A Matter of the Heart

My mom is approaching her 90th birthday, a greatly anticipated event. But two weeks short of becoming a nonagenarian,  she wakes up weak, disoriented, barely able to walk. The sun rises over the trees as I back out of the driveway to take her to the ER. As I look at the sky it dawns on me that I may have to make some very hard decisions today. Be strong. Be prepared. Over the past seven years of having mom in my home this route to the ER is not unfamiliar. Instinct is now trusted, not questioned, for I drive her directly to the hospital and not to her primary doctor. Here they will be able to do the bloodwork and tests that will probably tell me it is a UTI (urinary tract infection) that is causing her weakness.This time it is different. This time there are more tests. An EKG, an echocardiogram. More blood tests. An chest X-ray. A CT scan. This time it is her heart.Her heart.For 53 years, this woman has been my heart. The center of my world. My cheerleader, encourager. The one who loves me completely. The one who knows my heart. And today they tell me something may be wrong with her heart.And my heart breaks. Completely and physically. Thankfully my friend is on duty as an ER nurse today. Another nurse witnesses my breakdown and tells her, "You better go see your friend." She comes to me, and I crumble in her arms sobbing to her, "I don't know what to do, I don't know what to do."After seven years of caring for mom and learning more about Alzheimer's, Parkinson's, hypertension, I take in loads of information and try to process all the scenarios. Knowing what to do is a priority. In my head I know all these diseases are progressive. Our goal is palliative care and quality of life. But when the actual moment comes when a decision has to be made about the condition of her heart, I am lost. I am undone.The decision ahead is: do we do a heart catheter to look for blockage. Do we put in a stint. Do we choose relatively simple procedure? Is it worth the risk?Head spinning, I walk outside. Again I break down in tears, pacing the pavement in front of the ER doors I walked in hours ago, so distraught that the attendant that helped me wheel her in now walks over to me silently with a box of tissues. Driving here I had a feeling I would have to make a hard decision, but not this one: do I make the choice to give her a simple procedure? She has a living will and a DNR, decisions she made herself years ago.The weight of this decision is to heavy for me, and I gasp for breath in between sobs, taking in air, anything to clear my head to help me think. I can't think for myself, so I call others to help me think. Information, I need information, so I call trusted physicians, my cousin, my friends who dearly love my mom, to help me confront this dilemma: how do you choose what is right spiritually, medically? How do you choose what is right for mom's heart?Mom has been the heart of my family, my extended family, my friends' families, for as long as I can remember. Even with clouded memory, her heart and spirit shine from her frail body. The chaplain is called to pray with mom, to pray with me as I am completely distraught. He comments on her beautiful spirit. He reminds me her spirit is strong, her spirit is eternal, and any decision we make today will not affect her place in eternity. His prayer moves me to call my dear pastor friend, one I know has walked this hospital floor many times. Although he is far away my friend sings Amazing Grace over the phone to Mom as he has many times for her at the piano in my home. He reminds me that God will make it clear what is the right choice through the people around me. He encourages me to let go of the burden of carrying this decision.Through God's amazing grace I look back on the course of the day. On words spoken through those placed around me to remind me of his grace....a nurse,  the friend I watched pour through textbooks, studying to get her RN now encouraging me, God knows her days, He has them numbered, and it does not look like it will be today. She tells me if I made it here today just to tell you this, then it was worth it....a neighbor, a friend who for the past five years walked next to me and with me through the valleys and crags of caring for someone with Alzheimer's. She reminds me to do what is best for Lola, what would make her the most comfortable.......a physician, a friend who stood with us during my father's battle with cancer, reminds me mom's days are not determined by the decision we make now. Her heart loves God completely and her days are not determined by the physical condition of her heart which may not withstand a procedure.......and Mom telling me, looking me straight in the eye, telling me, she is ready to go. To go to heaven. Even as she lies in the hospital bed, she reminds me, God is so good to me, He will take care of me.And He does.He makes it clear.Choose Life.John 10:10 says I have come that they may have life, and that they may have it more abundantly.For 89 years mom has lived an abundant life. Loving abundantly. Serving abundantly. Giving abundantly. Teaching abundantly.Her life is abundantly full of people she has loved, touched, changed, believed in. Her life is not determined by a frantic choice in an emergency room. And by God's grace, I do not have to make the choice. Hours after reviewing all the tests, her cardiologist makes the choice for us. Her body, her kidneys, may not be strong enough to withstand a procedure.Without intervention, her heart will function. It would be better to let things be, than to try find a blockage and remove it. It would be better to keep things as they are than to try to fix it and possibly cause other complications.Even after the mild heart attack, the echocardiogram shows her heart is strong, the squeeze of her heart still pumping life strongly through her veins.At her beside the cardiologist reports despite what has happened her heart is quite strong for a woman of her age. Remarkably strong actually.I smile and squeeze her hand.Of course it is.It always has been.