My mom was admitted to St. John’s Hospital on Wednesday, April 29, with fatigue, shortness of breath, fever, and confusion. Upon arrival, she tested positive for COVID-19. Three days later, she was dead.
If you’ve ever imagined the final moments with a dying loved one, it likely involved yourself and family members gathered around that person’s bedside, holding their hand, and reassuring them everything would be okay. Or maybe saying nothing at all. Just being there. This is, after all, how the routine has gone for years, decades, generations. Then, in 2020 the novel coronavirus changed all that.
At first, the hospital’s ICU refused all visitors—including family—due to the danger of contagion. I tried calling my mom, but she wouldn’t pick up the phone. The nurse I reached said my mom was tired and likely wouldn’t be able to hear me anyway due to the rushing air through her CPAP mask. She also said my mom’s breathing was growing more laborious.
The next afternoon, a caseworker contacted my sister and suggested we begin hospice care. The process would entail administering morphine to ease Mom’s suffering, then removing all life support except for a small amount of oxygen via nasal cannula. If we acted quickly, the woman said, we might still be able to say goodbye; if we waited too long, she’d likely become unconscious. My sister and I agreed to speak with a doctor before making any decisions.
My dad was advised not to leave their assisted living facility because of a lockdown, and he complied. “It’s too much,” he said. He didn’t want to see his wife of 58 years in this condition. So, my sister and I met at the hospital in the morning, where a physician explained my mom’s prognosis. Her kidneys, heart, and lungs were failing; her blood was septic from infection; and she was bleeding internally. She was on the highest dose of oxygen prescribed before intubation. She would not survive much longer.
While he spoke, the floor began a gradual tilt. Not survive much longer. The hallway air was humid and smelled like every hospital: bleach and urine, sterilization and filth. I focused on breathing through the red fabric of my handmade facial mask, acquired downstairs a few moments earlier. The mask featured a repeating pattern of New England Patriots logos, all upside down.
My earliest memories of my mom involve her cutting my hair. She was a beautician, so when my dad or I needed a haircut, she took care of us. I was always first. I remember sitting on a folding chair in our basement, a hairdresser’s cape fastened around my neck. “Sit still,” she would say. Not an easy task for a boy, but I tried. I wanted her to be proud of me, to tell me I was doing a good job. Snip, snip.
Her ICU room was vacuum-sealed for the safety of care team members. My sister and I were not permitted to enter. Through the glass, we saw her propped up in bed, resting. To communicate with her, we used a tablet with video chat. Next to us was a transition room that connected her sealed room to the corridor; the doctors and nurses used this space to prepare for entry and exit.
By noon she was slipping away. Our first few attempts to start a conversation proved futile, but that didn’t stop us from talking. Instead, it had the opposite effect. We talked more to avoid the silence. And yes, there were technical glitches with the tablets. The microphone didn’t always work. The video feed froze. The Wi-Fi signal was spotty at best. And yet we talked.
“Mom, Mom, we’re here. It’s me, Pat. I’m here with Terri. Don’t worry, Mom. Just listen to the sound of my voice. We’re here. We’re right outside your door. And we won’t leave you. We love you, Mom.”
The doctor had explained what to expect when hospice began: She may appear to gasp for air or struggle to breathe. Her stomach and diaphragm may expand and contract in a bid to secure more oxygen. If this happens, he said, they would simply add more morphine and she would gently pass on. When I’d asked him how long the process might take, he said fifteen to twenty minutes, maybe longer.
So, we said goodbye. We told her we’d take good care of Dad. We told her to rest. That everything was going to be fine. Mom could no longer talk, but she did hear our voices. We could see her gray-green eyes open wide with recognition; she tried to talk, but all that came out was one syllable: “Guh.”
Fifteen minutes passed. Then twenty. Half an hour. The doctor and nurse remained by her side, clad in full PPE with face shields. To comfort my mom, they each chose one spot on her body to massage with a gloved hand. The nurse rubbed my mom’s shoulder; the doctor patted the top of my mom’s head. After a while, my mom began to look uncomfortable; she was fidgeting, struggling. I asked the team to put a cold, wet washcloth on her forehead, like she did for us as kids. The doctor couldn’t find one, so he dampened a brown paper towel and placed it on her head.
An hour passed. Then two. Finally, the doctor exited into the transition room, then reappeared in the hallway with us. He was being paged; there were other emergencies beckoning. “It’s in God’s hands now,” he told us. “Don’t second-guess your decision. You did the right thing.”
Before long, the nurse too excused herself, but my sister and I continued talking into the tablet. My mom continued to attempt a response. We talked about our family, her friends, fond memories. We talked about her favorite team (the Indians). Her homemade meatballs. Her love of bingo, bocce, and Uno. Her German stubbornness. How she called rollercoasters “rolly-coasters.” How she could watch Law & Order for hours on end. We confessed to having parties as teenagers when she and my dad were out of town. We teased her about liking my brother-in-law more than she liked me. We asked if she remembered Sanibel and Holden Beach. We told her she gave us good lives. That she was a good mom. A good wife. A good person.
A few more hours went by and Mom stopped responding. She still struggled to breathe but could no longer open her eyes. And yet we kept talking into the tablet.
Around seven thirty, one of the ICU nurses passed by us, her eyes welling with pity. “You guys are real troopers,” she said. Our tablet battery was drained, and she helped us sync up another one. Throughout our visit, the staff offered us water, ginger ale, coffee, and green apples in cellophane wrappers. We ate dinner from the vending machine, pretzels and Reese cups.
By eleven thirty, there were no changes. She was unconscious, but determined to stay alive. The doctor encouraged us to go home; the staff would call with any changes to her vitals. Around midnight, we acquiesced and headed out. Just before we left, I couldn’t help but notice the brown paper towel from earlier—still perched atop my mom’s head, now dry as a bone.
The next morning, the hospital phoned as promised. My mom’s heartbeat was rapidly faltering. She would likely pass away at any moment. Shoes. Wallet. Keys.
Do traffic laws apply to people in this scenario? I kept a safe distance from other cars, but only because a collision would slow me down.
The speedometer spiked to ninety, then 100, then higher. But despite my panic, a strange sense of calm began to overtake me. I can’t explain why. You could call it religion. Or emotional exhaustion. Whatever the explanation, I accepted it. The feeling coincided with a song on the radio: “Sugar Mountain” by Neil Young. I’d heard the song before, liked it okay, I guess. But this was the first time I really listened to the lyrics, felt the singer’s loss.
I knew then that my mom was dead.
I arrived at the hospital ten minutes later. A small group of people stood outside the same room. The same doctor greeted me. He put a hand on my shoulder and offered his condolences. I looked into the room. My mom appeared to be sleeping, her mouth open. Her skin was dull and gray. Her hair was slicked back, dry and straight. Thankfully, someone had removed the paper towel from her head.
My sister and I talked with the care team, arranged to have my mom’s body transferred to a funeral home. Then we visited my dad to break the news. Because of the lockdown, we could only stand outside his first-floor bedroom window. From behind the screen, he said, “I can’t say enough good things about her.” After that, we began making phone calls. Mostly, the day was a blur. Of course, it was beautiful that day, May the 2nd. All tragic days are beautiful.
Just six days prior, I’d had a phone conversation with my mom about the virus. It was our weekly Sunday call. She said there were now twenty-six cases at their facility, but she couldn’t leave due to the constant medical care she required. “I don’t want to die like this,” she’d said. I remember smiling, trying to cheer her up. I said, “I don’t think anybody wants to die like this, Mom.”
I regret saying that now. I wish I’d said something else, anything. Something to calm her, reassure her. Her voice still haunts me: “I don’t want to die like this.”
To lose a parent is to lose a version of yourself. Parents are mirrors into which we gaze throughout our lives, seeking approval, reassurance, love. A little boy trying to sit still for a haircut. When a parent dies, so does that mirror, that version of yourself, that lingering question.
Over the next few weeks, I listened to Sugar Mountain many times, trying to regain that sense of calm that had washed over me in the car:
Oh to live on Sugar Mountain
With the barkers and the colored balloons
You can’t be twenty on Sugar Mountain
Though you’re thinking that
You’re leaving there too soon
You’re leaving there too soon
Today is October 2nd. It’s been exactly five months since my mom died of COVID-19. Recently, a friend asked what I would say to people who refuse to wear masks in public. My first instinct: “If there’s even a slight chance that masks can help, you should wear one.” But then I paused, wondering how my mom might answer that same question. For starters, she would say, “Nobody likes to be told what to do.” So then, here is my amended response:
First of all, I understand. I’m angry too. And afraid. I’m on edge. Like many others, I was furloughed then permanently laid off. Now I’m worried about losing my house. Feeding my family. Finding another job. So yeah, I get it. I understand your frustrations. But I will also tell you that all those feelings, all those emotions you have stored up right now, they all pale in comparison to losing a loved one this way. To watching them fade from behind a pane of glass. To talking into a tablet for hours on end, saying everything, saying nothing. To wishing upon wishes that you could just stop talking for one moment, and step inside the room, and sit down next to that person without saying a word, and just hold that person’s hand one more time, squeezing it to let them know in that most basic of human ways that you are there with them, you are right there, and you’re never going to leave.
For Janice Pujolas