Tuesday, July 25
"So, I can stop taking the Decadron, right?"
The question seemed to come out of nowhere as I was sitting next to
him.
I had just given Don an Ativan for his "sundowing" symptoms, an
agitation that seems to seize him in the hour around sunset. I
had asked Maha to get me the pill, and when she handed it to me
I thought at first she had given me the wrong one.
"Is this the Ativan?" I asked, looking at the five-sided pill. "I
think it's a Decadron."
Maha assured me it had come from the Ativan bottle. I asked her to bring
over the evening's Decadron dose to be sure. Then I saw why I was
confused: both were five-sided, but the Decadron was a pentagon while
the Ativan was a five-sided polygon, like the outline of a house with
a pitched roof. I said something like, "Oh, it is Ativan,"
and gave the Decadron back.
It was shorty after that that he said, "So, I can stop taking Decadron,
right?"
The question struck me dumb. For a moment, I blanked.
Don and I had discussed what stopping the Decadron abruptly
would do, how it would lead to rapid brain swelling, unconsciousness, and
coma within a matter of days. Was he remembering those conversations
now? If he was, what should I do, what should I say? My silence seemed to
stretch forever.
Finally, I said, "That's a medical question. I'll have to ask the nurse
tomorrow morning."
He nodded.
A month ago, I would have known for certain what to say because I
would have known for certain that Don knew what he was asking. Don
was always oblique in making personal requests. It was never, "Can
I have some ice cream, please?" but always, "Do you think there's
any ice cream in the house?"
Now, as I sat beside him, I remembered how he would phrase such questions,
and I also remembered the conversations we had had about stopping
Decadron, how some brain tumor patients, worn out by the dying process,
would use that as a means to hasten the onset of coma.
Those are things the Don of a month ago knew all about. But did the
Don of today know them? What should I do?
Maha paused at the kitchen door as these thoughts were passing through
my head. "What's this?" she said, and she stuck out a finger and touched
me on the forehead between my eyebrows.
I had had it with this woman's invasiveness. You don't go about
touching people on the face. Besides, I was in no mood to share
my thoughts. I wasn't even sure what my thought were. I
was only aware of the turmoil within and annoyed at her intrusion
into a very private hell.
So I reached out and touched her on the deep wrinkles by her mouth.
"What's this?" I asked.
She didn't fall for it. "That's different," she said. "That's
age."
I shrugged.
"That was worry," she said, pointing to my forehead, "not age."
I said no more.
That night, after everyone has left and Ré has gone to bed,
I give Don his last Decadron of the day (and another
Ativan) I say, "Do you remember earlier when you asked me if you
could stop taking Decadron?"
He nods.
I take a breath. Can I word the next question neutrally enough?
Don is apt to say "yes" to any question properly phrased. I decide
I can't come up with neutral wording and I don't have the courage to ask
him directly. So instead I ask a different question. "I said I'd ask
the nurse in the morning. Do you still want me to do that?"
He nods again. The house is quiet for a while.
Then I say, "I'll ask her. We won't give you any
medication you don't want to take, okay?"
Nod.
"You're in charge here. We'll do what you say."
And that was what I had told him those
many months ago:
I would honor his request even if it was not what I wanted.
Of course, it could be nothing. He could just be mirroring, something
he's done a lot of lately. He might have heard me say something about
not needing the Decadron now and interpreted it as not needing it at all.
Getting off Decadron has been our goal three times before and perhaps
he simply thought we were starting another tapering schedule. Perhaps
he heard the concern in my voice and inferred from that that giving him
a Decadron would be a bad thing. Perhaps he was just rhapsodizing
on the last word he had heard.
Or perhaps he meant it. And if he meant it, could I do it? I had talked to
Rémy about this just the other day. I said then I didn't think
I could, but I didn't want to rehearse that dreadful decision ahead of
time. But now, it looks like it might be time. I would have to make
good on my promise.
Earlier that evening, Rémy was helping me prepare Don for bed.
As we leaned over him, getting ready to use the draw sheet to move him
upwards and center him on the bed, I told her, "Grab the sheet as close as
you can to the body."
She had grabbed the edge of the sheet. "Close?" she asks.
"As close to the body as you can," I say.
Beneath us, Don raises his hands. "Hey," he pipes up,
"I'm as close to the body as I can get."
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