Death watch

This is my sister-in-law’s last day of breath. She was diagnosed with head-and-neck cancer about four years ago. The primary tumor had metastasized and disappeared, so there was no “tumor bed” to excise, and her treatment was intense and painful and ultimately deadly: months of chemotherapy and, in particular, weeks of concurrent radiation seared her upper digestive tract so severely that she lost and never regained the ability to swallow, and the feeding tube that was intended to be temporary became a permanent necessity. The radiation destroyed some salivary glands and damaged the remaining ones, and she was forced to continually cough up and spit out the thick mucus that choked her.

Do you have any idea how awful it is to lose your ability chew and swallow food? To lose the carnal pleasures of “mouthfeel” and “umami” and sweet and sour and salty and bitter? To be forced to rely for nourishment on the grayish contents of a can poured into a plastic tube inserted into your navel? To lose the pretext of almost all social events? To lose your seat at the table, figuratively and literally? To be unable to participate in perhaps the most basic activity that all life forms engage in?

It depressed her, and she went to some lengths to find a solution in medicine to the defect that medicine had caused in saving her life. When it became clear that any solution might result in more damage—loss of speech the foremost risk—she resigned herself to carrying on as best she could and waiting for a breakthrough.

Then she began having trouble breathing. The mucus became so thick and her throat so constricted that she had trouble discharging the phlegm. She had some panicky episodes over the past few months. But a doctor assured her that such incidents were not life threatening.

He was wrong. On a plane from Tucson to Hartford yesterday afternoon, she choked on a mucus plug and stopped breathing. The plane made an emergency landing in Nashville, and she was rushed to the emergency room. By then she had not been breathing for 45 minutes. In the emergency room, doctors were able to restore her pulse and her breathing, but her brain has swelled and she is “nonresponsive.” She is racked by shivering and soaked by sweats as her body struggles to stabilize her temperature. Her blood pressure surges, then plummets. Are these hopeful signs—signs that she will live, and that her body is strong enough to have that life be a meaningful one? Or are they signs of her body’s losing battle, the spasms of shutting down?

A call from K reveals it is the latter. The doctors have made it clear that she is essentially dead, may not survive even till Other arrives in an hour. She has been maintained in this semi-dead state only as a matter of form (or perhaps forms, since I am sure there are many of the paper variety), so that Other can sign off.