The Why of Loss

I remember when a dear friend of mine died unexpectedly a few years ago, I couldn’t get past the question ‘why?’.  She had been through several complications and surgeries from a knee replacement, coupled with her longterm steroid use for rheumatoid arthritis.  Her muscles, tendons, and tissues were weakened by those steroids that she had to have in order to treat the arthritis.  When she was found dead one morning on her daughter and son-in-law’s floor, I couldn’t comprehend it. I had talked to her the night before, and she sounded great!

I had talked to her nearly daily since she’d moved in with them in another state, to be closer to her grandkids (she was so excited!). I had talked to her daily from each of the rehab facilities she had been in following the various surgeries.  She wanted a nurse’s input regarding some of what was going on, or for me to explain how things work in nursing and rehab facilities (one of which was a kinda creepy). She had done well during the various phases of her surgeries for the knee issues, until another complication set in. When I talked to her the night before she died, she asked me to call her the morning, as she’d be at home alone. She was perfectly safe doing that even with her cast. She was someone who just got it done. But she said she’d feel better if she knew someone was going to check on her- so I told her “no problem”.

When I called several times that next morning, and got a busy signal, I knew something was wrong. The house phone had more than one line. One line should be open.  A few hours later, her daughter called and confirmed what I already knew in my gut. She was gone.  It had apparently been very sudden, as she was next to the bed.  I couldn’t grasp it.  It still bugs me sometimes, but I understand that she didn’t suffer.  She’d been through so much.  At least the end wasn’t painful, like the years of rheumatoid arthritis had been.  I still miss her like crazy; we’d been neighbors, and while we hadn’t known each other for that many years, we had near daily contact during the last eighteen months or so.

When my mom got sick during her winter with my dad in Arizona, I was livid at the treatment she got (or didn’t get). The emergency room in Sun City West had blown her off. She had been brought in by ambulance, unconscious after a seizure- and they couldn’t get blood samples to find out if she had some sort of systemic infection (sepsis)- but they got an IV in. Most competent ERs get the blood from the IV site before they hook it up to fluids (if fluids are started- which they were). They got a urine specimen, that showed a bad urinary tract infection, which along with the altered level of consciousness should have screamed urosepsis (when the bladder infection gets so bad it gets into the bloodstream) and the need for admission to ICU for IV antibiotics.  That is SO basic, and yet it was ignored. She was sent home with my dad on antibiotic pills.  She was semi-conscious and they sent her home on pills (the home they were renting).  It took three people to get her into the car on the hospital end- they didn’t care how she got out of the car at home….with my 71 year old father as her only caretaker.  He found some friends to help, but he shouldn’t have been in that position. Period.

My take on the whole Arizona ER situation is that they saw my mom as some disposable dementia patient who had a ‘Do Not Resuscitate’ request IF she was to the point of needing resuscitation. But her heart hadn’t stopped. She had a treatable problem.  She had been with my dad to an art museum the day before. She still enjoyed things, even if just for the moment- but in the eyes of those medical ‘professionals’ the hospital people, she wasn’t worth the time. The hospital had been full; several people were waiting in the ER for a room. But the greater Phoenix area has many, many hospitals. A competent ER doctor would have sent her to another hospital, and that would have been appropriate. Instead, my dad had to make arrangements to fly her back to Chicago  after a few days of those antibiotic pills (crushed in applesauce) to make her just well enough to fly. When I went to help get her off of the airplane, the flight attendant told me that dad had to hold mom’s head up for most of the flight back. He’d left his car in the parking lot of Sky Harbor Airport in Phoenix, and flew with what he had on his back. The original plan was for me to pick her up with a family friend on this end of things, and dad drive the three days back. But the airlines wisely required that dad fly with her.

It’s a good thing that dad was with her, since he never would have made it back from Phoenix before she died. She was admitted to the hospital as soon as we got into town from O’Hare (airport near Chicago- for those outside of the US), and was dead within 48 hours.  Gone. I’ll never know if she would have had a chance IF the hospital in Arizona had done the right thing.  They took that away from us.  But, she also didn’t end up getting even more demented and lying in a nursing home, not knowing anybody.  I’d moved back from Texas just 3 1/2 months earlier to make sure she stayed out of a nursing home as long as it was physically possible for me to help dad keep her at home… and then she was dead.

I think about a 90+ year old lady who had been admitted to a nursing home I had just started working at in Texas. She had developed  kidney failure after a severe bleed in her gastrointestinal (gut) tract. The blood loss was so bad that her kidneys didn’t get enough blood to keep them functioning. The family decided that she was not going to get dialysis- the only thing that would keep her alive. She was admitted to the nursing home not knowing her own name or why she was there. This was a lady who had been living on her own, in her own house, doing her own yard work, etc.

Her life had changed in one single day. The aftereffects of that day lasted the rest of her 34 days. She got to the nursing home 17 days after the bleeding started. She left the nursing home a couple of weeks after that, following continued deterioration, and readmission to the hospital (and a physician who didn’t return calls to nursing homes; he was a problem).  Without dialysis, her body couldn’t even get stable. Her legs leaked fluid from the loss of proteins in her system, causing pools on the floor under her wheelchair, for the brief periods of time she tolerated being up. And her skin became fragile, and ‘broken’. The really sad part of that lady’s story is that her family decided that they’d like to profit from her death, and held the nursing home (four of us who worked there) responsible- even though they were the ones who refused the dialysis (and I understand why they made that decision- it would have been a miserable existence for someone who didn’t understand why it was happening- and getting a shunt into her blood vessels would have been a nightmare of torn vessels from the low protein levels). The doctor was never named in the lawsuit; he also didn’t help our defense attorney (provided by the corporation that owned the nursing home).

I was one of the people sued for wrongful death. To a nurse, that’s like saying I killed her. The lawyers had absolutely NO interest in the truth, or even the entire story- they just wanted some way to make money. Period. I felt like I was being accused of murder. I took care of that woman the best way I could; she was dying when she got there.  There was division  in the family about whether or not to sue- and nobody ever visited or called when I was on duty during the day, so I never even met the person who initiated the lawsuit.  What that lawsuit did was erase most of what made that woman who she was– an independent elderly woman who was amazingly strong and intelligent, and reduced her to a lawsuit.  The lawyers eventually settled, which angered me. I was ready to go to court. After a grueling seven (7) hour deposition, I wanted to see it through. But lawsuits don’t work that way- they just destroy people on one side, and issue a paycheck to someone on the other side (and their lawyers).  When there is some evidence of absolute negligence or malpractice, that’s one thing. When someone dies because their body breaks down, and someone wants to blame someone for it, that’s something else. 😦

Lousy things happen. Sometimes, there is some nice explanation, and it’s somewhat expected, even though it still leaves a sense of shock and deep, deep loss.  With each of the three examples above, I have to look at one thing: at least it wasn’t worse.  My friend could have ended up in a nursing home for life dependent on people to help her with basic mobility, her mind intact- that would have crushed her independent spirit.  My mom could have also ended up in a nursing home, oblivious to anybody or anything around her for years– at least she still recognized people up until 36 hours before she died. And dad and I were both with her- he wasn’t on the road, and I wasn’t stuck here waiting for both of  them to be able to get here, unable to have those last days with her.  With the lady in the nursing home, well, her situation was pretty bad all the way around. And it was made worse by the displaced grief and anger of at least one family member,  and questionable intra-family dynamics. She will always be associated with ‘the lawsuit’– not a sweet lady who had been changed by tragic and unpredictable physical disease.

I can’t pretend to understand why God allows some things to happen. I can understand why things fall apart from a medical standpoint. When one thing is going on, it’s usually pretty straightforward. When there are complications and coexisting problems, that makes it easier to understand in my head, though my heart has trouble catching up. I do know that in God’s timing and purpose, all things work together for good.  That doesn’t take the pain away, but it does help me realize that there is a much bigger frame of reference for things than my human brain can comprehend.  God has it under control- and He’s with me when I do or don’t understand why some things happen.  Sometimes it’s just so hard not to want to be able to make sense of it all….and some things just don’t make sense.  Except to God.

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