We continue our series on the Mystery of Death reflecting on the physical and spiritual care of persons as they near the end of life.
Thanks, God, for letting me do it right…this time.
In August, 1973, my family returned from Puerto Rico to my home in Wisconsin. My parents took high school students there during that summer to learn about the culture and language. I was thirteen then; my sister was almost sixteen. My parents and sister were linguists and absorbed themselves in the culture and Spanish. All I wanted to do, though, was play basketball…
Life in Wisconsin returned to normal with school fast approaching, except for one anomaly—my father’s skin and eyes turned yellow. He was diagnosed with hepatitis. Later, his health care providers correctly diagnosed him with pancreatic cancer and he underwent chemotherapy in the fall. He lost his hair and quite a bit of weight. He would get bruised and cut from falling, and lose control of his bowels. As an eighth grader concerned—to a fault—with image among my peers, I resented my father’s appearance and frailty. I treated him unkindly during his time of greatest need. Instead of being compassionate after he got “cut up” following a fall, I was mean-spirited.
My father was in and out of the hospital. Even though I was a scrawny little runt in eighth grade, I still played football. Once, visiting my father in the hospital, he asked me if he could see my next game. I said, “sure!” He asked me where to go and where exactly to sit. I told him where the game was being held and exactly where to sit—far away from where anyone would identify him as my dad!
I do not think my image problem could be reduced simply to diminished or nullified culpability because of the early adolescent “stage” through which I was developing along with its accompanying insecurities. Sure, maybe that was a part of it, but my pride and unkindness were tangibly real.
The last time my father was in the hospital, he was seemingly unconscious. In tears, I apologized to him for my shameful, despicable behavior. Did he hear me? Sometimes hearing is the last sense to go. I will never know, at least in this life. Shortly after, he died. I failed.
Fast forward: in August of 2008, I moved my mother, residing in Beaver Dam, WI, into an assisted living center in the same city because of her immobility and rapidly declining health. As a widow, she lived in the same home in which she and my father reared me starting when I was a five-year-old. My mother was a professional pianist and instructor whose social and professional connections extended well beyond Wisconsin. Though my wife, children, and I resided in La Crosse, Wisconsin—almost a three-hour drive from my mother—Beaver Dam was her home.
The moving transition was strange, difficult, and necessary. Her little assisted living apartment—with piano—was actually quite elegant. My mother’s time there was limited, though. Her heart was weak, and she suffered from circulatory problems. She was, in general, weaker than she should have been. (My wife and I think this could have been due in part to an undiagnosed chronic Vitamin D deficiency.)
Then, in late October, she was taken to emergency care to treat pneumonia. She stayed in the hospital, and was taken to a nursing home to recover. She had a series of setbacks, and never returned to assisted living. Her circulatory and respiratory systems further deteriorated, though she remained lucid. Her health care team asked her if she wanted to be designated “full code”—to resuscitate her if she had a respiratory or cardiac arrest—or “DNR,” meaning “do not resuscitate.” She could not decide, and left it to me. (My only sibling, Julianne, died in 2002.) I became her power of attorney.
To discern correctly, I consulted the Church’s teaching on the matter and prayed…and prayed. I knew that a full code procedure in my mother’s case would be very invasive, painful, and even crushing, literally, i.e., chest compressions could break her ribs. In consequence of a full code, she would be sedated, unconscious, and dysfunctional with no prospect of improving a seriously declining condition. Conversely, my mother would soon die in consequence of an arrest accompanied by a DNR designation. Among other sources, I consulted the Catechism of the Catholic Church: “Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted” (2278).
I discerned that the DNR designation was the correct (though very difficult) choice. With double pneumonia and accelerating weakness with difficulty breathing, she was taken out of the hospital two more times during Christmas week and placed in a nursing home where my family could visit her more easily. Then, a few days into the new year, she slipped into a dying phase. The staff noninvasively applied an oxygen mask to support my mother’s breathing. Their action throughout impressed me and corresponded to Church teaching, e.g., the Catechism, 2279, states “Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted.”
Because of my wife’s support and care for our children, I was able to spend significant time with my mother during the last month of her life. This included the last few days and nights on a cot at her side, watching and helping my mother die with courage and grace. These were among the most profound and memorable moments of my life. I also am grateful my family could play music at her funeral, and I could give the eulogy. I thank God for this amazing, grace-filled, moving opportunity to show my gratitude and love as a son…and for giving me a second chance. “I thank you, Lord, with all my heart…Your love endures forever!” (Psalm 138:1, 8)
Mark Koehne teaches moral theology for Saint Joseph’s College Online Theology. Programs.