Observation Day

November 12, 2009:

The phone rings, early. It's James*.

"Hi, Hannah. I'm so sorry to tell you this, but the doctors are saying it's time to gather Kristin's 'people.' They are recommending we take her off life support today. Can you come to the hospital?"

* * * * *

November 11, 2009:

I am driving to the hospital. I am later than I was hoping to get there, having waited for Brad to get home from work. I haven't eaten dinner yet. Kris has been here (again) for several days, after her doctor suggested she stay and get some further treatment for her breathing problems. This, after many weeks of lugging around oxygen tanks and sleeping with the Darth Vadar machine at night, transportation to and from her home bathroom/bedroom via wheelchair, begging her to eat...anything, knowing that her bowels aren't responding, watching her dehydrate. It's amazing, as I recall these details, that we were somehow still caught off guard by the ensuing events. Nevertheless, none of us are surprised at the doctor's suggestion that she stay. (It's not even close to the first time she's been admitted since September.) In fact, if we are being honest with ourselves, we are relieved. We have been taking round the clock shifts at her house for more than a month, and it's getting tougher to provide adequate care. And to care for our own families.

As I arrive at Northwestern Memorial, knowing there isn't really any sense of urgency since I'll be there most of the evening, I stop in the cafeteria for some soup. I never feared or dreaded visiting Kris in the hospital, but on this night I have to work a little harder to motivate myself to finish my food and head up to her room.

Ding. Elevator. People get on and I wonder, as always, who they are visiting. I wonder how many visitors get on and off each day with The Big C Word on their minds.

The elevator reaches Kris' (new) floor and I head down the unfamiliar-yet-still-familiar hallway. I see Melissa a few feet ahead of me. She looks panic stricken. Doctors, nurses and machines are streaming in and out of what I now suspect to be Kris' room at the end of the hall.
"What's going on?" I ask.
"I....I'm not sure," replies Melissa. "I showed up a few minutes ago and her code blue alarm was going off. They wouldn't let me in the room."
If it weren't for Dr. K's white coat, I would have never known she was a doctor. She looks 24.
"Is either of you named Ariane?"
"No, she's out of town with her family."
"Are you Kris' family?"
"Um, no. But, yes." She somehow understands. She pulls us into a closet of a room and closes the door. There are four boxes of tissues and four chairs in the room. I can tell I'm not going to like it in here. As she talks, I am clear on every detail of what she is telling us, though now my memory recalls it more like the Charlie Brown trombone ("wah wah wahwahwah wah wah"). Something happened earlier in the evening when they were trying to transport Kris from one building to another, through an underground labyrinth I had experienced with her a few weeks prior. Her heart had stopped. They were able to restart it. She was unconscious. On a ventilator. When a person's heart stops once, it is likely to stop again.
"Do we need to 'rally the troops?' Is is that serious?"
"Yes." Not one to mince words, that Dr. K.
Shit.

Melissa and I are utterly bewildered. Kris was "fine" earlier that day. Except for, you know, having stage four metastatic breast cancer and lymphoma. But she had just started a new chemo! She was only here because her lungs weren't working properly! We aren't ready....SHE isn't ready.

She was alone when her heart stopped the first time. She was alone when she lost consciousness.

Dr. K gives us a few minutes alone to process the information. My head feels noisy and buzzy and drunk and I can't think...or I'm thinking too much. I can't believe this is going to be the end. I can't believe I have to call her parents and tell them the gravity of the situation. (I can't believe they don't already know.) I can't believe I stopped for SOUP.

Dr. K tells us that Kris declared Ariane her medical power of attorney. Ariane, her best friend. Her "sister." The one of us who knew the most--not everything (only Kris had that information), but the most. The one of us that would now be charged with deciding how to proceed. The one of us stuck out of town.

We start making phone calls. Donna, Colby and Kate, Brad, Penny and James: The Team. Her parents. And Ariane, of course, who immediately books a flight for the next morning. Ariane calls Natalie, who also books a flight for the next morning. Her parents decide NOT to drive in from Wisconsin that night. They're going to "wait to hear some news" in the morning. I am dumbfounded.

Hours pass. There are are few of us gathered around her now. A kind nurse tells us that she can probably hear some of what we are telling her, which plays in a loop: "You're not alone; we're here with you." Her body is clearly being ravaged by the goddamned cancer, even as we watch. She writhes in pain and her forehead gathers into heartbreaking furrows. She makes strangling sounds in her throat as she slips in and out of awareness that there is a tube helping her breathe. The nurse smoothes balm onto her lips, and my brain flickers like a neon light: this is the end.

Two of us stay with her overnight, fearing she might pass naturally and unwilling for her to be alone.

* * * * *

November 12 is sunny and cold. The traffic sucks. I've left my son with a loving family member, so that I can be present on this awful day. I have made my peace with this loss, but I have a bigger purpose this morning. I know I can be clearheaded in the face of sadness. I know I am a vital trestle in this support system, and we exist to support each other even when Kris is no longer in need. I have built a tiny bridge between Us and her parents, and it's my duty to see this through.

I arrive. I park. I ride the elevator. I'm sure I screamed, "My friend is dying!!!" at the people in the hall, but no one hears me. Dr. K is there again. The oncologist has been there. All signs point to ending Kris' life support. "Life Support" is a double entendre today. We file in, one by one, to spend some time with our friend, who we're fairly certain can't hear us speak anymore. Ariane and Natalie arrive. We witness a heartbreaking scene between Kris and Ariane that is too private to share in this story.

As Ariane is the POA, the medical team is relieved (and swarming) when she arrives. I tell her that my job today is to be there for her, knowing the impossible decision she must make. The staff corrals Ariane and I into another suffocating closet with tissues. There are students, hospice care workers, oncologists, doctors, and others I don't know. I can't figure out why so many are gathered in this room. They give us the facts about Kris' prognosis, which isn't news. They present Ariane with a decision that doesn't feel like a decision. The best course of action, it is determined, is that when Kris' parents have arrived and everyone is ready, the IVs and breathing tube will be removed and nature will be permitted to take its course.

The worst part of the day ensues. Kris' students have gotten word of her condition and are trucking through the halls of the hospital and clogging the waiting rooms. I grow resentful, feeling intruded upon. Ironically, these "kids" have probably spent more time with Kris than I have, in total, but I still resent their presence, having wanted to keep this in the family--so to speak. They should not see her this way; she wouldn't have wanted it. Her parents arrive and I feel equal parts intruded upon and the intruder.

We gather. The sweet, empathetic nurse explains what is to happen. She tells us that when the tubes are removed, she will also turn off the beeping machines for our own comfort...this transforms the room completely. The nurse applies more lip balm, adds a blanket, adjusts her gown and sweat pants. She asks us if we can think of any other ways to make Kris as comfortable as possible. We can't. We wait. We cry. She is breathing on her own, but we can tell it won't last long. We struggle to find some humane way to usher her out of life. We gasp through a chorus of "You'll Never Walk Alone," from her favorite musical. We are all holding each other in a giant room embrace. We are all holding our breath.

And then she is gone.

* * * * *

November 12, 2010

I am sad today, on this anniversary that shouldn't be celebrated. I am disappointed that my consuming thoughts are of Kris' death, rather than her life. After a year, I am still processing those last few weeks and days. When I was in the thick of it I just kept trucking along, not giving much thought to what was really happening; and I wasn't alone. We all just did what we had to do to help her as much as possible, for a group of friends that are still no substitute for a family. (And while we're on the subject, it should be noted that her family's lack of participation in her end of days was a 50/50 deal: partly they chose not to be involved, and partly she didn't want to involve them.)

It is my hope, in writing my version of this story, that it will help me continue the grieving process...though I'm not naive enough to think it will end the process. Anyone who has suffered a loss knows you never stop grieving. Ever.

I miss you, my dear friend. I'm presuming your heaven is filled with Manolos and brownie sundaes, and I'm sure the theatre is spectacular. "Walk on, with hope in your heart."

*names have been changed