The End of a Long Goodbye

Halloween 2011

Ruby died this evening. The day started with a visit to the funeral home that tonight holds her remains. I went to make the arrangements for her death, but I had no idea that she would die on this day. After the funeral home, I went to the bank to look for an insurance policy that I thought might be in our safe deposit box. While I was rummaging through saving bonds, jewelry, wills and old coins, I had a call from Neshaminy Manor (the nursing home where my mother lived). It was the afternoon shift nurse. He wanted to know if I had been updated on Ruby’s condition. I said, yes, I had talked with the hospice nurse in the morning. I would come tomorrow to visit with her. He suggested that I might want to consider coming today.

It was then about four in the afternoon. I decided to go home and eat before I went to the nursing home. It might be my only chance to get a meal. I went home, ate some leftover wonton soup and a scrap of good sourdough bread…with butter. On the drive to the nursing home I put on a CD, a Bach cello suite, sensing I needed to collect myself for my work ahead.

When I arrived on the floor where Ruby lived, I looked up the nurse, Ralph, who had called me. He said he was concerned because Ruby was under hospice care, but there were no orders to keep Ruby at Neshaminy Manor. A nurse could decide that she needed more care than they could provide and call for an ambulance. I said that I did not want her taken to the hospital. He said that was fine, but if I went home and another nurse came on duty, that nurse might decide to send her. I said I would call hospice to make sure that my wishes were followed.

I put in a call to Donna, the hospice nurse. Meanwhile, a supervisor nurse came to the room and checked Ruby. She said she was going to order morphine to slow Ruby’s breathing. By this time Ruby was breathing like a runner exhausted from a ten-mile run. I wondered at her ninety-seven year old heart. How long could it work so hard? The morphine was given and I seemed to notice a slight relaxing of her breathing. Sitting beside her I started to get sleepy myself. I looked at the family pictures on the wall. I looked at a young and beautiful Ruby at her brother Raymond’s wedding (I think). It is the picture of  her whole family.

By this time it was nearly five-thirty. I started to think about my brother, Cecil, who was scheduled to leave the next day for a family vacation in Hawaii. Should I call and warn him that Mother might be dying? I decided yes, I will call him; I will let him decide if he wants to change his plans before he gets on the plane to the islands. I talked with Cecil. He said he would think about changing his plans over night and call me in the morning. We left it there and I went back to Ruby.

She seemed a little more settled. The hospice nurse returned my call. We talked briefly. She confirmed Ralph’s observation. There was no order to keep Ruby at Neshaminy Manor. The family was expected to make the decision. This was the very thing I hoped hospice would help me to do, to allow Ruby to die without medical intervention. I decided I would stay at the nursing home as long as I could, maybe sleep over. I asked Ralph if it was all right for me to sleep in the chair. He said it was no problem.

It was now close to seven in the evening. One of the aides came in to check Ruby, to see if she needed her diaper changed. We talked about turning Ruby on her side to help her breath easier. While the aide worked to make Ruby more comfortable, I went out to call my sister, Gloria. We talked briefly. I suggested that, if she wanted to see her mother alive, she might want to come to Philadelphia. We agreed to talk again in the morning. I still did not suspect that Ruby’s end was so near.

I went back to the room. The aide was gone. Ruby was propped up higher in the bed. Her eyes were open. Her breathing was more quiet. I thought she was looking at me. I started to talk, saying that I was her son, Ray, come to visit with her. There was no expression on her face. I started to watch her chest to see if she  was breathing. For the first time, I thought she might be dying. No, she was still breathing; each breath was shallow and taken after a long interval, but she was still breathing. I started to sing to her. I do not know what I sang, but most likely  they were old hymns. After singing for a while, I started to talk to her. I was direct. I encouraged her to go, to leave this life- almost like a chant- I said: go, go, it is all right to go, go, it is all right to leave this world.

Now I knew she was going. She was dying. At one point I thought she was dead, then there came another breath, then another. I do not know how long this went on. I stroked her head. I sang to her. I encouraged her to go, to find her way. Finally, I was fairly certain she was gone. I put my hand on her chest to see if I could feel a heart beat. I thought about a story I was working on. In the story a man, in his human vanity, tries to bring another man back to life by breathing into his mouth. I thought about breathing into Ruby’s mouth to bring her back to life.  I did once try to resuscitate  a young man who was injured and dying. I did not try it with Ruby. It was her time to leave this world. I went back to encouraging her to find her way to the next world. I sang more hymns. I said several prayers for her release; then I witnessed the last function of her body. As she expired a tear was formed in her right eye. We both shed a tear as we said our silent goodbye.

At this moment the phone rang. It was Nancy. I told her that Ruby had died. She said she was coming down to be with me. I said fine and hung up. I sang and prayed for a while longer, then I went to find a nurse to declare Ruby officially dead. When I approached the nurse, and said that I thought that my mother was dead, she looked shocked. She called for Ralph and they both came into the room with me. The female nurse used her stethoscope to listen for Ruby’s heartbeat. She shook her head to say there was no heartbeat. Ruby was dead. Both nurses left the room.

I continued to sing to Ruby for some time. The supervisor nurse came back into the room. She said that I was so fortunate to be here when Ruby died. Most people deal with death without experiencing it. She told me that her cat had died today and she was so happy to be there when the animal died. I agreed that I was happy to be part of Ruby’s end. I said, she helped me to come into this world and I was here to help her to leave this world. We both cried together.

The nurse asked about Ruby’s clothes. I said, give them to whoever needs them. She suggested that I call the funeral home to come for the body. I did this. I talked to a woman who said the funeral director would call me back.

I stayed alone with Ruby for a while longer until Nancy came into the room. We hugged and talked. The funeral director called and said that he would be there within half an hour. It was time to say goodbye. I kissed Ruby one last time. Nancy kissed her and said goodbye.

We drove home silently. I ate a big piece of apple cake with vanilla ice cream, followed by two glasses of Irish Mist. I tried to go to bed at about ten-thirty, but I could not sleep. I  have been writing for an hour and a half. Maybe I can sleep now that I have started the process of saying goodbye.

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