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Illustration by Gina + Matt<\/p>\nIllustration by Gina + Matt<\/p>\n
Trying to give my mother a good death.<\/p>\n
By Angela Nissel<\/p>\n
May 30: Give morphine every two hours. Family in agreement.<\/p>\n
May 31: Pitting edema in all extremities. Pt has difficulty swallowing liquids. <\/p>\n
I didn\u2019t know what pitting edema is. I no longer had the need to look up every complicated medical word I didn\u2019t understand. The words the nurses wrote didn\u2019t reflect the small miracles that seemed to happen the more time ticked on. Yes, \u201cPt has difficulty swallowing liquids\u201d was a sign that my mom had almost reached the end, but it was also one of the first times in my life she let me help her without arguing. I\u2019d wet a washcloth and hold it to her lips, watching her face relax as the moisture hit her tongue. If it\u2019s true that hearing is the last sense to go, then she also heard my brother and me play a game of who could find the earliest memory to thank her for. My brother thanked her for not killing him when, at four, he brought a sprinkler inside the house to cool off the TV.<\/p>\n
Even with the high dosage of morphine that kept her asleep most of the day, that morning, my mom\u2019s eyes shot open and followed an unseen person around the room.<\/p>\n
\u201cWho is that?\u201d she asked. Her suddenly open eyes didn\u2019t hold fear, just curiosity, like she\u2019d spotted someone waving to her and she couldn\u2019t place the face. Whoever my mom was seeing was as real to her as I was.<\/p>\n
\u201cWho are they?\u201d Mom continued, as if whoever was in the room had suddenly invited more people along. This time her voice was more politely concerned, like she was improperly dressed for whatever party was about to start in her bedroom. As her eyes scanned the unseen people, our crowded room felt a bit brighter, joyful even, much like it does when you\u2019re in the presence of a friend who \u201clights up a room.\u201d Whoever these friends visiting my mom were, they carried warmth, they were welcoming, and they apparently had delivered gifts.<\/p>\n
\u201cThey brought me roses,\u201d she said, her eyes crinkling into a smile.<\/p>\n
I\u2019d been filling up time by reading what happens when someone is actively dying. It was as helpful as speed-reading What to Expect When You\u2019re Expecting when you\u2019re already on the delivery table. But still, I did gather that hospice patients often hallucinated about taking a trip or seeing loved ones. Yet this didn\u2019t feel like a hallucination. Jade, the afternoon nurse, didn\u2019t call for backup or grab for a sedative. It seemed normal to her. She smiled at my mom.<\/p>\n
\u201cThey bought you roses? Sounds like people are excited to see you,\u201d she said.<\/p>\n
\u201cIt\u2019s all the mothers and babies you helped at the hospital,\u201d I said, guessing as to who would be in such a large heavenly welcoming crowd like the one in the corner of my room, then hating that I\u2019d stupidly suggested that all the patients my mom helped were dead. Still, she nodded as if she trusted me and closed her eyes again, still smiling at the roses only she could see.<\/p>\n
June 1: Assisted with positioning. Patient remains uncomfortable with uncontrolled symptoms.<\/p>\n
\u201cUncontrolled symptoms\u201d to me reads like my mom was thrashing in pain. Instead, her uncomfortableness manifested in small signs, like a furrowed brow or a soft hum.<\/p>\n
Jade motioned me into the living room. Once there, her voice took a stern tone.<\/p>\n
\u201cSometimes people like to pass away alone,\u201d she said. I took this to mean that hovering over our mom 24\/7 does not make for a good death. But I knew I was staying in that room until Mom woke up and told me herself to leave. She didn\u2019t. So I stayed.<\/p>\n
I wondered if Jade was correct and my mom wanted to be alone. But I also knew that was a mother-daughter spat I was determined to win, so I pushed that thought away and drank more caffeine to stay awake.<\/p>\n
June 2: Pain unable to manage with 20 mg morphine 2 hrs PRN. New order. Sbl patch will send tomorrow to avoid overdosing of morphine.<\/p>\n
Don\u2019t ask me what a Sbl patch is. All I know is Jade ordered it once my mom\u2019s throat made a whistling noise with each inhaled breath. Jade called it a death rattle. Death, apparently, was no longer a taboo word once it was this close.<\/p>\n
\u201cThe death rattle doesn\u2019t mean she\u2019s in pain. It just means other parts of her body are shutting down,\u201d she assured me. \u201cShe\u2019s ready to go,\u201d she added in a way that, again, hinted that my brother and I needed to scram. My brother and I ignored the hint.<\/p>\n
\u201cYou remember when we fought with hot sauce?\u201d my brother asked Mom.<\/p>\n
We were now digging into the deep cuts end of the memory pool, reminding her of things she probably would rather forget, like having to take a day off from work when she found hot sauce burning my retina after my brother and I had a food fight.<\/p>\n
My mom continued rattling and defiantly hanging on.<\/p>\n
Jade pulled me into the kitchen. \u201cShe\u2019s waiting for you to leave the room. Sometimes parents don\u2019t want to burden kids with seeing them pass away.\u201d<\/p>\n
I nodded as if taking her words to heart, but I was thinking, Damn, even in her last moments my mom wants to protect me from what she thinks is a burden. We are in a literal fight until the death over her own death. Again, I ignored Jade and vowed to stay in the fight. I borrowed another of my mom\u2019s favorite sayings: My house, my rules.<\/p>\n
\u201cMom, you can go if you\u2019re ready. I\u2019m going to stay right with you.\u201d<\/p>\n
She kept on breathing, like she was stubbornly determined to hold on longer than I could.<\/p>\n
June 3: Pt in transition.
Maintain pt comfort.<\/p>\n
My brother and I stood over Mom as she slept, just like we did when we were kids and would ignore her pleas for a little more rest. Every time she furrowed her brow, we shot looks at each other: She\u2019s giving in, she wants us here. Still, she kept hanging on. It was the death version of two kids in the back seat continually asking, \u201cAre we there yet?\u201d<\/p>\n
\u201cWanna get some air?\u201d my brother asked. Both my brother and I needed a break from the all-night heavenly tug-of-war. A while later, as we reentered the house to take our usual spots on the floor, Jade blocked our way to the bedroom.<\/p>\n
\u201cShe\u2019s leaving,\u201d Jade whispered, her arms stretched across the door\u2019s threshold to guard my mom\u2019s privacy. I raised Jade\u2019s arm above her head and held it up like a drawbridge while my brother and I passed under it. We both kneeled on opposite sides of our mom, taking each of her hands in one of ours.<\/p>\n
\u201cYou can go now. We\u2019ll be fine,\u201d my brother said, smiling at Mom. Her face scrunched up. She took another labored breath. Then another. I imagined Jade looking at me disapprovingly like my old babysitters. Child, if you don\u2019t let your mom be \u2026<\/p>\n
\u201cThis is your room forever, Mom. You can haunt it,\u201d I said. Because I wondered if she was scared and I knew a joke would make her feel more at ease.<\/p>\n
\u201cYou taught us how to be good people, we\u2019ll take care of each other,\u201d my brother said. He reached out for my free hand so all of us were joined together. My mom\u2019s whistling breaths came in spurts with a long pause between each one. It was as if each one took considerable effort, but effort she was willing to give.<\/p>\n
\u201cYou go relax in heaven. It\u2019s pretty over there,\u201d I said and that was not one of my lies. I was certain that where she was going was prettier than what she\u2019d been through. A single tear welled up in her eye and fell down her cheek. The next whistling breath we were waiting for never came.<\/p>\n
\u201cShe\u2019s gone,\u201d Jade quietly announced, and I turned, having forgotten Jade was even in the room. Her face was streaked with tears. I thought, She does this every day and she\u2019s crying. We must have given Mom a good death. With the single tear still staining her cheek, my brother and I kissed our mom one final time. I would hold on to that tear; it taught me that words don\u2019t need to be spoken for them to be heard. That tear contained everything left unsaid. It meant our mom loved us more than we could ever imagine and that she was proud of us. We\u2019d done well.<\/p>\n
Angela Nissel C\u201998 is the author of Good Grief, Pass the Bread, Mom is Dead (Amistad, an imprint of HarperCollins publishers, 2026), from which this essay has been adapted with permission.<\/p>\n
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