Appeared in Blood & Thunder magazine

Before dawn, the hospital is deserted. The lobby is gray and quiet, without its daytime assemblage of worried families awaiting the page that tells them a loved one is out of surgery or that a doctor is waiting to speak to them. The switchboard operator sits at her console in the dim light, directing calls from physicians and concerned loved ones. Cafeteria chairs rest atop tables in the darkened snack bar, like sentries watching over the halls. Library, chapel, pastoral department, all are closed.

On the five floors above, patients are sleeping, recovering, hurting, dying, while nurses go about their routine and young, bleary-eyed residents look at blue-covered charts. In my mother’s room, a ventilator breathes for her, hissing like a prehistoric beast as it pushes super-oxygenated air into her ravaged lungs through a plastic tube taped to her face with adhesive. Now and again loud buzzers and flashing red lights alert the nurses: “low exhaled volume”. She sleeps through it, healing or dying, we don’t know which. The yellow light reading “caution” is always on.

Before entering her room, I pull on latex gloves from the cart near the door, where a sign reads “CONTACT PRECAUTIONS”. Among the many things that have attacked her body in a run of bad luck are drug-resistant staph bacteria. While she was in intensive care, doctors thought staph had invaded her heart. But they were wrong. Now, she lies unconscious in a special respiratory unit.I sit in the chair and watch the beast breathe, my hands sweating in the latex. Hers are swollen like catchers’ mitts. In fact, her entire body is blown up with edema. She is barely recognizable. I take her hand in my glove and sit.

Her habits had finally caught up with her. My mother never broke a sweat for any reason, much less for good health. Exercise was something she did on vacation, walking from her room at an Indian casino to the slot machines, where she’d push buttons and hope to hear bells jangle a win. Though she cooked regularly for her family, she herself ate irregularly and poorly. I never saw her take a vitamin.

A steel heart valve had been pushing blood in and out of her big heart for 14 years, after a congenital defect had rendered her own valve useless. She had congestive heart failure and bad lungs, the result of a more than 50-year addiction to cigarettes, first Viceroy Filters, then, Viceroy Filter Longs. When something hurt, she took a pill, and when the hurt was psychological, as it was far too often, she took a different one. — more than a dozen a day – tablets to thin her blood so it would move through her artificial valve, to remove the fluids that accumulated from congestive heart failure, for high blood pressure, for her nerves. Pain pills for sciatica, for kidney stones, for headaches.My mother was kind, generous and loving; she was neurotic, self-centered, controlling. It didn’t matter; I loved her exceedingly. And though she never took care of herself, she had a youthful, vibrant spirit and she’d hung on to life with a desperate will.

For months the doctors took every extreme measure in accordance with what we all knew were her wishes, hoping for her recovery. But the outlook had been grim all along.

As dawn breaks, there is more activity in the unit. Looking out the room’s window, I see the maple trees across the road. Their leaves are vibrant red and rich gold. Living in warm climates, I haven’t seen the trees change color in years.

A unit technician, the nurse’s aide, comes in and introduces herself. A young black woman, maybe 25, she radiates a soothing, angelic aura. She asks how I am, and tears pool in the corners of my eyes. I can’t speak. She smiles softly and walks over to the window. She turns to look back at me.

“See those trees?” she asks gently. “There is a season to everything, and there is to life, too. This is something hard for us to accept, but it is part of God’s plan.” Later, I learn that her two-year-old son had died the year before.

I stare at the trees through a blur of tears. In this year of flying 1,500 miles every month to hold my mother’s hand for a week, or two, I have learned lessons of a lifetime, lessons that defined unconditional love. Just a few months ago, before this latest stint on the ventilator, I’d had to feed her. I’d give her a spoonful and she’d spit it out. Silently, I’d give her another, and then another.

“I don’t know how you do that, how you are so patient with her, I don’t even know this person,” my sister said to me. But this was my mother, the control freak, exercising the only control she could.

The unit is bustling now. Breakfast trays have been delivered to those who can eat. Beyond the door to the room, young residents sit at the nurse’s station looking wan, poring over test results on PC monitors, flipping through patient charts. Some charts, like my mother’s, are very thick.

The ventilator continues its steady breath, in and out. I settle back in the chair. I do not let go of my mother’s hand. I have her medical proxy and her doctor has asked me to sign a DNR order—Do Not Resuscitate. The paperwork waits on the tray table next to me.

“Remember, too, that there are miracles,” the unit tech says gently from the window. I look at her and then out the window at the trees. It is October. I have not heard my mother’s voice since July. She has been living on machines for months. If she lives, it will be in a nursing home.

I do not see a miracle coming, and from my seat by her bed, I am not sure I want the alternative.

Or that she would.

Still holding her hand, I pick up a pen and sign