THE SPACE BETWEEN
sumos quo sumos
-Lake Woebegone Official MottoLARRY RICHARDSON
They say, (the people who know), the universe is mostly space. An empty place. Furthermore, these people who know insist that the same is true for me and you. We are all, it seems, just lots of nothing between tiny bits of solid stuff, just barely enough to hold us all somewhat together and, to the world, make it appear that we are here. But this one thing I think I know for sure: a person needs a God to know and room to grow. And one place where there’s God and room, from everything I’ve seen, is the space between. Larry Richardson
Physical Therapists came yesterday to get Mom to stand and transfer to the reclining chair. The goals for her care have been the same for several days now. They are written on the dry erase board.
- Keep systolic blood pressure under 180.
- Increase awareness.
- Decrease oxygen demands.
- Out of bed.
The two therapists aimed at Goal #4. When they asked if she wanted to get out of the bed for a while (the orders are for two hours,) Mom said “No.” When coaxed about three times, and asked if she would help them get her up, she said, “Okay.” She helped to swing her legs around off the bed, and the female therapist said, “Well, look at you! And you’ve got a pretty pedicure, too!” When each therapist linked an elbow to each of Mom’s for support, she tried to push herself up with her hands, one of which is laden with IV needles and tubes. She got up, sort of, but she had no strength to turn herself to the near right to sit on the chair.
After the third try, they put her back in bed. She bent her knees on command and helped them scoot her up in the bed. Then they adjusted this fancy bed to simulate a chair.
She fell asleep as soon as they left the room. When her head bent dramatically to her shoulder, I lifted her head and re-positioned her pillow to make a support.
I wondered, What are we doing here? And then I thought, She really needs to be at home.
This morning, two nurses used the fancy lift in the room to move her to a chair. That machine is amazing! She ate five spoonfuls of oatmeal, drank half a cup of milk, and has been sleeping ever since. The breakfast tray sent earlier was not touched. At lunch, she tried to drink V-8 juice, but it didn’t taste right to her.
Getting her to eat is not one of the goals, even though she eats very little. I’m pretty sure I can prepare food that she won’t eat as well as the hospital does. (I threw that little funny in to make sure we see a little humor.)
The plan is to move her upstairs to what I have always called a step-down unit, a section of the hospital for those moving from ICU to regular hospital rooms or skilled nursing facilities. The criteria for that move is when she is medically able. While she is there, the caseworkers might usually plan for her move to a rehabilitation center. That is not going to happen, the move to a rehabilitation center. I’ve put that out there for everyone.
This morning, watching Mom sound asleep, crumpled in the bed, vulnerable to whatever treatment she receives and whatever is going on around her, I know she needs to be at home, in her own familiar bedroom, with Dixie, Dave, and Neil, and normal routines. (Well, “normal” for the Compound residents might not look normal, but it’s our normal.) We can plan for Home Healthcare, and we will provide true care at home.
She is more lucid than she has been, and she understands a lot of what I tell her, but she is still not completely in the real world. Or maybe it’s that she is in her world, and who’s to say that’s not the real world.
Now I wonder if she will ever be medically able to leave the ICU and at what point the doctor says, “Okay, I give up.” A nurse told me, “They don’t do that. They just keep trying different things.” Her awareness has increased. Her oxygen demands have been met and could continue at home. She’s helped out of bed each day. But there’s that first goal: If she did not have the high-powered drugs delivered by the needle in her arm, she would stroke within hours.
Today, three nurses tried twice each to start a new IV. Mom’s veins are fragile. I asked, “Okay, what’s the next step?”
A pretty blonde nurse answered, “We call in the professionals, the IV therapists.”
About thirty minutes later, a tiny woman appeared with gear in hand. She looked experienced. I asked if I could watch. On the first try, she couldn’t get the IV in, but on the second try (in the other arm), she made a perfect deep stick and entry. I learned a bit and was glad she let me watch, but that’s not really what I want to look at. I hope I never see another needle in Mom’s arm.
I like to picture Mama sleeping in a gauzy forest bed of flowers between two white veils. Through one of the semi-sheer curtains, she sees and feels the comfortable life in her apartment in the Compound and the beauty of all the blooms and foliage right now outside her kitchen window. Dixie runs over to lie in her lap every morning. Dave cares for her as he would his own mom. Neil fixes things and makes her laugh. I’m always there for her. She drinks orange Gatorade every morning followed by her favorite homemade mocha, enjoys her lunch from a tray on her lap, and eats sliced strawberries soaked in sweetened milk. Her nightgown is laid out on the bed each evening, along with night underwear and hospital socks.
Behind the other veil, there is a beckoning Bright Light, so bright that the semi-transparent drape almost disappears. At some point, the Love in that Light will become irresistible. The soul will make her choice.
At the end of this day, I watch her sleep soundly in her ICU bed. Today, she has fulfilled the requirement of getting out of bed and proven her awareness has increased by remembering her full name and the month she was born every time someone asks. (1931? She doesn’t come up with that.) She receives the oxygen well and is not struggling to breathe.
Her blood pressure spikes again and a nurse starts the IV drip.
I think, for this moment, Mama is warm and happy in the space between.