While my 91 year old Gramma was in the hospital with pneumonia three weeks ago, I began to paint the clouds in the sky after one particularly hard night. She was begging God to let her die, while all I could do to help was hold her hand. We prayed together that he would hear her and take her home. Finally, after several hours, she let me sing her back to sleep. The next day, my mind was on the clouds, and so I began to paint.Initially, I bought the large sheet of Yupo paper to attempt a portrayal of the monarch butterflies, a subject I'm often moved to paint because of my connection to their wintering grounds near my childhood home of Morelia, Mexico. In the past, I have painted the monarchs with the memory of standing among billions of them at the Del Rosario Monarch Sanctuary north or Morelia.
This time, I wanted to paint the beginning of their journey from here in the Blue Ridge Mountain of Virginia all the way back home to the exact spot of their births. In my mind's eye, I pictured a mountain landscape, the view off a favorite overlook on the Blue Ridge Parkway with a few butterflies fluttering around. But, after Gramma's horrible night, my head was in the clouds and I thought, "I'll just buy another sheet of paper later."
As I painted, however, I could not help but think of Gramma's struggle to die as a long journey not unlike that of the monarchs. I have always been fascinated by the thought of these tiny, seemingly frail butterflies and their ability to traverse continents in a few weeks only to breed and die.
Likewise, Gramma had become a frail, little thing struggling against the elements with each passing day. Having been diagnosed with severe dementia many years ago, she had very little hearing left, and macular degeneration had claimed her eyesight, too. She had very little quality of life for such an independent and active person, and she kept saying she had lived entirely too long already. It seemed she was ready to die, but just wasn't sure how to begin the final journey.
We prayed every night Gramma was in the hospital that God would take her, but alas once more she pulled through the pneumonia and returned to her home at Heritage Green Assisted Living a week later. At the time, she was diagnosed with the beginning stages of congestive heart failure as the underlying cause for the fluid in her lungs.
Then, last Saturday at four in the morning while I has home alone for the weekend, the nursing home called to say Gramma had fallen and cut her arm, that I should meet her at the emergency room. When I arrived, they already had her on a stretcher and were giving her high levels of oxygen. The nurse felt her low count might have been part of the reason she fell trying to get out of bed. Gramma was only in minimal pain, however, because the skin tear on her arm was superficial, and with her poor circulation, she really didn't feel it much unless they were touching it. Thankfully, there were no broken bones.
That night was our blessing. With the high levels of oxygen, Gramma was very lucid and clear-minded for a woman in her condition. So, for the four hours it took to find out she was officially okay - they literally applied Neosporin and gauze - she and I were able to really talk for the first time in ages. At some point, I told her I would give her memory back if I could. She really seemed to like that. I told her I loved her, and for once, I knew she heard me and understood.
That night was God's gift to us both. I'm sure of it. At long last, I drove her back to the nursing home and we got her tucked up in bed in her favorite pink pajamas under the quilt my aunt made for her last Christmas. Reluctantly, I left her when she said she needed to sleep, and by the time I arrived to check on her that evening, she had faded back into her dementia.
The next day, I returned to my studio and began to paint small butterflies onto my finished sky. Without much real thought, I landed on the number four. At first, I considered painting a whole trail across the sky, but once the first was painted and I saw the impact of the tiny creature in the large expanse of blue, that idea went right out the window.
In hindsight, I think the number four was my unconscious need to represent the four directions, earth, air, fire, and water, or north, south, east, and west, because I always give thanks to the four directions in my own spiritual practices. After several tries over a period of days, I got my butterflies just the way I wanted them and my painting was complete, except for my least favorite thing...figuring our how to frame it.
In the meantime, the nursing home staff began Gramma on short treatments of oxygen, but over the week her skin began to look grayish, and she seemed less responsive at times. My cousin Jason was scheduled to visit her on Tuesday, and he commented on how bad she looked. We assured him she had an appointment to see her doctor Thursday afternoon. They were planning to check her arm and discuss how they might manage keeping her on oxygen. We wondered if they could keep her from removing it all the time, because after about five minutes, she would not remember why it was in her nose and take it right back out.
Alas, that doctor's visit was not to be. Thursday at 11:30 the staff got Gramma cleaned up and dressed and had her in the wheelchair ready to go. But, when Mom arrived, she was slumped in her chair and not responding at all. After checking her over, the staff felt she had gone into acute cardiac failure, and they called for an ambulance.
I was at The Framery where I get most of my works framed. I decided long ago to save my sanity by never again attempting to cut my own mats. The guys who run the little frame shop down the street from my studio are great about letting me bring old frames I scavenge from garage sales and antique shops and cutting them to fit my work. Then, all I have to pay for is the matting and a small fee for the cuts. Plus, I get the added benefit of recycling old, used frames that might otherwise end up in our county landfill.
For my sky painting, I had chosen a silver frame and a warm, white mat that matched the color of my clouds. Having just unwrapped the work to see it for the first time in its entirety, my phone rang. I answered Mom's call excited to tell her how great the painting looked only to find out Gramma was being rushed to the emergency room.
During the long afternoon and evening ahead, Gramma was mostly unresponsive, and her breathing had taken on this loud, rattling sound. Every now and then she would moan, and I would talk to her until she calmed back down and slept. It seemed like forever before they finally admitted her officially and called our doctor's group in to consult.
Thankfully, we got Doctor Woodward. While he was assessing Gramma, he began discussing our options for treatments to remove the fluids from her lungs. I said that if I could convince him to do a Dr. Kevorkian I would. I complained about the fact that we had just been able to euthanize our elderly, suffering cat several weeks ago but could not offer the same dignity to my own Gramma. He responded that we were often more humane to our animals, but then miracle of miracles, he began to talk to my family about the option of "comfort care." He admitted that the hospital did not have to treat her at all, but could just give her pain medications and keep her comfortable until the end.
Gramma already had a DNR (Do Not Resuscitate) order in her living will, so it seemed we knew where she stood on the issue. Plus, the doctor admitted that even it they treated the fluid in her lungs, they had nothing to help heart failure of this stage, and we would simply be prolonging life until her lungs filled up with fluids again in short order. It seems a no brainer, but in the face of actually making the choice, we were all a little hesitant. How do we know for sure we are making the right decision? As if on cue, Gramma woke up and began to mumble to me. I was rubbing her forehead and she said it felt good. Then, she said as clear as a bell, "Please, please. I just want to go home. Help me find my way home."
The doctor moved Gramma up to a room in the stunning, new oncology ward with a view of the mountains. The hospital provided us with a pull-out couch and a lazy chair so we could be comfortable, and they called the hospice people to speak with us the following day. The doctor made sure Gramma was given morphine right away, and they took her off all other medications. In short order, she was sleeping deeply and seemed fairly comfortable apart from the horrible, loud, rattling breaths she took in a steady rhythm. I fell asleep that night to the steady rattle and the burbling of the humidified oxygen tank running above her head. She only woke once during the night and the nurses gave her another dose of morphine, quickly returning her to a deep sleep.
The following day, my family came to the hospital to relieve me. I convinced Mom to go home at 4 am and get a few hours of sleep in her own bed since she is dealing with a torn rotater cuff in her shoulder. Plus, I had the upcoming art show at my studio with 300 guest already invited on Sunday afternoon. It was Friday, and we had not yet hung the art on the walls. I was going to need to leave for a while at some point, too. Mom and my uncle convinced me it would be okay, although I felt a little frantic about leaving. We got a friend to come help us hang the art, and together with my studio mate, we worked non-stop to get the whole thing done as fast as possible. By late afternoon, I was back where I belonged at my Gramma's side. I convinced my family to go have a supper break, and I got some alone time with her to make up for leaving. I was so tired, I fell asleep holding her hand by the bed for a while.
Something woke me out of a deep slumber to find Gramma's eyes open. She was staring off into the distance and moving her eyebrows around a bit as if she was straining to make out what was there. Worried she was in pain, I called for another dose of morphine. Just after the nurse administered it into her IV, I began to rub her forehead and sing to her, trying to comfort her back to sleep, but she just kept looking into the distance. I sang her favorite song, "The Lord of the Dance," and another Shaker tune called, "How Can I Keep From Singing." I sang my favorite Ben Harper song, "Blessed to be a Witness." Then, I sang "Amazing Grace." I kept coming back to the verse that ends, "Twas Grace that brought us safe thus far, and Grace will lead me home," so I sang that verse to her twice more.
When the singing ended, Gramma took three more breaths and she was gone. The room went from the loud rattling to a still, quiet, comforting peace. Gramma's face went from struggling to see that distant object to a calm look of rest. While the nurses came in to listen to her heart, I called Mom to let her know. Within five minute, Gramma was pronounced officially home at last, and my painting had its title...The Long Journey Home.
