Eulogy for Nani

For those who do not know me, my name is Rob Marvin, and I am happy to count myself as one of Virginia’s friends ~ and quite possibly, her favorite.

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It’s my hope that Monday, October 17, 2011 will be remembered as the day when a loving family and many friends gathered in defiance of convention to celebrate Mother’s Day … at the time and place of their choosing … in God’s house … at His table … and later, at the cemetery on hallowed ground.

I will personally never forget this incarnation of Mother’s Day when we came together to honor the enduring love of a mother and grandmother, and for others, the life of a friend and neighbor, Virginia.

~~~~~~~~~~

As I sat to think about what I would say today, one image of Virginia was foremost in my mind:  She was seated at the head of a large table surrounded by family and friends offering up an insanely large amount of food.

How had I come to sit at this table?

~~~~~~~~~~

It must have been difficult for Virginia to sit idle, watching as her three children bore the responsibility of caring for their ailing father over two and one-half years as he languished in a nursing home. 

And while she could do nothing to ease their burden, she was surely proud to see her children acting on the example she had passed along to them over many years: 

Family is everything.

During this time, our families were living parallel lives within the same nursing home; three doors down a common hall from Dominic, our Mother was living out her final days.  And, as with Virginia’s children, we had long ago learned the importance of family in our lives.
When my twin brother, Jim, recently asked Charlie why it was that Virginia had taken to the two of us, his reply was simple:  “Mom didn’t say much but she watched people and took in everything.  She watched you care for your Mother and for my Dad.”

As months became years, all of us, the children of Virginia and Dorothy, were bound by a shared affection for our beloved parents as we did the only thing we knew how to do:  we cared for them.

The love of family is the tie that binds all of us.  Virginia respected this in her children … and in my twin brother and me in turn.

~~~~~~~~~~

Since being diagnosed with an incurable brain malignancy little more than four weeks ago, no one left Virginia’s side without being impressed by the living contradiction embodied by this first-generation Italian-American.  Increasingly frail and weakened ~ she remained strong in spirit; eyes hampered by age ~ her vision remained crystal clear; and, in a world of increasingly dizzying complexity ~ she projected herself as a selfless woman of quiet practicality and grace.

When the time came for the physicians, nurses, social workers and family to make plans for her future, it was clear there would be little allowance made for debate: 

Virginia was going home; to her home of 54 years where she raised her children and their children, to the kitchen where so much food was made and shared, and to the familiarity and comfort of her own bed.

Always the Mother, even at 83, Lucille, Joe and Charlie were still children in her eyes ~ even as they navigate through middle age.  It is as if her motherly eyes wouldn’t allow her to see the children grown ~ as if adulthood was the singular province of a mother.

Perhaps it is. 

Or, at least, so it seemed, until the morning of October 12^th ~ when, with Charlie, his dog Lulu as well as a trusted friend and caregiver, Anita, at her side, Virginia slipped quietly into that long, good night.

~~~~~~~~~~

Having lost their father only five short months ago, Virginia’s children are now learning, as did my twin-brother and I this past January, that the death of a mother is unique ~ it seems to affect us in ways far different from when our father’s die.

I believe it marks an irrevocable severance with the past ~ as if cutting the umbilical cord that binds our affections, making us grounded in the world.

And, unlike with our father’s, we are intimately and inextricably linked to our mother’s ~ as flesh of their flesh, and blood of their blood.

Yes.  Their childhood died along with Virginia this past week; but, like her, they are to be born again.

~~~~~~~~~~

His holiness, the late Pope Paul VI once remarked as to the relationship between Mother’s and their children when he observed,

“Every mother is like Moses.  She does not enter the promise land but prepares a world she will not see.”

Virginia bore two healthy sons and one daughter, and nearly lived to celebrate her 84^th birthday ~ which is tomorrow.  She lived her life preparing Lucille, Joe and Charlie as well as her four grandchildren for an earthly land of promise she will no longer see ~ at least not from THIS vantage point.

But, her Lord assures us that she is now in the heavenly Promised Land alongside her beloved family who had gone on before her.

It is the contradiction of our humanity, the resurrection, and our place in it.

~~~~~~~~~~

I will end this Mother’s Day card of sorts, in prayerful reverence of Virginia, my mother, Dorothy, and for all those mentioned silently within your hearts:

“The love of a mother is a veil … of a softer light … between the heart and our Heavenly Father.”

Virginia Ann Cervello is now fully in the light of our Heavenly Father by the redemption freely given by His Son.

And, through the promise of the resurrection, I speak for many when I pray for the day when we will no longer simply be our Mother’s sons or daughters, but united as children of God.

Sweet dreams, Virginia.

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.

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“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.

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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.”

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.”

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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)

Miss Ruby

There is something intoxicating about the smell of yeast bread as it is baking; it instantly makes my mouth water.

Mrs. Hanlin was responsible for this. She came to us when Mother was ill and hospitalized for a long period of time; she cooked and cleaned for our family. She was apparently very good at both but her cleaning is NOT what I embraced. I distinctly remember the smell of her yeast bread dinner and cinnamon rolls as they were baking. Long after she had gone that sweet smell was forever etched in my memory.

In the days when I started first grade there seemed to be little concern for children walking to school -- everyone walked. Over time, I came to use those walks as a barometer to gauge how my day would go; an ideal day for me would have begun by walking into the bright light of a Spring morning -- a crisp chill hanging in the air. But, perfection was realized only when the sweet smell of yeast bread goodness permeated the breeze as I approached school. Everyone always knew when it was cinnamon roll day. For this reason, and more, the cafeteria ladies held a special place in my heart.

Miss Ruby worked her entire adult life as a cafeteria cook; she was one of the vaunted ladies entrusted with the secrets to making my only vice come to life. I generally carried my lunch to school but it didn't stop me from coveting the "fruits of her hard labors." I might have sold my soul to the devil for one of those rolls; as it is, I had to settle for potato chips as my only bargaining tool.

I don't know what brought Miss Ruby to GVM. I only know that one of my brothers immediately fell under her spell. It wasn't until I found out what she had done for a living that my interest was truly piqued; I decided I would do almost anything to gain access to her secrets.

I can write that she is almost 100 years of age, nearly blind, and has a wicked sweet tooth. My brother began to spoil Miss Ruby and a gaggle of her lady friends early on by bringing Tootsie Roll Pops almost everyday. It got so bad after a while that one of them would invariably lose her manners by blurting out, "What have you got for us today."

I honestly am not sure if Miss Ruby actually eats Tootsie Roll Pops -- or sells them on the black market. I am justified in writing that because the basket of her walker always has the look of a porcupine for all the Tootsie Roll Pops that stick out of it. I always ask if she has any left, to which she softly replies, "No, I don't think so." When I point out evidence to the contrary she expresses surprised innocence; I choose to believe she is a very cunning actress. She is also irresistible.

She is extremely proud of her days as a cafeteria cook and also speaks quite fondly of her myriad students; she is one of the lucky people who truly loved her work. Yes, she does have the secret recipe for those cinnamon rolls but always insists she doesn't know exactly where she stashed it. She is wickedly cunning. I make a mental note to push harder the next time or to corner one of her unsuspecting relatives.

An amazing woman; soft spoken, kind, reflective, funny, and adorable. She loves to talk.

Sadly, just shy of her 100th Birthday, Ruby died in the comfort of her own bed on July 5, 2009.

That afternoon was unsettling for me; I was pensive. I later looked around the nursing home and noticed nothing seemed to have changed; clocks were ticking, residents were eating their meals, and medications were being passed.

I have been around medicine long enough to know better but still the question surfaces. Why doesn't the world quake or stop when a life is taken? Why aren't we forced to stop and immediately take stock of a life lived and lost?

And then -- in the same moment -- my revery ended as I remembered that I had been asked to find someone to address a problem for Mom. This is what happens -- life happens.

That evening I walked down Ruby's hall and noticed her personal effects were still in the room -- as if she wasn't gone. In a corner stood her walker. And there they were -- jutting out of the basket were two sticks from those Tootsie Roll Pops. I couldn't help but smile.

I keep imagining her as the cafeteria lady from my childhood. The thousands of greetings she must have received over the years!

Hello, Miss Ruby!

Even though I never did get that recipe, I know I am a better person simply for having known her.

The sweet smell of yeast breads baking will forever return me to memories of Mrs. Hanlin and the halcyon days of my youth. It will now also bring me back to these days at GVM, when I came to know one of the cafeteria ladies who once held a secret key to my heart.

Goodbye, Miss Ruby!

"525,600 minutes"

July 7, 2008

I will never forget that day.

Mom was up early and dressed; she actually seemed to be excited. She didn’t understand.

I couldn’t do the work my brother’s were doing – it was impossible. I was a coward.

Instead, I opted to go with my cousin, Lou Ann, and sister-in-law, Linda, who had crafted plans to take Mom shoe shopping and then out to lunch. She didn’t understand.

We also took along the new cherry-red wheelchair Mother had been so excited to receive; it didn’t matter what it was -- it had been a gift from her “Sweetie.” The wheelchair had not yet become an essential fixture in her life; it was available. She didn’t understand.

We walked out of their home around 10:30 in the morning. She didn’t understand.

We shopped for shoes, and then went on to the Olive Garden sitting down for lunch. That is essentially all I did; I was not interested in food. The mood was somber; it was a wake of sorts. She didn’t understand.

At noon, as choreographed, after a few cell phone calls, we made our way to the van. I was physically ill by the thought of what was to come. I understood. Did I?

We drove past the boulevard leading to their home? Oh, my God! This is for real.

We drove another half-mile or so and then turned onto a property I had visited before in the final years of my Grandmother’s life. I remember thinking, again, “Oh, my God.” But Mom seemed fine; she was making plans and even a grocery list. She didn’t understand. Or did she? She had certainly spent more time here with her Mother than any of the rest of us; could those memories have faded as well?

My twin brother was in the circle drive – as planned; he was hurting – visibly -- but he was determined to do what was necessary for Mom. He was strong – or at least he acted the part. He understood.

We had arrived. Our life, as we knew it, changed in a moment.

I remember the sense of a weight seeming to push me back as we entered the doors; I didn’t want to be there under any circumstance. It was supposed to be for the best, right? I honestly did try to put on a brave face. It wasn’t easy.

Feeling numb and moving along unfamiliar hallways, I felt pulled – as if by some invisible rope – toward an uncertain reality; I was blindly following everyone’s lead.

Suddenly, there it was. Room 610. Worse was the card that hung beside the door which read, “Dorothy Scott.” I felt weak in the knees.

What my brother’s accomplished in the hours after we left the house that morning with Mom was miraculous. As if by magic, many of Mom’s favorite things had been transported to that room – it quite honestly already felt like a “home.” On seeing her favorite rocking chair, Mom took a seat with nary a complaint; she was alright. My brother’s had worked a miracle – at least from my point of view. By making this day – this transition -- easier for Mom, they had paved the way for the rest of us as well.

I was the weakest link in the chain that day. I had not prepared myself for this eventuality. Yes, it had been discussed over time but there was a part of me that had continued to push the thought aside for “another” day.

July 7, the day that had dawned just a few hours before, had brought more change than I could have imagined.

Before leaving the house with Mom that morning I had the opportunity to tell Bob what was on my mind. I assured him that while I was personally distraught by the blinding reality of the day, I didn’t want him to feel any guilt. Though my heart was breaking, I assured him that he was doing the right thing. He seemed strong but I suspect he was holding on by a thread.

Has it really been one year? It feels like a minute. It feels like a lifetime.

Mom understands. Mom doesn’t understand. It is all true.

One year.

“525,600 minutes … moments so dear … how do you measure, measure a year?”

“Seasons of Love” from the musical, “Rent.”