My Mother's Last Three Breaths

My Mother's Last Three Breaths
Crazy talk, I thought. I kept telling her that it wasn’t cancer. I kept telling her that it was gone.
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How exactly do you move on from the loss of someone close to you?

At night, as I lay on my pillow and stare at the ceiling, the last three gasps of breath my mother took echo painfully loud in my ears. I try to forget that I was standing right next to her when she died, helpless and useless. And I get angry because I spent all that time in nursing school and I couldn’t save just one, precious life.

My family was looking at me, the nurse, to figure something out. And I knew that my mother couldn’t be saved but still I tried, knowing that everything I thought of would be like trying to grasp the wind.

I remember how my mother told me one day, “The doctor says I have an UTI. That’s why I’m having this blood in my urine.”

“Oh, well that’s a relief. Take your medicine and you’ll be fine.”

And I thought nothing else of it.

But when the bleeding came back, she went to see a gynecologist.

A few days later, I popped up at her house. Before I could sit down good, my mother said to me with a smile no less, “The doctor called. Seems I got cancer.”

I stopped and looked at her. “What?”

“I have endometrial cancer.”

At first, when she smiled, I was angry that she could take such news so lightly. But upon reflection, her smile wasn’t one of amusement but rather a sad smile. The kind of smile that people plaster on their face in order to keep from crying. But that was my mother; she never let anyone see her sad.

My mother was referred to an excellent oncologist. His treatment plan consisted of a hysterectomy, chemotherapy, and radiation therapy. After some gentle insistence from me, my mother agreed to undergo all the therapies.

However, the chemo treatments were rough on her. She got very nauseated and she started to develop neuropathy in her hands and feet. Soon, simple things started to become more and more difficult for her. And I knew she must have been devastated on the inside because my mother was a proud woman. She was used to being able to do things on her own from climbing on top of the house to fix the roof to laying down tile in the kitchen. She was used to cooking big Christmas dinners and going out to yard sales on the weekend.

But as days progressed, she started being more confined to the bed. I remember her telling me once that “this is not living.” However, in my mindset, everything was fine. My mother was here, breathing and laughing. Nothing else really mattered to me because she was alive. One wintry day in February of 2015, my mother said to me, “They found a spot on my chest and liver on my MRI.” This comment was said so casually as if she were speaking about the weather. She didn’t even look up from the newspaper she was reading. “My cancer has probably come back. They’re going to do a PET scan to confirm.”At that moment, I remember thinking what a worrywart my mother was and how it was probably nothing. My mother had been sick with a cold prior to the MRI and I tried to reassure that it was probably nothing.“It’s probably pneumonia,” I told her.

I wanted her to believe that as strongly as I did. I always pictured my mother as a strong woman that could overcome anything. There was no task she couldn’t handle and I absolutely refused to believe something like cancer would take my mother down.

When the day finally came for her PET scan, she went alone. I had offered to take off work to go with her but my mother refused. She was the type of person that didn’t like for others to worry about her. “I don’t want to be a burden,” she used to always say.

A few days later her oncologist scheduled an appointment for her to come in. She fretted that day on how she was going to get to the doctor. She didn’t have money to pay anyone to take her. I had offered to take her once again but she refused my help. I had just started a new job.
I’d only been there three months and she told me it would look bad if I called off work. I left early anyway.

The ride to the oncologist was like any other ride. We arrived to her appointment. My mother filled the time by pointing out different people that were waiting for appointments. She had apparently gotten to know quite a few of the other patients – some through casual conversation and others through observation.

While we waited, we watched the EMTs bring a patient from the back of the clinic out on a stretcher. It was a woman. She was propped up with an O2 mask on. She was pale and looked tired. In the pit of my stomach, I could feel my nervousness grow. The sight before me seemed like an ominous premonition.

Shortly after that scene, my mother was called back. We were led through the clinic and it seemed like one giant maze. But my mother, who had been here so many times in the past, knew the hallways intimately. We were placed in an exam room and told the doctor would be in shortly. The wait seemed to take forever. It was long enough for my mother to start talking nonsense again. “If my cancer has come back, I want to go on hospice. I can’t take those treatments again.”

Crazy talk, I thought. I kept telling her that it wasn’t cancer. I kept telling her that it was gone. She had the hysterectomy. She did the chemo treatments. We went through all of that and her oncologist assured us that her survival rate had gone up. He told us that she would live a long time.

And I foolishly believed him.

When her oncologist finally came in, he looked at my mother. He asked her how she was doing. He shook my hand and thanked me for coming.

“I’ve reviewed the results of your PET scan,” he started. I sat smug in my chair because I knew my mother was worried for nothing. “I have the unfortunate duty of telling you that the cancer has returned.”

My heart stopped beating for two seconds.

I looked at my mom. Her lips were pressed together in a thin line as she nodded. “I think I should go on hospice,” my mother said.

Her doctor seemed genuinely shocked. “No,” he told her, “We’re not looking at hospice right now. I’ve researched some cancer treatments specific to your type of cancer and I’ve found a treatment for you.”

But my mother insisted she couldn’t handle the treatments.
“This chemo is gentle on the body but aggressive towards cancer cells. I’m positive we can send this cancer back into remission.”

I’m positive we can send this cancer back into remission.

I grabbed onto those words as if they were my only lifeline. My mother would live to be an 80 year old woman. She would live to see her granddaughter graduate high school. She would live.

“You should do it, Ma. It’ll be okay!”

She looked at me. “You think so?”


My mother looked back at the doctor and agreed to do the chemo. He told us that he’d have his nurse schedule the appointment. He was just about to walk out the door when I stopped him. “What stage is the cancer in?”

He looked at me and didn’t reply right away. “Stage 4.”

This was the second time my heart stopped. The look on my face turned to disbelief. “How? She was just at Stage 1.”
“The cancer has metastasized from her uterus to her liver. Any time cancer attacks the liver, it’s automatically labeled Stage 4.”

While in the exam room waiting for the nurse, I told my mother that I had to use the restroom. When I finally found the restroom, I locked the door and leaned against it.

Then I started to cry.

Oh Lord, how I cried. And prayed. “Dear God, don’t let my mama die. She’s all I got.”

No, I thought, the doctor said he was positive that he could send the cancer back into remission. That one sentence, which I remember so clearly, was the only thing that helped me stop my tears.

Before my mother got too suspicious of me being gone, I dried my eyes and washed my face. I went back to the room where she was waiting and I smiled. And I repeated that same lie the doctor had told us earlier, “It’ll be fine. With the treatments, it’ll go back into remission.”

But she only had one treatment.

Everything happened so fast after that day.

The same week we received the news of my mother’s cancer, I had to rush her to the ER. She spent almost a week in the hospital. Her stomach started swelling because her kidneys suddenly started to shut down and she began to retain fluid. The fluid in her stomach made her feel full so she had stopped eating.

I visited her every day while in the hospital. She seemed like her usual, demanding self. She kept telling me how she couldn’t wait to get home. Her doctor had come to visit as well and he reaffirmed that the chemo treatments would help her.

She received her first treatment while she was in the hospital and then she was discharged home. My mother seemed to be doing great. The swelling in her stomach had went down and she was eating again. I was so happy!

But five days later, she was rushed back to the ER and eventually admitted into the hospital again.

And this time, they told me she had less than two weeks left to live. “We can look into some nursing homes to send her,” the doctor said.

I was angry at him. I was angry at the nurses. I was angry at every single person in that hospital.

“No, she’s going home.”

“She’ll need 24 hour care,” he argued.

“My mother is going home and that is the end of this discussion.”

Everything regarding my mother’s care fell on my shoulders. But I never once complained. I took two weeks off work. I handled every aspect of my mother’s care and did more praying that week she spent at home than I’d done in my entire lifetime.

I sat with my mother all day and night. She had a recliner in the room that I slept in. I got only a few hours of sleep each day. My nights were spent between praying, nodding off, and jumping up at every little moan that came from my mother’s direction.

“Are you hurting? Do you need something? Are you comfortable?”

It was the night before Easter when I heard the death rattle. As a nurse, we learn about the death rattle in school. It’s an eerie sound that the dying makes as fluid starts to enter the lungs. It is also a sound that one will never, ever forget.

I sat up all night listening to that sound. I’d stopped praying to God and started begging Him to save my mother. After a few hours of begging, I just stopped altogether.

I stood next to my mother’s bed and held her hand.

“I don’t want you to die,” I told her, “But I know that you’re tired and that you’re in pain. I just want you to know that I’ll look after everyone so don’t worry. Emily is going to be okay. I promise. And I want you to know that you were a good mother and I love you so much and I’m so thankful to have had you as my mother.”

Those were the last words I said to her.

When Easter morning finally arrived, I decided I couldn’t listen to the death rattle anymore. I wanted something to distract me so I began to wash down the walls in the house. I don’t know how long I scrubbed the walls but soon my daughter, Emily, flew into the living room where I was.

“Mommy, there’s something wrong with my Ma.”

Praying that she was still alive, I ran into her room. But upon inspection, my mother’s condition had not changed. Apparently, my daughter heard the death rattle. Even though she had no idea what that sound represented, she automatically knew that it was not good.
By this time, my sister who had been avoiding coming over that week finally showed up. She came into the house and sat in the room with my mother. She started singing and my mother opened her eyes.

My sister called us all into the room and I stood at her bedside. My brother and sister stood at the foot of her bed. And yes, she had finally opened her eyes. She looked at my siblings and then up at the ceiling. She was staring at something I couldn’t see. And suddenly bile started to spew from her mouth and nose. I immediately turned her head to the side and cleaned it as poured out.

After the bile had finally stopped leaking from her mouth and nose, she took three gasps of air. 

And then my mother stopped breathing.

“Mama! Mama!” I called out but she didn’t respond. She just stared blankly up at the ceiling. I felt an urge of panic rise up in me momentarily as I realized she was gone but I quickly pushed it to the side. Out of nursing habit, I checked for a pulse and then I checked the time. After confirming what I already knew, I closed my mother’s eyes.

My sister, who had ran out of the room in a panic when the bile started to come out of my mother’s mouth, stood in the hallway looking into the room at me. “Ray, is Mama gone?”

I couldn’t find my voice. So I nodded.

The sorrow in the house was so heavy that day that I’m not even sure how I managed to keep standing. Or how I even held back the tears.

It’s been several months now since my mother’s death but I still find myself crying at the oddest times. The world doesn’t feel quite right to me anymore. I feel out of place and lost. I spent so much time with my mother but when she died, it felt like I hadn’t spent enough time with her.

My mother had accepted her fate towards the end. But as for me, I’m still working on that acceptance part. I’m still working on not being angry at everyone around me. And I’m still working on not hearing those last three gasps of breath.

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