The Night Watch

4-17-09 11:00 pm, from the soft white underbelly of the health care system, the emergency room at Harris Methodist hospital in Fort Worth,Texas.

My mother is 92. She remembers horse drawn wagons, the new electric lamps on the street where she grew up. Once, when I was a child, she fascinated me with a story about how when she was very little, she stood holding her father’s hand as the Memorial day parade floats went by in suburban Chicago, watching one wagon that carried little old men in blue uniforms with long beards. They were Union soldiers; Civil War veterans from that part of Chicago.

I listen as my mother lies in bed looking impossibly frail.

“Do you see him?” she asks.

“No, mom” I say, turning to look at the blank emergency room curtain in front of her rheumy stare. Her eyes, once china blue, my eyes, are now dim and misty, an indeterminate grey, like a puff of magician’s smoke A dull silver grey fish color is in them.

“The little old Dutch man.” She says, pointing.

Her health had been deteriorating for weeks. Kidney failure was signaling changes to come in the not too distant future. She’d fallen last night and hit her head, been groggy all day. She was mostly lucid, but she had been hallucinating. She had a subdural hematoma, the same pooling of blood on the brain that had taken Natasha Richardson’s young life not two weeks prior.

“He’s wearing a blue suit. He has a mustache.”

I play along. “How do you know he’s Dutch?” I ask.

“I’ve been listening to him talk. He’s been walking up and down, right out there.” She said, motioning to beyond the curtain that separated her little emergency room bay from the main floor, a little put out that I hadn’t obviously heard the Dutch being spoken not two feet behind me. I looked, and of course there were nothing but doctors, orderlies going about their duties.

“Are you going to take me home?” she asked, and I suddenly flashed back to a summer Illinois day on the farm where I was raised. My friends were busy, I’d eaten lunch and had to rest for a little while after eating. But that was OK, because she was reading Huckleberry Finn to me every day at this time. I remember looking out the window at the giant Sycamore outside the second story window. The leaves moved slowly in dappled sunlight. Huck and Jim were on the river. They’d “lit out”.

“You’re searching for the traditional Albert.” This caught me off guard. I asked her to repeat herself as I leaned closer, making sure I understood her words, thick and syrupy.

“You’re searching for the traditional Albert.” She repeated.

“You… are… searching for the traditional Albert!” She said, urgently, leaning towards me a little. Her face was suddenly intent. I had no idea how to respond, so I didn’t.

“You should be. It’s about that time.” She said, content that I’d finally gotten the message. These were the last clearly spoken words I heard from her, save for her calling me “Jack” about 3 am., my father’s name. I hadn’t heard her say this name in 20 years. It came out clear, succinct. I almost expected him to respond from somewhere in the cold dark ICU room. I’d checked her into the hospital at 7 pm. By 11 pm it was mostly gibberish, slurred words. By 3 am, after hours of fighting to get out of bed (“I want to go home now.”) the nurses put her in a restraint. This was necessary, but a kind nurse asked if I wanted to go outside, knowing what it looked like. I shook my head No. Watching someone restrain your mother is something no child should ever have to see. She fought, literally for 5 hours, to get out of the bed, at one time plaintively wailing what I think was “You can’t do this to me!”. At 4:45 am she fell asleep. I had been clenching my teeth so hard that my jaw hurt. I went to the waiting area to try to lie down, but an Indian couple had taken up camp there; magazine, food, TV blaring, newspapers. I wondered whom they were waiting for to die. I was on a death watch. You are close to death at all times in a hospital. It is the hush that floats over the florescent lit hallways, fake leather furniture. The empty chapels and consultation rooms wait like dugouts for the teams of life and death. I once said to a nurse friend of mine that with all the death that happened in hospitals, you would think that you’d hear all kinds of stories about haunted hospitals. She simply said “You’ve never asked a night shift nurse, have you? You just haven’t talked to the right people. When you’re sitting there at the computer in the nurses station and doors open and close with no one there, well, you’d think differently about that…’

Watching the sun rise grey amidst the hospitals steel, brick and glass towers, I felt no warmth or relief. The coffee had made me nauseated. It was Saturday morning. Hospital staff were starting the morning shift, slowly, quietly filling the hallways, but without imbuing the place with any sense of life. Just presence.

My mother’s condition improved today. Much of what she had been struggling with, despite the subdural hemotoma and kidney failure was simply a lack of oxygen and too much carbon dioxide. The more distressed she got, the less she breathed though her nose where the oxygen tubes were, and the more she gasped fish like through he mouth, worsening the situation. By 5 am, her struggle to talk had left her horse which, combined with the rattling of her breathing gave her the unnatural sound that the ghost in the movie The Grudge made. I looked at the clock thinking it had frozen. I had pleaded with her for hours to sleep, and finally given up when it was clear she didn’t even know where she was. As she fell asleep I prayed for understanding.

Later that day the news got better. She may even recover from this, although it’s by no means certain. My father died suddenly – for the most part. Rather, he lost consciousness almost immediately although his heart fought on for a few days. Mom always said she wanted to go this way. Her nightmare would be to malinger, and I had watched her malinger for 14 hours.
God in all his wisdom know where this will go, and we have little control over it. Tonight, while she is intubated, assuring the oxygenation, I will sleep, hopefully well, in my own bed. I am so tired.

Later.