That’s how many days have passed since I last heard my mother say my name before she drifted off to an uneasy sleep on the afternoon of July 18, 2015 after I gave her a dose of tramadol to ease the pain in her back that she complained about not long after our shiftless and dishonest home health aide (a woman I’ll call “Consuelo” even though that’s not her real name) had left.
That last Saturday of my mother’s life is now 2,557 days in the past, and while I have forgotten many of the tiny details, I still retain enough memories of that awfully hot, terrifying day to last me a lifetime.
The thing that you most need to know is how exhausted I was by noon of my mom’s last weekend. She and I had not had a restful night after we went to sleep late on Friday, July 17; sometime around 3 AM she woke up to hallucinations that her brother Octavio – the middle child of my grandparents’ three kids and the first one to die – was in her room, perhaps to usher her in into the afterlife, if you believe in that sort of thing.
Mom had been having difficulty sleeping after she came home from one last stay at Kendall Regional Hospital; most nights she took her nightly medication without a fuss, but on the Thursday and Friday nights before she died, she had trouble falling asleep, and she’d wake up feeling anxious and clingy.
Sometimes, she’d call for me ( despite her dementia and a few sad episodes where she thought I was my father, she never quite forgot who I was), or my Uncle Octavio, who had died in 1993, in the predawn darkness. And since I did not have the services of a full-time nurse, I had to attend to her calls, whether I liked it or not, no matter what time it was.
On the morning of July 18, 2015, those calls started at 4:45 AM.
In those days, I slept on a thin “egg-crate” style mattress on the dining room floor of the small townhouse I’d shared with Mom since late February of 1978. I could, conceivably, have slept on the extra bed in Mom’s room. It would have been a bit more comfortable as far as bedding goes, but I preferred sleeping in the dining room because in her last five years, Mom became afraid of the dark and always slept with a lamp on.
In addition, her bedroom – which is the smallest of the three bedrooms in that dwelling as far as living space goes – was also the stuffiest and smelliest, so I tried to spend as less time as I could when I was not “on duty” as her caregiver. That room was cramped, hot, and not a little bit smelly, and more than a bit depressing.
I don’t remember at what time or under what circumstances I went to bed on the night of July 17/18, 2015. I do recall that I was tired, cranky, and more than a little on edge that night. The male hospice care manager from Catholic Services – I’ve forgotten his name now – had warned me a few days before that Mom did not have that much time left, although he could not tell me if it was a matter of weeks or days.
I do remember that I did not sleep deeply that night, and that I was on my feet, alert, wide-awake, and scared to death when I heard my mom’s voice, loud, plaintive, and crystal-clear, crying for her late brother.
“Octavio! Octavio! Octavio!”
To this day, I still remember the mix of anxiety, frustration, and sadness that I felt when I half-walked, half-ran to Mom’s room without turning on the living room lamp. I had lived in that house for 37 years and knew its geography so well that even now, seven years since I moved to Lithia, I can close my eyes and see my old living room as it was then. I could, and often did, make my way through that house in the dark, without the need of a flashlight, even.
“Mom,” I said in as gentle a tone as I could muster. “Mom, I’m here.”
“Octavio?” Mom said, with a mix of hope and confusion.
“No, Mom. I’m not Tio Tayo. It’s me, Alex.”
“Alex?” Mom said, with more confusion than recognition in both her eyes and her voice.
“Yes, Mami. It’s me. Alex.”
“Estoy esperando a mi hermano Octavio. El quedo de venir a recogerme,” Mom said in Spanish. “I’m waiting for my brother Octavio. He was supposed to come and pick me up.”
I tried to explain that, no, I was not her brother but her 52-year-old son. That “Tayo” had passed away 22 years earlier. That she was in her house in Miami, in her bedroom, and that she was going to be okay.
Mom was not convinced, but eventually, she calmed down, and by 7 AM she had fallen asleep.
I, of course, could not go back to sleep, so I grabbed a book from a pile I’d made on the living room couch and lay down on that other bed across the room from my sleeping mother. And until “Consuelo,” that shiftless, nearly useless home health aide from Nursing South that my half-sister loved because she was pliable and easy to manipulate, arrived at 9:30 AM to make Mom her last breakfast, clean her up, change her adult diaper, get her into clean sleepwear, and then stay with her for just one hour instead of the mandatory three hours she was supposed to stay on Saturdays.
I don’t remember what book I read while I kept my mother company. It was probably my first copy of Rick Atkinson’s The Guns at Last Light: The War in Western Europe, 1944-1945, a book that was among my favorites at the time. Or it could have been James Luceno’s Star Wars: Tarkin, the first Star Wars hardcover I’d seen with the Disney logo on the back cover after The Walt Disney Company’s purchase of Lucasfilm Ltd.
Regardless of which book or genre it was, I alternated between reading and looking at the clock on the opposite wall, counting the hours till my half-sister drove to the townhouse from St. Agatha Catholic Church after attending the 5 PM Saturday Mass service.
I had not slept well, so I was exhausted. I was also more than a little pissed off that the home health aide never spent three hours with Mom on Saturdays. “Consuelo” gave my half-sister a sob story about her own dad had Alzheimer’s and made a secret arrangement – over my objections – in which Consuelo would do all her home health aide duties – which included watching Mom while I took care of myself for a bit, whether that self-care involved rest and relaxation or going for a walk around the block – for one hour instead of the obligatory three hours. I did not like this arrangement at all, but Vicky did. She hated Margarita, the previous, more competent HHA because their personalities clashed, and because Margarita had told her on more than one occasion that she answered to me – the designated primary caregiver – and not to Vicky.
(In a Machiavellian bit of maneuvering, in early March of 2015, Vicky goaded Margarita into losing her temper and causing a scene in front of my mom, then manipulated our mother into asking for Margarita to be replaced.)
Anyway, sometime around noon, one hour after Consuelo made her hasty departure from the townhouse, Mom – who had been remarkably calm and quiet throughout the late morning – suddenly called my name, her voice shaking with obvious pain.
“Can you get me something for the pain? My back hurts.”
I put my book down on the bed and looked across the gap between the two beds and saw my mother’s face, pale, drawn, and clearly racked with pain. Unbearable pain, at that.
There weren’t any medications in Mom’s room; I had taken all her prescription medications to the kitchen some years before because she had threatened to commit suicide a few times when she began suffering from depression. One of those prescriptions was tramadol, a powerful painkiller that I was only supposed to administer when the pain was too much for her to bear.
“Alex, please. Give me something for my back. It hurts a lot.”
“Sure, Mami. I’ll go get you some tramadol. Be right back.”
Mom managed to give me a smile. A wan, bittersweet smile, but a smile, nonetheless.
I made my way to the kitchen, went to the corner where all her medication containers were, and sought out the one with the tramadol. I took out the proper dosage, then walked back to Mom’s room.
“Okay, Mom. Here you go,” I said as she gingerly took the small white tramadol pill in her shaking left hand and slowly, oh so slowly, placed it on her tongue.
I unscrewed the top of her Thermos water bottle – she had to have ice-cold water or else she would not drink it – and handed it to her. She couldn’t hold it steadily, so I had to help her keep the water bottle so she could take a long draught from it to swallow the tiny pill.
I had noticed over the previous days that my mom was having trouble swallowing. That’s why she wasn’t eating a lot of solid foods, and that’s why sometimes she could not swallow small pills on the first attempt. That’s why I got into the habit of asking Mom to either open her mouth or, sometimes, to stick out her tongue so I could confirm that she had, indeed, swallowed her pills.
“Mom,” I said as gently and patiently as possible, “please say ‘Ah’ so I can see if you swallowed the pill.”
Mom looked at me doubtfully as if to say, “I might not be able to,” then slowly, and with a great effort on her part, said, “Ah.”
I looked at my mother’s open mouth and, there, on the surface of her tongue, sat a small white tramadol pill, stuck there like a white fly on a sheet of flypaper.
Shit. This is going to be harder than I thought.
Mustering up as much calm and patience as I could, I smiled at my poor, tired mother. I could see sweat forming on her forehead. I also saw a look in her eyes that was both full of apology and confusion.
I gave my mom the metal Thermos again and got her to take another big gulp of ice-cold water. Her hands shook and I had to help her hold the silver-and-black bottle steady. I even heard her making a loud gulp sound as she swallowed.
Once again, I asked her to say “Ah” or stick out her tongue so I could see if she had swallowed her tramadol. And once again, the white tablet, which was somewhat dissolved but still mostly intact, was stuck on the top of her tongue.
Even though by now I was beginning to get annoyed – I get irritable when I am either too tired or under a lot of stress, and patience is not exactly my strong suit when I’m tired or stressed – I had enough presence of mind to not show it.
I dimly remember hearing, in my sleep-deprived mind, a strain of Leonard Bernstein and Stephen Sondheim’s “Cool” from West Side Story:
Boy, boy, crazy boy
Get cool, boy
As much as I hated to admit it, I understood instinctively that Mom was dying. If not at that very moment, her voyage to Shakespeare’s “undiscovered country” could not be put off for long. In her diminished state, the most of a reprieve from death that she could hope to get was a day, maybe two. And I loved and respected my mother enough to not let my fear, my frustration, my sadness, or my anger show. Not while she was still conscious, and not while she was still alive.
Boy, boy, crazy boy
Stay loose, boy
Breeze it, buzz it
Easy does it
Turn off the juice, boy
I took a deep breath. Forced myself to smile, even though I truly wanted to cry like the toddler I had been a half-century before.
“Okay, Mami. You’re doing all right. You’re doing your best,” I said gently. “Let’s try this one more time.”
To my surprise, Mom nodded. She even gave me a small, wan smile. She reached for the water bottle – even with all her issues with dementia, Beatriz Diaz-Granados was still there. Depleted, certainly, but she was still trying to help me to help her.
Once more, Mom took a large sip of water from her metal bottle – the early afternoon sun glinting off its silvery outside casing and sending reflections of the beam onto the walls and ceiling of Mom’s sickroom – making gulp-gulp-gulp sounds almost like those from a Tex Avery Warner Bros. cartoon.
The third time’s the charm, I thought before I asked my mother to stick out her tongue one more time.
Wearily but obediently, Mom did as I asked.
I suppose if my mother was not dying, the mere image of an 86-year-old woman obediently sticking her tongue out on command would have been comical. It wasn’t, though. To me, my mom’s discomfort and my desire to relieve that discomfort were paramount. As the computer in the movie Alien states when it is revealed that the Nostromo was supposed to find the titular alien creature and bring it back to Earth for bioweapons research, “all other priorities rescinded.”
I looked at my mom’s tongue, hoping that this time, the half-dissolved tramadol pill (which probably tasted bitter and yucky) was gone.
At first, I expected that stupid pill to still be there, taunting both Mom and me by its permanence on my parent’s tongue. And in fact, for one crazy, born out of sleep deprivation second, I thought I saw the tramadol sitting there, stubbornly clinging to Mom’s tongue like a tiny man-made barnacle.
But when I looked again, the pill was gone, borne down my mom’s throat and on its merry way to her stomach.
I still remember my mother’s expression after I said it was okay to put her tongue back in its place. It conveyed so many emotions that it still remains the most vivid memory I have of July 18, 2015. In one brief glance, Mom seemed to ask:
- Did I do okay?
- Will the pain go away?
- Will you be okay?
- Did I do what I was supposed to do?
“You did great, Mami,” I said, holding back the hot, salty tears that were welling in my eyes at that moment.
My mother looked at me with gratitude and love. And then, with a great deal of effort, she spoke to me for the last time:
“Thank you, Alex. You’re a good boy.”
And with that, she laid back on her pillow, adjusted her hospital bed one last time, and drifted off to what I hope was restful sleep.
That, Dear Reader, was 2,557 days ago.