June 9, 2011

     Now it's time to start exploring those memories and stories that just won't go away.  Some bring waves of fondness and the sorrow at the loss.  Others, like this one, stick in my craw and don't dislodge easily. 
     It was the night of my brother's death.  He had a pain spike early in the evening.  A bad one.  I did everything the hospice doc told me to do.  It wasn't enough.  I had two options, well three, really, if you include trying the same thing again and expecting different results.  I could quickly rule that one out.  I could call the triage nurse, have her page the doctor, and then wait for to hear back.  We didn't have time for that.  My brother was in pain.  Plan B?  I could do my own thing.  Earlier in the day, the nurse pretty explicitly told me that the doc definitely didn't like my way.  The concern was rather strange and possibly not fully communicated but came down to a "toxicity issue with chronic use".  This wasn't going to last long enough for long term toxicity to be an issue.
     So I brought up my plan with the family members at hand - my sister-in-law, my dad, and my mom.  If my brother's pain was not brought under control via the doctor's method by a certain time, I wanted everyone's permission to go to Plan B.  I needed to know if they were ok with it.  Now was not the time to sow the seeds of regret and I sensed some hesitation in my dad.  Or, possibly I was projecting my own doubts and fears.  I certainly had my own.  Everybody agreed.  The agreed upon time came and went and my brother's pain was still not under control.  Plan B.
    This is not a story about my helping my brother.  This is about my own sense of shortcomings and my mortal fear of doing him harm.  At some point, I walked outside and called my wife back at home.  I made a demand of her that I've never done before, from her or anyone else.  I asked her, "tell me that I'm right.  I need to hear the words.  Tell me that when I make medical decisions, I'm always right."  I needed reassurance like I never needed it before.  And I hope that I never need it again.  Don't get me wrong, when I don't know or am uncertain, I am quick to ask for help.  I ain't too proud to beg, so to speak.  I know my limitations. 
     But right then and there, I needed to hear the words.  Logically, I knew my proscribed course of action would work.  No, that's just hubris.  I hoped it would work.  Or, maybe I did know.  Who knows?  That logic needed some emotional backup, though.  About a few months before all this occurred, my brother once told me in the middle of a rather heated discussion (which is a gross understatement), "you're going to be wrong one day, and I hate to see what that's going to do to you."  He said the words with a bit of venom and it did cut deep.  I guess those words hung around with me until that very night.  I knew at some point, I'll make an incorrect decision but I never imagined it'd be with him.
     I was stuck. Waiting was not an option. Allowing him to suffer was not an option.  Getting it wrong was not an option.  That night would NOT be the night I got it wrong.  If I was wrong, it'd destroy me.  Likewise, if I let him suffer in pain and followed the doctor's original path, it'd destroy me.  Neither option would allow me to live with myself.  I see the reason why we're not supposed to treat family members.  I had to be right, more so than at any other point in my life.  My brother depended on it.  So I did what I thought was the best course of action and my wife reassured me.  From where her confidence in me came, I have no idea.  I never asked her.  I'm a bit afraid of the answer.  But she was right.  Within a short time, his pain subsided.
     As I write this, I now realize why this story has haunted me.  It's not, I repeat not one remembered and told out of confidence.  Au contrarywise.  I was utterly terrified of his prediction coming true that night.  I didn't know it at the time, though.  That fear was displaced by the overwhelming grief of losing him.  It's just now resurfacing.  I'm just now remembering all the other emotions that were felt leading up to the point.  It was all such a blur of pain and sorrow and agony.  One demon exorcised.  Many, many, many more to go.

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