Eighteen Hours

I ran through the snowdrifts as fast as my legs would allow.

The interregnum of the prior nine days had been all but too much to bear; the days apart weighed heavily on me.

But I abandoned all the heartache as I plowed through fresh snow blanketing an invisible but well-known path.

Rounding a bend, I made out the silhouette of my twin brother standing under an arcade beyond the head of the trail; he, too, had been anxiously awaiting my return.

“That’s really nice of him to welcome me back!” was my only thought.

But just as we began a short walk along the colonnade to the entrance of the nursing home, my brother stopped, turned abruptly to me and then said,

“Mom is not doing well … she’s not doing well at all.”

A veil of denial immediately enveloped me as I struggled to catch my breath and my legs buckled under the sheer weight of his words.

It was as if I had been punched in the stomach.

It was as if I had been driving a speeding car and then forced to come to a complete stop and reverse directions in the same instant.

Life – as I knew it – was about to be altered irrevocably.

My brain immediately became awash in the panoply of human emotions as well as thoughts too disparate to grasp. But in the midst of all the mental chaos, an eight word sentence – a fateful harbinger spoken to a trusted friend nine days earlier – took hold, repeating itself in an endless loop time and again within my head; it would continue for the next eighteen hours … and beyond.

~~~~~~~~~~~~~~~~~~~~

“Everyone dies.”

I learned this lesson as a child. All of us do. But to a child, death is merely an abstraction; in the mind of a child, we are all immortal.

Over the years as Mother’s health declined, I will also admit to occasionally fantasizing about how I would react when Death finally came for her.

I don’t believe there is anything strange about this. How many among us has not contemplated such thoughts? Consciously or not, do not the exigencies of Life force each of us to become mentally prepared for nearly all eventualities?

But even with the benefit of nearly five years of introspective preparation for Mother’s death, my brother’s words that morning as we walked along the colonade, forced me to face – head on – an unwelcomed revision of the ill-understood lesson from my callow youth,

There is no good way to prepare;

Mother’s die, too.

~~~~~~~~~~~~~~~~~~~~

While finally making our way into the nursing home, I do remember being conscious of how quickly the excitement of the morning had turned to trepidation and fear while simultaneously being surprised by an unanticipated calm – or numbness – that came over me. It could very well have been denial; I don’t know. After all, Mother had weathered many storms over the past two and one-half years.

As we reached her room, however, the protective instincts evaporated as quickly as they had emerged. Even though I desperately needed to personally “lay eyes” on Mother, I was not at all certain I was prepared to deal with the probability of this harsh new reality.

As I opened her door, I instinctively knew Mother’s current situation was different from all prior scares; she was surrounded by too many people, both expected and unexpected.

“This is not good.” was my only thought.

I quickly made my way through the crush of uncomfortably silent nurses, aides and family members to come face to face with Mom.

I was shocked.

Whereas nine days before I had sat laughing as Mother interacted cogently with two very surprised hospice nurses – both of whom later went on to make a glowing report, the woman in front of me that Thursday morning was nearly unrecognizable; Mother was unresponsive with her mouth agape, laboring under the burden of oxygen deprivation; her oxygen debt was outwardly manifested by the most foreign and hideous of watery rattles imaginable, presumably precipitated by either an oddly rapid onset of pneumonia or a silent but profound cardiac event.

I acknowledged the truth in that first instant – Mother’s life was rapidly coming to an end.

~~~~~~~~~~~~~~~~~~~~

My recollections of the ensuing eighteen hours are a blur of activity and people moving into and out of Mother’s room.

The “comfort care” medications, Roxanol and Intensol, were administered; hospice nurses came and went according to shifts; a family conference with the hospice chaplain; tears and anguished cries; family members, friends and fellow residents visited; more tears and laughter erupted sporadically as everyone spoke of Mother’s life; dinner was unexpectedly provided by the beloved family members of another resident; hugs – lots of hugs; a young, devoted private duty aide returned twice – on her own time – to continue her dedicated service to a much loved charge; more Roxanol; more Intensol; more tears; more laughter; more tears; more hand holding; silent conversations with Mom; and a hard working nursing home aide, despite completing his shift at 11 pm, who was determined to remain at Mother’s side, caring for her as well as his “second family” until …

Mom received a final dose of Roxanol.

Twenty minutes later, with her daughter, two sons, and a surrogate “family” of friends at her side, Mother was assured by each of us in turn that we would “be alright” – it was “ok” for her to “go.”

She then took one last breath and never relinquished it.

Mother’s long, wonderful life and decade’s long struggle with Parkinson’s disease came to an end with her death just before 4:00 am on Friday, January 14, 2011.

That last breath and her death were not peaceful, at least as far as I was concerned; the reality of both came at me with the force of a tidal wave; I immediately felt myself drowning in the waters of a very deep and painful private sorrow.

In that instant, I was forced to acknowledge that one of two people who had always been integral to my life was now gone – forever.

I will never again hear her laughing through tears as she delivered the punch line of a favorite joke.

I will never again hear her perky morning or afternoon greeting, “Hi, Sweetie!”

I will never again see her beautiful smile.

I will never again receive the gift of her kisses or feel the incredible strength of her tiny hand taking a firm grasp of my own.

I will never again hear her assure me with an, “I love you, Bobby.”

And, I will never again experience the intensity of her eyes locking with mine – as if peering into my soul.

No.

At that moment, her death became all too real; the promised separation could not be undone; her death was absolute.

And just as she was mercifully cut loose from the moorings of a long and blessed life ~ impaired, in the end, by debilitating infirmities ~ a part of me most surely died as well.

But even while no longer whole, I also knew that I would grieve and ultimately recover in a manner best suited for me.

And please forgive me if I ask that no one offer a recipe for grief, complete with certain ingredients and results; I will find my own way given time.

Life has taught me that Death is a mystery and is loathe to provide answers; alternatively, would any certain answer magically render the sting of Mother’s loss and our loneliness less painful?

No.

Unanswerable questions are a part of life.

~~~~~~~~~~~~~~~~~~~~

To this day, I still am haunted by the eight words spoken nine days earlier to a trusted friend after leaving the nursing home to the abyss of an imposed uncertain return,

“Mother will not be alive when I return.”

String With No Kite

I have been waking up the past few nights in a cold sweat.

Mother has been visiting my dreams; she is young and beautiful again, exactly as I remember her from my childhood. She then moves toward me and stares directly into my eyes while painfully asserting,

“I wanted to go home and you wouldn’t let me.”

I don’t sleep following these dreams. Instead, I spend time trying to convince myself she is wrong; after all, I hadn’t actually had a say in the matter. But, I am painfully aware she has never liked being in the nursing home ~ at least when she was able to fully process and articulate such thoughts.

Eventually I convince myself she must, on some level, understand that making the fateful decision was extremely traumatic for every member of our family.

There simply was no choice.

This might seem incredible but, to my recollection, I don’t believe I have ever had a dream specifically involving Mother, especially odd given our intense experiences over the past two years and more. If there is any one factor that might explain her appearing to me in my sleep these past few days, it is likely because we have all been riding a non-stop roller coaster of emotions these past few days.

~~~~~~~~~~~~~~~~~~~~

Many have fallen prey recently to a particularly vicious respiratory bug that has been blazing a trail across the country. I can personally vouch for its sting. While not certain if I have ever had the flu, I am now convinced my experience with this unwelcomed intruder could not be far removed.

As with any outbreak, the elderly, who are particularly vulnerable to virulent assaults, have not been spared; many residents in Mother’s nursing home have suffered the full wrath of this virus. And while most are recovering slowly, a couple of these elderly residents have been recently felled.

Unfortunately, this is the scenario which has generated so much concern for Mother these past few days.

Rarely requiring even over-the-counter pain relievers, Mom suddenly began complaining of daily non-specific body aches late last week. Over the next couple of days, she then began to demonstrate some nominal upper airway congestion. No problem. We used the available drugs at our disposal so as to dry up the secretions and all seemed to be going well.

Until Sunday night.

Just as one of my brothers arrived from out of town, Mom began to sound as though she was awash in fluid within her lungs. Our sister, getting off of the phone after trying to speak with Mother, was horrified by what she had heard; the only words Sister could utter were, “She is drowning!"

This is a noise you never want to hear.

Yet another drug was ordered to further manage the secretions, Hospice was put on alert, and Mom very quickly withdrew further into her own private world.

No matter how long we have anticipated a dramatic decline in her condition, no matter how hard friends have worked to assuage our collective concerns, the oft-told axiom holds true ~ at least for me:

“You are never prepared.”

~~~~~~~~~~~~~~~~~~~~

“It’s just that when I go into that room, I am now left not knowing what to do. I can’t even tell if she even knows I am here!"

Even before the dread virus entered our lives, attempting to wrest Mother even further from our grasp, we had all been dealing with the reality of her worsening dementia.

Many a friend has done his/her best to convince all of us that we have been doing everything for Mother “just by being there for her!”

My mind understands this.

But, my heart can't.

Intellectually, I grasp what has been happening to Mother over time, but the only indelible image I have in my head is not the face of the elderly woman lying unresponsive in the nursing home bed but an idyllic image of the younger woman who raised all of us.

“Mother doesn’t know who I am. She is just lying there with her eyes closed or, worse, wide open with nothing but a vacant look on her face. This is the woman who was everything to me when I was a little boy. But, who am I to her now?”

I can’t adequately express just how hard it is to look on as someone you truly love ~ like this woman who actually still resembles our Mother ~ who has lost so much of what made her the person you knew.

A thousand thoughts keep swirling through my head.

Dad did it right. He drove home, went to bed after a great dinner with Mylla, Uncle Jim and Kathy, and never woke up.

While the aftermath of that experience proved incredibly painful, I am convinced it is a far worse fate watching as someone you love dies ever so slowly from a progressive degenerative disease compounded by the twisted effects of dementia.

Nature allows for this double jeopardy; suffering two deaths is a cruel fate.

“Relationships are made of a multitude of invisible things” such as memories, shared experiences, hopes and fears. But when a person slowly disappears with dementia, family members and friends are left alone. It has been likened to “holding a string with no kite.”

A person might work hard to sustain himself after these losses, but the “invisible stuff” that ultimately makes up valued relationships becomes lost forever.

Exactly like a splinter under your skin. Even unseen, that splinter is no less painful.

~~~~~~~~~~~~~~~~~~~~

As yet another sad attempt has been made by one unwelcome Hospice nurse to cavalierly declare Mother’s life to be at an end, I am here to reiterate my firm belief that we ~ none of us ~ has a say in the matter.

The virus will run its course but I suspect Mother and the hand of God will ultimately be the guardians of her fate; after all, no one can deny Mom has proven, time and time again, to have an amazingly resilient soul.

If asked, I would admit to being somewhat guilty of not wanting to let go. I would love to have the Mother I once knew back ~ more than you can possibly imagine. This is still the woman who signed my report cards. This is still the woman who sent me to school, fed and clothed, every day. This is the woman who made certain there was food on the table at night as well as orchestrating ridiculously memorable Thanksgiving, Birthday and holiday celebrations.

I do most certainly want her back.

But, of course I know the fantasy will never come to pass.

In the meantime, her family will do its level best to take comfort in all of the little things. If given another opportunity, I won’t bemoan the fact that Mother can no longer fully enjoy a favorite song as she was capable of doing even a month ago; instead, I will work hard to simply enjoy watching one of her toes move to the rhythm of a “Rhapsody on a Theme by Paganini.”

We are all committed to do whatever it takes to fill whatever is left of her life with happiness and joy.

And in the end, when she has made her final decision, I will honor her wishes by surrendering to the greatest act of love available to everyone … by letting her go.

Maybe then, our eternally vibrant and beautiful young Mother will no longer haunt my dreams; perhaps, she will come and carry her youngest son on a walk to visit with her father in the middle of that beautiful field of flowers she has spoken of before.

I would surely welcome such a dream.

Time and time again.

Momento Mori

“She has changed a lot since the last time I saw her.”

For some reason, Linda’s words immediately threw me off balance. I have been listening to quite a few medical professionals coldly discuss Mother’s condition for the past two weeks, but this aide’s words struck a discordant chord with me. It then suddenly dawned on me as I looked again at Mother …

I have been in denial. Or, at least, in part.

That’s alright isn’t it? I am her son, after all. No one would expect me to see all the changes coming to Mother clearly; I’m not an objective observer. And … no … I am not so blind I haven’t recognized the changes of recent months ~ I’m not completely shut off from reality.

But, there was something so simple, honest, and unaligned about her words that made me stop for a moment and think; in the end, it seems hers was the one authentic voice I needed that allowed me to confront the truth that Mother’s life is surely fading away.

~~~~~~~~~~

Mother has been under the care of hospice for almost two years. During the intervening time, we have all witnessed many horrific changes that have come to her. My response to anyone who asks is that Mom continues on a downward physical spiral but that we do enjoy even the increasingly transitory benefits of “ups” that come (with downs) along the way. We all try to take every measure of joy from these good moments while simultaneously maintaining a firm grasp on a realistic understanding of her condition as well as her prospects for longevity.

Time is not on her side

Over the twenty months or so since Mother was introduced to hospice, our family has been informed by care providers that her death has been imminent no less than two times ~ perhaps three. Every time these pronouncements have been made, family members were left to struggle with an impending “reality” which has long been “assured.” To date, each of these prognostications has been proven false and wantonly premature.

How does this happen?

“Hospice kept talking about the quality of my father’s life. My father, even though he was not able to walk around and talk to people, certainly got a huge grin on his face whenever he saw my children,” the woman said. “And that was a couple times a week. He still had joy in his life, and who had the right to take that away?”

This represents but one woman’s final account of her father’s death; suffering with Parkinson’s for many years, he died after only thirteen days in Hospice.

Since the Hospice movement first made inroads within the United States during the 1970’s, these organizations have faithfully served more than a million patients at the end of their lives by providing a wide range of services which include the management of pain and physical symptoms as well as psycho-social concerns.

Unlike this woman, many families who have previously engaged hospice would gladly sing the praises of their personal experiences ~ especially as they related to hospice helping them with difficult circumstances when traditional medical practices seemed to fail them. But, since the 2005 controversial, court-imposed starving death of Terri Schiavo, reports have increased dramatically speaking to the alarming growth of a very dark side of the hospice movement known as “terminal sedation.”

~~~~~~~~~~

Stephen Connor, Vice President of Research and International Affairs for the National Hospice and Palliative Care Organization, is on the record stating, “Hospice neither seeks to hasten nor prolong dying.” “Any family engaging the services of Hospice needs to know, from the onset, who is in charge, what protocols are routinely followed, and where a particular group stands on the important issues of food, fluid, and the practice of ‘terminal sedation.’”

Food and Water

Connor stated his organization’s standard for medically administered food and hydration is that “people have a right to decide whether they want those interventions or not. And a decision about whether they should have them or not resides with the patient, usually made in the context of a family system. Families ought to decide if they want it or don’t want it, and those wishes should be respected.”

Mr. Connor also went on to add that hospice does allow for the withdrawal of food and hydration, even when the patient is not in immediate danger of death, keeping in mind that individual hospice programs vary in their policies with regard to medical nutrition and hydration. Some go so far to as not allow patients to have intravenous fluids or feeding tubes, as an example, while others may opt to permit their use.

Former hospice nurse, Ron Panzer, agrees that hospice is “a wonderful service if done with integrity and morality. But since Schiavo’s death in March of 2005, he has heard from an increasingly vocal group of patients, families and caregivers who are raising grave concerns about their hospice care ranging from overmedication to the limitation or refusal of food and water.

Panzer, who now is employed as a home health care nurse, is not alone when stating his belief that hospice groups DO now increasingly engage in the practice of hastening death while fighting almost every attempt to prolong life. “The current tendency is to interfere at almost every step in ordinary care.” “They’ll pull the rug out from under a patient by limiting food, removing adequate hydration and essential medications, as well as refusing to provide treatment for easily treated infections.”

Terminal Sedation

Some bioethicists and physicians have proposed “terminal sedation” as a legal, ethical alternative to assisted suicide and euthanasia.

Terminal sedation is defined as the “deliberate termination of awareness for relief of intractable pain when specific pain-relieving protocols or interventions prove ineffective.” Essential components of terminal sedation also include withdrawal of most, if not all, treatment for medical disorders; limiting fluids and some, if not all, foods ~ all so that death occurs as soon as possible.”

With an alarming reported increase in frequency over the past five years, patients enrolled by Hospice are dying as a result of the implementation of terminal sedation. Cloak the process any way one might choose, but the ugly truth behind terminal sedation is that death is ultimately achieved by circulatory collapse brought about by a lack of adequate hydration.

Mandatory subsistent hydration has long been considered a standing order for critical care physicians who treat the terminally ill; any notion of withholding hydration as the process of death ensues is generally considered unconscionable. In the setting of “terminal sedation,” potent sedatives are also employed to mask the very real symptoms of iatrogenic (induced) suffering brought on by the limitation of fluids, the resultant dehydration, and the inevitable circulatory collapse.

Those who support terminal sedation view this as an “innovative” way of getting around the “sticky” problem of the euthanasia movement’s general inability to convince the voting public and legislatures to enact assisted suicide laws. So, increasingly, terminal sedation is being incorporated into the practices of hospice and other end-of-life programs even though, as pointed out by author Brian Johnston, euthanasia supporters openly admit that “terminal sedation is tantamount to euthanasia or, at least, a “slow” kind of euthanasia.”

It is generally believed that terminal sedation is not a “rarely used option of last resort” as many of its supporters maintain. The current reported prevalence of terminal sedation ranges wildly from 3% to 52% in terminally ill patients. But, when one stops to reflect on the unknown incidence of “terminating awareness” ~ or to put it bluntly, “ensuring unawareness” ~ calculating the use of terminal sedation as a form of “comfort care” may very well be approaching epidemic proportions, even outside the realm of the hospice movement.

It should also be noted that some physicians who otherwise condemn “assisted suicide” actually embrace the notion of terminal sedation as an “ethical alternative.” Dr. Robert Kingsbury, Director of Sister’s of St. Mary Catholic hospice in St. Louis, wrote recently in support of terminal sedation calling it “comforting and critical for patients who are profoundly fearful of terrible suffering at the end of life.” He went further to reject the generally held medical view that withdrawal of food and water results in undue suffering.

To my way of thinking, the evolution of terminal sedation and its incorporation into the practices of hospice proves that proponents of euthanasia are nothing if not creative and persistent. There are many people who are convinced that tolerating even a “little bit of deliberate death” will eventually afford them control at the end of their own lives. But if a growing culture of death is allowed to continue seducing even well-meaning patients, families and medical professionals into making death decisions that are based on the problems of health care cost containment, stressed and overburdened caregivers, as well as fear of suffering or diminished quality of life rather than following the traditional principles of “not causing or hastening death,” we are all ultimately at serious risk of being compassionately rationalized to the notion of death.

~~~~~~~~~~

Each of us, unfortunately, has but one final debt to pay for the privilege of living this life; the joy of viewing the beauty of another sunset or the wonder at the moment of the birth of a child each carries with them the seldom considered cost of the death each one of us will eventually owe (momento mori). While none of us is ever guaranteed another moment of life, time and circumstances point to the undeniable fact that Mother’s days are certainly numbered.

The image of that grieving woman’s father who was only capable of smiling a “huge grin” every time he saw his beloved grandchildren haunts me. I choose to believe, as did she, there must have truly been joy at the heart of his smile, even at the very moment a biased observer declared his life to be at an end.

Mother recently looked at my sister and declared no less than three times, “I don’t want to die.” What was my sister to think?

Mother looked at a brother and made a request for the joy of a summer strawberry; when he returned with his store bought harvest of berries, her words and smile spoke volumes, “Ohhh … they are delicious!” What was my brother to think?

Mother looked at me, adjusted my hat and shirt, and then admonished me not to be gone for long because, “I will miss you.” What was I to think?

I’ll tell you.

Hospice does have a place in Mother’s life as she approaches her final days; I whole heartedly welcome the services hospice was initially intended to provide both to Mother and her family. Our situation being as it is, I have absolutely no say in the matter ~ nor would I want the burden of such responsibility. But if I were given an opportunity to simply be heard on the matter of terminal sedation, I would state, unequivocally, I have no use for any organized process that might serve to make a calculated, capricious or dispassionate decision as to Mother's fate.

While it represents simply one son’s opinion, this is where I would choose to draw the line.

Allow Mother all the days or hours she is due. Give everyone, including Mom, the opportunity to enjoy even the smallest wonder each of those days or hours has the potential to bring.

Enjoy the gray-blue intensity of her eyes as they bore into your soul.

Live vicariously as she revels in the simple pleasure of a strawberry ~ not to mention, chocolate.

Sit, listen, and allow yourself to become captivated by her rambling conversations. Then watch the fluid movement of her hands as she sews an invisible dress from her memory of years gone by.

Oh, and lest I forget to mention ...

You don’t want to miss a Mother's smile.

Room 803

Spend enough time in a nursing home and you will come to know -- even love -- a colorful cast of characters. Going to visit a family member or friend, a person can find himself with a stiff neck -- turning this way and that -- offering up "hellos" to the new friends you have come to know along the halls leading to your loved one's room.

My brother, Jim, arrived early Sunday morning to spend time with Mom. Completing his litany of greetings as he neared Mom's room, Jim passed Room 803 and noticed that Guy was still in bed; he is not a man who "sleeps in." Jim stopped and offered up his usual greeting; Guy responded in kind.

An hour later, Jim decided Mom might benefit from spending a little time outside among the flowers, enjoying the early morning sun and an unseasonably cool breeze. While heading out, they were passed by the blur of Guy's wheelchair as he headed in the same direction.

Sunday was no different from any other day. Guy was on the move.

Guy is 84 years old and "doesn't look a day over 65" -- whatever that means; age is relative, after all. While heart disease and a debilitating stroke have recently rendered him unable to walk, he has managed nicely.

Herodotus famously wrote of ancient couriers who allowed, "neither snow nor rain nor heat nor gloom of night," prevent them from swiftly completing their appointed rounds. While this may not accurately apply to modern-day mailmen, Guy is the living, breathing embodiment of this credo. From the moment he laid eyes on his Quantum 600 wheelchair, he has been of a singular mind -- nothing was going to prevent him from getting the hell out of "that" building. He wasted no time.

Guy's adventures are a constant source of entertainment at GVM -- the veritable "stuff" from which nursing home "legends are made."

Once free of the building, Guy effectively took ownership of the extensive properties surrounding the facility. Everyday after breakfast, Guy takes off through the front entrance then heads down a long, winding drive eventually arriving atop a summit known affectionately to many as, "Guy's Hill." I don't know how much time he spends up on his hill on any given day; I have seen him basking in the morning sun as well as the growing evening shadows; he ventures out in rain, sleet, or snow. He wants nothing more than to be free.

There is/are (a) gaggle(s) of geese that have taken up residence on his property. He apparently makes a daily tally of these large-(ly dirty) foul. At last count, there were 44 -- give or take a few errors in accounting. And recently, he was beside himself with excitement over the discovery of a beaver at work in one of his ponds; while he never personally saw it, he went to great lengths explaining the beaver's handiwork to anyone who would listen.

I first came to really learn about Guy through word of his exploits. Gossip around the nursing home spreads faster than any fire. I had previously heard several reports of the "renegade resident" who "constantly escapes from the building in his wheelchair and 'hides out' up on a hill." One day, similar gossip was enhanced by a report that the "same man" had been discovered upside-down -- with only his wheels visible to passers-by. (Guy was fine if not a little embarrassed.) The nursing home administration ultimately conceded the futility of discouraging his adventures but demanded he add an embarrassing orange "caution" flag to the back of his chair; he decorated their flag with a "skull and crossbones."

And, this is how it was on Sunday -- as Mom and my brother set out to enjoy the beautiful morning, Guy met them along the way to his hill. My brother's earlier impression had been wrong; "Guy looks great!" Always in the mood for a good conversation, Guy was eager to sit and talk but Mom suddenly asked to be returned to her room. Before heading their separate ways, Guy asked, "Are you going so soon?"

The irony is staggering; Guy passed away two hours later with his daughter at his side.

His death came as a complete shock.

I am grateful for the time I shared with this man. I don't know what experiences made up the other 83 years of his life before coming to GVM; I only know the man who lived two doors down from Mother these past thirteen months. We all knew him as a gentle giant of a man. We shared pizza (but, sadly, no beer) on Super Bowl Sunday; birthday cake this past April; made dinner reservations for him so that he might enjoy a nice dinner (and a lot of wine) with his daughter; watched as he unabashedly flirted with my sister; made fools of ourselves attempting to decipher the "greek" instructions for a "simple" TV remote; laughed together at the latest new joke his physical therapist had shared; brought him the daily newspaper.

Like so many other family members at GVM, Guy's daughter, Suzie, disrupted her own life in another city to be close to her father after he suffered a stroke and ultimately entered the nursing home. Shortly after his death, Suzie called to relay the sad news; she later confided that she would not have traded the experience for any reason because, "I got to fall in love all over again with this man -- my Father."

Guy did make the trek up to his hill that morning. Just like every other day, he had a place to go and geese to count. None could have predicted where his journeys would ultimately take him on Sunday, but we are somehow comforted knowing he now moves unencumbered. Free of the wheelchair at last, he is travelling on his terms. Guy is truly free.

When the Poet thought of "Those Who Were Truly Great," he finished his work with, "Born of the sun they traveled a short while towards the sun, and left the vivid air signed with their honor." These words come closest to expressing the respect I hold for my friend, Guy.

A new resident will eventually move into Room 803. Guy's name placard will be replaced with one bearing the name of the stranger. And with time, many of us will probably come to love this person as well. But that room -- it will never be anything more than, "Guy's Room," to me.

And, I will never pass your hill, Guy, without thinking of you and that silly flag. We are now left alone to wonder where your new adventure has taken you.

May the road rise up to meet you.
May the wind be always at your back.
May the sun shine upon your face;
the rain fall soft upon your fields
and until we meet again,
may God hold you in the palm of His hand.
(Gaelic Blessing)

Nursing Notes Excerpt

Her First Mother's Day

"The older I get, the more I see the power of that young woman, my mother." Sharon Olds

Sunday, August 2, 2009 (10:45 pm)

"Jeannie, I love you more than you'll ever know. I miss her.

I can't explain how precious you are to me."