What’s a mother to do?

“He doesn’t know what he’ll do if he loses me.”

“It’s hard on families, especially with young kids.” I said, trying to be supportive.

“Did I tell you we were high school sweethearts? He could always talk me into stuff. I’m crazy about him.”

I didn’t say anything. I nodded back, noncommittal. I wished for a different death for her. I knew the one she was heading for. Dying in the hospital when she wanted to be home, with Christmas decorations and the gift of her girls clamoring to be near her, with her mother singing to her while she rocked in the rocker she’d rocked her babies in.

“He thinks it will be a bad idea for the girls to see me die at home,” she said.

“He said that?” I was surprised since he refused to discuss what might happen if the chemo didn’t work.

“No. But I know how he thinks. He’s afraid.”

I wanted to say it was her place to be afraid and his to be strong instead of the other way around. When he was at her bedside, she comforted him, telling him everything was going to be okay even though we all knew it was a lie. But it was her lie.

Her symptoms kept changing. She suffered in ways that medicine did not help. One day, she was fatigued but otherwise fine. The next day, her pain was out of control or her nausea was relentless. One thing was con­stant, though. Her family kept urging her to stay strong, as if any sign of giving in was a personal failing.

“They don’t want me to give up.” She said it as a rational explanation and expected me to accept it as fact. They were trying to cheerlead her into good health.

“How do you feel about that?” I asked.

“Loved.”

“Of course, but it’s hard on you.” I wanted her to open up, to admit that the pressure her husband and family placed on her was a burden. But how could she admit to that when she knew her family was praying for a miracle?

She was readmitted to the hospital for the last time early in December. We had spoken by phone since her most recent discharge, so I knew she was declining, yet the sight of her was still a shock.

“I want to make it to Christmas.” Her hands curled over the side rail, her skin as pale as snow, the gnarled ridges of tendons and bones blanching her fist. She was literally hanging on. I knew it was unlikely she would last until Christmas, but I nodded back.

“Let’s do what we have to do.”

I wasn’t there when she passed. She picked a time when her husband was home with the girls, the early morning time when the hospital was eerily quiet. Her night nurse said she just faded away. No pain, no clenched fists. Peaceful.

She didn’t make it to Christmas. But she did everything she could to make it. She did what she thought was best for her family. She did what mothers do. ONA

Ann Brady is Symptom Management Care Coordinator at the Cancer Center, Huntington Hospital, Pasadena, California.

From the May 01, 2010 Issue of Oncology Nurse Advisor