Fresno Community Regional Hospital

It's a long story, but my baby brother, Sam, had a brain tumor when he was 10 years old-40 years ago. He was left with limitations but has been in quite good health all these years. In November, 2021, he had a stroke. He was hospitalized and then sent to rehab in Turlock. He made a lot of improvements, walking, talking, telling jokes. He kept working until he was able to return to Stephanie's House, in Dos Palos, under the care of Elsa Snyder, where he had enjoyed living the past few years. After only a few days of being home, he had a 20 minute seizure and was sent to Fresno Community Regional Hospital. After a couple of days, Dr. Dais, the neurology doctor at the ICU, called me and said my brother was very sick. The CT and MRI showed a severe stroke on the opposite side from the previous one that left profound and permanent damage to his brain. Dr. Dais suggested that the family discuss palliative care that focused on his comfort as opposed to life support. We held a family zoom meeting and agreed that that would be the best course of action. Mom, Mary, Megan and I flew into Fresno feeling good about the decision, but for me, I was apprehensive about the process and recognized that I hadn't done many things harder than this. At the hospital there were still residual COVID restrictions, which made the 4 of us visiting Sam challenging. The hospital only allows 1 person per patient per day, 2 for Intensive Care. We received permission for the 4 of us to be with him, but we needed to get permission each time the staffing shift changed. When we entered the hospital each day, we had to get clearance, show our Immunization card, and get a new wrist band. We had 1 car, 2 drivers, and a Mom that needed a wheel chair and rest.

Mom and I arrived at the hospital first. The Doctor showed us the images which gave us even more evidence that it was time to let Sam go. We decided  to remove the ventilator at around 10:00 am on Wednesday, Mar. 30. Mary and Meg flew in Tuesday night and we would all be with him Wednesday morning at 9:00 am.

Each time we entered Sam's room, we were asked to gown up in addition to masks and gloves. 

When it was time to extubate, we stepped out. After Sam's tube was removed, his oxygen went lower, but he adjusted and it climbed. He spent the evening with O2 levels in the 90's. Waiting for the end is an interesting experience. As the doctor says, each patient is different. They provided us with information that described the process, but the doctors and nurses all said, no one knows the day or the hour.  It's the same when we come into the world. I guess that's how God's business is. We look for the signs, but He decides the time.

We spent our time together sharing memories of Sam, enjoying each other's company, singing songs and watching and listening. Listening was hard. It's so innate to care for and try to heal people. The labored breathing brought us closer to our, what's the word? goal, decision? but we wanted to fix him. Help him be well and take a big, clean breath. 

Wednesday night, I went back to the hotel with Mom. Mary and Meg slept in chairs by his bed. 

Thursday was a long day. We were concerned that we would have to leave Sam alone before he passed. Our flights were on Saturday. Once again, we were not in charge. There were a few things I was thankful for. One was our group. Mom definitely needed to be there. I had to take her there, but she doesn't feel well enough to endure the vigil. Having one sister would have been helpful, but having two was perfect. There was usually someone else to sit with. For those who have been in a hospital with a sick loved one,  you know that if you don't have a companion, fear will fill the space. 

Thursday evening Sam was moved to palliative care. Mom was resting at the hotel.  The nurses were strict about their visitation rules, but once again had mercy. The supervisor said that since the patient was "Imminent" they would allow 3 visitors. This was the first we knew of him being imminent. Since he hadn't passed in the hours before, I guess we began to believe somehow that it wouldn't happen. Family called in to share memories of Sam. More singing. 

That night Megan took a turn to stay with Mom in the hotel. Mary and I stayed with Sam. The new room had an empty twin bed. Compared to the chair the night before, Mary was thrilled to sleep on 1/2 of a twin bed. We tried to sleep skinny and still...and listen.

Friday morning, April 1, 2022, Sam was still with us. Mary went to the hotel to get Megan and Mom. This was my time alone with Sam. I told him how much I loved him, thanked him for being a good brother, and thought about how I would miss his phone calls and jokes. I tried to sing, but for all my desire, my voice was lacking. I shared some of my favorite hymns from my phone. I knew Sam would be meeting Jesus soon, so I played prelude music. 

One surprise we had on Friday morning was that since only 3 visitors had been approved the night before, 3 would be the maximum number allowed on Friday. When the other girls returned, I had to leave. I knew it was the way it had to be, and that we had been lucky on all the other days, but it wasn't what I wanted. I gave myself a little talk about accepting a no answer, grabbed some breakfast and a cupcake to make me feel better, and returned to the hotel. Not long afterwards, Mary called with the news that Sam had passed, and that I was allowed to come back to the hospital. 

That was one of those drives where I kept looking at all the other drivers thinking, "Don't you know that my brother just died?" When I got to the entrance of the hospital, the employee had to first get my clearance and there was a delay. He asked me where I was going and I heard myself say, "Palliative care. My brother just passed." The poor guy really wanted to help me, but he needed his job so we both just waited while I gave myself another talk about staying calm and not getting crazy or rude or angry or belligerent. And then I was cleared and on my way to Sam's room. It was real. Sam was gone. Mom was lying by him, holding him gently. His sisters' love was spilling down their cheeks. I took my seat on the empty bed and we sat... tired, relieved, sad, tender and thankful. The staff came in and asked us questions we didn't want to answer. I made phone calls I didn't want to make. I prayed that we could finish strong, and then we drove away from the hospital and the good people that cared for my brother and 3 hard days that we were privileged to live.

We still had jobs to do. Mom and Mary hosted Mom's friends at the hotel. Megan and I went to Dos Palos to get some of Sam's things. It was heartwarming to see his place. His drawers and closets were neat and tidy. His walls were decorated with calendar pictures. He had scrapbooks that were lovingly filled with pictures of his family and more calendar pictures and stickers. His chair was draped with hand crocheted afghans. His favorite DVDs were stacked on a shelf as were his joke books. All was in order, just the way he likes it.

 

Then Megan and I took a drive through town. First we drove by our old home. There is a quarter mile drive from the road to the house. We drove right up, circled and drove right out. No explanations. Next we went by our High School and the Senior patio where we hung out as seniors before and after school. The memories were flooding in as we reminisced. We commented that we were keeping our eyes out for people we knew. Unfortunately they were not in the 18 year-olds. Our friends would be found looking slightly older than that. 

Next we started driving through the neighborhoods that our friends had lived in. The fact that our hearts were facing a big change made it more saddening that time had marched on in our childhood place and we couldn't go back to where our memories were born. Many of the people we loved lived in other places. Wouldn't it be fun to be able to visit them again? We were happily surprised when we saw this pretty lady out walking her dog. Millie Richey had had a positive impact on our family as a teacher and friend. She cheered us up with her smile and stories.

We drove the hour back to the hotel for our last night in Fresno. We had done what we came to do. It was time to go home. 

Bedside Musings:

The clouds cover the sun today. 

The celestial orb remains, but its radiant light doesn't warm my soul. 

It is not shining happy brightness into my mind, lifting my worries and beaming hope.

The clouds cover your light today.

They've cast their shadow for 30 years and grow dense and dark. 

I do not see your smile.

Your happy humor does not tickle my funny bone,

I do not hear "Integrity," or "Sam the Millionaire," 

or "I Love You Too."

I know behind the cloud cover you are shining

with your glorious smile and sparkling, twinkling eyes.

So today I enjoy your silent company and wait.

I wait for your next adventure,

your sunny day, your restoration and healing

through the grace of your loving God and Heavenly Father.

I wait for the day we circle around in family love

and see in eternal sunshine."