Pismo Beach, which Mark managed while at school. After he finished, and they retired, they sold the apartments, and used the proceeds to buy their dream house in Shell Beach, up on the cliffs overlooking the Pacific Ocean, with a gorgeous, well kept garden. Without doing any math, I think this must have taken place in the early 80's. At some point, they also kept a condo in Los Angeles, but I only visited there once.

Upon sensing old age approach, they began to search for a place to settle, preferably near a child to help. The East Coast was out of the question, so we were eliminated, and they didn't want LA either, so Mark was out, leaving Ted, who was married and settled and starting a family in Murphys, California with his wife, Monika. Initially, Mom and Dad bought a double wide trailer in a park there, but after a few years had a nice, but not luxurious house built in the same development as Ted and Monika. Ted and Monica had three children, Karl, Bethanni and Katarina, and Mom and and Dad, but mostly Mom, became the babysitters of first resort. They grew up splitting their time between the two houses, and the bond between grand parents and grandchildren is very strong. In latter years, the children repaid with love and attention to their needs.

At the approach of her 80th birthday, she wanted a special celebration, and started the tradition of family reunions in August in Pismo Beach, first at a series of motels but in all recent years at the Sea Crest.

90th birthday in Pismo Beach

Mom had her up and downs with health. She survived uterine cancer, skin cancers, and colon cancer. Just 3 or so years ago, she was diagnosed with breast cancer that had spread to lymph nodes, but after lumpectomy and pathology, it was decided that it was a slow growing variety, to treat with low impact chemo and no radiation, because something else would kill her first.

That something was to be heart and lungs problems. The first sign was atrial fibrillation, which was treated with a pacemaker and Coumadin, which, when Camp Hillary tells you is an innocuous drug, don't believe them. Used to thin the blood and help prevent clots, the amount needed is variable, and requires close monitoring of clotting times, and makes subsequent surgeries trickier. She also developed type II diabetes, which she controlled very well with diet, although she loved her sweet things.

About 3 years ago, she was diagnosed with congestive heart failure, a long-term, chronic progressive deterioration of the heat which often leads to edema, fluid build up around the heart and lungs. Two years ago it became so severe she needed 24 hr oxygen, which she hated, but learned to manage. Last year, pulmonary hypertension was added to the list, and the doctors basically told her the end was somewhere around the corner, but nothing was foreordained. At that point she made the statement to anyone who asked that her goal was to live to see Katarina graduate from high school.

The end started a week ago yesterday, when she fell in the bathroom, and grandpa couldn't pick her up. The fire department was called, and they picked her up and set her in a chair while Ted drove home from Strawberry Music Festival. She was apparently OK, but shaken, However, the next day one of the granddaughters noticed that one of her feet was blue, and cold, and apparently lifeless. She was taken to the hospital in Sonora, where a blood clot in the leg was diagnosed. She then transferred to Doctor's Hospital in Modesto, accompanied by Mark, who had arrived that day from Los Angeles where, it was hoped a vascular surgeon would be able to restore blood flow. We rapidly found it wasn't that easy. By Tuesday, we were told there were basically three options, a clot busting drug called TPA, amputation of the leg above the damaged area, or "comfort care", making sure she was treated for pain while allowing the damaged tissue to slowly kill her.

Taking her expressed wishes to see Kat's graduation in mind, we opted for the TPA treatment, which was administered on Tuesday. After one day, it was observed that while the TPA appeared to have dissolved the clots, the tissue was not re-perfusing with blood, and was continuing to die.  After another long discussion, we decided on the amputation and she concurred. As Georgia and I scrambled for airline tickets both Mark and Ted's whole families assembled in Modesto. The amputation was performed while we were in the air. Upon our arrival in Sacramento on Thursday at 4 PM Mark called and informed us that while the surgery had gone OK, afterwards she had developed breathing and heart problems and that it was urgent we arrive quickly if we wanted see her alive. We made it to the hospital by 6 to find Dad, Ted and Mark and all of their families assembled at her bedside in ICU.

I barely recognized her, all shrunken and gasping for air. She was not really conscious but able to react to voices in her ear, and stirred when we announced our presence. She was heavily medicated with a fentanyl drip to kill the pain, and epinephrine to keep her heart rate up. At last we agreed that it was time to let her go, and the epi was stopped. The doctors expected her to pass then in a few hours.

After staying at her side until late in the evening, the boys left to go back to college, we went to a nearby hotel to get a room, while Ted and the girls stayed to sit vigil. The next morning we found her in much the state, in a new room under "comfort care",but obviously fading.  We stayed there on and off through the rest of the day, and by evening, Georgia and I were all but exhausted, and we left to get a hotel room again. When I kissed her good night/bye, I noticed she was barely breathing. While we were checking into the motel, we got a call from Ted saying that Kat had noticed she had stopped breathing. We came back to the hospital in time to be there for the official pronunciation, and help with the paperwork. In America, even dying takes proper paperwork. We took Dad back to our hotel room for a night's sleep.

I haven't seen many, but as deaths go, it seemed pretty good. She was surrounded by those who loved her most, the pain was relatively short and heavily treated. At 93, she had outlived most of her friends and relatives.

We're now dealing with the aftermath, making burial, service, and financial arrangements, and trying to set Dad up for life without Mom. While he's a little fuzzy around the edges, he knows what's happened, and that we need to make new arrangements. We'll be here several more days.

Apologies for light blogging.

1 comment: