Last month my elderly mother — she’s in her 80s –and I went to a family reunion where we both caught a nasty case of the flu. I was in bed for two days with a 102 degree fever. I had to give up running for a week, but I managed to recover. My mother wasn’t so lucky. The flu led to pneumonia, and in her weakened state she fell and broke her hip for the second time in three years. The surgery was successful and she was transferred to a physical therapy and rehabilitation center, but at that age you don’t recover easily from a traumatic injury. Her limbs became swollen. She was unable to make progress in physical therapy, and she developed an intestinal blockage, which required a second major operation.
So this is a big part of my life now, walking up the big hill in downtown Summit, New Jersey and taking the elevator to the ninth floor of Overlook Medical Center to visit my ailing mother. Overlook Medical Center is not only an excellent hospital. It has stunning views of Manhattan. My mother is getting just about the best healthcare money can buy. Nevertheless, as she nears the end of her life, my mother is not a happy woman. The American healthcare system is excellent for people who can afford it, but it’s still coldly rational. It treats the body but ignores the soul. The doctors and nurses at Overlook see the world through the very narrow perspective of treating the body. One has an injury. You treat the injury. There are then a series of steps you most go through to recover from that injury. In the case of a broken hip it looks something like this: After you undergo surgery, you are moved from the operating room to intensive care to the cardiac and surgical division back to a regular hospital bed before being discharged. Then you spend the next few weeks in a rehabilitation and nursing home learning how to walk again.
It all makes perfect sense. Who doesn’t want to get better? Back in 2013 when I had a cycling accident and spent three days in intensive care with a severe concussion I couldn’t wait to get out of the hospital. Had they not let me out the day after I was moved to a regular bed, I probably would have escaped and walked to the nearest New Jersey Transit station. But while doctors and cranky middle aged cyclists see recovery as a rational series of steps that lead back to normality, frail elderly women do not. The constant moves, the lack of a regular routine, the inability to get up and walk around, the knowledge that she’s approaching the end of her life have disoriented my mother.
My family is not religious. We don’t prepare for death. It’s not supposed to happen. The result is denial, and my mother, not wanting to face the grim reality in front of her, is beginning to deny reality. Her old habit of repeating questions until she gets the answer she wants is getting worse. She asks me to explain things that I, not being a doctor, cannot explain. When I call a nurse into her room to give a more authoritative response, my mother drifts off into her own world until she can once again ask the same question to me, hoping she can bully me into saying something like “no, you will not have to wear a colostomy bag for the rest of your life” or “yes you are being treated badly by these excellent health care professionals.”
Perhaps it was better when Hospitals were managed by the church. I don’t believe in God, but I do believe in the soul. A purely rational approach to healing based on pushing the injured person through a series of steps on the way to recovery might make sense for a 30-year-old, but for an 80-year-old it almost seems like a death march of denial. So I stay as long as I can and say whatever I can. Then leave my mother’s room and walk down the hall to console myself with the view of the Freedom Tower off in the distance.