Cancer in Pregnancy; The End of Life; A Young Mother's Final Day

By Larry Puls @larrypulsauthor

The Death of a Mother

I walk into the room and cannot even recognize her face anymore. How far we have come over the last two years. Laying there, I see a very thin layer of skin covering her collar bone, painted with an ashen pallor. A physician's heart is crumbling. I conclude the end is very near. My desire is to leave the room. My job is to stay by her side. The smell of death is unforgettable.

I pull back the bandage and stare at her wound. There, gazing back at me is the enemy, the cancer, the "small cells" I could not eradicate—though for two years I tried—in fact, many of us tried. Looking at the wound, I see the pulsating beat of the major artery moving her skin up and down, up and down, surrounded by the advancing malignancy. Her pain meds have rendered her groggy and minimally verbal, but at least she looks comfortable. She wakes up enough to ask about end points, about timing of other treatment, about whether or not I have further plans for her. I don’t honestly want to answer those questions. How do you say "I have run out of plans"? I have no other magic pills, magic bullets, magic cocktails. I can only wait. And wait for what? I just can't verbalize that, since I don't want to think about what is to come. God is totally in control of all things now—and always has been, lest I think differently. But what I do know, from where I stand, is that there is very little time left--and that the life here before me is hanging on the edge.

Walking out into the hall with my team, I sigh. I turn my head to the left, then to the right, and am suddenly captured by the unexpected sight. There I see the reminders of that day in the delivery room two years ago, the day it all started, when her baby came into the world. And now that baby has become a toddler. The little girl is dragging her grandmother down the hall, trying to hurry her along. Mommy is at the end of their rainbow. My mind can hardly take it in. But I can't ignore her family. Seeing the patient’s mother walk up, I pause and talk while the granddaughter runs on into the room. I wonder if my dying patient will even notice her daughter at her bedside for the narcotics. Trying to find something encouraging to say to the mom, I am at a loss for words. There is nothing encouraging about what I just saw in that hospital bed.

Ten minutes pass and I am two doors down the hall, the nurse runs out of my patient’s room screaming for help. She yells for us and orders the unit clerk to call for a code. Something bad must have happened. A madhouse of people starts running everywhere. We fly into the room, clear it of other people, and see that blood is pouring out from the groin. The dam just broke. How could this timing be any worse with the little girl in the room? We grab gloves and try to hold the pressure, but that proves nearly impossible. The cancer has created a large hole in the artery to her leg. And it cannot be repaired or patched. In minutes there is blood all over the bed, on the floor, triggering my patient’s heart to stop. Life is slipping through our fingers and we feel helpless to prevent it.

We start the chest compressions, but every time we push down on her chest, more blood escapes through her groin. It is checkmate. To stop the flow of blood means no compressions. No compressions means no life. There are twenty people in the room looking at every option, every ounce of knowledge is brought to the table and no solutions can be found. Thirty minutes of work and this mother of one passes from this life to the next. The entire room stops, looks around at one another, and sadness permeates every soul. How could it not?

I have to now collect my wits and address the family, but how do I do that? I take a moment, silently grieve, take a deep breath and search my soul for comfort. And for me, that is in the Lord--Him alone. Knowing that He controls all things—life and death. But it doesn't negate the fact that I still wanted to see her live.

So now the hard part. How do you tell a mother she has lost her daughter and tell a daughter she has lost her mother, all in the same statement?

I crawl into the hall and the little child is playing with one of the nurses. Words are lodged in my throat. That child isn't making this any easier. Finally, thoughts eke from my mouth to the patient’s mother. My voice cracks several times. I am met with initial silence. The words have to sink in. So, I wait patiently. Suddenly, I can tell there is understanding. She grabs my lapel and first tells me, then yells at me, that I am wrong. I have made a mistake. Her daughter is not dead, but asleep. I simply need to go in and wake her up.

I shake my head no.

The daughter is still running around us in circles, playing with the nurse, smiling as she goes. She will never see her mother smile again. Her mother will never tuck her warmly into her bed. Who will read her books now? Will she find comfort in her stuffed animals?

The mother shakes me again, now harder. "Go wake her up! Go wake her up," she orders. Two minutes I stand before the grieving mother and the shaking continues. Her wrath, her sadness, her pain overwhelm me. I feel it too, only mine is now mixed with shame that I could not make it all go away, that I couldn't cure the patient. Grief consumes me. Until finally a nurse, caring and compassionate, gently comes up and puts her arms around the hysterical mother's shoulders and embraces her. The shaking stops. A deluge of tears comes tumbling forth—from Mom—from me--from everyone. We all have crushed hearts. Sadness owns the hallway. My patient's body and soul have separated. A big piece of me died with her.

Please post under comments how you may have dealt with the loss of a loved one.

Cervical Cancer in a Young Mom; End of Life; Unspeakable Sadness, Larry Puls, (Click to tweet)

Please consider reading Part I; Cancer in Pregnancy; A Young Mother Fights for Her Life

Please consider reading Part II; Treatment for Cervical Cancer, Recurrence, Facing Death