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When Cancer Wins: A Surviving Spouse's Story Chapter 6 - A Final Farewell On August 3rd, I decided to make one of my increasingly rare appearances at work. About 9:40 PM, I kissed Jan on the forehead, said goodbye to Brad, and drove off, not knowing that I would never see my wife at home again. I felt uneasy at the pre-shift briefing and more so as I took my mobile crane out to start the night's work. A premonition perhaps. At 11:30, just 1/2 hour into my shift, my cell phone rang. It was Brad. He said his mom couldn't stop vomiting and she had made a mess of her pajamas and he didn't know what to do. I got him to help her into clean clothes and, since it was nearly due, got him to give her some anti-nausea medication. I told him to call me back in 30 minutes. At exactly midnight, my phone rang again. Brad said that she was worse than before, and that she had thrown up all over the bed and on the floor too, that he had changed her clothes again, and that he couldn't get her to use the spit-up tray. I could tell he was completely overwhelmed, and his voice told me it wasn't just minor vomiting, so I told him to call an ambulance and I would be home as soon as possible. I parked my crane, quickly explained why I was leaving, and jumped in the car at 12:10. My drive is normally about an hour and fifteen minutes but I arrived home at 1:05. Brad was waiting and said the ambulance had left about 10 minutes earlier, after the paramedics had done what they could to check Jan's condition and try to stabilize her. We raced off to the hospital and covered the 30 minute drive in about 20 minutes. Jan had immediately been moved to a critical care emergency room. I was shocked when I saw her. Her third pair of pajamas were a mess. The TPN results in black vomit and she was covered. She was barely conscious. A moment later, Dr. Fred Kaethler, who had seen Jan on previous visits came into the room. He examined her, we talked, and she was quickly admitted to a temporary room upstairs. They put her on her standard medications but introduced a different anti-nausea drug. She stabilized and in the morning Brad and I headed home for a brief time to feed the animals. I was horrified when I walked into the bedroom and saw the extent of the mess from the night before. As I set about trying to get the worst of it cleaned up, I tried to imagine the horror and helplessness that a 14-year-old boy felt watching his mother be so violently ill. I was unable to imagine it. I think he aged at least two years in that one night. When we got back to the hospital, Jan was still in the temporary room and was still occasionally vomiting, but not like the previous night. However, she was acting very strangely, and at one point began shouting obscenities at the nurses - something she would never ever do. I finally managed to calm her down and carefully explained what she had been saying to them. She was quite groggy and totally unaware of anything she had said. It never happened again but it was probably a precursor to news I would later get from Dr. Kaethler. Brad and I dozed in the room and another day passed. I made two brief trips home to care for the pets and returned as soon as possible each time. Dr. Kaethler came in to check on Jan, and then the two of us went into the hallway to talk. He said he had arranged for Jan to be moved to the palliative care suite. I asked how long she had. He said probably no more than a week or so. He also said that he suspected the cancer had spread to her brain. He told me they would send her to Owen Sound to confirm it if I wanted. I didn't - there was no point. And I guess I already knew it anyway. The palliative care suite was quite nice. It was originally a 4-bed ward, and was quite large. Through the generosity of many, it was nicely decorated, equipped with a large TV, stereo, sofa bed, reclining chair, coffee table, small dining table with chairs, sink, fridge, microwave, private bathroom, and, of course, the patient's bed at one end. It had large opening windows overlooking a quiet side street with lots of trees and was located at one end of the main hallway so it was generally quiet and private. With Jan comfortably established in the suite and resting peacefully, Brad and I headed home. It was the evening of the third day since Jan was rushed to hospital. We both grabbed a shower, had a quick bite, and I made further attempts at cleaning the bedroom. Neither of us had slept for more than an hour or two in almost three days and we were totally exhausted. Brad wanted to go back and stay with his mom. I couldn't say no, so I drove him back and stayed briefly. But before we left the house, he found me sitting on the garage steps with tears streaming down my face. He asked me what was wrong. I looked at him, then got up and held him, and had to tell him his mother wouldn't be coming home this time. He started crying too, and told me he already knew. We just held each other and cried. Then he said that she was in a place that could make her last days more comfortable than we could. Fourteen years old. When we arrived back at the hospital, the nurses, superb as always, brought Brad blankets and pillows so he could sleep comfortably on the sofa bed. Jan was resting peacefully so I headed back home to tend to the pets and passed out on the couch. The following morning signaled the lifestyle that Brad and I would lead for the next four weeks. I arrived at the hospital early on August 7th to find Brad and Jan sound asleep. I laid back in the recliner and waited until Brad awoke. Then we headed off to the local grocery store and bought plenty of supplies for the room, something we would need to do more often than I had imagined. Shortly after we returned, Jan awoke and was surprisingly coherent. She was weak and exhausted but we were able to talk for a little while before she dozed off again. It was probably the last time I ever had a meaningful conversation with her. The days came and went. Brad spent most nights at the hospital, coming home with me only every 3 or 4 days. I still worked when I could, stopping at the house in the morning to feed the animals, then heading to the hospital and returning home at dinner time to feed the animals again and grab two or three hours sleep before work. Many nights I just stayed at the hospital, unable to muster the energy to tackle an 8-hour work shift. By mid-August Jan had become almost comatose. On the rare occasions when her eyes opened they were usually rolled up in her head. She didn't speak. But she could still squeeze my hand occasionally and I lived for those moments. I'd squeeze her hand back, kiss her on the forehead, and tell her that I loved her. I'd sit for ages just holding her hand and looking at her. My wife never lost her feisty spirit. Because of being bed-ridden, fluids built up in her chest and throat. To clear them, the nurses needed to use a suction device which involved slipping a plastic tube into her throat. Jan obviously hated it. On several occasions, they got the tube into her mouth and she bit the tube so hard that she severed the end off it! Brad and I took some solace in knowing that the spirited lady we loved was obviously still there. The vomiting had diminished but was still an occasional problem whenever they tried to move her in bed. Jan was still on TPN and Dr.Kaethler asked me if I wished to continue it. He said they gladly would but it was adding to the nausea problem and wasn't going to extend her life in any meaningful way. I said I'd think about it. Pulling the plug on your wife's only nutrition source isn't an easy decision even when you know there is no possible positive outcome. After a couple of agonizing days, I realized that continuing the TPN was probably just feeding the cancer and my own selfish hopes, and doing nothing to make Jan's final hours more pleasant so I instructed the nurses to discontinue it. Do you have any idea how hard a decision like that really is? Brad had become one of the hospital's "staff". He was there so much that they had him helping with inventory, making deliveries from stockrooms to ER, clearing obsolete stock, etc. The entire nursing staff had adopted him and he loved it. I can't say enough about the nurses at the Markdale hospital. They are truly some of the finest people you could ever have caring for you or a loved one. As August drew to a close, I knew we were on borrowed time. A one-week prognosis had become four. Jan had ceased to open her eyes at all and no longer squeezed my hand. She just lay there, breathing infrequent, shallow breaths. Without the TPN, the nausea was entirely gone and she seemed at peace. I hated myself for not stopping the TPN earlier. Although she was still clinically alive, I knew she was already gone. On the afternoon of September 2nd, Jan was somehow still holding on, to the amazement of the doctors and nurses, and I decided to head home for some sleep and try to go to work. Brad stayed at the hospital. I left for work at 9:45 PM but had only driven about 15 minutes when my cell phone rang. It was the hospital. They said they thought Jan was nearing the end. I turned around and raced north to Markdale. When I got there about 10:30, her breathing was very shallow and more irregular than before. Even to me, it seemed she couldn't hold on much longer. I sat beside her holding and kissing her hand for hours. But she wasn't letting go of life yet. She somehow held on all through the night. Brad and I stayed with her to the end. At 6:45 AM on Sunday, September 3, with both of us with her, she exhaled one final breath and was gone from us forever.
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