December 01, 2004

In late evening the night nurse called, to ask what she should do, for my mother had started screaming at her and would not let any of the staff anywhere near her: for she had hallucinated her sister and her father, and had come to the belief that the nurses were keeping her from them. Remembering standard nightwatch policies (for I had worked them for others before), I went in to pull the all-nighter and watch over my mother so as to forestall the impersonal plastic restraints and security guard.

From too many people in my life, as well as from my own studies and line of work, I have learned too much of what brain tumours and metastases can mean. My father has not, and has encountered only the simplest (if perhaps harshest) of her newer delusions: a complete inversion of balance, such that she firmly believed she was standing and about to fall while lying flat on her back in bed; that the rest of us, standing or sitting, were in fact lying down; and that I was doing this to her deliberately.

For the first part of the night, I managed to identify a few of the many people who peopled her waking dreams. (Oddly enough, I found myself among them even when I was standing right beside her.) For the second, she trusted me sufficiently to play with her a game of "real"/"not real", where she would look at me for guidance as to whether a particular item or person she saw had any objective solidity, and I would run my hand through the space where she reached for it and vaporise it.

The last two hours before dawn she spent shrieking curses at me for forcing her into that terrifying state of almost-fall, or pleading desperately with me to stop doing it. She did not fall asleep; but she lied and smiled to the nurses after I had to leave, while quietly clinging white-knuckled to the bed side-panels.

The next night, I found myself this time requested in (despite the carrying results of the last few hours): running on two full days without sleep at this point, and counting. The hallucinations at this point were far too established to even begin to question, so instead I managed to discover the pattern of the newest one and to help her turn it to something relatively constructive. Even as I gave myself and my absent father an identity within that construct, both of "us" interacting with her to clean out and sort the contents of a mass of shelves, I recognised the metaphor implicit within it: and I helped her work to achieve its completion.

A quarter of an hour after finishing, an hour before dawn, she began a pattern of agonal breathing. The staff thought an hour, maybe two at most. I called my father in. He arrived three hours later, three hours of my having told her alternately with every breath that I was with her, that my father was not yet, if she could stay with us just a little longer, just until he arrived ... and then I was even at one point laughing with her, telling her that it was all right, that she was doing well, in the way an obstetrician tells a labouring mother that she is doing well.

After still another hour of gasping breath, her breathing finally lost the rasping rale. She may even have fallen asleep then, exhausted from days upon days of non-sleeping and very active hallucination. Her breathing eased. Slowly, almost imperceptibly, her breaths grew shallower, until a breath settled into stillness ...

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