I awoke from a postcall nap to phone my mom about Easter dinner arrangements.
“I’m not understanding you, Mom. What are you saying?”
“I think I have a bladder infection,” she said weakly.
Her lucidity returned but not to baseline. What is going on? I struggled through my grogginess to wade through her confusion. My aunt confirmed my fear, “Your mom is not doing well!” Hopefully this is only a bladder infection. While driving the next morning, family called me exclaiming,
“Your mom has holes in her skull!”
“She has multiple myeloma,” I replied as my heart sunk.
How am I going to get through this? The multitude of emotions and uncertainty on how to proceed weighed heavily. Sigh.
My mom’s lucidity lasted only 48 hours. The demands of being a daughter and a resident took their toll, and I hit a breaking point. A busy rotation forced me to play telephone tag with her oncologist. Finally connecting with my mom, she cried deliriously, “I think he is trying to kill me.” Attempting to balance the honor for her autonomy and knowing that she needed this treatment, I pleaded with her to consent for plasmapheresis. In the end, I consented.
The cascade of cancer care brought serendipitous changes. The topic of her medical conditions built a conduit for communication. As her blood sugars soared, I coached her about affordable insulin. “Monique, how much should I take?” she inquired nightly to dose her NPH. These talks became part of our emotional lifeline as we chatted about my girls, husband, memories, life, death, and so forth. These shared daily moments catalyzed our new bond.
During my daughter’s third birthday party, my mom judged a Cookie Monster impersonation contest, and we giggled during the raspy renditions of a song. Through the laughter, I could feel the mixed tension building in my viscera. My aunt and I agreed that, due to her declining health, it was time to change mom’s living situation. The festivities bolstered my mom’s spirit, and happy celebrations blended into a placement discussion.
When the oncology team called me months later, “Your mom is vomiting feculent matter,” I knew it was time. Nothing more could be done about her cancer. By this time, I could confidently run a family meeting, and it was the best one I ever conducted. She asked longingly, “Am I going to miss Christmas?” So, our family gathered over her favorite turkey dinner, singing Christmas carols around her bed with pine-scented decorations. She died peacefully 18 hours later. This intense journey solidified my identity and built my competence and courage as a healer. Acting as a daughter and physician from diagnosis until her death transformed me into a family physician. Thanks, Mom.