To Liz Moore, In Memoriam

In Memory of Elizabeth Brackett Moore

March 18, 1922-May 4, 1997

Chapter 4  Morphine Haze

Hummingbirds are hovering at their feeder, tiny pulsating out-of-focus splashes of blue-green iridescence shimmering just inches away just outside the bedroom window. Beyond the window, past the hummingbirds, past the garden of emerging flowers edging the neatly trimmed lawn, beyond our small lake surrounded by willows and sycamores, the Virginia countryside is coming alive with the colors and sounds of spring. It is early May, 1997. Twenty years ago.

On my side of the window I stand watch over my dying mother. The colors in her room are the faded ivory of over-washed bed sheets, the stale white carpet stained with spilled medicines and bodily fluids, the flat peach walls on which hang muted prints of obscure Renaissance cities. All are shadowed in death’s gray imminence. The ceiling fan beats in dull syncopation to the gasping tremors of my mother’s labored breath as the tattered remains of her lungs struggle to process the sanitized air. 

Turning away from the world of new life surrounding the house, I walk the few steps to my mother’s bedside and sit next to her to listen to the fight between breath and death. It has fallen to me to mediate the endgame. Death is winning. But the battle is not over.

During the past year, I have used up most of my negotiating tools: the doctors, the nurses, the special equipment, assorted drugs, and God. For a while, any combination of these options temporarily held back the tide of pain for my mother or otherwise diverted the rivulets of fear and frustration that inevitably weep from the walls of denial hastily built in the minds of the terminally ill. My mother made little pretense of building such walls.  

The boat in which she sailed to meet death was floated on an ocean of alcohol undulating beneath a cigarette haze. She knew where she was going. Her only fear and frustration was in not getting there before the pain. I abetted her devious plan to arrive at the finish line first by supplying her with all possible implements of relief, short of her own preference for a quick end. Now, as I watch her, I notice a small quake of pain sending a shockwave across the taut skin of her forehead. It is gaining on her.

I get up and walk to the kitchen, open the refrigerator door, and take out the small, chilled bottle of morphine. Only her doctor, the nurses attending her, and I, are allowed to administer the doses needed to quell the tremblors and subdue pain’s aftershocks. In another time, the responsibility would have fallen to my father, but he is wheelchair-bound and is himself becoming an invalid. Even if he were able to help, the demons that live within him would prevent him from treating his wife to the contents of this vial.

With a syringe and morphine bottle in hand, I return to my mother’s bedside. In my brief absence, the pain has set in and as I enter the bedroom I hear her moan in discomfort that will lead to terror. She is lying on her right side, her tiny figure barely perceptible beneath the thin sheets and comforter. Her head is turned toward the ceiling, her eyes closed, their crinkled parchment lids yellowed and damp. 

She is 76, and for the past 20 years her spine has been curving inward, slowly, cruelly, stretching and molding her shoulders into a rigid hump that finally deprived her of any chance to lie on her back. Fifty-five years of smoking and drinking, little calcium intake, no real effort, and certainly no desire, to learn new nutritional habits or to grapple with the problem in its early stages have left her vulnerable to the worst this disease has to offer.  Making my way around the foot of the bed, I watch her body twitch, as if she is trying to shift position, and I hear her take in a sharp breath.

“I’m right here, Mom…hold on for just a moment.” I’m never sure when she can or can’t hear me – or at least I’m not sure that if she does hear me, she comprehends anything I’m saying. I keep up a banter nonetheless, probably as much to soothe my own nerves as to calm hers. I take my place on a small chair by the bed and reach over and hold her right hand for a few moments, gently rubbing her palm with my thumb to let her know I’m there. Ever so softly she closes her hand around my thumb and I know that we’ve made contact.

“Are you in pain?” A stupid question, no doubt. Even as I ask it, I begin to feel her skin vibrate against my hand. It is the kind of low-voltage shock that I used to get whenever I touched the leads of an electric transformer. It was disconcerting buzz, and I cannot imagine what kind of pain is causing the same buzz to course through my mother who is now only skin and bones.

“I’m going to give you some morphine, Mom. It’s going to help in just a minute. Hang on.”

Hang on? That’s all she’s been doing, for God’s sake, much to her own disgust I’m sure. I open the bottle and carefully withdraw into the syringe as much morphine as the doctor prescribed.

“I’m recommending this dosage, though you may find a need to modify it depending on your mother’s pain,” he had told me several days ago. His orders for my mother’s drugs were always colored with more than a little vagueness; he didn’t want to bear the outright responsibility, or culpability, for allowing me to administer a lethal dose, but he had given me more than enough leeway to do so. The attending nurses – as kind as they were – never strayed from the prescribed dosages. But I knew that if they were to arrive at the house and find my mother dead, no questions would be asked. Perhaps it was this silent conspiracy to acquiesce that hardened, rather than softened, my resolve to withhold the dose that would release Mom from her tormented body.  

As I took my place beside her and prepared the morphine dose, I was being given an opportunity – a free-throw, if you will – to lie with permission and bring a swift end to her suffering. And who would blame me? I was being encouraged (most explicitly) to accept the support of people who were willing to turn a blind eye to my ultimate lie rather than allow my mother to continue her agonizing descent into a living hell. But I wouldn’t take that gift…my confessions will have nothing to do with a mercy killing.

“Can you open your mouth a little, Mom?” I ask her this same question every time, and I think that if she can hear me she at least will understand what is about to happen. Whatever she may or may not comprehend, her jaw usually relaxes enough for me to squirt the morphine into her mouth. As I press the tip of the syringe to her lips, her eyes suddenly open as her hand slides above my wrist and clamps down on my forearm. I abruptly pull the syringe back, afraid that she might bite down on it. For a moment, I think she is actually going to die and that this is the final struggle…the death throes. Her breathing does not cease, however, and after a minute or so, her grip relaxes a little, though her eyes remain open and begin scanning the ceiling as if looking for something familiar.

“Mom, I’m over here,” I say, sliding my free hand under the back of her head and gently angling her face toward me. Her eyes fix on me, staring but unseeing. I remember them as they once were – sparkling, piercing, blue-gray, capable of picking out a song bird at a thousand yards or a lie at three feet.  Pilot’s eyes. Artist’s eyes. A mother’s eyes. Now they are little more than runny and diluted water color remnants of their former selves, coated in a viscous layer of mucous and dotted with particles of junk skin. Yet, there is still a light – a glimmer somewhere below the surface that I see. Or want to see.

“Uhnnnnnmmmmm.” The sound comes from deep within her; her lips don’t move. The part of her that is afraid of the pain is trying to get out. She tries to move her left hand and arm but the most she can muster is a feeble flailing. The pain is digging in.

“Look at me, Mom…hold still for a moment. Look at me….shhhhhhhh. It will be okay.”  I let the side of my free hand, still holding the syringe, caress her cheek and then glide across the top of her head. I’m flying blind here…I don’t know any other way to soothe her, to assuage the fear and help her withstand death’s savage entreaties.

“Ohhhhhhhhhhhhhaaaaaaa……….”

“I’m here, Mom…I’m right here. Hold on and let me give you your medicine. It’s going to help you but you need to help me first.”

“Mmmmmmnnn.”  She blinks back a thick tear, her eyes widen, and all at once I see an open passage to the dark keep where the spirit of who she once was struggles against the chains of her disease. The happy ingénue, the carefree aviatrix, the hell-raising bleach-blonde, the head-over-heels new wife, the mother of two, the Renaissance woman so far ahead of her time…the frustrated human being encapsulated in a crumbling shell of mortality.

I press the syringe to her lips, pushing it in half an inch, and simultaneously depress the plunger to release the potion that will calm her fright and still her pain. She watches me as the morphine spills across her tongue and drains down her throat.

“I’m here, Mom. I’m here. It’s okay. Hold on.”

The buzz that has been traversing her skin suddenly ceases, and her grip on my arm relaxes. I know the morphine takes several minutes to work…but she knows it’s there. Her eyes close. Morpheus has taken the high ground for now.

As the pain killer kicks in, my mother goes limp, and I arrange her arms and head in the least uncomfortable position I can, not really knowing what does or does not work for her. I do know that the first hour or two of the morphine experience sends her somewhere far beyond the pain though in the beginning a similar dose used to get her through an entire night.

Once she is squared away, her pillow and sheets carefully arranged, I take the morphine and the syringe back to the kitchen where I note the date, time, and dosage in a small notebook. In the end, the book matters very little, but it’s a record of sorts and it seems to make the nurses feel better when I stick to their routine. I’ve neglected a few entries from time to time, fudged the dosage by a tiny bit, but I chalk those up to desperation – mine, mostly – when I was trying to quell a particularly heart-wrenching episode with my mother and her pain.

After storing the morphine in the fridge and washing the syringe, I walk from the kitchen to the study where my father is watching a VHS tape of My Fair Lady in a self-imposed exile from the crumbling world on the other side of his house. In his late 70s, during these, my mother’s last days, he is a victim of glaucoma and diabetes and an as-yet undiagnosed creeping paralysis of his legs. His principle source of mobility is his rubber-wheeled electric scooter which he uses to cruise through the house, knocking into walls and doorways that are outside his diminishing field of vision. We also have a chromed, four-wheeled mini-crane – a hospital-grade sling lift – to transition Pop from his cart to his chair, or from his cart to his bed.  He no longer has the upper body strength to move himself horizontally from one seated position to another. Standing up became impossible for him several years ago.  His disability crept up on him, but not completely without warning. He simply ignored the signs or dismissed his doctor’s plea to undergo early tests that might have uncovered the precursors to his paralysis and glaucoma.

The back room of the house became my father’s refuge with the comforts of a television, a videotape deck, a CD player, and a radio at the ready to satisfy his need to be immersed in old movies, old songs, and his beloved Redskins football, which he preferred to listen to on local radio rather than endure the broadcast-booth banter of commercially telecast games. The room was originally designed and constructed to be an office space for both my parents, with dual desks, cabinets, and drawers set into an expansive, built-in floor-to-ceiling bookcase. This bookcase contained my father’s entertainment center and custom-designed drawers for videotapes. 

These videotape collections held important clues to my parents’ world views. Their tape library is a mirror to a world that never, ever existed in real time, but was very much in existence in their imaginary world. Musicals (South Pacific, Oklahoma, My Fair Lady, The King and I, Carousel); Retrospectives (Life Goes to the Movies, That’s Entertainment); Film Noir (Citizen Kane, Sunset Boulevard, The Lost Weekend); Early Cinema (King Kong, Wings, All’s Quiet on the Western Front); and hours and hours and hours of taped episodes of the original Star Trek, a chain of morality teleplays thinly veiled as science fiction. The tape collection represented either escapist fare, contained in the musicals and retrospectives, or moral punishment, detailed in the stark black and white dramas with no redemption for their fallen heroes.

My mother’s father, the movie screenwriter and producer, released two hard-hitting social dramas in the 1940s. One detailed the downward spiral of alcoholism and the other examined the irretrievable glories of faded youth. The movies earned my grandfather his first Oscars. Both movies, counterpoints to his other, less threatening films, exuded a moody darkness upon which my mother fed, as if taking a meal of her father’s often troubled soul. 

Pop’s declining mobility and fading vision eventually discouraged him from using his side of the office area; my mother, on the other hand, despite what was a very painful spinal curvature and diminished health, continued to use her calendar, phone books, notepads, and computer to stay in touch with the outside world until she could no longer pull herself out of bed.

An inveterate, incendiary – some would say ‘bomb-throwing – author of pointed letters to the editor, my mother applied herself daily in her little office cubby, cranking out letters of outrage against local politicians, zoning commissioners, hunters of cute woodland creatures, and failed national leadership. As my mother’s health continued to decline, my father’s fear of her condition ascended and, by the time she was no longer able to recognize him or communicate with him, he had withdrawn entirely from the caregiving side of her world.

Once in a while, he would cruise into the bedroom while the nurses were changing my mother’s Depends or feeding her a liquid lunch. On those occasions, he would turn abruptly and leave the room. He did this, not out of a sense of decency, but out of a need to get away from the weakness, frailty, and vulnerability he could not comprehend and certainly could not assuage. By the time I had moved in to help my mother die, Pop had completed the distancing process and was fully ensconced in his private world of old movies, old music, and radio football.

When I walked in on him after administering my mother’s dose of morphine, he was watching My Fair Lady for the third time that day. In the background, Liza Doolittle was belting out “I Could Have Danced All Night,” and my dad was in tears.

“Hey, Pop.”

“…and still have begged for more……”

“Pop!” I shouted over the orchestration.

“I could have spread my wings, and done a thousand things…”

“Hey, Pop!”

“I’ve never done before…”

Pop was canted back in his reclining chair, not really focused on the movie, but rather somewhere off in time, reliving the scene and trying to capture the moment as if he were on the set with Rex Harrison and Audrey Hepburn.

I walked over to the television and bumped the sound down a notch or two, not wanting to be rude, but, at the same time, knowing that the only way to get his attention was to break the musical’s spell on him.

“Hi, Pop….”

He opened his eyes and peered across the room, squinting to make me out against the busy lines of the bookshelf. Thanks to the glaucoma, his sight was down to a tiny window of imaging – a small circle of recognizable objects surrounded by a ring of gray and then a ring of black. The gray ring was inexorably encroaching on the visible field of vision, and the black ring was beginning to cover the gray. Within a few years, only darkness would remain.

“Mom is resting now. She’ll sleep for a while,” I said, trying to stay within his line of sight.

“Oh?”

“She had a hard time of it…I think she was in quite a bit of pain,” I started to explain. His eyes met mine for a moment, then he glanced back toward the muted television.

“Are you staying for dinner?” he asked, moving off the subject at hand as he always did.

“Yes, but I wanted you to know that Mom’s had her medicine. She is okay now.”

“So you say.” This was my father’s ultimate one-line dismissal of virtually everything that he deemed unimportant or threatening. For years, ‘So you say’ signaled the end of near-confrontational conversation.

“It’s not just me saying it, Pop. Mom has been in a lot of pain lately…it’s getting worse and more frequent. I just wanted you to know that she’s resting quietly now.”

Audrey Hepburn danced silently across the television screen, and my father reached for the remote to push the volume up.

“I could have danced, danced, danced..all night.”  Pop watched Liza Doolittle collapse on her bed, worn-out giddy from success and love, and I wondered how he would know – or if he ever knew – what that was all about. 

“I’d like a steak tonight. Are you going to the store?” He’d closed his eyes again and pushed back in the recliner, his feet lifted up, his body parallel to the carpeted floor. The movie continued on without him.

“I’ve already been shopping,” I replied, “and yes, we’re having steaks tonight. You want a baked potato too?”

“Sure.”

“I’ll get things started in an hour or so…I’m just going to go back to check on Mom…see how she’s doing…make sure she’s comfortable.”

I knew it was a fruitless attempt to refocus his attention on something he had no desire to revisit, but I was the helpless student of years of learning how to motivate with guilt. This skill had been taught to me by a master of the art who was even now, though she lay dying, reaching out to me to prick my father with her little needles of shame. Their pinpoints did nothing to move him to think more or less of her condition than he already did during the time when he and she could still talk about it. As I spoke to him, I could see that nothing had changed.  I walked out of the room as he turned up the sound of the movie.  “Danced, danced, danced………..all night.”

My mother was sleeping when I walked into the bedroom, so I took a seat at the table that was set into the room’s bay window. I aimlessly sorted through a stack of mail that had not been attended to in several days. Some bills. A magazine or two. A few letters of concern from neighbors. Ads for charities. The usual mix of letters and crap that normally filled their mailbox. I put the mail aside and stared out the window, listening to my mother’s breathing from the bed behind me.

So it all came down to this: Sitting by my mother's bed, repeatedly filling a syringe with enough morphine to keep the haze in place without actually killing her while I watched her gray-blue eyes well up in a silent plea for release. Her small fingers, with skin like thin, dried apricots, clutched at my wrist. They held me as if my arm were a trapeze bar high above the floor with no net. Desperate fingers. Her frightened eyes, bathed in a wash of mucusy tears, darted between my face and the vial of morphine from which I injected that measured dose of relief. 

With perfect knowledge of the consequences of my actions, I resisted and did not do that one thing my mother wished me to do. Each time I capped the vial, watched her eyelids flutter, and felt her fingers slip away from my arm as she fell to the net of painless sleep, I knew that her wish remained the same, but I did not comply. 

I turned again to the window to watch the geese flare low across the lake and settle into the slate-colored water.  Soon the cattails, willows, and sycamores along the water's edge would replenish themselves to bask in the spring sunshine and bend softly in the first zephyrs of summer.  And I would be standing by this window with my back to an empty bed.