“No one gets out of here alive.”

And it’s true.  At some point, some sooner than later, we all have to die.  Mama left this earthly realm at 4:25 a.m. on Tuesday, August 4.  The doctor pronounced it at 4:35 a.m., but she took her last breath ten minutes before that, while my sister and I stood on each side of her, crying, holding her hands and telling her how much we loved her.

I could write a play-by-play of how events transpired, beginning early Monday morning when my sister stopped by Mama’s house to deliver a prescription she needed.  How she noticed the corner of Mama’s mouth drooping and she immediately thought “stroke”.  How we knew Mama disliked the hospital in Clear Lake, so we took her to the hospital in Pearland, and how they didn’t have a neurologist on call with the ER, so they transported her to Memorial Hermann in Houston.  How Mama seemed better while at the Pearland hospital, passing their questions with flying colors (“Do you know the date?”  “What is your name?”  “Press against my hands — you still have good strength in your hands.”) and nodding when they observed that the drooping at the corner of her mouth seemed to have resolved itself.  How she asked several times, “After they check me out, can we go home?  I want to go home.”

My sister told her, “Mama, they are probably going to admit you so they can keep an eye on you for a day or two.”  She made a funny face.  She didn’t like that at all.  The EMS guys finally arrived to transport her, only to discover they didn’t have a piece of equipment on their truck necessary to monitor her during the trip into Houston.  Another 30 minute wait, and then the second truck arrived.  It seemed like there were six EMS guys cramming into the small trauma room to transfer her to the ambulance.  So my sister and I tried to get out of the way by stepping into the hall.

I remember looking past a couple of EMS guys and seeing her propped up in the bed.  I waved, said “we’ll see you there” and then turned to head toward my car with my sister.

I can’t remember if I told her I loved her.

You learn something new everyday, and I learned that you’re not supposed to follow an ambulance en route to a hospital.  We were hungry and decided to grab something to eat.  We figured by the time we ate and made it to the hospital, Mama would be settled in her room and we could figure out what we needed to do next.

I don’t know if I’ll ever be able to eat at a La Madeleine’s again.  At least not the one in Pearland.

We were headed up 288 toward the hospital when my phone rang.  Someone named Veronica was calling to find out if we were on our way back, and how long it would be before we got there.  I told her we were at the Beltway and 288 and we’d get there as quick as we could.  My first thought was, “Oh, great — we’re in trouble because we went to get something to eat and Mama’s wanting to know where we are.”  Then I asked my sister, “You don’t think something happened in the ambulance, do you?”  She shook her head “no” and said “surely not.”

We had a hard time finding a parking place.  Once we got inside, we asked for Veronica, who appeared a few minutes later and took us to a small room named after Dr. Red Duke.  I remember thinking the room wasn’t very fancy to have been named after someone so important.  Not only is Dr. Duke an institution in the Texas Medical Center, he also has the distinction of being the Parkland Memorial Hospital surgeon who received John F. Kennedy in the emergency room after the president was shot in Dallas.  Journalists have tried to interview him about that tragic day, but he refuses to speak of it.

Finally, a doctor came to speak with us.  Strange.  The doctor needed to speak to us before we could see Mama.  The feeling in my gut said, “this can’t be good.”  And it wasn’t.

When they brought Mama in, she appeared to be fine.  They got her situated in the trauma room to take her vitals and the doctor said she was talking and they were laughing about something —

And then she stopped breathing.

He told us they “got her back” with CPR and intubated her.  She was breathing with the help of a ventilator, and now that he’d explained everything, he would take us to her.  I don’t think I’ve ever experienced anything so gut wrenchingly painful.  Mama wasn’t there any longer.  We stood on each side of her, crying and asking her to squeeze our hands if she could hear us — but she never did.  We were told that they were waiting for a bed in ICU and as soon as they had one, they were going to move her up there.  A little while later, we all made the trek to the ICU.

The nurses in that department are wonderful.  They told us that they were going to give Mama a bath and put a fresh gown on her; that we could wait in a room down the hall and they would come get us as soon as she was more comfortable.  About 45 minutes later, we returned to her room to find her still unresponsive, but looking a little better.

There’s no point in recounting the next couple of hours minute by minute, since really all we did was stand on each side of her, talking to her and telling her how much we loved her and how sorry we were for the things we wished we could have done differently — wishing we could have been there more for her.  Her blood pressure kept dropping and they kept bumping it up artificially with drugs.  She was trying to go, and they weren’t letting her.  So we talked to a kind nurse who understood that our mama did not want home healthcare or to be put in a nursing home.  We explained how many times we had asked Mama, “Can we please get some help?”  Not so we could “dump” her, but so we’d have some energy left to be able to actually make a few last memories with her.  She didn’t want anyone taking care of her but us, and her condition had passed a point where she wouldn’t be going back home.

The nurse spoke with the charge nurse, and then a doctor came in and the charge nurse said, “You have to be the one to tell the doctor what you think needs to be done.  It has to come from you.”

My sister is the bravest person in the world.  She told the doctor that the drugs and the ventilator were keeping Mama alive when Mama was trying to go.  She explained that Mama was a very private and modest person, and she would not want to live in such a dependent state, one in which she was not able to return home.  All I could manage was a nod of my head in agreement.  And so at 4:00 a.m. the nurses removed the ventilator and removed the drugs that kept her blood pressure from dropping.

Twenty-five minutes later, Mama went home to the Lord.

There’s comfort in knowing that she had a real relationship with Jesus and she will spend eternity with her savior.  While her passing was not unexpected, it was not expected quite so soon.  We thought we had a little more time — a month or two, at least.  Because of that mistaken hope, we didn’t make good use of the time we did have.  Truly, we both blame a great deal of that squarely on MD Anderson.  Mama was not in good health to begin with, and if the doctors at MD Anderson had taken her other issues into consideration, they would have said, “Ms. Swan, go home.  Spend time with your family.  Share your stories and look through your photographs.  Bake your mama’s coconut pie and sit around the table eating it straight out of the pie plate with forks.  Play cards with your grandchildren.  Give them some memories to finish out the story of your life.”

But it’s about money.  And so they prescribed radiation treatments that magnified her existing fatigue and fried her taste buds so nothing tasted good any longer.  Her already thinning hair felt out completely.  A short time before she passed, she began saying “I just want to feel good again.”  And even more recently she said, “I miss my mama and daddy.”

My comfort is that she feels better than she ever did, she has been reunited with her mama and daddy, and someday I’ll see her again.  But it’s so very hard to remember she’s gone right now when I have something to tell her and I almost reach for the phone to call her and say, “Mama, whatcha’ doing?”