Cathy's Story
Cathy found out we were pregnant in January. We were surprised and excited. Surprised because we thought we were barren. Excited because there was going to be another life in our house. Our youngest was six and a half. Our oldest 19. And we have another son who was 13 at the time. So just about every seven years we added to the family. We should have consulted a calendar rather than rely on our chemistry. Anyway, we were giddy. Yes, we were old, too. Well, old to be bearing children. Cathy was 40, I was 45. But, doggone it, we were very comfortable and settled and had the resources this time around to do things in a fun way.
Besides, we make damn good looking babies! Cathy was a pre-school teacher who volunteered to take infants. Now, that's a vocation. I think a part of why she did it was because she knew she would have no more children.
Well, we had just moved back home to Louisiana from Atlanta only a few months earlier. We were excited to be so close to family and friends and when we announced we were pregnant, our neighbor and closest friend said, "Well, I hope you know this will be a community baby. She'll be raised by everyone." Those were prophetic words.
Cathy was looking forward to her pregnancy because she always felt great. She had energy and a great complexion. But she could be mean as hell! Her hormones really did a number on her with Number 3. I wasn't too excited about going through that phase with Number 4. But she was older and a littler mellower.
It came as a surprise when her doctor, a very conservative OB/GYN, ordered temporary bedrest, four hours a day in the middle of the day. We never had problems before. The only problem ever encountered was that Cathy could not deliver vaginally. Every one was a section. And we had already scheduled "Katy's" birthdate as 9/9/99. She was due 9/16.
Cathy was very faithful to her bedrest regimen. I didn't put too much stock in it. I mean, like I said, "SHE NEVER HAD PROBLEMS BEFORE." It was like a mantra. Pretty soon, Cathy was going to the doctor every week, and she was just four months along. The weekly visits turned into twice weekly. And home health nurses were called in twice a day for blood pressure, weight, swelling, etc.
It was around that time that I read an article in Reader's Digest about an expectant mother who died and lost the baby due to eclampsia. I had heard the term but never realized the severity. In the story the woman's BP was something like 135/78. And it was considered high because her normal pressure was much lower. I am on hypertension medication for life and I have my cuff which I use almost daily. So I'm the "doctor" of the house taking BP for Cathy, the kids and myself. I knew Cathy's baseline so I asked what her latest reading from home health was. I was shocked to hear 135/78. Cathy's normally 112/60, or in that range. Very low. She used to tease me all the time about me trying to get below 90 when she barely crept above 62. Now I was concerned.
The routine became monotonous. Every three days we went to see the good doctor. Get weighed, pee in the jar, get hooked up to the machine and wait. Things looked good. No protein in the urine. No headaches, no flashing lights, no ringing in the ears. Good. Go home.
My brother had an aortic aneurysm in mid-June. I was torn between home and the hospital two hours away. I made the trip back and forth many times. Sometimes staying overnight in the ICU waiting. Finally, he was released. Cathy and the kids came with me on one trip to visit him. He looked well but was still feeling pains.
Then came a phone call that he was in serious trouble again and undergoing surgery. The family should come. I got there too late. He was already gone. I returned home to get clothes and was heading back to the hospital. Cathy said she was going to go to the doctor that morning for a final checkup and then would meet me at the funeral home. I told her if she heard about any arrangements while I'm traveling to page me. About halfway there I get a page. I stop at a pay phone and ask her what arrangements were made. She said that she was being admitted into the hospital. Her doctor would not only not let her go to the funeral, she would have to be admitted for observation because of a BP of 150/85 and climbing.
Naturally I headed back and met her in her room. She was comfortable but very upset at not being able to pay her last respects to my brother. I told her I would take the kids and we would stay at her mother's. We would be back in a couple of days. I hated to leave her but she insisted.
She was released while we were gone. Our wonderful neighbor watched her like a momma hen. I am forever in her debt. When Cathy returned home with a clean bill of health, home health was cut in half, but her twice weekly office visits remained. After the funeral I told her we need a vacation. So we took the kids to the Mississippi Gulf Coast, about two hours away, her maximum traveling distance, to have a little fun and sun. Believe it or not, Cathy remained on her bedrest schedule. Except her bed was a sand dune and blanket. She was very faithful.
A couple of weeks later she was readmitted to the hospital for a stress test. They were only going to induce labor temporarily to see how the fetus fared. She passed with flying colors. We came home. Our goal was 32 weeks. Get the baby to 32 and the doctors would be comfortable. We had already had genetic counseling and high-risk assessment. No problems with either. Baby looked good. Cathy looked good. But we all knew she wasn't going to full term, although that was the ultimate goal.
Then don't know what happened, but Cathy was placed on 24-hour bedrest with bathroom priveleges. For the next few weeks I was to learn exactly how to mop a floor, handle all of the laundry, cook and clean. For some reason, I did this ungrudingly, which is very unlike me. I don't particularly care for extra duties, but I knew if I did it right Cathy would be comfortable and I would feel better. She was a model patient. Home health was reinstated twice daily.
At exactly 32 weeks Cathy was admitted again to the hospital for observation. Her BP was elevated. We went in with a jovial mood. We knew the routine, the nurses, everything. She was made comfortable, the kids would visit. We'd get her comfort foods. Haley, my 19-year-old made brownies, Theo and Spencer made cards and gifts. On Friday, 32 weeks and one day, we had a heart to heart with her doctor: our goal now is 35 weeks. If you deliver now, the baby must be airlifted to a NICU in Baton Rouge or New Orleans. We live about half-way between the two. At 35 weeks, the baby can be cared for here. OK, so we have our orders.
That evening the kids came to visit. We played, joked, watched TV. Finally they told her goodbye, I brought them home for pizza. My routine was to feed and bathe them. Get them settled for bed. I would returned to the hospital after 9pm when the 6-year-old is down and would stay until past midnight. She never let me sleep over. She said I needed to be with the kids.
I was picking up pizza dishes around 8pm when the phone rang that Friday evening. Cathy asked if I could come over now rather than later. She wasn't feeling too well. She felt kind of funny. I dropped everything, told Haley to take care of the boys, and left.
When I reached her room a nurse was trying to comfort her. She was having severe gas pains. Haley had made her a plate of brownies and Cathy was so hungry after her pitiful supper that she at the whole thing. She thought they were making her ill. A doctor came in the room, new guy, one of the partners. He had been apprised of Cathy's case and was watching her closely. He would give her something for the gas, but was casting a wary eye on the whole thing.
She settled down a little. The pain was still there, but she was using some long-remembered Lamaze techniques to manage it. When Haley was born we had gone through Lamaze, one of the first couples in our community. Haley was in distress so they had to do an emergency section. The epidural was not fully in effect. Cathy endured some of the birth with Lamaze. A section with Lamaze, that's pretty gutsy. We also tried VBAC for the boys and went through Lamaze two more times. We didn't even bother with this one.
Then without warning the BP machine starts to alarm. I'm watching the numbers rise to way above 150! I'm not yelling, but I'm pretty adamant with the doctor to do something. Magnesiums sulfate was considered, but let's just see... Then all hell broke loose. Cathy began writhing in agony. Something was rushed in and injected in her IV, the magnesium. The doctor is asking her the same old questions we've heard for months: flashing lights, headaches, ringing in the ears. She could barely hear anything in the room because of the noise in her head, which felt like it was splitting open. When I asked her again about the flashing lights she said she couldn't see me. I held her hand as she suffered a brief seizure and lost consciousness. The room went crazy. An order for a maternity med-flight was made. Ten minutes later that order was belayed and a new one struck for an infant evac to NICU, Baton Rouge.
I was ushered from the room and told to go wait at the nursery. Cathy was prepped and wheeled from the room to surgery. I called the kids and our neighbor. They arrived about 20 minutes later. I told them the whole story. Around 10:10 that evening a pediatrician, a friend of ours, came out of surgery and told me that the baby was alive and fighting. They're doing everything to prepare it for it's flight. She turn to go back, I stopped her and said "Boy or girl." A little boy. How much! Don't know, didn't have time for that right now. A little boy, I thought, Graham Christopher, named after my brother Chris. Cathy had named him a couple of weeks before. We knew all along that it would be a girl. But we never picked out a formal girl's name other than "Katy."
Wait, what about Cathy? The pediatrician said that her doctor would be out soon to talk to me. I waited another ten minutes, agnonizing minutes. He finally came out with a look on his face like he's about to tell me more than he knows. Her liver had ruptured at the diaphragm. There is no way they can stop the flow other than to pack it off. There's a lot of blood lost, but they're managing to control it. You can't stitch up that area. She'll be in ICU after while. That was the pain she was feeling in her belly. It wasn't Haley's brownies. It was her liver blowing out.
We watched Graham being worked on by about eight nurses and doctors. Tubes were everywhere, he was moving quite a bit. Then four more people wheeled this contraption into the room. Graham was placed inside. A nurse technician told me they were taking him to Baton Rouge. They brought his isolette into the hall and allowed me to touch him. He was small, 3lbs 2.6 oz. We watch the helicopter ascend into the darkeness. I sent the kids home and told our friends good night. I went to ICU waiting and waited and nearly froze to death, shivering in the cold air conditioning.
Every once in a while the doctor would rustle me from my thoughts and give me no news. She's resting, still bleeding, comatose. My thoughts that evening were scattered. My primary thought was how upset Cathy would be. I'm sure the recovery from a ruptured liver is quite long. Graham will be in Baton Rouge for God knows how long. How long will it be before Cathy gets to see her baby? Boy, am I going to have to do a lot of comforting and endure a lot of tears. What if Cathy's disabled? How are we going to manage with a new baby, a preemie at that, my job and her disability? Oh, the things that went through my head.
About 5am I was rustled again, this time two doctors. The rupture is indeed irrepairable and unstaunched. She's had 15 units and it looks like more will be needed before long. I'm O-neg, just take it out of me. No, that's not what we mean. Listen, there's more to it than the liver. What? What more? Well, when she had the flash of light, she couldn't see, the headaches and the ringing and then passed out, we think she may have had a rupture in her brain as well. The neurologist will be here soon and we'll run some tests. Oh, she did aspirate some food during her seizure, but we cleared her lungs, so that's OK. Good, I thought, at least something.
The neurologist arrives. Doesn't look good. What do you mean? It's like my mother all over. I sat vigil with her through the night to receive no news all night long only to be told at daybreak that she was long gone. Is this deja vu. One question: should I call the family. That's probably a good idea.
I called Haley. Get the kids ready and come to the hospital. I know you don't have your driver's license but you know how to drive. It's only a couple of miles and at this time of the morning you'll be fine. I called the neighbors. Don't worry about the kids. Come when you can. I called Cathy's sister who was staying at her mother's a couple of hours away. As luck would have it she was visiting from Oklahoma City and taking care of mom-in-law who just endured back surgery. If you can make it, come. I called Cathy's best friend, I called my sister.
As I waited there alone our priest came through the door and asked how to get into ICU. I told him which door. He had only recently been assigned to our parish and I knew him, but not well. He had never met Cathy before. She was on bedrest when he came. So he didn't know of her strong volunteer streak. But he would be apprised later by just about every person at the school and in the parish. When he came out a few minutes later he finally connected me with her. Oh, that's YOUR wife! We talked for a while and he stayed.
Within the hour the waiting room was beginning to fill with people I didn't even call, but who heard.
The neurologist called us in a while later. An EEG confirmed a major event in the brain. He didn't call it an aneurysm, it was a hemmorhage, and one whole half of the brain was filled with blood. It was inoperable at this time. And probably would not be an option at any time. The other doctors spoke. She's on unit 16. There are no signs of viability. She's not breathing for herself and responds to nothing. Her liver is all but gone. A transplant would not even work. And she can't live without a liver. I'm afraid a decision has to be made.
In my mind there is no decision. We were never into heroics. We were never into extreme measures. And we never, ever cared for life support for the sake of maintaining an artificially breathing organism. I spoke to the kids the best I could. This is a logical decision and I had to have affirmation from each of them. Even the six-year-old. Goodbye, Momma.
We got to see her a few more times. Went to touch her and talk to her. Of course, there was no response. Nothing was measurable even on all that equipment. Our words didn't even bring a blip.
But I got my skin fix. Every morning when I would awaken her I always had my hand on her bare back. Somehow I would manage the folds and tucks of any gown she was wearing to rub her back. She called it my skin fix for the day. Nothing really erotic, just intimate. After 23 years of marriage of course we developed our little "things" for each other. This is what got me started on my day. Realizing that I had reach the end of my fixes I couldn't stop touching her.
She looked so different. No belly. Her belly was in children's hospital in Baton Rouge where I hope he was doing well. I was not too concerned about him right now. I didn't really know him yet. I was worried about his mother. And how much longer we had left. I told everyone of our intentions. We were waiting for the organ donation team. Everyone was given an opportunity to visit. Her best friend in the whole world was there. Claire was the first person I called that was not family. She was taking it extremely hard. We had only been back home a year and they were making plans for the rest of their life.
Some co-workers were there. Cathy had made friends with them when we first moved here. She did that well. They asked for the keys to my house. I gave them without question.
The kids and I stayed in the small consultation room a lot. Family would come in for a while and go. I tried talking to the kids but could barely get anything out of them. Flashbacks to Mom were awful. I tried picturing Dad during this time. I was too busy with my own grief for Mom. Finally, the donation team arrived and assessed. We were called in and told the situation. Too much had been damaged from the high blood pressure. Every organ was affected and tainted. Nothing could be used. He was sorry. We were too. Did we want an autopsy? Sure, I guess so.
So all that was left was to pull the plug. Did we want to be in there? Gee, I don't know. Should I be? Well, it might be a bit much to take if there is a problem. Then I don't want to be there. Our priest asked if we wanted him to be in there. Yes, if you'd like. He came back ten minutes later saying she went peacefully. The machine was stopped and she gradually faded. There were no problems. She was ready to go. In my mind she went last night as I was holding her hand. But I am not going to argue about when they decided she left. This was good that it was today and not yesterday. Today is Cathy's death, yesterday was Graham's birth.
We said our last goodbyes in the room. Touching her, kissing her, crying over her. The staff had tears as well, and comforted the kids and me.
We went home. I was floating in another world, doing things by autopilot. Our house was full of food. Every room had something in it, napkins, cokes, deli trays, cheese, fruit, breads. My co-workers has made sure we were stocked. We were going to stay home the evening. Cathy would be sent to her hometown, her mother's town, for burial. We would be there tomorrow.
I went to bed alone. The numbness overpowered the loneliness. Nevertheless, the ever-present tears soaked the pillow. And I slept, and did not dream about Cathy.
Remembering Cathy