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November 5

St. Michael, Spring Hill

 

If the size of the church to the number of residents means anything, then St. Michael’s parishioners  had a heap ton of faith. The tall spire could be seen for miles from Highway 4, which was good since I had never been there. Farms dotted the landscape all around with a handful of houses in Spring Hill. The church’s cornerstone was dated 1900 and much of the interior had changed little, I suspected. Most churches have modernized, but this church seemed more traditional from my first glance of an ominous statue guarding the main entrance of  St. Michael slaying a dragon. The church seemed outsized for a farm community consisting of the classic small Stearns County town with a bar or two and a church.

Inside, the confessionals were ornate, heavy structures on the sides that looked like they could handle all the venial and even mortal sins. Statues lined the altar and dozens of unlit beeswax candles stood ready. The tall stained glass windows captured the morning sun through a dove flying over the earth.  I couldn’t help but imagine the sunset streaming in the other side through a giant bright blue eye. Most of the windows symbols were familiar but I did not recognize an anchor-type cross and an egg-shaped object. The ceiling featured eight angels in circles facing St. Michael at the front while underneath stood rows of dark pews, probably original, creaky even though they had been reinforced at least twice in the middle of the long sections. Ten souls celebrated Mass in that beautiful church, not all singing acapella, but those few voices harmonized like a well-rehearsed choir. Father Marvin’s homily related using gifts and talent from the first reading Romans 12:5-16 “Since we have gifts that differ according to the grace given to us, let us exercise them” My take-away was this reflection as I am way out of my comfort zone in any matters evangelical. Writing about my faith was a big stretch and helped me hone the gift of finding faith and spirituality in any situation.

I definitely felt the presence of regular daily Mass attendees there and wondered if they probably conferred afterward to analyze who this interloper was. Maybe I should have introduced myself to someone, but I mischievously enjoyed the mystery.  It also made me wonder if I could do a better job connecting to other lone worshipers  and be more like my Mom who would certainly have extended herself.

 

 Mom’s Faith

Growing up almost in the shadow of the steeple, my Mom surely attended St. Michael’s at some point. Her faith was truly part of her very being, in fact if you looked closely you could see small indentations in her forehead from a sign of the cross mishap. As a young girl, Mom thought she had a bottle of holy water, but it was muriatic acid and burned through her shirt at the shoulders and ate away the skin on her forehead. Truly marked with the sign of the cross! This same faith would prove inspirational when she made decisions at the end of her life.

I was fetching the mail when Mom called. Instantly I rolled my eyes and chuckled. It would be Mom letting me know Dad had cancelled our trip to St. Cloud. He had already cancelled twice. When she said,  “I’m in an ambulance. They want me to go to St. Cloud Hospital. Would you pick up your Dad and meet me in the ED?”  I stopped in the middle of Becker Lake Circle.  So began Mom’s cancer journey, literally and figuratively.

We waited in the ED for the OB-GYN who was making a delivery. Mom had vaginal bleeding that wouldn’t stop, but since she had a hysterectomy decades ago there shouldn’t have been any bleeding. In a blur of white, Dr. M introduced herself, covered the medical history and showed Dad and me to the hallway as she did her exam,  exemplifying the best traits in a doctor: caring, competent and efficient. In just enough time for us to start looking for reading material,  the doctor called us in. Mom needed treatment beyond what St. Cloud could offer and she recommended nationally-ranked Dr O at Fairview. Mom was off via ambulance to the University of Minnesota Fairview, her third ED of the day. Processing her transfer plus the drive would take hours, so the doctor recommended that Dad and I go home to sleep and meet Mom there in the morning.

When Dad and I arrived at 5am the next morning, Fairview’s ED was dead quiet. Undoubtedly we looked silly going in the entrance, calling down empty hallways, then stepping back outside to make sure we were in the right place. Finally we heard voices and tracked them to maintenance staff who gave us directions. We walked through long tunnels and took two sets of elevators and eventually found her room. Dad looked worried but pleasantly bantered about how we’d find our way back out and made comments aloud to help us remember the path later, always a lesson to be had near Dad. He ambulated slowly with the aid of two canes he had fashioned from copper tubing. For someone who disliked the chaos of St. Cloud, this trip pushed him out of his element.

We found Mom in good spirits and settled in a double room with a view of the Mississippi. Around 9am, the gynecologic oncologist arrived with four fellows and asked a few questions before Dad and I left during the exam. The doctor poked her head out after only a few minutes with a bleak message: “It’s ovarian cancer. I am 99% sure.” A biopsy would follow to confirm stage IV ovarian cancer. Stage I was considered poor and stage IV dismal. Mom accepted her dismal diagnosis with amazing courage. She cried for a few minutes but was laughing before the tears dried  just as she would many times during the next  22 months.

While I stayed overnight at Fairview with Mom, I missed a day of back to school teacher workshop. Mom was a veteran teacher who had taught part-time or full-time over 41 years so was well versed in teacher workshop experience. At the end of the next school year I missed part of another day. Somehow, despite the severity of her illness, I never needed to miss work with others pitching in for appointments or scheduling them after school. It was like as a fellow teacher, she somehow kept my school days intact, knowing the burden of planning for a substitute. When I got a call from Coborn Cancer Center on the last Friday morning in May 2016, I slipped into the hall. They wanted me to bring Mom there for the results. Today. In my experience, oncology always scheduled appointments in advance, never with urgency so I knew the last CT scan results were bad.

In the past few weeks, Mom had been filling up with fluid. I had taken her to a radiology appointment on Wednesday afternoon in Paynesville to have it drained from her abdomen. They gave her some lovely narcotics so she slept through the procedure, but I sat in the room where the ultrasound gave Scott and I the first glimpses of Ben and where the first images of my first tumor were captured as well.

“You may never see this again in your career,” the radiologist whispered to the student and technician as the bottle filled with liquid that resembled lard before it solidified. “Chylous ascites. It should look like beer.”  The thick, cloudy liquid indicated that all the fat Mom ingested was not being digested but filling up in her stomach instead. Her system was shutting down. Though she barely ate with little appetite, she had a distended belly that made her miserably uncomfortable. And she burped often and uncontrollably. She had a CT to check on the cancer progression. A short vacation from chemo in the spring had given her more energy, but also proved that taking the foot off the chemo pedal gave the cancer a chance to grow unchecked. Her tumor markers had shot up also indicating the presence of more cancer. We were at the crossroads of quality vs quantity of life.

I got through the class and drove to Paynesville to pick Mom up. She was ready at the door of the assisted living facility that had been her home for less than a year, wearing a bright sweater and matching scarf. As we made our way on HWY 23 to St. Cloud, she was chatty, giving details about the new seating arrangements in the dining room due to some personality conflicts. She gave me updates on family members, laughing while she related the latest antics of her youngest granddaughters.

As we hit the first stoplight in St. Cloud, I finally had the courage to tell her that the urgency of the appointment had me worried. Her dark brown eyes filled with tears. “I think the CT results are going to be bad, right?”  My eyes filled with tears as I nodded and said we might need to start hospice and focus on comfort now. She nodded and shrugged with tears splashing off her face onto the scarf, “who knew this was fashionable and functional?” she laughed as she blotted her face dry with a grin that was a mismatch for her red eyes, runny nose and blotchy cheeks. We were terrible criers with our faces mottled long after we stopped crying.

The oncology appointment was marked by the usual waiting room waiting and then waiting in the patient room. The oncologist’s face delivered the news before his voice. Dr. R brought up the scan on the computer and seemed to be searching for options when I quietly said, “We’re ok with hospice.” Sighing loudly with relief, he reached for Mom’s tiny hand, “You will have no pain, MaryAnn. I promise you. Yes, this is time for hospice.” With more eye contact than my teary eyes could handle, he looked at me and said, “You should have all family visit this weekend.”

The trip home was the opposite of the trip there. Before we left the parking lot, she squeezed my arm. “I am ready to meet Jesus,” she said both to me and herself. She closed her eyes with no tears in sight. Her acceptance of her end was complete and astonishing. From the moment she asked for hospice care, she was tranquil. As she accepted dying, I pulled from her strength and marvelled at her brightly living faith.

On the 45 minute trip back to Paynesville, I kept looking at her napping peacefully. As lively as she had been on the way to St. Cloud, she started shutting down on the return trip. Images of the walking dead Viktor Frankl described in his holocaust memoir, Man’s Search for Meaning filled my head. He cited several examples of inmates who gave up  hope and the will to live. Once they shut down and moved like they were sleeping-walking, they did not last long. He could identify those who consciously gave up the will to live by the way they moved. I could see this in Mom. It was like an ember in a fire, her spark of life was fading, but I knew her faith was still an inferno.

Within hours of being called, the hospice team showed up at her apartment. Dr. R recommended no more food and only ice chips or a wet sponge for liquids. Though it did not seem humane, and a few people brought food or drinks despite his advice,  she was not hungry and seldom thirsty. The food would not help, but only prolong her suffering. The fluid in her abdomen indicated that she had not absorbed the proper nutrition from food for some time. At this point anything she ate would only make her uncomfortable.

Although she had no IV’s anymore, her wrist bore neon medical alerts: FALL RISK, NO FOOD and DNR. With every hospital stay, she was sure to get her Do Not Resuscitate (DNR) bracelet. When she had issues with her heart years before, Mom had filed her advance directive with DNR status based on advice from her primary care physician, Dr P, who explained that it was not often successful and broken ribs were guaranteed. “If I get to heaven and you bring me back, I will haunt you!” she had threatened with a stern voice but mischievous eyes.

With her permission, we let her go.

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Once Upon the End: Hovering in the Last Chapter of Cancer Copyright © 2021 by Linda M. Liebl is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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