Put me to sleep, Doctor

July 21, 2014

I inwardly shuddered when Mom bluntly spoke to the doctor, but tried to appear calm on the surface. Regardless of any success or failure in hiding my feelings, no one in the hospital room was paying attention to me. We were focused on the surgeon’s visit with Mom.

“They put pets out of their misery,” Mom said. “Why can’t you do that with me?”

If the doctor replied, I don’t remember his comments. In his forties, he resembled other doctors who’d visited Mom after her operations because of his white lab coat, but also different because he sat beside her as if to physically declare he’d stay as long as necessary. Other doctors—there were many—had stood, smiled unconvincingly, and soon fled her room.

In July 2013, Mom was diagnosed with cancer. Because the cancer had grown so rapidly in her 88-year-old body, the doctors couldn’t pinpoint its origins. They called it stage four, if only because that’s the highest number oncologists apply to cancers. But the cancer was no longer the worst of Mom’s concerns. Surgery had been attempted to provide relief from the relentless spread of tumors. Though I won’t share details, her first surgery failed. She had another surgery the next day. I suppose the second effort succeeded, except its aftermath left her with weeks, if not months, of recovery. She was stitched together by rows of metal staples, which appeared like the tips of landmines on the battlefield of her abdomen. Mom referred to the staples as, “My barbed wire.” They were still there when she died a few weeks later.

“Put me to sleep, Doctor.”

I shuddered.

Mom and I (and my sisters) had chatted over the years about her “end of life” desires. She’d completed her Durable Power of Attorney for Health Care forms along with other documentation. No extraordinary measures. No life support on machines. Just. Let. Me. Die. A. Natural. Death. No decision we made, confronting the cancer, or wrestling with the aftermath of the surgeries, contradicted Mom’s stated interests. Except I think they did. But how could we know how horrific the cancer could get when no doctor identified it until that grim fourth stage? How could we know a surgery would fail? Especially because of my work with a hospice, I tell everyone to fill out the forms. It’s important to make informed personal decisions about what you want, or don’t want, for health care.

But forms can become formless, a barely remembered exercise in futility.

A few weeks ago, with tears and tough decisions, my wife and I put our 15-year-old cat Madison to sleep. She was in misery. Days before Madison had seemed her usual overweight, aloof, minimally active self. Then she crashed. According to the vet’s scale, our ten-pound cat barely tipped six pounds. Madison wouldn’t drink, wouldn’t eat, and soon, like so many pet owners, we faced limited and lousy choices. As I witnessed the vet prepare Madison for the final drugs that would (mostly) peacefully take her life, I thought of Mom.

How could I not?

“Put me to sleep, Doctor.” Mom didn’t add “please” to her bedbound demand. Normally polite and certainly respectful of the medical profession, she no longer cared about pleasantries.

I don’t think the surgeon ever answered her. How can you? Humans are different, right? We are not like pets, right?

In watching my parents die—Dad slowly from dementia, Mom rapidly because of cancer—I have no easy answers for why there is such suffering, for why I put Madison to sleep while Mom lived her last weeks in anguish. Yes, the good doctor sitting beside her hospital bed promised—and kept his promise—that no more “measures” would be used. And yes, she would receive medications that—so the professionals reassured—kept her pain-free and eventually non-responsive.

Did I treat Madison better and Mom worse?

I don’t know. All I can claim is that I tried to make Madison’s life as happy and safe as possible. All I can claim is that my family tried to honor every one of Mom’s wishes.

On this side of heaven, we stumble along. While I could argue the pros and cons of euthanasia for all creatures great and small, here’s my truth: the rights versus wrongs, the laws versus ethics, can feel formless and futile. I care most about relationships. About honoring the bond of love. Madison, from first to last breath, was under my wife’s and my care. We did our best for her. Mom, who raised me to think for myself, who sent me into the world to live independently, asked me (and my sisters) to help her and Dad think through future decisions that represented their lifelong values. At the end, I tried to do my best with and for my family.

But I never once felt good about what happened. Honoring your parents, when love is the strongest, purest reason, can be the hardest commandment of all.

Originally posted at Patten's blog