Easy to die hard to say goodbye

ST-LUC THE PHYSICIAN CHAPEL WINDOW

EASY TO DIE HARD TO SAY GOODBYE A DIARY BY DARYL ZOELLNER

PATRICIA ANN MARTIN’S SURGERY AT THE FOOTHILLS HOSPITAL

EASY TO DIE / HARD to SAY Goodbye “Unable are the loved to die, for love is immortality.” ~ Emily Dickinson

A diary, by Daryl Zoellner, April 27, 2011 – June 8, 2011.

Preface “How’s Mom doin’?” This question would be frequently the opening line of telephone or computer conversations held from April to June 2011, so I decided to send my family these daily e-mail reports of my observations, my research and my thoughts about my mother’s recovery from bowel resection, C-difficile infection, Vancomycin resistance (VRE), colon removal, ileostomy, anorexia in the elderly, and image guided aspiration of puss in the abdomen.

My husband spent 10 days beside me as we sat with Mom in the Foothills Medical Centre in Calgary. He also travelled to Quebec City, Montreal, and Cornwall and my brother, who at the time was dealing with water retention and clotting in the blood vessels of the leg and unable to join us, was in Lunenburg south of Halifax, with his wife, Jill, for medical treatment. He also drove to Charlottetown to promote his music. My sister, who lives in Calgary, usually took the morning shift as we supported my dad to keep vigil over Mom. Her husband, Don, was sometimes in Fort McMurray and in Idaho for various job related sales and services. Other family members live in various places in Kelowna, Calgary, Ottawa, Montreal and Quebec City.

There are different means to hope. The human eye will depend on one means to hope. The electronic “eye”, the microscopic “eye”, and the x-ray “eye” have their own hopeful means as well. To add to these, there is an unveiled hope on which my life is grounded. It is my mother and my father who introduced this invisible hope to me. Their conversations with me helped me see through the eye ‘that has not seen’ and hear through the ear ‘that has not heard’ - all the wonderful things the Lord Jesus has yet to give. I heard the stories of Jesus from my parents at an early age. My future hope is this earth, as beautiful as it is, all wonderfully restored with no pain and tears and death. My future hope is heaven, never ever being separated from self, from others, from God, from the beautiful earth that will benefit all God’s new creation, always contained under that canopy of God’s rule and sustenance.

The human eye is but a small part of the body. It is made of tissue and blood vessels. Our eye is highly overrated. It cannot distinguish hope from meaninglessness. I look at a shrivelled body that has been horribly compromised by incisions and drug therapies and possessing diminishing immunological and nutritional defences, a body that is naked yet not shameful; hungry yet perpetually satisfied. “Best be going!” is one of Mom’s rote sayings before parting. She remarked one day after her emergency arrival at the hospital that she didn’t know how hard it is to say goodbye when one is close to dying. Roger Nicole, my husband’s friend and a Christian theologian, wrote before he died, “I didn’t know how easy it is to die.” As for myself, I didn’t know how easy it is to want our immortal bodies and yet want the comforts of this life at the same time. God knows how to satisfy both desires. He tells us to cover our eyes. He has a surprise for us.

Pull yourself up by your own bootstraps, Mom! Use a little bootstrapsa! The phrase finder (http://www.phrases.org.uk/meanings/290800.html) says, “The origin of 2 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

this descriptive phrase isn't known. It refers of course to boots and their straps (laces) and to the imagined feat of a lifting oneself off the ground by pulling on one's bootstraps. This impossible task is supposed to exemplify the achievement in getting out of a difficult situation by one's own efforts.” One of Mom’s favourite jokes is, “It’s not the cough that’ll carry you off…it’s the coffin they carry you off in!”

In martial arts studies, I learned about the life force described by the Chinese as Qi. There is a tipping point in health care when the patient is able to direct his or her own care once again from an inner will to live. I learned in martial arts defence to look beyond the visible goal to a further invisible goal; beyond the board I am about to break with the side of my hand to an imaginary stopping point for my hand to rest. Mom’s Qi or bootstrapsa returned to her through confrontation, “Pull yourself up by your bootstraps now!” and she made it through many obstacles of microbiological warfare by keeping her eyes fixed on the ultimate goal of her faith, the ressurection of her body.

Remarkably, my mother in her early stages of dementia, and as a result of anaesthesia, had no lasting memory of where she presently lives. As a result, she willed, through her present trial, to “go home”, wherever that hospitality might be. Dad, Judy and I wanted her to choose her present home. My Alberta-born father printed seven images of different rooms in the wheelchair accessible South Calgary condo they live in and taped them to the wall beside my mother’s bed, but we slowly realized that my mother knew she had other choices. She was a free woman and a child of God. God could take her home, she could go into a hospice or remain for a prolonged stay in the hospital. It all depended on the best-suited hospitality presented to her on any given day. Dad agonized over this. He is not one to enjoy competition.

“Doctors have a 100 % failure rate - we all eventually die,” said the Dean of students at our son’s convocation from McGill University’s music program several years ago. The Dean was bemoaning the inestimable amounts of private donations to university medical faculties and trying to solicit money donations for the music faculty.

Music seems to last forever and the ears that hear it seem to pass on too quickly.

Lately, my mother almost met with that one fatal calendar date assigned to her.

Her warfare was against a multitude of invisible enemies that were about to do her in. To illustrate her ordeal, I will quote from an article printed in 2010 in Scientific American magazine, include research I found on Internet sites, insert correspondance from family members, include some photos and illustrations and recount my own vigil of 45 days.

Legend: ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

3

♣ Stopping Infections: The Art of Bacterial Warfare New research reveals how bacteria hijack our bodies' cells and outwit our immune systems--and how we can use their own weapons against them. By B. Brett Finlay | February 15, 2010 | 9 retrieved June 5 2011 from http://www.scientificamerican.com/article.cfm?id=the-art-of-bacterial-warfare “Most bacteria are well-behaved companions. Indeed, if you are ever feeling lonely, remember that the trillions of microbes living in and on the average human body outnumber the human cells by a ratio of 10 to one. Of all the tens of thousands of known bacterial species, only about 100 are renegades that break the rules of peaceful coexistence and make us sick.

Collectively, those pathogens can cause a lot of trouble. Infectious diseases are the second leading cause of death worldwide, and bacteria are well represented among the killers. Tuberculosis alone takes nearly two million lives every year, and Yersinia pestis, infamous for causing bubonic plague, killed approximately one third of Europe’s population in the 14th century. Investigators have made considerable progress over the past 100 years in taming some species with antibiotics, but the harmful bacteria have also found ways to resist many of those drugs. It is an arms race that humans have been losing of late, in part because we have not understood our enemy very well.”

I have grateful memories of Dr. Toshiya Yamamoto, my Microbiology professor at the University of Alberta in 1976. He introduced me to the most sophisticated microscope on the market at the time and gave me an eye for the nearly invisible.

I want to thank the staff on Unit 102 in the Foothills Medical Centre Calgary, Alberta Canada for taking up their battle posts honorably and with great enthusiasm and dedication against the invisible enemies of the flesh that threatened a neighbour, friend, sister (and for some, a sister in Christ), mother, grandmother, great grandmother and spouse, Patricia Ann Martin. You know who you are. You work wonderfully and harmoniously together. I wish you much success and satisfaction in your future work.

Alberta Health Services (AHS) is the provincial health authority for overseeing the planning and delivery of health supports and services to more than 3.5 million adults and children living in Alberta. It is my wish to give 50% of the proceeds of the sale of this diary to the AHS and 50% to the Quebec health and social services agency to help us care for some of our loved ones, most of whom do not live in Alberta.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

4

♥ After an urgent message for me to get in touch with her, Judy Simmons wrote : Dad just called. It’s 1:40 pm April 15 and she [Mom] is out of surgery. Doesn’t sound like they did anything except spring cleaning. The leakage was coming from the colon. Dad hasn’t seen her yet. She is still in recovery, but her blood pressure is good and they did attach a colostomy bag. So that is all he knows. He is going home to get some sleep and will call me later…Let me know when you get this. Judy.

Dad seems to think he will manage with so many people in the church offering to help, so I will let you know what Mom's feelings are on the matter (about you coming).

She may just want to be left alone if she is tired. This week will be the most exhausting for Dad and even if I do go up there alot he seems to feel he should be there most of the time soooo it will be hard to convince him otherwise. I will let you know when I come back from the hospital and what they think. Judy ♥ On Sat, Apr 16, 2011 at 4:06 AM, J. Clare Martin wrote: Dear beloved family and friends in Christ. I woke up early this morning (Saturday) after sleeping about 4 hours trying to make sense of what has happened to my beloved wife. But even more what happened to me yesterday to not have any strength left after about 40 hours without sleep to not stay there at the hospital and care for her. I was so exhausted from trying to be there to help her that I just had to leave without helping her get settled into the room she was assigned. When I phoned the unit after I was home to see if she was there from Post Op Recovery for more than 4 hours, they let me speak to her, and I now am so overwhelmed with guilt and grief over her remark to me (without her teeth), "I wove you Clare," that I had abandoned her to the Foothills graveyard where people go to die! And I can only think that I must go back there and take her in my arms and watch over her until she heals. She has had so much pain in the last 48 hours, that I can't even imagine having that much myself without dying, and has survived to be able to say those words, that I have broken down in tears at having utterly failed her. And I am trying to figure out how I can do go back and take her in my arms, if she is still alive, without killing her with more pain from the hug. When I asked her how it was, she whispered, "painful." Perhaps this will teach me to know what it means to really love someone with unconditional love. My eyes just now have turned to Christ who died for me because He says "I WOVE YOU." I just phoned the hospital and one of the girls there told me that she had just checked on her and said that Pat was sleeping and was resting comfortably. Is this the same case senario as in the garden when Jesus returned from His prayers to say to Peter "Could you not watch with me one hour?" (Matt.26:40). But I am relieved that "my beloved" is still alive. ♥ On Sat, Apr 16, 2011. Daryl Zoellner wrote: Hi Judy, I was just talking to Mom, then Dad. Mom recognized me I think, but she said it bothers her that she is so confused. She would love to be able to think straight but I don't

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

5

know if she ever will be the same in terms of memory. We'll see when the drugs are removed slowly.

It seems like a good idea for me to come out there and stay with Dad for a week or two until he gets enough rest to see things clearly and until Mom is released from the hospital. This could be as early as a week from now, Dad thinks.

She will have the bag for at least a month.

People in the church can help after that. For now, they need some family around to make them feel secure.

I would like to check flight schedules first but the airlines (Westjet) might let me take the ticket I have already bought for July 25th and apply it to this trip instead of having to pay full last minute fare.

When I get there I could go directly to Fish Creek/ Lacombe Station or get you to pick me up. Maybe I will call Ken and Margaret Moore.

Dad seemed to not be opposed to me coming and thought Mom would appreciate that. How much time do you have?

Daryl ♥ On Sat, Apr 16, 2011. Judy Simmons wrote: You can let me know when you are coming. Right now I am driving Justin to work every day down to for 8am start time until he finds an apartment down there ...he is still in a walking cast and has an appointment on tuesday am April 26th for another xray and removal of cast so let me know. ♥ On Saturday, April 16, 2011 at 12:22 PM, Daryl Zoellner wrote: Hi Judy, I am not able to leave here until I finish getting the x-rays for my recent back pain. I went to the Dr. on Tuesday and had x-rays next morning. I have had a cold as well and so people are bringing me food. It looks like we are a sad lot. I need to get an MRI on my backbone and I should start exercises or physiotherapy. I had a long hard semester of 4 full time courses and a practicum with 10-12 year olds at a community centre. There was a lot of carrying of books and materials involved and I ignored my back for too long. So I will see how things look and by Thursday I should be able to make a decision. The kids are all getting together for an Easter Brunch on April 25th (depends if Ed and Sara have a new car or are not doing an open house for buyers if they end up coming from Ottawa to Montreal).

Daryl ♥ On Monday, April 18, 2011. Judy Simmons wrote: I feel much better today about Mom. She is sooo much more with us now and even followed my crass humour hahahaha. Met surgeon today and he says she is doing well but will probably not be eating until the end of week. She will be there for at least 2 more weeks. She will be keeping the bag guesstimating at least 6 months til they will 6 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

think about hooking bowel back up so she will have to get used to it and does not seem upset about right now. She was in pain today because they have to remember to give her some pain killers before they make her get up for her walk and she was quite out of breath. All in all her mind was sharp today which I am so happy about…thought we had lost her completely there for awhile. Judy ♥ J. Clare Martin wrote : To all those who want to know the events that led to Pat's surgery last Friday April 15, here is a summary of the events.

About 2 hours after having a light lunch on Thursday April 14, Pat came into our office and told me she was experiencing severe abdominal pain. It got progressively worse until she was bent over and in agony. We went to the local South Center Medical Center which has an Urgent Care Unit that we have used for some medical emergencies before. They gave her some morphine to try and alleviate the pain. It helped some but they weren't able to find the cause. They decided we needed to go the the main hospital in Calgary (Foothills) so got an ambulance for us. We arrived at the hospital about 6pm.

She was put into a bed where blood pressure etc. were monitored while we waited for a doctor to examine her. That took awhile but finally one showed up and sent her for xrays. That did not show anything so we went back to Radiology for an ultrasound. That showed that there was something wrong with the bowel, namely that there was a rupture and was leaking waste into the abdominal cavity, causing infection, and thus the pain.

They could see over a short period of time that her blood pressure kept going down and the heart rate was going up. So we were advised that they needed to do surgery quickly to stop the infection from getting any worse. So by about 8am they proceeded to discuss what was needed to be done and scheduled surgery for 11am. They took her into OR and performed the surgery which took about 2.5 hours. After surgery she was placed in the recovery unit connected with the OR and was there for quite awhile.

Meanwhile, I was informed that the operation had been completed and had gone well. I was advised that she would be placed in a room in Unit 102 on the 10th floor which is designed to receive patients with these types of internal problems. I went there to wait for her to come so I could help her get settled, but was so tired that by about 6pm I had to leave. I got a taxi [that a nurse’s fund paid for] and went to pick up our van and get home. I called the unit where she was to be and they had got her into bed. The staff (Nurse Irma) told me she was resting comfortably. So I was able to get to bed for a few hours before getting up and going to the hospital to see her. Since then she has been making steady progress.

Thankyou for your love and prayers for us. We are encouraged that the surgery was successful that the massive infection caused by a malfunction in the waste management system cleaned up. A new company has taken over and has installed a new system. The problem with it that it has been designed by fallible engineers, so isn't as good or efficient as the original one designed by the Creator. The original system failed because of the polluted environment in which had to operate. As you know the pollution was caused by the early take-over and attempt to operate without the infallible engineer's oversight and plans. So by breaking the rules, the inevitable failure of the system has 7 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

happened in some of the original units. This secondary system requires more effort on our part to make it work. We are hoping that once things are cleared up and going well with the patient that perhaps the original system might be re-installed. Only time will tell if that will be possible. Clare ♥ On April 20, 2011. Judy Simmons wrote : They started her on liquid diet yesturday but she didn’t have much.....she is just happy being able to have water to drink but would sure enjoy a nice cup of tea. Dad said maybe he can take her down to cafeteria today for one. Judy ♥ On April 24th, 2011. J.Clare Martin wrote (to his three adult children & families): Hi everyone, My beloved had a good day today, Easter Sunday. My bus driver was excited when I asked him if he had been to Church today. "You are a Christian too ?" He wrote down the Bible passage I shared with him. He said he went to a Good Friday service but had to work today. I arrived at the hospital at 9am. Pat was calmly waiting for me to come and was happy to see me. We enjoyed a few minutes chatting and then had a time of worship together as I read John 20 and we prayed and talked about the resurrection.

She was still having a few stomach cramps but with some help from médication, that was aleviated. Through the morning we talked about various things. She was alert and I was able to share some thing I was reading with her. She was stronger than she has been since the operation. After the nurse had lunch, she and her helper gave Pat a sponge bath. One of our neighbours came as promised and we were able to go for a walk with Pat and sat in an area near the elevators and talked for awhile. When we got back to her room I helped her get into bed. She was ready for a rest so the neighbour and I left for home. She had driven over so I got a ride home with her. Much quicker than the trains.

I hope all is well with you and your familes and that you took time to think about the Easter message of resurection and life.

Dad

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

8

♠ Beginning of Diary. Thursday, April 28, 2011. Recounting 45 days by Daryl Zoellner I arrived at the Foothills Hospital at 1pm from Montreal. My sister, Judy, and niece, Amy, drove me from the Calgary International Airport. Judy was careful to make the right turns. She hates driving. Traffic, Calgary skyline, parking, luggage, elevators that took 15 minutes before we were on the 10th floor.

The first thing Mom did was lift her sheets and her issued gown and show me where the colostomy bag was attached. “Isn’t this ugly?” she asked me. Pretty mother, abused, tube in the arm, out the nose, out the bowel, getting cleaned from inside out, getting nourishment from outside in.

The second thing she did was ask to go home. I could tell she can’t get used to this public bedroom. Only Dad goes into her bedroom at home.

The third thing she did was ask about my flight and then we talked. I told her it was time to learn how to paint. I need students now that I am becoming an art educator.

She had to think hard about whether she is bored. “No”, came the firm answer. “I am sick, very sick.”

The main points of pain are her abdominal connection to the colostomy bag and the severe diarrheal cramps from the nourishment taken through her IV in the right arm.

Rhonda, the nurse from Newfoundland, said it was to be expected, until she can eat solid food. I conclude that her stomach and intestinal linings need to be reconstructed, a process none but her own body can do for her. When she begins to eat and digest, she may go home. Nurse assistant, Julie, prescribes a week in the hospital under surveillance and coaching and patience. The exit goal is Wednesday May 4th.

Mom made no errors in logic or comprehension. Dad can’t hear her very well, but they succeed in communicating…eventually. I pointed out the flower vases that had no more water in them. Dry Calgary air. Dad found a cup and took care of managing the task. Male caregivers just need tasks, so I am told. Lots of cards and flowers from friends.

Amy Simmons opened the venetian blinds before she and Judy went off to Amy’s third job interview in one day. They left a large lunch bag of pickles, turkey sandwiches and drinks. I thanked Amy for carrying my suitcase.

I learned where to locate the family lounge, the public bathroom and the 1$ fundraising snack basket at the nurse’s station right outside the door, not to mention bystanders like the friendly old logging truck driver from Cranbrook waiting for his wife to come up from the recovery room. Every husband hoping to recover his wife. In the lounge, Dad sat me down and he told me his initial ordeal all over again.

The Lebanese man, a Catholic who prays for fellow patients (when they pray too), has been released from bed 1060-1. Now Janet, a woman with pancreatic cancer has entered the scene. It should make Mom feel better to have a mom next to her. Adult children came and went while we were there.

Dad and I stayed to see Mom get up to use the bathroom and take a second walk that day around the nursing station (with nursing assistant, Rose). “Urea cream best on her bedsores,” she said. (Not Crabtree & Evelyn hand lotion grabbed from home). My suitcase under the bed confused everyone for awhile. The bed would not descend. I love warm flannel blankets draped over me when I am cold too. Mom gets cold when she is out for her walk. Rose tucked the blanket around her. Mom is due to walk again this 9 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

evening. She tolerates this routine parade around the 8 to 10 staff members at the station.

She knows it does her heart good. She hates wetting her “pad”. She was glad to see me. I was checking to see if I could stay a night. Lots of gurneys and one sleeping chair in the hall.

At 3:45pm. there was still a red helicopter on a platform near the emergency door. Dad and I found the van (whew they didn’t tow it !) and drove back to the condo. $13.50 for a day worth of parking at the hospital. Calgary skyline, no more rain on the windshield. He knows what he wants for he and Mom. Her… home. He already takes care of everything else at home (except the laundry) because of her fatigue. She should be less bothered by the 4 month fatigue caused by the infection, once she is back on her feet. I bought public transit tickets for tomorrow. 10 tickets for $24. ♠ Friday April 29th, 2011. Ste. Catherine of Sienna’s Day, Kathryn and William’s wedding day, day of hope.

Yesterday, Dad and I took the train to Lion’s Park Station, then hopped onto bus 40. It was snowing and it snowed all morning.

Mom started out talking about a fear from a dream. She thought I had left yesterday on an airplane to go home. Mom had a good night otherwise.

Nursing assistant, Rose told us she was from the heart of Africa. I said, oh!

Congolese? She wondered how I knew. Mom had come from her shower. Her hair was still wet as we sat out in the hall.

Back in the room, Nurse Rhonda gave us the day’s activities and a progress report. She gets a lipid rich liquid by IV that smells like baby formula. She has an antibiotic every 8 hours which takes one half hour to go through and she has a mild pain killer and some sodium chloride (Gatorade water) going through. Her colostomy bag is not attached to a pot but is now stable and independently cooperating. Early morning blood tests showed there is a need for a potassium injection. Mom will have a drainage tube removed from her nose tomorrow (Friday) but they will put it back if she gets nauseous. There is a cancer treatment on her right nostril which makes it sensitive under the bandage. She is going to be brave, she promised. Her ostomy had gone from 175cc to 600cc., quite a big deal…on the way to eating.

We met her new friends on her first walk, a Chinese family from Thunder Bay. The mother (54) went through a similar surgery. The daughter, Amy, Skypes her three children from her motel room, where she and her father are staying. She promised to give me the hospital access code password.

I showed Dad some family photos on my laptop when we returned from a tour of the cafeterias below. Then later I showed Mom my Christmas videos of the family, still photos of Erin’s thirtieth birthday and recent ones of Adrien, Clara and Beatrice. Mom was so excited. Dad is telling church friends how much she has returned to her usual self. He stayed until 2pm. after we had eaten the lunch Judy gave us yesterday. He forgot to tell Mom about the two (Easter) rabbits outside the patio door at home.

She later got up from her one and ½ hour nap (tucked in warmly on her side). I sat with her outside her room, a pause in her 2nd promenade of the day. I forgot to plug in the liquid nourishment, but a little girl directed me to the electrical outlet. I gave Mom ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

10

backrubs while she sat up so she can get circulation back. She has breathing exercises to do. Very few stomach spasms today.

Mom’s pain is not as high as I had told my brother, Carl. She is closer to a 2 or 3 out of 10, according to Dad. Her greatest inconvenience today was dry lips. Grape Lysol did the trick. She doesn’t ask for pain killers.

She shooed me away and wanted to take a nap around 4 pm so I came back to Fish Creek. Everything coincided with good order just like the Royal Wedding. Yes, I was watching it as I wrote this. From royal entries in Bentleys to Royal Air Force winged salutes over the balcony kisses to Royal toilet tissue commercials from the PBS/BBC news station. All was recorded for Mom to see when she returns home.

I talked to my aunt Joan and to Nancy Whitham on the phone later and gave them some news.

Lots of snow forecast for all day Friday. The sun came out in London. Not a drop of rain. ♣ The rain it raineth on the Just and on the Unjust Fellah But chiefly on the Just because the Unjust has the Just’s umbrella.

-Lord Byron ♠ Saturday April, 30, 2011 Dad went up early to the hospital (in the sleet and rain and snow at 3o C). I had to get a watch battery at Sears at North Hills Shopping Centre so I took a later train. I got a Mother’s Day gift and my lunch at the deli at Safeway too.

Dad had left by the time I got there 10:45 but Mom was on her early walk.

Lesley, the dietician said they had advanced her diet, so she is getting more to eat (sort of). She hinted that Mom will be in for “a little bit longer” – until Monday, for sure when Lesley will be returning with diet information papers for her.

Magda, who is in charge of teaching about how to care for the colostomy equipment will send Julie or Jen on Tuesday at 10 am to review changing bags with Dad and Mom.  For more info on this I refer to www.medicinenet.com/colostomy_a_patients_perspective/article.htm. ♠ Yesterday, Mom’s 18 staples were removed. Today, it was the tube in her throat.

She had beef soup broth, tea and jello by the teaspoonfuls. Then when she came back from her walk she had some apple juice.

I made sure she had everything nearby and the nurse’s call button at hand when I left. She was to get a new roommate by the time she woke from her nap.

I came home and spent the evening talking to Dad who is relieved that the tax deadline has been extended until May 2 (after the elections). He is filing online but receives a small US pension that he doesn’t know how to file because of the exchange

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

11

rate. I assured him if he doesn’t have to pay any taxes, Revenu Canada is not in too much of a hurry to get his tax form.

The resident doctor, Dr. Maclean, came on duty and introduced himself.

I am looking forward to seeing Mom get through to Wednesday. She is picking up but still has short term memory issues.

Daryl ©http://www.youtube.com/watch?v=OoYf2hNFMDA Sunday May 1st, 2011

Maypole or Whitsun pole ♦ Sing a Whitsun song for Mom who has been married for nearly 57 years. ♠ Dad and I went up to the Hospital in the car. I was surprised at how empty the parking lot and hallways are on the weekends, a sign that a lot of the work goes on through outpatient services.

Mom slept fine through the night. This caused her to stay awake a little more in the afternoon. She was bright and cheery and smiled a lot today. Mom still speaks of no pain and has no painkillers. Her appetite has returned and she ate lunch while I was there. She bowed to thank God out loud then ate 125 ml. of vegetable soup with crackers, half of a tuna sandwich. I got philosophical all of a sudden and wondered where that fish swam or where the field of grain grew; where the seed for the vegetable oil in the mayonnaise had grown? What cow or sugar cane gave the milk and sweetener to her pudding? Under the sun in what far away country, did her tea leaves grow?

Mom’s entering that stage in life where she doesn’t have to keep track of anything anymore. Where was that sweater I bought for her and where was that pair of green slippers she couldn’t remember I had placed? The psalm Dad left on her table was new every time she looked at it. She tried to plan the meals for Dad and me and asked once in awhile what we were having for supper, as if she needed to make it. Will coming home be possible soon? The new doctor on call said it will happen on his shift (within one week). She would like me to stay forever, she said but that wouldn’t be good for my ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

12

family. Is it because she likes my curly hair? This is what she notices every time I come in the room. “You have such nice thick hair.”

The biggest challenge today was incontinence but I got her to the bathroom in time twice. She has to have her pole unplugged and then get her slippers on and the Attends has to be managed.

I am starting to pay attention to storing items so they will not be stolen. Flowers are my main upkeep besides Mom, and, of course, my tiring self. There is a lounge for families and the chairs are comfortable enough to nap in. One woman and her 17 year old son were in the room when a nurse came to tell her she hadn’t driven all that way for nothing, her husband survived the heart operation. She was in tears. Her son was just waking up from a siesta and shared her moment of joy.

On one of her exercise walks, I stopped Mom along the hallway to show her the Digestive Tract Disease Chart. Gall stones, Polyps in the Colon, Appendix, Peritonitis, Pancreatitis, Diverticulitis. I want more than ever to treat this system right!! You can’t just throw anything into it like a garbage can. ♥ On Sunday, May 1, 2011. Carl Martin wrote: Daryl, Does Mom speak about Judy or me at all? I am curious to know how her mind perceives people or events beyond her own situation (a true sign of spatial thinking).

I like your "through my eyes" commentary. Induces a 3d thought pattern.

Keep it going, thanks, Sent from Carl's iPhone. ♦ For diagrams on the digestive system I went to : http://catalog.nucleusinc.com/generateexhibit.php?ID=10797 and (see next page)

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

13

http://www.find-healthy-food.com/Diseases-Conditions/diseases-of-the-digestivesystem.jpg ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

14

♠ Monday, May 2, 2011. Voting Day… Osama Bin Laden’s Last Day… .

Dad and I had carefully planned yesterday. Judy agreed to spend some time in the morning with Mom. We went to the church for 10 o’clock. Dad was greeter, usher and attendant at the Lord’s Supper. Reverend Frank Lanting took the words of Jesus after the resurrection and is doing a little series. He used “Don’t cry” last week. “Don’t doubt” this week. Friends were genuinely relieved to hear of Mom’s successful operation and pray she will recover quickly. Mom once was a caregiver for Pastor Lanting’s mother-in-law, Johanna, who has since passed on.

We went straight to the hospital and arrived in time to have a long lunch with Mom. She kept saying how much she liked the turkey sandwiches. Her desire to “just go to sleep” may be a sign of self pity or depression. She was hot so she pulled covers away but her temperature is normal and she has no infections (we thought!). We stayed a little after lunch and then let her go to sleep. Normally about this time of the day she is worn out since she is awake early.

Next Dad and I had a chance to go home and get some rest. I slept for two hours.

We had a snack and then went to a 5 pm prayer meeting at the church. I gave a report on our work in Quebec and explained the connection to Jan Buchanan and our west Africa trip. I mentioned the Woodgreen /Boisvert connection. We prayed for many other subjects that were on a printed sheet. I also shed a few tears as I remembered what it was like to be mentored by the McCauleys, Mercers, and Jewells back in those early days in the 1980’s when we were in our twenties. Afterwards, I talked at length with a family who had lived 11 years in Montreal and I answered questions and showed pictures (of children and grandchildren) on my laptop to Rich and Jessie Mercer. They were most interested in downtown Montreal.

The rest of the evening included a light supper, a phone call from Garnet and some lunch preparation for today. We caught the two speeches by Barack Obama and Stephen Harper and went to bed. So the terrorist from Saudi Arabia is found murdered.

The invisible terrorists here in the hospital are more destructive than he. Yet, all will be measured by Christ the righteous.

If any of you wish to call Mom she is on the 10th floor, Unit 102 in Room 1060 bed 2.

1-403-944-1335 ask for Unit 102.

Today, Dad was at the voting station working as a Returning Officer, overseeing and counting the ballots at Woodgreen Church’s federal election polling station. He finished late in the evening. Dad and Mom are in the same riding as Prime Minister, Stephen Harper whose Conservative Party hopes to receive a majority win.

Tuesday, May 3, 2011. Daniel’s 23rd birthday. What a day that was 23 years ago!

Premature and born so small that his whole body was measured from his father’s palm to the elbow. Our family is still holding together through many very considerable ups and downs.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

15

The Conservative Party had a majority win and the New Democratic Party has become the official Opposition (a huge increase for the NDP especially in Quebec and a defeat for the Liberal Party and the Bloc Quebecois).

I have some more sober news today. Mom has reached a plateau. She is stable but spending all her energy on eating. It takes her nearly an hour to eat a few tablespoons of food. She goes for a short walk and then sleeps for long periods. Her calorie intake is monitored now by the dietician and her nutrition by Intravenous is diminished by half. She is still taking electrolyte supplements (potassium). She almost makes it to the bathroom but she has bedsores from staying too much in bed and a muscle pain on the right side from getting too much out of bed.

Monday brings back all the support teams, so her heart team came by. Then Dr. Campbell the heart specialist came by at 3pm. to confirm their findings. They asked 100 questions about her past cardiac history. She has to have her thyroid checked, get an electrocardiogram long enough to show some pattern and an echocardiogram. This is the reaction they are showing to her arrhythmia after the surgery. They suspect blood clots could be in the making when there is too high a heart beat (remedy is blood thinners).

She needs to drink a lot of liquids. Blood pressure excellent so far. 112 over 69 today.

She has no history of high blood pressure or angina. Her temperature is a little higher today.

Mom is getting good care of her dressings and her colostomy bag.

There is good news about medical equipment and supplies. The colostomy bags are covered by government subsidized medicine except for 25 %. They are delivered to the door from a local establishment that also rents out equipment. So it might be onestop shopping. My friend, Andrea Kirsten, gave me advice about Scandishake which has 600 calories per can as opposed to Ensure Plus which has only 320 calories in their maximum enriched drink. The difference is in the MCT oil. The Scandishakes are prescribed and covered but have to be ordered by an exceptional medication form. Mom could add a Tbsp. of olive oil to her soup to get extra calories (120 calories per Tbsp. and she could add MCT oil. Cashews may be crushed and sprinkled on everything…

1/16th of a cup is equal to 160 calories. (stop eating these by the handfuls, Garnet). Mom may receive short term nursing care at home. She needs to work on her wardrobe so that it fits comfortably over her bag and pads. She has the possibility of reattachment of her bowel and the Dr. who did surgery will follow up on this. She has also got some comfort knowing that her living space at Millrise Pointe is ideal in her situation and she has assisted living in a full-time caregiver (Dad) who is more than willing to keep her around a lot longer. She should get lots of exercise and may even bathe or swim with her waterproof bag.

I am not exactly the best company. I didn’t initiate conversations today but tested her to see what interested her (result: weather, flowers on the sill, what are my children doing today). I felt like I was staring at her and she was trying to play shy. It was an exercise in itself. She is concerned that everyone who serves her be thanked properly.

She thought I had gone back to Montreal. She daydreams a lot, not because she thinks she did something wrong but because she tries to make meaning out of her situation. She was totally disoriented this morning when she woke up and thought she had been moved to a campsite. She is picking at her lips. Is it a nervous tick or a sign of dehydration?

Answering questions from the staff is really hard. She looks to me to answer for her.

16 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

♣ I saw a program for nursing elderly patients called HELP The Hospital Elder Life Program developed by Sharon K. Inouye M.D., Yale University School of Medicine, and the Institute for Aging Research, Hebrew SeniorLife (2007) online. The HELP program shows how to keep the elderly from coming away from the hospital in a worse state than when they entered. Confusion is a big part of the reason why people go into nursing homes instead of to their own home. http://www.hospitalelderlifeprogram.org/public/patient-family.php?pageid=01.01.00 Old age offers its challenges but it simplifies life enormously. Mom has had a lot of beauty in her life, a lot of travel, a lot of family and a lot of peace, joy and love. She wants to know that she and Dad did nothing to hinder her children from finding the Kingdom of heaven. ♠ Wednesday, May 4, 2011 I will tell you how Mom was yesterday (Tuesday). My last letter was about her day on Monday.

Dad and I arrived at about 9:30 am. She still had a tray of breakfast food in front of her but had only nibbled at half a muffin. She no longer wishes to eat and is annoyed that we “force her”. If she doesn’t eat she cannot return home. I now regret that this has become a cause of distress for her. We did not want to push it but we know this is crucial.

The first thing that occurred, was a visit from nurse Sonia who had spoken to Mom’s doctor. She asked if we had any questions. This prompted us to look at five areas in particular. A thorough discussion was held about incontinence, dementia, heart disease and caretaker burnout and possible bowel reattachment in a month. (Dad brought up the first and last ones and I brought the next two up and then the nurse brought up the fourth one while looking Dad solemnly in the eye with a determined voice).

1. incontinence: Mom makes attempts at getting to the bathroom but only to not make it. She could go from the larger “diaper” to a panty liner (ie. POISE) designed for incontinence if she keeps up her desire to make it to the bathroom first, we concluded. These items may be supplied along with the bags for her colostomy.

2. dementia: the surgery on her forehead for skin cancer two years ago was the beginning of her present dementia. She is losing much of her short term memory but she has some good days and some bad days. The colon surgery is affecting her also. I said I have trouble measuring her progress or decline. Dad says he has to be with her more to determine if the surgery has caused further memory loss, it is too soon for him to tell. He sees her conversation as pretty normal again.

3. heart disease: I told Sonia about Dr. Campbell’s consultation yesterday and she found his report, photocopied it and gave it to Dad to be taken back to her family doctor, Dr. William Healy. Dad and I read it. He said she is “almost ready to go home”. It mentions she had asymptomatic paroxysmal atrial fibrillation of her heart after surgery. The surgery was called Hartman’s (for perforated diverticulitis). He diagnosed short term memory loss / dementia.

4. caretaker burnout: Sonia wanted to be sure Dad would use all the options available to him including home care. She will provide him with information so 17 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

that he leaves the door open to this. (I thought of articles and books I have read about male caregivers. They are reluctant to have outside interventions and want mostly to do things themselves). Dad said he wants to try first to see how much he can do. I thought this was fair since he hasn’t seen yet how tired he will become and how much Mom will be able to do on her own. She is still in recovery stage and may greatly improve. He mentioned feeling inadequate to some degree (hygiene, medical interventions, and guilt because of fatigue causing him to abandon her the first day after the emergency). There are no “secrets” since they have been married for 56 years. He needs to get a chair for the bathtub. He also wants to draw on people he knows who can help Mom besides him so he is making a list of contacts. “A helpline is always there,” Sonia said this about the senior care plan provided for by the Alberta Government. It is not an emergency service and can take up to seven days however. The emergency ward is also there. It is up to him to call. Dad said there is also VON (Victoria Order of Nurses). Now we will see how much he avails himself of all these. “Caretaker burnout” is a danger, Sonia said. She was in tears as Dad talked about his love for Mom. Burnout usually occurs before it can be stopped. It is always hitting a wall before we see it.

5. Sonia gave Dad a map and an address for Dr. Mulloy who is to follow up on the surgery that he performed. His office will phone Dad in a month. Reattachment may be discussed.

After Sonia, we met Nurse Katie who did her studies at a Christian College in Chatanooga, Tennessee but did not know of Covenant College. She gave Mom a shower and we went to read in the hallway.

After Katie, the occupational therapist, Julie, came in to show Dad how to remove a colostomy bag, clean the stoma and put in place a new bag. She will return to show him again (so he will be completely comfortable doing this on his own).

Hopefully Mom will cooperate. She got annoyed with the sticky tape on her soft skin. She is also picking at her I.V. needle since it is itchy. She didn’t seem to know what it was today. This doesn’t reassure me very much. She is starting to get some intestinal gas while eating which also causes some bloating and discomfort. Her new diet will largely be tailored to this.

Dad is anticipating her return home and actually looking forward to the new challenge. I think he will have to keep his concentration high and not neglect her or cut corners. He needs all the resources offered to him. He is often talking about how he will care for her spiritual needs too.

We need to support Dad as much as we can in this imposing responsibility. ♣ (Tag! You’re it, Dad!) from ch. 4. p. 30, Sheehy, G.(2010) Passages in Caregiving. New York: Harper. http://www.gailsheehy.com/caregiving.php. ♥ Thursday, May 5, 2011 Hi Carl and Garnet, The day yesterday went really quite well. Mom is able to sit in a chair for some time and she is eating albeit very slowly and in small portions (about 500 calories per day).

18 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

The dietician saw her and is giving her two bottles of Ensure Plus (27% protein) per day.

This adds 700 calories to her daily intake (IF SHE DRINKS THEM).

Dad had a colostomy bag change demo today. Maybe Mom will come home before the weekend. She had visitors today (the Mercers) and enjoyed the lively conversation. I went out with Gordon and Nancy for lunch but it was not possible for Mom to see them.

She was being showered and given lunch. ♦ Nancy sent me a link to the new version of Halleujah written by Leonard Cohen. [ http://www.youtube.com/watch?v=guhr0Vh2hE0 ] by Kelley Mooney, from Iona, PEI 2006 -2008. I am reflecting again of Easter morning joys. A wrist IV, a pierced side and the Lord is very close to Mom. So all is well that ends well. My input has been to keep Dad and Mom from getting impatient or misinterpreting the medical staffs' instructions and intentions or wanting "to go home and die," as Mom said just after surgery. If Dad takes control he will most certainly drive it the way he wants it to go and for the most part he has the skills to do everything according to the present need. I am confident he will not resort to impatience and the rejection tactics that beset us all. I would like to see if he might read some books like Passages in Caregiving: turning chaos into confidence (see above) I'll be at Judy's after supper this evening before she takes me to the airport*.

Dad led his Chinese life group last night of people who had gone up to the hospital to bring lily and fresia bouquets to Mom just shortly after the operation. One of the leaders offered to drive me to the airport at 11 pm late tonight so I can have more time with Dad (he almost insisted). If Mom gets out today I may take him up on this. Love to all, Daryl

*I cancelled my return home at the last minute and Westjet offered to only charge me a small fee for compassionate reasons. ♥♠ Friday, May 6 201. I am still in Calgary!

After the rather uneventful Wednesday, except for a very kind visit from Jessie and Rich Mercer, Thursday seemed to never end. Mom had some visitors, Hilary Smith, a girl she almost treats like a granddaughter since she babysat her for many years as a toddler. Hilary had already visited and brought a teddy bear for Mom. She was there for an hour. She might have been overwhelmed when I had to take Mom to the bathroom inch by inch and try to settle her in a comfortable position on the bed. Mom fell back eventually onto the bed and gave up trying to turn her hips. This is when I realized she almost needs to be carried to the bathroom. Her legs, arms and shoulders and even her idea of walking have failed her today.

I realized Mom’s life is counted by months now, maybe weeks, maybe days, maybe hours. It depends on our love for her and our ability to care for her needs. “The Hospital seems to think it is omniscient, omnipresent, omnipotent,” Dad concluded at lunchtime. Yet a man Dad’s age, whom they met on the four bed ward, had just brought his wife back to the hospital. Since she had gone home too soon, he was unable to deal 19 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

with the two times she fainted. I am getting a more real perspective on Dad’s capabilities. He received the paper with a phone number linking him to all the extra help he may receive for the end-of-life care of his wife. Instead he has become depressed and angry at the system he says “makes one die”.

Mom was singing with me after Dave Morton’s visit. Dave and his wife and three children are members of Woodgreen. They know Christian Adjemien, who came to be Dean of Farel but is now suffering form Lou Gehrig’s Disease in Montreal after moving from Boston to teach and do administration. Dave is heading off to a youth retreat for the weekend. He was a big encouragement. In God’s timing, some old friends of Mom and Dad’s are visiting their son just across the hallway. The son was near death when he contracted appendicitis, it ruptured and he was left to wait for 11 hours in emergency since there was no back-up for the doctor on call. The son is finally coming around and able to eat but it was a very difficult time for them. Carole and Willie (the parents) who are members of the Northridge (New City) church are moving to Costa Rica to retire. So we have heard all about this. Their visit with Mom really brought her back to the real world for a little while this afternoon.

So Mom was given an x-ray, and x-ray computed tomography (CT) and a urine sample were scheduled for the evening. This forced her to be on a fast. I am tired of checking off menus since her food all returns to the kitchen. I asked Amanda, the nurse, if I could eat her supper which she gladly allowed me to do. Amanda also took care of me after Dad went home at 5:30. She advised me on dealing with Westjet, so I rescheduled my flight when I got home. Garnet had been unsuccessful (from Montreal) but when I tried, the woman who assisted me let me change it to next Friday a.m. for only $5.70. Amanda asked me to phone when I got home to be sure at 10 pm when I called I was safe. Although she has direct bedside manners, she sure knows how to reorganize an electronic hospital bed and make it into a hotel lounge chair. I left Mom in good spirits and comfortable in her “bed chair”. It has an automatically adjusted inflatable mattress on it. They never got around to doing the CT last evening so it will be done early this morning. (They do these around the clock apparently).

Mom and I sang some camp songs early in the evening. I trimmed her fingernails for her. We laughed a little about the Ensure she is ‘sure’ not to drink. Otherwise, I left with a little fear of how Dad was doing at home. When I arrived, we talked in the kitchen about this new turn of events. Dad recognizes that Mom is now in a terminal phase. We do not know how to pray except to keep the option open of praying for her to go home to her eternal rest. We decided to get some sleep and go see her in the morning.

I told Garnet of my successful flight change. Judy called at 7am. Dad wants me to give his hair a trim. Love, Daryl ♥ Friday, May 6, 2011. J. Garnet Zoellner wrote, Dear Family, I've just finished talking with Mama in Calgary, who wants you to have the following news after a number of tests on Grandma.

1) Her colon has been reinfected and she is on a serious treatment of antibiotics. ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

20

2) This treatment will continue for 72 - 96 hours, at which time we will know if the treatment will work or if she is too weak to respond.

3) If the treatment does not work, there is nothing more that can be done to prolong her life, as her body is not strong enough to survive another abdominal surgery*.

I'm looking at flying out on Sunday afternoon to join Mama. I will keep you informed as soon as I have further news.

Pray for Grandma, Grandpa, your mother, and the medical staff (who appear to be excellent). *the decision was later made to do another surgery to remove the colon (as a last resort).

Saturday, May 7th 2011 This is written Sunday and includes correspondance to Carl and Garnet on Saturday.

Daryl ♥ Daryl wrote : Hi Garnet When I read what Judy and Jerry concluded, it was pretty clear that this is a possibility.

She had all the symptoms.

Look at what this says. Daryl ♣ www.publichealth.gc.ca Skip to content | Skip to institutional links canada.gc.ca Home > Infectious Diseases > Fact Sheet – Clostridium difficile (C. difficile) Diseases & Conditions Infectious Diseases Chronic Diseases & Safety Travel Health Food Safety Immunization & Vaccines Emergency Preparedness & Response Health Promotion Injury Prevention Lab Biosafety & Biosecurity Research & Surveillance Agency Canadian Integrated Program for Antimicrobial Resistance Surveillance Information Public Health Agency of Canada About the Agency What is Clostridium difficile (C. difficile)?

Clostridium difficile (C. difficile) is a bacterium that causes diarrhea and more serious 21

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

intestinal conditions like colitis (or inflammation of the colon). In the industrialized world, C. difficile is one of the most common diarrheal infections in hospitals and longterm care facilities.

How do people get C. difficile?

C. difficile bacteria are found in feces. People can get infected if they use their hands to touch surfaces contaminated with feces, and then touch their mouths or eyes. Healthcare workers can spread the bacteria to their patients if their hands are contaminated.

Healthy people don’t usually get C. difficile. People who have other illnesses or conditions requiring the use of antibiotics and the elderly are at greater risk of infection.

How does using antibiotics contribute to the development of C. difficile?

Using antibiotics increases the chance of developing C. difficile diarrhea. Treatment with antibiotics alters the normal levels of good bacteria found in the intestines and colon. When there are fewer of these good bacteria in our intestines and colon, C. difficile has the chance to thrive and produce toxins. When combined, the presence of C. difficile with a large number of patients receiving antibiotics in health care settings can lead to frequent outbreaks. In these settings, C. difficile infections can be limited through careful use of antibiotics and routine infection control measures. The Public Health Agency of Canada (PHAC) has developed these infection control guidelines such as proper hygiene and the proper use of antibiotics. These guidelines are a resource for the provinces, territories and healthcare organizations.

What are the symptoms of C. difficile?

Symptoms include: watery diarrhea, fever, loss of appetite, nausea, and abdominal pain/tenderness.

What can be done to prevent the spread of C. difficile?

PHAC publishes infection control guidelines as a resource for the provinces, territories and healthcare organizations. As with any infectious disease, frequent hand-washing is one of the best defences against the spread of C. difficile.

If you work or visit a hospital or long-term healthcare facility, wash your hands often, ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

22

especially after using the toilet. Most healthcare facilities provide an alcohol-based hand sanitizer at the entrance. Be sure to use it. If your hands are visibly soiled, use soap and water to wash them instead of an alcohol-based hand sanitizer.

When prescribed antibiotics, follow your doctor or healthcare provider’s instructions and the directions on the label. Keep taking the antibiotics as long as your doctor or healthcare provider recommends to kill all of the C. difficile bacteria.

If you have concerns about C. difficile and medication you are currently using, talk to your doctor or healthcare provider.

Is C. difficile fatal?

In rare cases, C. difficile can be fatal. More commonly, the infection causes diarrhea.

Diarrhea can lead to serious complications, including dehydration.

How is C. difficile treated?

For people with mild symptoms, no treatment may be required. For severe cases, medication and surgical interventions may be needed.

What puts a person at risk of getting C. difficile infection?

Those at risk include the elderly, people treated with antibiotics, or cancer chemotherapy. In addition, patients taking stomach ulcer drugs known as proton pump inhibitors are at increased risk to contract C. difficile infection.

What is the Public Health Agency of Canada’s role in preventing and monitoring C. difficile?

PHAC publishes infection control guidelines as a resource for provinces, territories and healthcare organizations. The Agency has helped examine the outbreaks of C. difficile infection in a number of jurisdictions across Canada.

Through the Canadian Nosocomial Infection Surveillance Program (CNISP), the Agency recently completed a six-month surveillance study on C. difficile Infection (CDI, formerly C. difficile associated diarrhea or CDAD) in teaching hospitals across the country. The study focussed on patients suffering from CDI who had severe ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

23

complications, including dehydration, surgeries, admissions to intensive care units and deaths.

PHAC’s National Microbiology Lab is also studying the bacteria to see if there is a way to tell the difference between mild and severe cases of CDI. They’re also looking at whether or not there is a strain that exists that is causing more serious disease in people than before.

In January 2005, PHAC also surveyed all hospitals in Canada to get a better understanding of their infection prevention and control practices for C. difficile. The survey results were used to inform and improve PHAC's surveillance activities and clinical care guidelines related to C. difficile.

In late Fall 2006, The National Notifiable Diseases Working Group (WG), an assembly of epidemiologists and laboratory experts from provinces and territories and from the Public Health Agency of Canada, recommended CDI be added to the list of Nationally Notifiable Diseases, as published in the Canada Communicable Disease Report, 2006: Volume 32, Number 19. The National Notifiable Disease List will take effect when associated case definitions are revised, approved and published, in December 2008.

A new ongoing surveillance project for CDI was initiated on January 1st, 2007 in 48 hospitals in nine provinces. PHAC is using the information from the 2005 and 2007 CDI surveillance project to refine the infection prevention and control recommendations for C. difficile in the Infection Control Guidelines. The recommendations for the prevention of C. difficile are found in "Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care" on the PHAC Web site.

The CNISP has conducted targeted surveillance in which it examined outcomes for patients with C. difficile. The patient outcomes (what happens after the person is infected) will be correlated with the laboratory specimen to determine if there is a relationship between the severity of illness and the NAP1 strain. [end of public health citation].

The evening of Saturday May 7, 2011 I did research from websites on C-difficile on Google I took a quiz on the MedicineNet.com site to test my own digestive system. http://www.medicinenet.com/clostridium_difficile_colitis/article.htm This information made me believe we all have Crohn’s Disease, Irritable Bowel ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

24

Syndrome or Colitis from another bacterium. The antibiotic Ciprofloxicin on MedicineNet.com claims it is used for Diverticulosis and Crohn’s Disease and that is what Mom has been receiving. http://search.medicinenet.com/search/search_results/default.aspx?Searchwhat=1&query =Cipro&I1=Search ♠ My concern is that it is not the best antibiotic to treat C-difficile. Mom needs either metronidazole (Flagyl) or Vancomycin (Vanocin). [p.s. What did any of us know ? Mom is VRE Vancomycin resistant, as it turns out].

Tetanus and Botulism are similar bacterium to clostridium difficile, I understand.

I will definitely pray and ask God for wisdom at the worship service today and try to find out if Judy has talked to the hospital personnel. Therefore, I will say what the Lord gives me to say and trust that He sees all. I remember successfully being treated with oral doses of Flagyl and Cipro for diverticulitis a few years ago. I will ask if the staff at Foothills is planning to use these on Mom. Yours, Daryl ♥♠ Sunday May 8th 2011. Mother’s Day Hi again Carl, Judy and Garnet, Here is some info from my notebook…

Yesterday, Mom was wide awake and barely seemed to be sleeping in the afternoon. Judy had been beside her since 6 :30 am. She had contemplated staying the night before after visiting Mom with Ken and Jerry her brother and sister-in -law. She extended her parking time and I took her for a muffin and coffee. She remembers having Potassium supplements when she was in treatment for 6 months. Mom is deemed to have sufficient Potassium levels, Judy said, so she is being taken off these electrolyte enhancers.

The hospital doesn’t let us look at Mom’s file without council from the attending physician. I noted there was a catheter for urine collection and she received oxygen until after her wash up in the bathroom. She is receiving Ciprofloxacin but I didn’t notice the doseage on the IV bag.

Mom got a new roommate, Richard, a coal miner living in Fernie who has melanoma skin cancer. Dad seems to get along well with him. He is in his late 30’s /early 40’s I think.

I finished reading "Three Cups of Tea", the story of Greg Mortenson and Pakistani and Afghan schools. Reading a book like this is a good distraction to remind me of those women who might want to help their populations in the future by gaining knowledge and critical thinking skills.

Caleb Hope is still on nursing duty and is unwittingly training Dad how to be gentle with Mom. I am getting a lot of quiet explanation from Caleb and he is really encouraged every time Mom shows signs of getting rid of the infection. Before I heard the comments by Judy and Jerry on C-Difficle, I had spoken with Caleb, in Mom and Dad’s présence, on Montreal’s Royal Victoria Hospital’s prevention of superbug infections. He changed the subject to talk about renovating hospitals to put condominiums next door to them. It would increase a hospital’s revenue, especially for 25 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

outside landscaping. This made me think about my walking tour of the new McCaig Tower in the Foothills. It is like a Hotel.

I was wishing the ostomy smell could be replaced by flowers and later the neighbour received Calla lilies and roses. It was an answer to my desire and I remembered the Spirit prays for us when we don’t know how to pray. It was reassuring.

We said good-bye to Wally and Carole and their son Matthew who had peritonitis, who were going home. It was good to have people Dad knows nearby for a few days.

Judy, Dad and I all agree we don’t want Mom to die alone. She is hearing how we react and is wondering what is going to happen to her. We are now discussing how much to tell her. She says, « I hope Clare looked after the bill » and she was making all her plans to leave at the end of the day thinking he had gone to get the car to take her home. When I went home at 5pm I had to leave her at the elevator with Caleb who was taking her for a walk. Dad later phoned to see if she was still in this panic state of getting ready to go home. I asked her where home was and she said, ‘Nelson’. She is talking about Calgary as if she was in Nelson. This is significant for her and I am contemplating the fact that Nelson was the last place we all were as a family and she was in a home that Mom and Dad were renting to buy (her dream home ?)

Dad and Mom have frank conversations and they are spending some time alone while I go for walks. Mom has a wonderful sense of humour and they were laughing and joking most of the time. Dad is pleased about how much Mom is alert today – not always lucid or acurate in her comments, but alert. To love ourselves correctly is to see ourselves as God sees us and to allow the Word, not the world, to defone who and whose we really are. The clearer we capture the vision of our new identity in Jesus Christ, the more we realize that our deepest eeds for security, significance, and satisfaction are met in Him and not in people, possessions or positions. A Biblical view of our identity and resources in Christ moves us in the direction of loving others compassionately (1997, Face to Face, Kenneth Boa, p. x).

Diane Smith (Hilary’s Mom) and her younger daughter Jaqueline were in for a visit in the late afternoon after Dad left. I decided not to translate Mom’s confused statements. I’ll let others just listen to her. Diane gave Mom a novel (" for Clare to read to her"). I read it instead.

Sam, Fu, and their son, Tien came for a visit. They left flowers and a card "for Mother’s day". These Chinese friends live very close to Mom and Dad and Dad is leading a Bible study with them. They are totally committed friends. They were off to a 1st birthday party at someone’s house.

I left thinking about Dr. Mulloy’s conversation with me - what is going to happen and what is not going to happen in his mind. He says we are doing a wonderful job and he continues to hope the best for Mom. She is just above palliative care (we cannot say with assurance that she is going to die soon) but just below heroic measures to keep her alive (because they are too dangerous at her age). I am disappointed, but understand, that she will not have her bowel reattached (unless we all insist on it). He says the nurses see how much Mom means to Dad. They all want her to go home. Again, I realize that it is up to us (and within our rights) to request whatever we want from him.

He mentioned "infection" instead of talking about "superbugs". He only mentioned the "latest" infection and it was only when I read Judy’s e-mail from Jerry on the way home that I began to think about C-difficle and its possible effects on Mom. So 26 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

many patients, in her late-life post surgery situation are dying within 30 days of their secondary infections. The elderly are not coping well from treatment after abdominal surgery with antibiotics in North Amercan Hospitals.

This joke (I hope you can see it) is on a door by the elevators. I accessed it at http://www.barricksinsurance.com/blog/2010/04/29/jokes/now-i-know-why-they-call-iticu/ I hope I am not giving too much for you to read, Love Daryl ♦

♥ Sunday, May 8, 2011. Sara Ludwig wrote : Thank you Mama.

I am actually not worried for Grandma since I know she loves the Lord and will one day be made new again if she is not healed in this life. I was feeling sad for you and Grandpa and Papa. It's those that are left behind. What a comfort be to Children of God. Happy Mother's day to you and glad you can spend it with your mother. Please hug Grandpa and Grandma for us.:-) Love you, Sara

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

27

♥ On Saturday, May 7, 2011, Daryl wrote: Hi Sara Have a Happy Mother's Day! Don't worry about Grandma. She is taking every day with prayer and thanksgiving and is not in any discomfort because of all the wonderful care she is getting.

Love, Mama ♥ Sunday, May 8 2011. Carl Martin wrote : Judy and Daryl (and interested significant others), I have decided NOT to travel to Calgary in the next while unless absolutely necessary for several reasons. I will mention three of them in this email. They are prioritized :First, if Mom continues to improve her digestion of food so that her caloric intake approaches or surpasses the minimum daily intake, I see her in no immediate peril. I accept the doctor's opinions for her ongoing treatment based on the current diagnosis. Careful monitoring by medical and paramedical staff should continue after she leaves the hospital on a semi daily basis. Assisted living arrangements that are within their price range along with medicare support should be the immediate goal. I am not challenging Dad's ability or inability to care for her, just that it be done without error or omission.

Second, I have some major health issues of my own I need to get under control.

My G.P. and an Osteopathic Surgeon recommend I not fly due to increased risk of blood clots in my legs. I have appointments with both this month I cannot miss.

Third, I do not feel welcomed by our father and wish not to be present in the decision-making process. As stated above, arranging professionals to help should be what Dad works towards. If not, he will be responsible for her demise.* Last but not least, I have responsibilities to people in Lunenburg over the next several weeks. They are certainly not as important as family however we all have duties where people depend on our actions and involvement. The culmination of my actions will directly affect the success of others, some financially.

Judy, thank you for your kindness and insights and dedication to Mom. Your different "take" on the situation is much appreciated. You are a true saint.

Daryl, thank you for presence with Mom, being her friend, choral mate, story teller, and all round nice person. For you to give up being with your own family, functions, and duties, you are a true soldier in faith.

Love to you both, Carl ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

28

♥ Tuesday, May 10, 2011. Daryl wrote : Hi Carl, I will reply more precisely to your letter here.

The issue with eating does not put her in a better state. She has to deal with the microbiological imbalance between the superbug and the good bacteria in the bowel.

They cannot release her from the hospital until she has about 7 days of stability after improvement. Your desires were clear (Careful monitoring by medical and paramedical staff should continue after she leaves the hospital on a semi daily basis. Assisted living arrangements that are within their price range along with medicare support should be the immediate goal. I am not challenging Dad's ability or inability to care for her, just that it be done without error or omission) and I will respect those and your reasons for not coming out. We all had to make the same choices to be here. We all have to pay for our own decisions. Thankyou for your kind words at the end and I pray things will be resolved between you and Dad since there are blessings when we live in harmony, Love, Daryl ♠ *Carl and Dad were reconciled on June 16th in a phone call after several e-mails in May to better see the other’s point of view. It should be noted that Neva Isabelle Masee, Carl’s first grandaughter died in a Halifax maternity ward this past March after only two days of life. Carl’s response was, "I have my guitar." I know what he is saying. He is grieving in his own way. His guitar was gently weeping. ♣ When he read a book on Chinese philosophy, George Harrison of the Beatles, discovered a new idea to him - the idea of fatalism /relativism - that all is relative to other events. He is known to have said, "I wrote "While My Guitar Gently Weeps" at my mother's house in Warrington. I was thinking about the Chinese I Ching, the Book of Changes... The Eastern concept is that whatever happens is all meant to be, and that there's no such thing as coincidence - every little item that's going down has a purpose.

"While My Guitar Gently Weeps" was a simple study based on that theory. I decided to write a song based on the first thing I saw upon opening any book - as it would be relative to that moment, at that time. I picked up a book at random, opened it, saw 'gently weeps', then laid the book down again and started the song." ♠ My siblings and I come from a generation that randomly rediscovered doubt and meaninglessness which breeds nihillism. This relativism runs tandem with faith because the Job experience and the Ecclesiastes experience, Jeremiah’s Lamentation and the cynicism the apostle James deals with in the first chapter of his letter are all a part of the human story. Where we decide to live in that story, will show our true character. I prefer to live in this sacred story of when mourning is turned to dancing. Tomorrow will be my dancing day. I don’t want to underestimate grace. God fills us up with himself every time this world disappoints us.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

29

♥♣ To Colleen, the mother of Carl’s grandaughter (my niece) who nearly lost her life too, I wrote : Maurice and Colleen, You will start to receive all these Quiet Responses through e-mail.

Here is one of them.

"How can the guests of the bridegroom mourn while he is with them?...

While he was saying this a ruler came and knelt before him and said, "My daughter has just died. But come and put your hand on her, and she will live," Jesus got up and went with him, and so did his disciples...When Jesus entered the ruler's house and saw the flute players and the noisy crowd, he said, "Go away. The girl is not dead but asleep."

But they laughed at him. After the crowd had been put outside, he went in and took the girl by the hand, and she got up."

Matthew 9 15, 18-25.

If Jesus could do this then, how much more, now that all power in heaven and in earth has been given to him will he be able to do it !

I am trusting that when Neva Isabelle Masee died, Jesus took her hand and she just…"got up".

Love to you all, Daryl. ♠ Monday, May 9, 2011. Clostridium Difficle.

Yesterday, I made 48 cups of coffee since I was replacing Mom for the Mother’s Day coffee hour at Woodgreen Church. During the worship services, Frank Lanting preached on "opening our eyes" a sermon based on the 153 fish caught and Peter being restored to faith after the ressurection. Dad and I fielded questions from members of the Church and we headed directly for the Hospital. We sang and hummed the last hymn by Horatius Bonar from Titus 3:5 while driving to the Foothills, ‘Whatever God Ordains is right’.

I felt like I was storming into the compound where my mother was being detained. "What anti-biotic are you using and has my Mom received a test for CDifficle ? " I asked Jane, the Phillippino nurse caring for Mom. Maybe Judy had asked the same questions this morning before I came to visit. She is on the same exploration team. Whatever happened yesterday, the nurse looked at the chart and "yes" Mom had been tested for the bacteria. A few hours later, Jane told us the test was positive and she was going to isolate Mom in Rm 1056. Mom seemed to know and was talking in the past as if this had already happened. Everything seemed deceptive. There was no Flagyl or Vancomycin anti-biotic on her IV pole. Instead the nurse said she was still receiving Cipro. Soon after she said, "The nurses are doing research on the proper anit-biotic to change to, if needed". It was a few hours (4 :40 pm) before Flagyl (500 mg. / 100 ml) was administered. The room was ready about 5 :15 pm.

I was able to get to know Jane before introducing the subject of isolation and what that entails. Dad seems to be so elated that Mom went for a walk, had a wash up in 30 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

the bathroom, was able to eat and was chatting away about this being Mother’s Day that he did not seemed to be phased by the superbug news. I was still thinking about how I found her, before Dad parked the car. She was sitting up in a chair but had uncontrollable shivering. Three warm flannel sheets and her bathrobe were still not enough to warm her up. I encouraged her to eat soup and drink her tea. It helped, and by the time Dad arrived, she was alright, but later she was so hot we had to put cold cloths on her forehead. When Justin and Christopher, her grandsons arrived, Jane was trying to get Tylenol tablets down with water. Mom gagged and her lunch came out. Mom just took it in stride and smiled and kept talking to the boys. Justin was saying how he had received a metal Bible in the shape of a coke can. He is reading it. They both gave me hugs when they arrived and left. They described their broken bone injuries and how they occurred. Christopher still has to take asthma medicine.

Dad and I got Mom settled into her room, helped her drink Ensure and eat her supper and then I came home at 7 pm.

When speaking with Garnet, I learned that Kira and Beatrice were coming with him. I don’t know if this is wise for Beatrice to be here. I consulted some nurses and there was a mixed response. If she stays out of the room, is in the hallway for a short time, if Mom doesn’t hold her, it might be possible. I will see what Kira decides.

It seems from the blogs by daughters of elderly mothers like me, that the patients who have C-Difficile go home but eventually end up in hospice or nursing home care.

This seems inevitable. Mom gets to profit from sooner entry into heaven rather than later entry. Death gets to be swallowed up in eternal life in the twinkling of an eye and this is not a bad thing. ♣‘All things work for good to those who love him and are called according to his purposes’ (Romans 8). ‘Surely goodness and mercy shall follow me all the days of my life and I will dwell in the house of the Lord forever’ (Ps.23). Mom and I recite this together. She was looking forward to her eternal home yesterday. She is not unaware of her total undeservedness of this gift of God. God takes pleasure in giving it because he paid for it with the perfect obedience of his Son who died in Mom’s place.

She does not now have to die for her sin. ♥ Tuesday, May 10, 2011 Hello Judy and Carl and various other family members, It has turned sunny and warm here after all the rain.

Mom had a mixed day yesterday. The presence of family was the highlight for her. The incredible shivering and then hot flashes were the down side along with a very painful fight I witnessed between her and Dad. Mom ended in tears and felt like Dad was running off and rejecting her. She was more worried about him than herself. Dad calmed down after he met his little great grandaughter, Béatrice. Dad is living with the reality of having to say goodbye to his dear wife of nearly 57 years. "I can understand that," says Garnet. My conclusion is that Dad has had the most success and control in his life through a pattern of various angry outbursts but this time his anger has failed him. It will not save Mom. Neither will it ever reconcile you to him, Carl. His anger is not a substitute for heartfelt forgiveness. This deep sense of rejection that Dad feels, when it surfaces in his relationships, is rooted in his relationship to God. Dad feels God is not able to forgive him. Yet God is very capable of forgiving him. Dad insists that He isn’t because others are so slow to forgive him. What happens when you run into someone 31 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

who is fighting with God ? If this were resolved, Dad would be able to see that God is capable of giving the very best things to the least deserving person. Timothy Keller points this out in a book Dad has read. The Prodigal God : Recovering the Heart of the Christian Faith (2008, Penguin Group Dutton). As a repentant Older Brother, he too would be free to give the very best things to the least deserving people around him. Dad was so angry at the world this morning that he took it out on Sarah, one of the nurses.

She calmly but firmly said, " That sounded pretty accusatory ". Dad later apologized to her. I am sure he also apologized to Mom. I sang a lot with Mom today. It helps to have a private room. I have a little old gospel hymn book I picked up at a used book sale in Jasper last year. Heavenly Sunshine and Unto the Hills Around Do I Look Up, Come to the Saviour Make No Delay, Blessed Assurance, etc. were on the program for today. She knows the words all by heart. She was especially encouraged when I said she had been ‘bought for a precious price’.

The Foothills staff are doing a great job. When Mom is nauseous, they put some anti-nausea medicine through her blood. When she is not eating, they increase the TPN nourishment. When she has a fever, they give orally ingested Tylenol. Flagyl antibiotic (metronidazole) is being given orally through her stomach and intestines and bowel. She is getting Vancomycin to her bloodstream through the IV. Some are very expensive drugs and I see that one dose expires in June. They have to use these up soon, I guess.

Dr. Mulloy came in to see her. Her nurse is 6ft. 1 and her name is Sarah, a young blondhaired woman with whom Mom said she had had "a good cry" a week ago. Now Sarah sees her and says, "Your Mom has a pretty powerful infection." I know what she is saying. The battle between good bacteria in her bowel is being lost to the bad bacteria, which is 10 times more powerful. Through the Mayo Clinic in Rochester, Minnesota, I learned that Saccharomycus boulardi (a probiotic yeast) with a CodY protein gene tells C-Diff not to make any more toxins. I bet Dad wishes he had that power. Don’t we all ?

I don’t know how to get this into Mom. Garnet being here, I have asked him to do some things with and for Dad. Some of them have to do with wills, cell phone service plans, and income taxes. We will wait to look into Meals on Wheels, Home Care, and shopping for items like bath chair, protective bed covering etc.

Kira has a Comfort Inn Hotel room within walking distance of the Foothills. We will drive up there and use it as a base today. She will hopefully get to introduce Beatrice to Judy and Don. So there it is for yesterday (Monday or ‘Momday’).

We’ll see how it goes today. I am so glad to see Kira and Beatrice and of course, Garnet.

Love, Daryl ♣♠ Wednesday, May 11, 2011.

"Just look around and find people in need and help them. Don’t let wealth get to you". Those are some of the words of advice that Mom is giving. It sounds like Beth in the story of Little Women. Mom is still with us and is very comfortable and chatty when her fever is below 37.5. After that her heart rate goes up past 115 and then things are really unpleasant for her. She doesn’t open her eyes then and she cannot even suck from a straw.

Two of Mom’s doctors came in to the room while Mom, Judy, Dad, and I were gathered waiting for them to give us some news. This was the moment of truth for the 32 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

doctors. They wanted to make sure we knew Mom was dying. The day when the use of the new antibiotics will turn for the worst or for the better (the watershed) is to be May 11 (today). We will know by her appearance. Tylenol does the trick now to make things right for awhile but the clostridium difficile is not going to just go away, not unless the surgeon takes Mom with it.

We drove Mom to a site I call, ‘Beulah’ today. Actually with her pole in front of the wheelchair she looked and acted like she was driving an F1 racing car. It was really funny. It makes me think about how she sees her whole life, " Didn’t we have fun ? " We sat her outside the McCaig Rehabilitaion Centre where Beatrice met her with Kira and Garnet. She was in awe of her great grandaughter and the snow capped mountins and the beautiful sunny day. "Unto the hills around do I look up my longing eyes. " (Psalm 121). When she got too hot we took her to the shade, when she got too cold, we brought her back out into the sun. The nurses and doctors were glad we were doing this.

They give permission for her to go home on a day pass too. After some discussion last evening, Don, Judy, Garnet and I said, "No, this would not be wise". Dad would want to keep her home and Mom would want to stay home, where they both would give up living. Mom found ½ hour away from the hospital bed to be too much. [p.s. Many beautiful photos were taken and displayed in her room where she could remember the day long after Kira and Beatrice had left].

So we will see what happens today. The nurses have been extremely kind to her.

The next stage might be hospital palliative care unit which requires that the doctor, nurse, and a social worker approve.

Kira was such a breath of fresh air for us all. We went our for meals together and she visited as often as she could at the hospital. We are grateful to our son-in-law, Patrick who said, "Do you think you want to go see your grandmother ? Let’s make it happen." His family in Montreal is saying goodbye to some of its own dearly loved aging family members.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

33

© J.G.Zoellner

©J.G. Zoellner

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

34

©Daryl Zoellner

♠ Thursday May 12, 2011.

Mom is receiving doses of blood thinners - Heperin by injection in the shoulder.

We think of the treatments she is receiving and how costly they are but then we would not want to put her in a boat and send her down the river or lay her at the top of a temple building (a gift to the gods or earth spirits) as is common in some past and present cultures. The doctors are relieved we do not want to expose her body to further harm by sending her for further surgery. They are able to do it, no problem, but that is to do further harm than good [elder abuse?]. So we do good to her, and give life to her as much as we can, until the day when life swallows up death; until the veil is crossed over and we see her no more in her present form.

Actually we see very little of Mom’s spirit at this time. We see and hear more of the Spirit of the living God who lights up her eyes when she hears the Scriptures and hears praise of God, prayer, and signs of love, joy, peace, and patience. She does not much remember the things of this world. This was obvious today as she barely moved from one position in the bed except to raise and lower her knees. Food is a thing of the past except for “2 cal.”, a calorie rich drink that tastes like soft ice cream, Mom’s favourite food. She prays for family members by name.

Mom’s vital signs have been good in the past 48 hours. Her white blood cell count has gone down to 14,000 mcL from 19,000. Normal value ranges are 4,500 – 10,000 white blood cells per microlitre (mcL).

Dr. Ryan Snellgrove (originally from Newfoundland) came in this morning to cheer us and test the sensitivity of Mom’s abdomen and Dr. Mulloy came in after a day in High River to see her, but only to check on the nurses reports and say hi to us, the family. He told Garnet in the hallway that so many of his patients are left at the hospital door and are never visited. He reassured Garnet that when the time comes, a consultation with the social worker and a nurse will take place when further changes in Mom’s care become necessary or when they want to release her from the hospital. He warned that there are virtually no places available in Government sponsored extended care units.

Jerry and Judy came by and a Chinese lady named Jane who acted as an interpreter for Dad at one time came with her baby daughter Serina. We worried about Serina being there. Phone calls from friends kept Dad from napping in the afternoon. ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

35

Loving support is all around him. Community Care is only a phone call away at 403943-1920. A neighbour, Eva, supplied supper tonight and a gift of $1000.00 was gratefully received from a wealthy friend.

I mentioned Saccharomyces boulardi yeast to the dietician yesterday. This probiotic tells the C-Diff not to make toxins. Through genetic reconstruction, DNA (CodY protein) may one day be commanded to reduce bad bacteria toxin output. Since all creation has been subjected to death, DNA runs our lives but DNA is not God. This all makes sense when we compare Scripture’s Creator- creation relationships and redemption that leads to the new heavens and the new earth. I might, I admit, see genetic reconstruction as too redemptive, whereas some see it as human messing up of what is already natural. Nature is subject to an overarching intervention from the Creator, however, and so we pray and wait expectantly for God to do good to and through it. The dietician will send probiotic yogurt with her meals.

A cell tel problem with Rogers and Nokia phones was solved today. Dad is somehow subscribed to automatic messages (daily riddles) that cost him $.75 a call.

Hundreds of dollars are added to his phone bill because of these. We are working on a way to delete these and get reimbursement.

Wills and dementia do not mix well. The family doctor has to be informed of results at the hospital. Dad still has income tax to file. Every day has enough worries of its own. Garnet and I changed our tickets with Westjet, so we will be staying here for another week. (May 20th departure on flight #218 at 1am.) Love, Daryl (Mama) ♠ Sunday, May 15, 2011.

Since Wednesday, there have been very few changes other than the white blood cell count and a hint that Mom will be getting out at the end of this coming week. Her white blood cells are over 20,000. There is some fear that pneumonia might set in. She needs to dry out her lungs by doing breathing exercises, which she dislikes. Maybe the promise of coming home is a little premature. She fasts tonight for her abdominal scan tomorrow morning. The doctors will be back then too.

Mom is still in a fairly good mood. Who wouldn’t be with all this TLC? No pain and she makes it most times to the bathroom. Her sighs at the end of the day mean, “I want to come home.” She still has very little certainty of where home is. She will miss the nurses, or so the nurses say. So many student nurses have been around this week and it became a little annoying, even scary for Mom (when several come in noisily all at once without warning). I had to calm her down before the nurses could work with her.

She looked at me terrified and said, "These people aren’t supposed to be here are they ?"

She really thought she was in her own bed at home.

Dad would do well with a short-haired (one that doesn’t shed) non-barking, medium sized dog that enjoys being inside yet can still enjoy a good walk. I haven’t decided which breed would be best.

There are other visitors around, so Mom has a little variety in her day. We took her for a wheel chair walk again. Her wall is covered in pictures of home and photos taken on the ‘Beulah’ adventure to meet Beatrice. She eats less and less every day. Not sure what this means. We obviously cannot read her heart.

So with the three of us here, we have a routine. Dad covers the morning and Garnet and I stay later in the evening. That gives Dad more time just with Mom and it 36 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

gives us time to clean the apartment, do errands and visit with relatives like Gordon and Nancy. Judy comes almost every day now.

We found Mom’s wedding rings at home, as she had told us. We thought they were lost at surgery. Garnet and I had gone to the basement of the hospital to check lost and found.

We’ll see how things go tomorrow.

Daryl ♠ Monday May 16, 2011 I went up in the morning. Judy and her brother-in-law, Ken were there also. Dad went up in the afternoon and stayed until 5pm. Today, I witnessed unethical treatment of Mom and did not realize its full consequences until Garnet pointed it out to me later and I read an article about Computer Tomography (TP). I learned that CT may be the equivalent of 500 x the radiation of a chest x-ray. Others say it is low level radiation and the light tube moves quickly around the body. We all should have been informed about this and its secondary effects before Mom was told to sign a consent form for her own CT this morning. (The doctor knows of her dementia). She had to take 48 oz of Telebrex which some say causes diahrrea for days afterward. The Telebrex contrast agent needs to be flushed out of the kidneys in the next two days. No one told us of this either. Why am I so stupid? Why can’t we be informed of these things? I just feel duped now. Judy and Ken were also not in on the consultation.

Mom also probably has Thrush, (Candiasis fungus). Her tongue is white, she has trouble swallowing and has sores in her mouth where her teeth rub. If the fungal growth is limited to the mouth, there are simple topical drugs that can help. Nystatin (Mycostatin) liquid is used by swishing a bit in your mouth several times a day and then swallowing the medicine. Throat lozenges called Mycelex trouches are slowly dissolved in the mouth like a cough drop, distributing medicine to the infected areas. This type of therapy is usually more effective in fighting thrush because the medicine stays in longer contact with the surfaces in the mouth that are affected. In people with recurrent Thrush, oral medications such as Diflucan (fluconazole) is used. (About.com).

Thrush happens when the white blood cell count is high. It causes difficulty in swallowing because it goes into the esophagus.

Left unchecked, esophageal candidiasis can cause severe respiratory complications. (About.com). I will have to ask if they are treating Mom for this at the Foothills. They told us to prevent it by brushing her tongue. I did not realize she probably has it.

I try to cheer Mom up when I am with her but I find her suffering today to be very unhappy to say the least. She was only able to drink about 1 ¾ cups of the 4 12 oz. cups of Telebrex. It was so funny and we laughed so hard when Mom was rocking as she sat up beside her bed and drank the Telebrex. She started singing "Rock a My Soul in the Bosom of Abraham ". I let her eat her dry, bitter antibiotic pills with two spoonfuls of chocolate pudding even though she was supposed to be fasting. The nurse said it wouldn’t be a problem for the CT scan.

Mom and Dad were talking about funerals and nursing homes today. Mom cannot judge her own state of health but knows she may die any time. Sometimes this is relieving to her and sometimes she is so full of self pity she cries - sometimes because 37 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

we all love her and she has such good memories. She is very grateful for her life. Dad asks for permission from her to go home and rest.

I bought Mom new slippers today and washed her other ones. She is finding it hard to be incontinent. When she pees on them, I think of two of our daughters when they were learning to use the toilet. How many pairs of little shoes did we o through ?

Mom looked so beautiful in her new blue alpaca wool tuque from Diane Smith which she gladly wore to the CT scan. She gets so cold when she goes downstairs for the scans.

We are so afraid she will die in the night. It was sad that no food was sent up to her room today, even after her fast and scan were over.

She had to put her teeth in later when Dad came. I must admit, she looks better with them in. Dad is afraid she will have to get new ones if her face shrinks too much from weight loss.

I did not want to, but I had to look up septicemia.  http://www.medicinenet.com/sepsis/article.htm What more can I say ? Wherever and whenever the septicemia occurs it has a lot to do with the superbugs, blood poisoning, and fatality. However, Mom does not have low blood pressure because of the IV unit and she has a high urine output.

Keeping Mom in my prayers and visiting regularily will keep me on track here.

Yours Truly, Daryl ♠ Thursday, May 19, 2011.

Tuesday, (Ed and Sara’s 14th wedding anniversary) Mom’s white blood cell count went up to 22, 000. Her weight has come back up however and she is at 99 lbs.

Dr. Mulloy has asked the whole family if he may do another surgery on her.

Ryan Schnellgrove agrees it would be a really good thing and they see that Mom is a strong person (spiritually and physically) and has support around her from family. She may go to ICU after for a few days and have the same private room post-surgery. [p.s. she went straight back to her room and did not require ICU).

Dana and Amy watched while Jenna did the dressing change. Sterile gloves, 30cm by 2 cm of gauze tape in saline solution to be placed in a skin hole near the belly button. The depth of the hole assessed with a sterile Q-tip. University of Calagary and other training schools are still sending nurses to get training. “This is the best Unit to see many treatments at once,” the nurses here say.

Mom teased some of them and said after she had the CT she ‘had to stop at every fire hydrant on the way back to her bed’.

Mom was discouraged later and said, “I didn’t ask God for this.” I was reading about the Leper (Matthew 8.1-3) and encouraged her by saying the Leper didn’t ask for his leprosy either. “If you are willing, you can make me clean,” he said to Jesus. Jesus replied, “I am willing, be clean!” So he was made clean. Mom sees this operation as making her clean. It hopefully will do that (take out the entire colon / large intestine which is infected with the C-difficile bacteria). She will then have a stoma on the other side of her abdomen since she will be given the surgery for an ileostomy. Frank Lanting, her pastor, came in at that moment and prayed with us. ♣ Mark 5: 34 gives an example of when Jesus said, Daughter, be healed of your disease. ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

38

Mom had surgery Tuesday night between 7 and 10 pm. Dr. Mulloy was elated when he came out and said to us to go home and get some sleep. He wanted us to go have a beer with him, I think, but said we needed sleep. True.

Mom had a good night and Wednesday we went to see her, but the whole day was rather uneventful (she slept) except that they discovered that Morphine (even at 5 mg and then reduced to 2.5 mg every four hours) gave her nightmares and made her too lethargic. They switched to old people’s medicine for pain. (Fentanyl). She has injections of Heperin every four hours as well to thin her blood. She has leg socks that inflate to keep her blood moving in the legs.

She agreed on a new name for herself. Moana Lit ça. Garnet wrote it on the whiteboard on the wall. ‘Moaning in bed about that’ is the loose translation. It sounds like Mona Lisa. We sang, ‘His eye is on the Sparrow’ (Matthew 10. 29, 31), which is in the Charles Alexander hymnal I had with me.

Mom is taking antibiotics called Flagyl (by mouth) and Ciproflaxocin again by IV. The physiotherapist got her to do a couple of turns of the feet and ankles while sitting, she stepped out of bed and was standing. After two weight bearing steps for her legs, a check on her lungs from behind, she got back into bed and slept the day away.

She has a catheter and a new ostomy bag (this time on the right). She has stitches over the other ostomy hole that was repaired. Her tummy hurts a lot but the painkillers are sufficient. Her blood pressure was way down, but steady at 88 over 44. Today the nurse said it was up to 97/50. They are injecting water into her as well as giving her the IV and 3 lbs of oxygen (the max). The goal is to get her to RA (room air) at 96 or above. Her white blood cell count has been as high as 35,000.

Mom makes jokes about giving up but she is most often serious about this.

Where is there any hope in all this? Dad has a bad cold, is losing the will to bring her home and has no idea how to deal with his bad relationship to Carl. It is a rainy, gloomy day (weather-wise) here in Calgary. Garnet also has a cold. [He later gave it to me].

Maybe we have caught something worse. We are all wearing masks around Mom. She has called me Dr. Daryl at least once but that was due to the new vocabualry I am using.

I am also writing a lot of things down.

I see it as a wonderful challenge to prepare a diet for Mom. I worked for 7 years for cafeteria catering companies that serve high schools and universities in Montreal. ♣♦ There is a webpage just for this purpose at: http://www.nutritioncare.org/uploadedFiles/Professional_Resources/ASPEN_Patient_Ed ucation_Manual_Sample/III_B5a_IIeostomy_Diet.pdf Also my friend Andrea Kirsten has been solicited for information. She knows a ton of stuff on these sorts of things having been a paramedic.

Ileostomy Diet Purpose: The ileostomy diet is designed to avoid blockage of an ileostomy or a narrowed gastrointestinal tract and to reduce fecal output. Use: The diet is designed for use postsurgically for a patient with an ileostomy or ileorectostomy. It may also be used when narrowing of the esophageal or intestinal lumen occurs and after abdominal surgery in progression to a more liberal diet. ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

39

Adequacy: This diet restricts dietary fiber, the plant cell material that is resistant to digestion. This diet can be nutritionally adequate when attention is given to selecting a variety of foods. However, strict reductions in vegetable and fruit use will limit ascorbic acid and folate intake. Individual food use should be assessed and supplemented accordingly. (My Dad heard from Dr. Malloy that Mom should eat as she did before the surgery since the body is used to it.)

General Guidelines: 1. Limit fruits to the following: Fruit juice; canned and skinless fruits; pureed fruits and ripe bananas. Avoid raw fruits and canned fruits that have skins or seeds.

2. Limit vegetables to the following: Vegetable juices; tender cooked vegetables limited to asparagus tips, beets, broccoli tips, carrots, peeled eggplant, peeled potatoes, peeled tomatoes, pumpkin and squash; other vegetables in pureed form are acceptable.

3. Use white or refined breads and cereal products, rice and pasta products.

4. Choose well cooked, tender meat, poultry, fish, eggs and cheese. Avoid meat and shellfish with tough connective tissue or gristle. Avoid meats in casings, like hot dogs and sausages.

5. Chew all foods thoroughly.

6. Drink plenty of liquids to avoid dehydration.

7. Foods more likely to cause blockage include: Celery, Dried Fruit, Popcorn, Raw Carrots, Coconut, Grapefruit, Salads, Oranges, Coleslaw, Corn, Nuts Suggested Meal Pattern with milk, coffee or tea BREAKFAST LUNCH DINNER Orange juice Tomato soup V8 juice® Corn flakes Lean hamburger on seedless bun Broiled chicken breast Ripe banana Canned peaches Mashed potatoes and gravy White toast Cookies Asparagus tips Margarine/jelly Dinner roll/margarine

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

40

Ileostomy Diet, CONT. FOOD GROUP

FOODS YOU MAY EAT

FOODS TO AVOID

Milk Products

Milk; cream; plain cheese; plain yogurt

Cheese with seeds or nuts; yogurt with nuts, seeds or fruit skins

Meat and Meat Substitutes

Ground or well cooked tender beef, ham, veal, lamb, pork or poultry; eggs; fish; oysters; shrimp; lobster; clams; liver; smooth peanut butter

Tough fibrous meats with gristle; chunky peanut butter; dried peas and lentils; meats in casings like sausage or hot dogs

Breads and Starches

White, rye, graham breads and rolls; sweet rolls, donuts, waffles, pancakes; French toast, biscuits, matzoh

Breads, rolls or crackers with added bran, seeds, nuts or coconut

Soda, saltines, graham crackers; pretzels, rusks, melba toast, zwieback

Cereals with whole, grain, bran, raisins or nuts; cereals advertised as “high fiber�

Cooked cereals: cornmeal, farina, cream of wheat, Malt o MealÂŽ, oatmeal:

Potato skins; brown or wild rice; popcorn

Dry cereals: corn, rice, oats and refined wheat cereals Mashed, baked (without skins), creamed potatoes; macaroni, spaghetti, noodles, white rice, hominy; potato chips Vegetables

Tomato and vegetable juices; Tender cooked or canned: asparagus tips, beets, broccoli tips, carrots, eggplant (peeled), pureed or canned skinless tomatoes, tomato paste or sauce, winter squash, pumpkin, avocado; pureed vegetables

All raw vegetables; artichokes, baked beans, beet greens, brussel sprouts, cabbage, sauerkraut, cauliflower, collard and mustard greens, green peppers, parsnips, peas, mushrooms, onions, rutabagas, fresh tomatoes, turnips, spinach, watercress, zucchini, green beans

Fruit

Fruit juices except prune juice; Cooked and canned: applesauce, peaches, pears, fruit cocktail; mandarin oranges; pureed fruit; ripe bananas

Apples, apricots, berries, cranberries, currants, cherries, dates, figs, grapes, grapefruit, guavas, melons, nectarines, oranges, prunes, fresh peaches, fresh pears, fresh pineapple, fresh plums, fresh rhubarb; dried fruit

Fats and Oils

Margarine, butter, cream, mayonnaise, salad oils, plain salad dressings made from allowed foods, plain gravy, crisp bacon

Other

Soups and Combination Foods: Bouillon, broth, cream soups made from allowed foods; any strained or pureed soup; casseroles or mixed dishes made from allowed foods Desserts/Sweets: Plain cakes and cookies, gelatin, sherbert, ice cream, popsicles; pudding custard, cream pies, pies made from allowed fruits; hard candy, honey, jelly, molasses, syrup, sugar, chocolate syrup, gum drops, marshmallows

Soups: Soups made from vegetables not allowed Pizza: Made with vegetables not allowed Desserts: Desserts or candy that contain nuts, coconut or dried fruits; jam, preserves, marmalade Condiments: Coconut; pickles; olives

Condiments: Catsup, horseradish, prepared mustard, vinegar, cocoa powder; all spices and herbs

3FQSJOUFE XJUI QFSNJTTJPO GSPN UIF 'PPE /VUSJUJPO 4FSWJDFT 'SPFEUFSU .FNPSJBM -VUIFSBO )PTQJUBM .FEJDBM $PMMFHF PG 8JTDPOTJO 3FWJTFE "NFSJDBO 4PDJFUZ GPS 1BSFOUFSBM &OUFSBM /VUSJUJPO r XXX OVUSJUJPODBSF PSH

1"(& 0'

  ♣QUOTE RESEARCH ♼CORRESPONDANCE ŠPHOTO ♌ILLUSTRATION ♠VIGIL

41

♠ Saturday, May 21, 2011.

Garnet had to go back to Montreal without me. I was able to get an open ticket based on a credit bank for Westjet flights.

Last evening, I made a shopping list for Dad for the foods that Mom is allowed to eat. He can just keep it in his wallet to consult when he gets groceries.

Mom’s mood was very somber yesterday. She had walked all the way to the elevators and was very strung out and crabby. Fortunately Judy was there all morning and the nurses and Physio got her to help them. She just wanted to feel sorry for herself.

Dad and I were here to spend the afternoon. She did not want us to leave at 5 pm so we stayed until 7. Her pain is manageable but it is the painkillers that keep her so doped she cannot even tell where she is or why. We had to show her the incision and her ostomy bag several times to get her to understand but she gave up and said, ‘I just don’t understand’. This was a temporary hallucinatory state fortunately. The nurses are trying to keep her from overdosing on pain meds. They fear she will lose touch with reality, I guess. She panics when she wakes up. ‘How long?’ she cries out, as if tortured. Yet she wants to work with and not against the attendants, so she does not give up. Noises are very bothersome to her.

Yesterday she came off the oxygen and is breathing well at room air. She had the leg constrictors off, which she detested and did not accept, and she managed to keep them off until her nurse (Cherri) took them away this morning. The catheter was removed, and Mom had a good wash up and even went to the toilet on her own. It is very hard for her to walk since her leg muscles are stiff. She has a certain amount of rehab to do but it is encouraging to see her want to get up. Her BP was 136/75. Her heart rate was 100. Her O2 intake at Room Air was 91 but her temp was up to 37.7. Her respiration was at 25. She is looking very pale but sometimes flushed when she gets too hot. A little fanning and some cold cloths get her back to skin colour. She tried a little oatmeal and mint tea but gets pretty nauseous. Her grape popsicle from Rose yesterday was really appreciated.

READ PRAY SING and the evil spirits (anger, self-pity, complaining and feeling of abandonment) are chased away. It is so remarkable to see God keep his promise in this regard. Very shortly all is calm and Mom’s perspective is hopeful and full of faith until doubts start to creep in again, usually just after she wakes up. I find this to be no great challenge to get her back to a brighter outlook when I have had some rest, but then I need to have faith too.

The travel time today was long. One hour and 15 minutes. I had to get off the train and take a bus detour to Sunnyside train station, get back on the NW train and take a bus from the Lion’s Park Station to the Foothills Hosp. I am glad I have my computer with me, but I hope it is not stolen since the theft rate is high in this unit. Maybe the person who is supposed to help hook me up to the Wi Fi in the hospital here will be by to see me soon.

Signing off, Daryl

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

42

♠♣ Monday, May 23, 2011. Victoria Day Long Weekend or Fête de Dollard in Quebec Brian Clark, student campus minister at the University of Alberta, preached for a second time at Woodgreen yesterday. This time he spoke about fear and how it grips us when it should not. The fact that Brian spoke on the same text that was preached when God first convinced me of his presence in the world (Fairview Church in Vancouver) was significant for me. He spoke from Luke 12.4-11 and 22-34. There is no doubt that love casts out fears. God truly loves us. Even Mom, who can’t bear to be away from her loved ones for any waking hour, knows that she is alone when two or three are not gathered around her in Jesus’ name. She wants to be able to bless people and be there for them in Jesus’ renown, yet she has asked that while she goes through this present stage of healing, we should ask visitors to wait to see her for a few days. She has a hard enough time saying goodbye to her loved ones, she said, so she wants to limit access to us. The sermon reminded us we are ‘in Christ’, the chosen Saviour of mankind who said, “Fear not little flock, for your Father has been pleased to give you the kingdom.” The next verses say essentially, “exchange all your wealth for that kingdom and stop exploiting the poor, give to them instead. Your heart will then be in the place that demonstrates you are under God’s rules, where God’s treasure and heart is” (paraphrase of Luke 12.33,34). This sounds so much like what Mom keeps whispering to me. “Look around you and help those in need.” This is what Mom has done all her life - trusting and obeying those words.

Yet I am not helping her, it seems. She wrote on a piece of paper (because her voice is hoarse), “I am dying and nobody cares.” Dad sees this as Mom’s sense of humour, from a private joke between them related to the story of a sick girl who wrote to her parents on a paper airplane she sent flying down the stairs, “I am starving and nobody cares”.

What I regret is how human thought fails us when presenting the Paradise to which Mom is entitled because of her relationship to Christ and to which our merciful God has destined her. Take two authors from the Post Empire Building (and the Colonizing Age) of Great Britain and France, Rudyard Kipling and Antoine de Saint Exupery. Both take a feeble stab at the conquest of the fear of death.

Kipling writes in ‘When Earth’s Last Picture is Painted’: When earth’s last picture is painted And the tubes are twisted and dried, When the oldest colours have faded, And the youngest critic has died, We shall rest, and faith, we shall need itLie down for an aeon or two, Till the Master of All Good Workmen Shall put us to work anew.

In contrast, the Bible says that Mom will do perfect effortless, satisfying work; she will worship; she will reign in the new heavens and the new earth. Kiplings’ aeon of rest does not figure in God’s apparent plan as John MacArthur points out in his Bible Study Series, ‘Heaven’.

43 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

In this book’s contents the reader, curious about what the Bible says about heaven, finds Looking Toward Heaven: 1. What Heaven is 2. Where Heaven Is and What it is Like 3. The New Jerusalem 4. What it Will Be Like 5. How We Will Relate to One Another 6. How We Will Relate to God 7. What We Will Do Quotes are included from Genesis to Revelation.

I picked up a paperback in the Emergency Room and read it through. In Wind, Sand and Stars by Saint Exupery (Lewis Galatiere English translation), the author compares the contradictory value placed on human life, first in a mining accident, and then in the Spanish Civil War of the 1930’s. The community rushes to the rescue of one single trapped miner, yet hundreds of thousands in Barcelona or Madrid remain unaided by the international community of onlookers during Spain’s Civil War. As one pilot, Exupery felt helpless because of the expendability of individuals during a time of war.

Picasso painted his commissioned work, Guernica, at this time - the first bombing from an airplane of a civilian population.

Exupery reminds me of the empire, who is my mother.

Each individual is an empire. When a mine caves in and closes over the head of a single miner, the life of a community is suspended.

His comrades, their women, their children gather in anguish at the entrance to the mine, while below them the rescue party scratch with their picks at the bowels of the earth. What are they after? Are they consciously saving one unit of society? Are they freeing a human being as one might free a horse, after computing the work he is still capable of doing? Ten other miners may be killed in the attempted rescue: what inept cost accounting! Of course it is not a matter of saving one ant out of the colony of ants!

They are rescuing a consciousness, an empire whose significance is incommensurable with anything else.

Inside the narrow skull of the miner, pinned beneath the fallen timber there lives a world. Parents, friends, a home, the hot soup of evening, songs sung on feast days, loving kindness and anger, perhaps even a social consciousness, and a great universal love, inhabit that skull…

Just a quick interruption: “ Only the Spirit if it breathe upon the clay, can create man” is the last line of Antoine de Saint Exupery’s book. …By what are we to measure the value of a man? [or a mother, who costs the taxpayer 7,000$ a day and 12,000$ for two operations? For whom we pay our air flights, bring out grandchildren and lose work time? ]… It stirs us, prolongs itself in us. Man’s gestures are an eternal spring. Though we die for it, we shall bring up the miner from his shaft. Solitary he may be; universal he surely is.” [end of quote concerning the miner].

‘Only free men may gamble with death’, Exupery says to define the rescuers. Of one brave sergeant in particular he says ‘ A great wind swept through you and delivered from the matrix the sleeping prince you sheltered…that man within you’. If there is such a thing as a woman within a woman, there has to be some way that the princess comes 44 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

out of Mom from the matrix that was Mom. Could this not be said of all the nurses and the two doctors who are searching that spark of life that is left in our dear mother, wife and grandmother? We hope the staff are not pure materialists; of those who feed themselves, clothe themselves, look after their daily needs but have nothing inside, no inner cultivated life that only looks at Mom as a piece of furniture in a bed that has to be constantly cleaned. If they are, then they too are of the same stuff. “Each sentinel among men is responsible for the whole of the empire,” claims Exupery. “Enlist for good, all those who swing the pickaxe in the community of mankind and you have set them free!”

However they see Mom, it is great to see this team of health care workers find meaning in their work. I only hope Mom recovers and we can all rejoice in our work.

The Asian nurses treat her with enormous respect, gentleness and white crisp linens.

Similarly, the African nurses want to enrich her with luxuries like grape popsicles and tea. The local Caucasian nurses slap her like a good horse and seem to say, Buck up!”☺ and the Eastern Canadian nurses use reflective language, encouraging her to do the right thing.

Yesterday her blood pressure was at 129/67, her heart rate at 108, her oxygen intake at 95% even at room air only. Her temperature was 36.4 C, her respiration (pulse) was at 20 and her white blood cell count was down to 13.5. She has swollen ankles, the left one in particular. Her incision is a little ‘weepy’ but the dressing is being changed frequently. I gave her a quick haircut, something she really wanted.

Dad reassured her that he cares about her dearly. He massaged her skin with cream (anointed her nose and forehead with oil). He reminded her of her friends who care and are careful with her. Mom had requested we take her to see a doctor but that it was probably too late to go to a hospital. Dad and I smiled at that one! I find it amusing that the nurses are sometimes more confused about her than she is about them. She has either pain or no mind or an alert mind with pain. Medication requires daily measurement.

‘Whether we live or die we will always be with the Lord’ (Romans 14.8). Saint Exupery adds in his 1939 argument, the Spanish Civil War had ideologies that opposed it, and the War ideologies ‘swallowed up faith’, “ Although we don’t know it, we are in search of a gospel to embrace all gospels,” Saint Exupery said. After testing all sorts of ideological spirits of the age, the twentieth century was left behind with no other gospel but the only true gospel we find in the grace and truth of Christ.

As Dad and I were about to leave (we always get Mom’s permission) Mom recited with me, “Now I lay me down to sleep, I pray the Lord my soul to keep. If I should die before I wake, I pray the Lord my soul to take” (A New England Puritan’s prayer). We cannot fight against God when he wants to destroy our body and replace it with an imperishable one. There is a time to be born and a time to die, the Ecclesiast says. Mom believes it is her time. We cannot deny her this and we know it, but we will see what today brings. ♠ Tuesday, May 24, 2011. Boston, Tampa Bay, San Jose, and Vancouver play for the Stanley Cup. Vancouver is in the finals as of tonight.

If fires in Slave Lake, Alberta, floods in Manitoba and the Richelieu River in Quebec, tornados in Joplin Missouri take out so many homes and so many lives, do I ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

45

have the same level of care? Yes, they make me weep, they make me sad, they tear my heart out, but “I have a Mom in the Foothills Hospital in Calgary and she may not live today,” I think, as I take the train to Lion’s Park Station, thankful the weekend detour is over. The detour proved to be a scenic route on Bus 20, which I was happy about because I saw the distant Rockies from Glenmore Trail but another route through downtown meant crowded buses. A young mother with a stroller did not come on the 201 bus because she thought it was too crowded. I felt sad for her, because there really was room and nobody at the front shouted out to her from the door. The bus left without her.

It was a cloudy rainy day and I was sad for Mom and cried all the way to the hospital.

The digestive system must be re-trained after surgery. According to Nurse Sabrina, the small intestine trains itself to do some of the work the large intestine did before it was removed. ie. absorb water from the mush that is to be eliminated. The rectum and anus have not been removed, so every three weeks or so the urge to eliminate brown mucus as stool will occur. The body is adaptable and the system will start to work better as Mom eats. A stool sample was taken today to see if the C-difficile is eliminated. The anti-biotic pills are impossible for Mom to swallow, so the Doctor took her off them (one day early).  Last night I was ‘googling’ again. I checked out swallowing difficulties, anorexia in the elderly, Candida yeast in the throat, and how anesthesia or dementia or medications alter cognition which alters hormones and enzymes to the degree that appetite is lost or swallowing is hindered. Ghrelin is a peptide hormone that is produced in the stomach and pancreas and has to do with the appetite. Wikipedia says, Peptide hormones are a class of peptides that are secreted into the blood stream and have endocrine functions in living animals. There is a relationship between the hours of sleep and blood plasma concentrations of ghrelin, as the hours of sleep increase, ghrelin concentrations were considerably lower, thereby potentially reducing appetite, David E. Cummings, Professor of Medicine at a University in Seattle Washington wrote in 2006. I was concerned for the loss of appetite and Mom gagging all the time on anything taken by mouth. Her gag reflex has been perturbed by the anesthesia. I concluded Mom should be out of bed more. For this reason, and because I was so sure Mom was going to pass away from starvation once she got home, I headed up to the Foothills at 7:00 am. just to feel her presence again. I also wanted to spend the morning with Judy.

I had a few minutes with Mom before Judy came. I was glad to see Nurse Rhonda back and I met Alyssa, who is a nursing specialist who seemed to want to help a lot. She said, “It is time to make up a new plan. Getting her to swallow the Flagyl tablets is not working, and food absorption is not happening.” Lesley, the dietician, was wondering why the TPN was taken off. She talked of sending Mom to have a swallowing assessment (with barium) by a speech therapist. Alyssa managed to convince Mom to take some nausea medication by IV. She had no problem swallowing the Thrush medicine. It tastes like banana. Mom still had to receive a blood thinner by injection in one of her badly bruised shoulders. For the first time, because of Alyssa’s keen sense of judgment, Mom was offered the option of having the needle in her leg or 46 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

stomach. “Because the 29 staples won’t be out until next Tuesday, the abdomen is NOT an option,” she said, to our relief.

The first thing Mom said to me privately was, “I have never thought of suicide before, but now I am.” “Why hasn’t this all worked out? How long, Lord?” I wept all over her nightgown as she spoke. “Oh, Daryl, I am so tired!” she sighed. I mentioned our hope in Christ. She was so glad I was there to encourage her, she said. Again when I referred to home she asked, “Where’s home?” [p.s.Our son Daniel, a photography student and artist, corrects my optimism from time to time. He claims I don’t see beyond the dream. I agree, we have a sorryful tragic love for God and we finish our days with a sigh. Here is my correspondance with him after I returned to Montreal. He sent me two disturbing video links and I responded to them.] ♥ On 21-Jun-11, at 8:57 PM, Daniel Zoellner wrote: Hello son so far but so near! ♦ Here is my first thought on seeing the linked first video you sent. http://www.youtube.com/watch?v=6gYBXRwsDjY&feature=player_embedded#at=97 Perfectionism taken to the extreme!! This is what putting on make up is like for a 13 year old girl. I remember taking it all off afterwards. Do I really know what face I want to put on in public? It also represents shyness taken to the extreme.

Here are my thoughts on seeing the second linked vidéo. http://www.youtube.com/watch?v=LqlwqR0--_U&feature=related Putting on sack cloth and ashes represents turning to God. Is this lamentation more related to mocking God and finding self more valuable than anything outside of self? Or is it true turning away from sin and toward God as saviour? Happiness within is a gift of the Holy Spirit. This is the happiness that man desires. Peace with God. Separation from the self God intended one to be (an adopted son) and attacking self is attacking the image of God in self. The character portrayed by Olivier seems to have missed peace, kindness, love, joy, self-control, meekness, gentleness, faithfulness and patience somewhere along the way. What relief people find when they are reconciled to their Creator! Nothing they have done is counted against them. "He lifts my countenance" but when God shakes his fist at someone "who can change God's mind?"

What does God require oh Man? That you practice justice, love mercy and walk humbly before your God. Don't sit with scoffers. Stand in the company of the redeemed. Do not fear those who can kill the body but not the soul. Is Olivier trying to kill his soul? ♣ (Psalms 1. 1—41) True happiness 1 Blessed is the one who does not walk in step with the wicked or stand in the way that sinners take or sit in the company of mockers, 2 but whose delight is in the law of the LORD, ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

47

and who meditates on his law day and night.

3 That person is like a tree planted by streams of water, which yields its fruit in season and whose leaf does not wither — whatever they do prospers.

4 Not so the wicked! They are like chaff that the wind blows away.

5 Therefore the wicked will not stand in the judgment, nor sinners in the assembly of the righteous.

6 For the LORD watches over the way of the righteous, but the way of the wicked leads to destruction. ♠ I realize that the medical team, (including us, the family) need to constantly assess each day and its needs. Wickedness is crookedness and inaccuracy. Righteousness is straightness or accuracy in gesture or behaviour (nothing ill-thought-out or unfounded being applied). Makarios (blessed) means we can feel supported if we are not wicked (crooked). There are moments when things seem chaotic, and the decisions have to be made a little blindly, but most often a little time is given to discover if something is working and we wait for the body to respond or do its job. This is the way of hospital treatments and health care. Several solutions are there and when the patient responds well, there is progress. I see these as a bag of products that have proven themselves to be useful. With excitement, the health care worker says, “Well let’s try this now.” There never seems to be an end to this. Where there is a will, there is a way. At this point in time everyone is saying, “Let’s get her out of isolation - get her out of her room.” ♣ A book my husband once read came to mind, a book by Sherwin B.Nuland called "How We Die: Reflections of Life’s Final Chapter". Nuland demystifies dying and empowers the living not to make death a friend, because it never is, but to face the enemy with humility and intelligent wariness. The contributions of other intensely sensitive people and the scrutiny of specialists in various diseases made this a good read for my pastor /army chaplain/ theology teacher husband.

On the train, I thought of letters I wrote to family members of one young mother who was dying. She wanted to let her family know different things related to her love for them so she asked me to help her write them in good English. I accompanied Helen Mui during the last days before she died of cervical cancer.

Consequently, I decided to make a list of Mom’s immediate family members (34 in all) and as I mentioned each name, Mom started to give me her thoughts to say to the person and then she prayed for that one. Judy arrived and we talked to her. Judy took Mom’s hand and my place, so I was able to sit down in a chair instead of on the bed.

Mom was able to find some humour in the inflatable cover on the bed mattress. She praised our faithfulness in not deserting her since she had expressed earlier her fears of being deserted by everyone, especially Dad, who ‘she can’t get enough time with’. One day she said she thought Dad was out duck hunting. Again, where did that thought come from? Was it a memory of her mother saying her husband Fred, a duck hunter, was always too far away in the woods?

Towards lunchtime, her two doctors came to see her and discussed their assessments. They included Mom in the conversation. They answered all our questions 48 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

doubts and fears. Dr. Mulloy had to leave, but he came back in the afternoon when Dad was there. Dr. Snellgrove did all he could to encourage us. “We have come this far, why give up now,” was Dr. Mulloy’s comment. “She has swallowing problems, that’s normal after surgery. It will change for the better.” He later told Dad that he is looking into follow up by way of a transition stage between the hospital and home, maybe to the Rockyview Hospital where Mom may undergo some rehabilitation in a less hospitallooking environment. Her nutritional needs are not being met right now but the nursing staff will give her a few days to see if she is still having difficulty swallowing or loss of appetite. Then they may install a tube for the stomach to keep it involved in digestion or they may put her back on IV feeding but that would NOT be their first choice since it is artificial means and interferes with her progress to self-sufficient eating. She is being treated for Thrush, has crackling in her lungs, which Nurse Sabrina indicates might mean puss is there (Aspiration or Hospital pneumonia). The white blood cell count is down to 10,000 (normal). Her blood pressure is at 116/70. Her heart rate is 100. Her oxygen is 93. Her temperature is at 36.9 but her respiration has gone down to 18.  As I went to the cafeteria today, I walked by a display table with notices from the Canadian Association of Speech – Language Pathologies and Audiologists (www.caslpa.ca). “Gulp! Here’s the bottom line on swallowing disorders,” the title on the information page said. “How appropriate, I thought!” I read it as I ate lunch and took it for Dad to look at. Mom’s anorexia (for that is what Dr. Malloy agreed it was) has been demystified for me in the last 24 hours. I am not so worried about it anymore, although it is a cause of demise in dementia patients. Gerontologists are still trying to figure out its cure.

Dad arrived and handed me the keys to the van. “Here, take the car home and we won’t have to pay so long for parking,” he said. I was thankful for this and as I drove back south, I decided I needed a good walk in the spring air. I pulled into Heritage Park and spent three hours chasing ducks on muddy roads that made me think of the Road to Avonlea and taking videos of the steam as the train chugged out of the stations. I chatted with each of the shopkeepers and spoke in French to the period costumed figures in the Fort, at the fur trading counter and at Our Lady of Peace Mission. The schoolteacher at the Little Gleichen schoolhouse asked me what brought me to Heritage Park. So I told her about my mother. The re-enactment teacher was from Numbia, Africa and seemed to have a Scandinavian accent (a missionary or the daughter of missionaries?) I believe she was a Christian as we shared our hope for heaven where there are no more tears and no more disease. We talked about the Lord’s Prayer recited daily and health checks performed weekly in former Alberta prairie classroom settings. Dirty or clean fingernails was the determining case against the health delinquent. I don’t know what the punishment was for not saying the Prayer our Lord taught us to say. Students today may hear it sung by Andrea Boccelli and the Mormon Tabernacle Choir on the Internet media networkYoutube.

All the young gentlemen tipped their hats at me, I bought a penny candy (for the inflationary price of 10cents) from the General Store and I toured the cottage hospital with a healthcare worker from Texas. The Northwest Mounted police officer had just left to do his rounds, so he had closed the station. At the Hotel Wainwright, I smelled the potato soup, which reminded me of a rainy spring walk taken on the boardwalk beside 49 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

the ocean in New Jersey during a break at a teacher’s conference. After photographing the beach chairs, I ordered a potato soup whose taste I remembered for years after.

I was alone in most of the buildings at Heritage Park and had long conversations with the historic re-enactors about antique cars, the Town Hall’s role and singing God Save the Queen (Victoria) at school. Oblate Missionaries were sent from St Albert to the Blackfoot Indians. Bed bugs and lice were greater annoyances in winter than the cold at Fort Calgary. The paddleboat SSMoyie was built in Nelson. I almost took a 3$ cruise in it on the Glenmore Dam. After some reflection, I felt it would be too lonely since I would likely be the only passenger on board. Although there were school groups earlier in the day, by the end of the afternoon it was pretty quiet. Spring is beautiful when there are groomed hillsides, horses grazing in the fresh grasses, grey skies, newly formed leaves on the trees through which one may still look. Families on wagon rides passed through the small byways. A ride on the paddlewheeler would almost be the ultimate romantic ending to the day. It would only have increased my loneliness for my husband, so I opted for returning to Millrise Pt. I was satisfied with my little detour, a much needed break from the hospital.

Daryl ♠ Wednesday, May 25th, 2011. 40 Days and 40 Nights already gone by Where did these forty days start? I am also inflicted with diverticulosis. I don’t generally see this as something to talk about. Pockets probably started to form in my intestine beginning when I was pregnant with Martin. I also have gallstones that will eventually have to be removed by laperoscopy.

Regardless of how pockets form in the intestine when one is constipated, it is necessary to be careful that these do not become infected.

Judy and Mom and I had a long visit together early in the day. Judy asked her about her early nurse’s training in the St- Eugene Hospital and Nursing School in Cranbrook. She dearly remembers her friend Bertha who married and became Bert Price. Mom really liked working at the Bowcrest Nursing Home in Calgary too (after her children had all grown up and left home). ©Daryl Zoellner I am comforted by the presence of my shy sister, Judy, who has lived so far away most of my adult life.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

50

Today, Mom was starting to get unresponsive by late afternoon. No walks, no pushing her to eat. It frustrated Dad. I know her doubts are weighing on her. “Can Clare take care of me?” Life has become so hard. “Who’d a thunk it?” she was jokingly saying when she first woke from anaesthesia. Now she says, “I just want to let go.”

Mom had a chest x-ray this morning but we don’t know the results yet. Ensure was ordered again and she drank 160 ml. She received three small bags of Potassium (KCL) drip. Dr. Snellgrove approved the taking of a sterile urine sample by catheter. An “in and out” catheter was used for this but it requires 4 nurses to do this procedure. Mom had just woken up so I was afraid she was going to panic again with all the people in the room. She did not. Dad changed her ostomy bag with Julie, the nurse in charge of these.

Metaclopromide for nausea was prescribed in the morning. She has a 4x a day treatment for Thrush called Nystatin (Mycostatin) the same medicine I had found when I had done my research. Mom still likes drinking it. This may be the reason Mom was in a real slump after all this. She is sensing that she has no control over her situation and that is kind of scary.

There is not much else to report.

Daryl ♠ Thursday May 26, 2011.

Fire alarms were on for nearly an hour at the Foothills this morning. Doors had to be kept closed and the drill put everyone on edge for a while. Elevators were stopped, so I took 20 minutes between drills to wait for them to work. I had my computer with me and a heavy can of beef stew in my bag so I was a little reluctant to walk the 10 flights of stairs. Mom’s vitals are BP 112/62. Her T. 36.8 Her O2 intake is 92 % at RA. Heart bpm 92 and respiration is at 24. She hates it when the nurses ask, "out of 1 to 10 what is your pain". The nurse wrote on the white board that her throat pain was (8/10). I asked if she had a sore throat when I came in but she said, ‘No’. Maybe they gave her something for it. She had a sore shoulder from an injection. I put compresses on it. (First hot then cold).

Mom is to have another CT today so she has to drink four big cups of Telebrex again. We made a game out of it. She took a sip for every member of the family I mentioned. It was like giving each person a kiss. “Here is a sip for Judy, a sip for Krista, a sip for Adrien, and one for Mathias”. She made it through two cups this way. The nurse (Amanda) was pretty surprised and thankful she did this since they had called Dad at home to get someone to come and help them. He told them I was on the way.

I told Mom to ask any questions she wanted. She asked three times how she got here. She asked where I was staying and what date Garnet and I were coming back for our summer holidays. Her usual question came up, “What is Clare doing?”

What a rainy day! 30 mm are expected.

Mom was very encouraged by the Scripture readings in Philippians and I Thessalonians 4. She knows these off by heart but they remind her to think of others who are suffering in the world and to not complain and to endure. The trial is nothing to God. The endurance is what he prizes. Paul was in prison about to die. His joy is remarkable for its satisfaction in things real concerning redemption and restoration of 51 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

the creation.

Dr. Mulloy came and spoke to Dad about puss accumulation in Mom’s abdomen.

Her white blood cell count has increased to 14,000. So the CT scan, x-rays and blood count in the past few days are indicators that there needs to be some way to drain the puss, “which is probably why she is probably feeling so misérable.” The way they are going to go about this (starting tomorrow and monitored as the stints drain into a bag over the weekend) is to use Image-guided Needle Aspiration. When they test her white blood cell count again on Monday they will be able to see if it is all removed. Sabrina, her nurse, assured me that this is not a biopsy even though it is done in the Cancer Unit.

The liquid will be examined for its content.

Something amazing happened today. Mom said she was hungry and wanted to have a piece of toast! I could barely believe my ears when Dad told me this after I came back from lunch. She skipped breakfast and lunch because of the fast before the CT and she has not been on any food intubation supplement for a few days. Dr. Mulloy is talking about her going back on the TPN in the morning at a reduced rate, however, so she can increase her nutritional intake and get stronger.

Mom is so boney now that it is very painful for her to lie on a hard plastic stretcher they use for the CT scan. It is hard for Dad to get a good idea of what the doctor or nurse might explain to him, so I still feel I need to be here to get the important details for him and to comfort Mom when she cries.

Today Dad arrived with 2 beautiful pictures of Marc, Erin, and Clara just as Mom was over her cry about the hard stretcher. Clara has her little arms outstretched as if she is giving her Great Grandma a hug. It was very useful to show these encouraging photos to her as we went down the elevator to the “morgue” she calls it, because "it is so cold". The day is not yet over.

Thanks for all your love, concern and prayers and thanks again for the flowers, Ludwig family. (We have your Christmas photo posted here where Mom can see it).

Daryl ♣ It’s Friday But Sunday’s A Coming! http://www.youtube.com/watch?v=UWh6h-­‐Al0us&feature=related ♠ Saturday, May 28, 2011.

The image-­‐guided drainage of abscesses, one on the left and one on the right side of the bowel, took place yesterday afternoon between 2:30 and 4:30 pm. Mom has two more bags on her tummy. We can count on five to seven (but no more than ten) days for this kind of drainage. Bleeding and possibly blood poisoning (sepsis), infection of and malfunction of major organs, or injury to the interior of the abdomen may still occur. These risks seem to have been avoided at the moment.  The best website and information I have found on the subject of risks is from the National Institutes of Health: http://www.ncbi.nlm.nih.gov/books/NBK6937/ ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

52

Common sense is required. The author, M. Schein of the Dept. of Surgery at the New York Methodist Hospital states that the puss may be just a sterile pocket, which will later come to terms with the rest of the body. Getting inside to remove the puss surgically might be the better method than drainage (which requires constant sterile care) if there is fever and high white blood cell count after four days of drainage (surgery may be done on very ill patients who have had surgery already). So this procedure might not have been necessary but Dr. Mulloy is using his common sense to evaluate as we go. If in four days the output is not lower than 25ml. then he may opt to do more surgery or put her in palliative care. ♠

Mom was cheerful and alert for a little while after the procedure but she promptly fell into a sedative-­‐induced deep sleep and missed the supper she was looking forward to. She was wondering if she had eaten recently because we think she finally felt hungry after the abscesses were ruptured and began to drain (like two balloons being popped under her stomach). We’ll see today if this is the case.

(This morning she ate a piece of white toast with peanut butter and jelly and drank tea). Monday should show if the abscesses are going to be sufficiently drained to make her feel better. She needs to be at less than 25 ml of output to call this a success and on average it takes 7 days. If she has persistant fever and high white blood cell count after the fourth day it can be considered a failure. [p.s. It only took a few days to drain all the puss.] Hopefully she will not have a chronic filling up of puss in the abdomen requiring surgical removal. There will be a culture of the puss done to see what bacteria is involved (ie. C-­‐Diff or something else). The Doctor (a resident) was Dr. Wiens. She was very nice and did not want to scare Mom, but she had to tell her the risks. Again Mom felt like there was no other solution so she agreed to the procedure. But Sunday’s coming!

Mom’s vital signs after the procedure: Bp 118/62 Temperature 37.6 Oxygen intake 95 Heart beats per minute 94 Resp 26 She had a very high breathing rate, so in the evening they put her on some oxygen. ♣ Matthew 28.17-­‐20 says: Now, the eleven disciples went to Galilee, to the mountain to which Jesus had directed them. And when they saw him they worshiped him, but some doubted.

And Jesus came and said to them, all authority in heaven and on earth has been given to me…(insert Jesus’ co-­‐mission for would-­‐be missionaries)… “And behold, I am with you always, to the end of the age.”

Jesus taught his will to the world. His will is with us always. He is… who he is… forever. Nobody can change that ever. He has received the promised dominion, HIS promised domain. It is not our will for a healthy body to expire. I tremble at the ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

53

thought that there is a will superior to my will for if it is God’s eternal purpose to take Mom ‘home’, there is nothing any medical personnel or family member can do.

Nothing! ♣ The Lord cares deeply when his loved ones die (Psalm 116.15). We may use words to give courage to her spirit until the medical profession has its way. We may clean the body as Jesus cleansed the leper, but it is the way of all humans to die in this body and then be judged. We may not attribute worthiness to Mom or unworthiness to her until the one who has dominion pronounces his last word on this earth (Job 19.25). Then will he measure us and show the world the ones he values. 

How do we judge doctors? My own doctor Joyce Valois has a 4.9 rating out of 5, Dr. Malloy has a 4.3 based on 7 reviews. If we want to rate the value of our doctors (helpfulness and knowledge only), we may do so at www.ratemds.com/doctor-­‐ratings/110851/Dr-­‐Mulloy-­‐Calgary-­‐AB.html but I think the value of any doctor is up to the verdict of our Final Judge. When God wills to ‘lift the veil’ of separation from His glory and tells Mom or any of her doctors or caregivers (or me) to walk into his holy presence, I am convinced he will do it. ♣

Richard Dawkins, in ‘The God Delusion” masters the worldview of doubt, in fact he attempts to decriminalize it so as to not give the upper hand in society to those who believe, for belief is always dangerous when attached to religious zeal. Is belief dangerous or is God dangerous? God is perfectly free to do as he wills. “He is not tame, but he is good”, as C.S. Lewis states through the character of Aslan in the Narnia accounts. If we begin to live our lives as if God is good, many things change.

To be called according to his purposes, is already to be subject to God’s goodness or at least to have good works to do that have been prepared in advance for us to do so that nobody (nurses, doctors, friends and children like me) may boast.

“Your will be done, in heaven and on earth”. ♠

I have come to the conclusion that nursing is 100% relational. Yet, every behaviour has to be predictable and accounted for.

“So what is happening?” “How do you feel?” “I am going to do this now.” “Could you please do this for me?” “It looks like she has…” “Good point, we’ll put that in her file.” “We’ll tell the doctor.” Nothing is fixed, everything must be weighed and evaluated in consultation on a daily basis.

A shopping list is still on Dad’s mind.

A raised toilet seat.

A walker with 2 wheels, a walker with 4 wheels and maybe a wheelchair. ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

54

A bench for Mom to sit on in the bathtub.

2Cal drinks for quick calories. incontinence pads and mattress protection for the same.

Ileostomy equipment.  What about my own shopping list? I am thinking of a flannel sheet to heat in the dryer … something heavier than 6 oz. and made with 80% thick unbleached cotton and 20% polyester. So far I have found FIVE STAR ENTERPRISE to be an excellent source for all types of linens. I don’t think I would buy anywhere else: http://www.fivestarenterprise.ca/images/CATALOGUE%202008.pdf If Mom should “die before she wakes”, I would choose to have a Fish Creek Park bench dedicated to her with upkeep guaranteed for 10 years. Cost $3500. http://www.friendsoffishcreek.org/content/view/26/39/ Dad could go over and sit on it every day, maybe have a little dog to accompany him.

♠

Dad and Mom had a very difficult time today. When I arrived at 2 pm. they were saying a Forever Goodbye to each other. It was not the pleasant kind of “I will see you soon!” It was the adieu kind where nothing will be the same… ever. All hope was gone and Dad was in despair. He had Mom bawling her eyes out because she thought he was angry and blaming her. In fact, he was blaming all that is wrong in medicine. He was genuinely sad and defeated. He apologized for being negative and mumbled on in his “Martha” moment (John 11.20-­‐26). ♣ Do you believe that I am the Resurrection and the Life? Jesus asked Martha.

The passages below are taken from Max Lucado’s book “God Came Near,” published in 1986 by Multnomah Publishers, Inc. “HOW WAS THE NIGHT?” ASKED THE NURSE. The young man’s weary eyes answered the question before his lips could. It had been long and hard. Vigils always are. But even more so when they are with your own father.

“He didn’t wake up.”

The son sat by the bed and held the bony hand that had so often held his own.

He was afraid to release it for fear that doing so might allow the man he so dearly loved to tumble over the brink. He had held it all night as the two stood on the canyon’s edge, aware of the final step that was only hours away.

With words painted black with confusion, he summarized the fears that had been his companions during the darkness. “I know it has to happen,” the son yearned, looking at his father’s ashen face; “I just don’t know why” The canyon of death.

It is a desolate canyon. The dry ground is cracked and lifeless. A blistering sun ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

55

heats the wind that moans eerily and stings mercilessly. Tears burn and words come slowly as visitors to the canyon are forced to stare into the ravine. The bottom of the crevice is invisible, the other side unreachable. You can’t help but wonder what is hidden in the darkness. And you can’t help but long to leave.

Have you been there? Have you been called to stand at the thin line that separates the living from the dead? Have you lain awake at night listening to machines pumping air in and out of your lungs? Have you watched sickness corrode and atrophy the body of a friend? Have you lingered behind at the cemetery long after the others have left, gazing in disbelief at the metal casket that contains the body that contained the soul of the one you can’t believe is gone?

If so, then this canyon is not unfamiliar to you. You’ve heard the lonesome whistle of the winds. You’ve heard the painful questions, Why? What for? ricochet answerless off the canyon walls. And you’ve kicked loose rocks off the edge and listened for the sound of their crashing, which never comes.

The young father crushed the cigarette into the plastic ashtray. He was alone in the hospital waiting room. How long will it take? It all had happened so quickly! First came the news from the hospital, then the frantic drive to the emergency room and then the explanation of the nurse. “Your son was hit by a car. He has some serious head wounds. He is in surgery. The doctors are doing the best they can.”

Another cigarette, “My God” The words of the father were almost audible “He’s only five years old.”

Standing on the edge of the canyon draws all of life into perspective. What matters and what doesn’t are easily distinguished. Above the canyon wall no one is concerned about salaries or positions. No one asks about the car you drive or what part of town you live in. As aging humans stand beside this ageless chasm, all the games and disguises of life seem sadly silly.

It happened in one fiery instant, “Where is the bird?” shouted a space engineer at Cape Canaveral.

“Oh, my God” cried a teacher from the viewing stands nearby. “Don’t let happen what I think just happened.”

Confusion and horror raced through the nation as we stood on the edge of the canyon watching seven of our best disintegrate before our eyes as the shuttle exploded into a white and orange fireball.

Once again we were reminded that even at our technological finest, we are still frighteningly frail.

It is possible that I’m addressing someone who is walking the canyon wall.

Someone you love dearly has been called into the unknown and you are alone. Alone with your fears and alone with your doubts. If this is the case, please read the rest of this piece very carefully. Look carefully at the scene described in John 11.

In this scene there are two people: Martha and Jesus. And for all practical purposes they are the only two people in the universe.

Her words were full of despair. “If you had been here. . .” She stares into the Master’s face with confused eyes. She’d been strong long enough; now it hurt too badly.

Lazarus was dead. Her brother was gone. And the one man who could have made a difference didn’t. He hadn’t even made it for the burial. Something about death makes us accuse God of betrayal “If God were here there would be no death!” we claim.

You see, if God is God anywhere, he has to be God in the face of death. Pop 56 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

psychology can deal with depression. Pep talks can deal with pessimism. Prosperity can handle hunger. But only God can deal with our ultimate dilemma---death. And only the God of the Bible has dared to stand on the canyon’s edge and offer an answer. He has to be God in the face of death. If not, he is not God anywhere.

Jesus wasn’t angry at Martha. Perhaps it was his patience that caused her to change her tone from frustration to earnestness. “Even now God will give you whatever you ask.”

Jesus then made one of those claims that place him either on the throne or in the assylum: “Your brother will rise again.”

Martha misunderstood. (Who wouldn’t have?) “I know he will rise again in the resurrection at the last day.”

That wasn’t what Jesus meant. Don’t miss the context of the next words.

Imagine the setting: Jesus has intruded on the enemy’s turf; he’s standing in Satan’s territory, Death Canyon. His stomach turns as he smells the sulfuric stench of the exangel, and he winces as he hears the oppressed wails of those trapped in the prison.

Satan has been here. He has violated one of God’s creations.

With his foot planted on the serpent’s head, Jesus speaks loudly enough that his words echo off the canyon walls.

“I am the resurrection and the life. He who believes in me will live, even though he dies; and whoever lives and believes in me will never die” (John 11:25 NLT).

It is a hinge point in history. A chink has been found in death’s armor. The keys to the halls of hell have been claimed. The buzzards scatter and the scorpions scurry as Life confronts death---and wins! The wind stops. A cloud blocks the sun and a bird chirps in the distance while a humiliated snake slithers between the rocks and disappears into the ground.

The stage has been set for a confrontation at Calvary.

But Jesus isn’t through with Martha. With eyes locked on hers he asks the greatest question found in Scripture, a question meant as much for you and me as for Martha.

“Do you believe this?”

Wham! There it is. The bottom line. The dimension that separates Jesus from a thousand gurus and prophets who have come down the pike. The question that drives any responsible listener to absolute obedience to or total rejection of the Christian faith.

“Do you believe this?”

Let the question sink into your heart for a minute. Do you believe that a young, penniless itinerant is larger than your death? Do you truly believe that death is nothing more than an entrance ramp to a new highway?

“Do you believe this?”

Jesus didn’t pose this query as a topic for discussion in Sunday schools. It was never intended to be dealt with while basking in the stained glass sunlight or while seated on padded pews.

No. This is a canyon question. A question which makes sense only during an all-night vigil or in the stillness of smoke-filled waiting rooms. A question that makes sense when all of our props, crutches, and costumes are taken away. For then we must face ourselves as we really are: rudderless humans tail spinning toward disaster. And we 57 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

are forced to see him for what he claims to be: our only hope.

As much out of desperation as inspiration, Martha said yes. As she studied the tan face of that Galilean carpenter, something told her she’d probably never get closer to the truth than she was right now. So she gave him her hand and let him lead her away from the canyon wall.

“I am the resurrection and the life. . . Do you believe this?” (pp.81-88)

Sunday, May 29, 2011. Woodgreen Presbyterian Church, on Canyon Meadows Street, Calgary. ♣♦ Sunday’s here! Here it has been, since the resurrection. That’s My King! http://www.youtube.com/watch?v=yzqTFNfeDnE&feature=related ♠ I took Mom in a wheelchair to see the art in Foothills Hospital and to see springtime out the windows and “ to look up unto the hills” (Unto the Hills Around Do I Look Up - a hymn based on Psalm 121 came to mind again). I took photos of her in the chapel’s window her blue knitted alpaca wool hat. It looked like she was outside on the balcony.

It was too cold to go outside, so I made the photo-illusion. It makes her look like she has “passed through the veil”. “We see but through a glass dimly” (I Corinthians 13.12). In the chapel there is space for putting a rug to pray facing east towards Jerusalem. If someone outside the kingdom of God chose to pray toward Solomon’s temple in the days before Jesus revealed himself as the final temple, their prayers were heard. Some people practice this form of prayer to this day. ♣ I Kings 7. (41-43) says, "Moreover, concerning a foreigner, who is not of Your people, but has come from a far country for Your name's sake (for they will hear of Your great name and Your strong hand and Your outstretched arm), when he comes and prays toward this temple, hear in heaven Your dwelling place, and do according to all for which the foreigner calls to You, that all peoples of the earth may know Your name and fear You, as do Your people, and that they may know that this temple which I have built is called by Your name."

The stained glass window of St. Luke, the Physician, impressed Mom. Adonai Raphe (Hebrew for God who heals) in Exodus 15.26 says “If you will listen carefully to the voice of the Lord your God, and do what is right in his sight, and give heed to his commandments and keep all his statutes, I will not bring upon you any of the diseases that I brought upon the Egyptians; for I am the Lord who heals you.” Hebrew and Aramaen, maybe Greek, were languages that Luke spoke.

In a hallway near the Cancer Centre, a painting of a woman with a cat in the atrium made her say, “Daryl, you could paint that!” I told her, “There is a lot of basket and rug pattern and roof detail in it.” Painting means sitting for a long time. I have been sitting here in the hospital and not using my hands at all. I should be down by the Bow ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

58

River painting the Canada geese nesting on its banks and listening to the leaves unfold in the wind, sun and spring rains.

Mom had a special thought about her granddaughter Amy Simmons yesterday.

“Best be going, Grandma!” she used to say, mimicking some TV actor. Mom could picture her grandaughter at her bedside saying, “Best be going, now, Grandma!” In my mind, I had other thoughts. I thought of an italian song sung by Giorgia Fumanti “Time to Say Goodbye”. “Con Te Partiro” is also sung by Andrea Boccelli and Sarah Brightman. Is it time to say, Goodbye? http://www.youtube.com/watch?v=tcrfvP11Hbo One half hour was enough for Mom. She was cold and tired so I went back to find Rose and Adriana to help me put her back in bed. Rose, the Congolese nurse’s aid told me that in her church there was a man who was taking care of all his blind mother’s hygiene. Rose feels it is inappropriate for sons to do this for their mothers so she organized the women in the church to do it and they encouraged the man to get married so his wife could help too! She told her adult sons, No, no, no! This is a woman’s job.

Dad said there was a male nurse named, Keith, who changed Mom’s pad twice yesterday afternoon. I think Dad was somewhat impressed by the professionalism of the male nurses.

After the “Martha moment” I chased Dad home to get some sleep. He had not eaten lunch and it was 2:30 pm. I felt over-assertive and impatient, as if I had broken up a fight. It was rather ‘a chasing away’ again of evil spirits that offer no comfort - only blame, shame and despair. I calmed Mom down and shared some “comfort by which I have been comforted” and as she calls it, “wisdom” with her. Who has comfort and who has wisdom but our Lord? I cannot be the Holy Spirit. Every individual has a road to follow. Even on Mount Everest climbers are aware of advanced planning in the event of imminent death. For one is mortal and it is one person who dies at a time. A Christian wife may have to tell her husband, “You may want to go down the road of self-pity but I will not follow you there!” Later, Mom asked me to call Dad to let her see how he was (if he had eaten or had a nap). He was fine and he had apologized for his negativity and asked what time I would be back. “Don’t be late!” he said as any father would say to a daughter travelling on public transit the weekend of the Calgary Beer Fest. It was a short phone call but much appreciated. Mom then begged me to find some help for Dad…a Christian brother who could give him a bear hug; a friend at church who could care for him. Dad says David Joosse is in charge of the deacons. I told Dad about Agape Hospice. Dad said he had worked with the Salvation Army Soup Kitchen and homeless men’s residence through the deacon’s initiatives. Agape is by Grace Hospital where he had his first knee replacement operation.

I spent some time looking for a Plan B last evening. Plan A is to get Mom home and have nurses come in to help. Plan B, I have decided, is to wait until all treatments are finished at the hospital. Then we could take Mom to the Agape Hospice run by the Salvation Army (www.agapehospice.ca). I wrote the hospice an e-mail to get information. I sort of wrote a letter to the deacons of the church but I will wait for a bit and see if I can’t get more info on what the deacons at Woodgreen do. This waiting and life changing decision-making is hard for Dad. He explained to me why he doesn’t believe in too much planning. I was almost convinced. He feels he needs Mom’s pension income to continue staying in their condo. I concluded he needs the deacons in the church to review the whole situation for Plan B to work. Humility, humility, etc etc. The hospital also functions as a deaconal-associated network of servants, all working in the 59 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

interests of God-like care. The principal founders of these social movements come from Christian belief bases.

How much of a Princess and the Pea lifestyle is afforded Mom at the hospital? I am always questioning how much earthly comfort we should provide one’s self and others. We need stress, good stress to keep ourselves active and alive. A nurse found a small plastic needle cap in the bed sheets. Mom feels only the bones in her hips, sticking out of the skin. Is it wrong to give babies and the elderly everything they want when they cry? What happened to the adventurous suffering servant my mother was all her life? As we went to the elevator, Mom said to the nurse, “I am hoping to find someone in the hallways who needs a kind word of encouragement”. I like to think Mom has been dorothyized as we say about women who come under the influence of my mother-inlaw, Dorothy Zoellner - a sweet 81 year-old B.C. lady who can always find someone worse off than herself. Courage is fear that has prayed! A Foothills Hospital volunteer in the elevator gave a little speech, in a serendipity moment, on how much we should honour elderly Western Canadian woman for their tenacity and their servant hearts.

In faith and hope, anchored on Jesus, the Way, the Truth and the Life.

Daryl ♥ 2011/5/31 (mother-­‐in-­‐law in Kelowna B.C.), Dorothy Zoellner wrote : Dear Daryl:

I am so sorry that you are going through such a sad time-­‐new problems, new decisions to be made-­‐ and always the question of "Am I doing the right thing?" The only solution for me-­‐was that I had to trust to do what was right in my judgment.

Sometimes-­‐even now-­‐ I wonder if I should have done things differently. You are not alone and will be able to talk things out. I'm sure the right decisions will fall into place!

Heard from Nancy and Gordon. It is their Calgary home that is flooded and Nancy is down with a bad cold. They are trying to get ready for their trip to Russia in ten days. Deb and Darren have been a big help to them, and so I'm sure that all will work out!

Please keep in touch. Sorry I'm not much help-­‐except, hopefully with words of encouragement.

Love, Mom Z

Daryl wrote:

♥ 2011/5 30 Dear Mom Z. (Dorothy Zoellner) Thankyou, I know you speak from lots of experience.

Every decision has to be weighed against integrity and gratitiude.

Daryl

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

60

[p.s.] In 2003 my WW II air force vétéran father-­‐in-­‐law, a superintendant of schools, a drama and English teacher who was also a fibres artist, died in Kelowna of bone cancer. He was awarded for his volunteer service at the Kelowna Cancer Centre after he became too ill to continue. ♥ Correspondance with fourth daughter, Andrea (journalism student at Concordia University and working for Girl’s Action Foundation, in Montreal) : Monday, May 30, 2011. Daryl wrote : Hi Andrea, I am sorry you are sick. It is of course more worrisome for me having spent some time in hospitals.

It is so great to have a family that loves me. I am homesick and miss everyone.

My time here is so routine but it is becoming very sad.

There is so much to console me however and this is the time to put into practice the substance of faith.

Hoping you get well soon, Love Mama ♥ Monday, May 30, 2011. Andrea Zoellner wrote : Hi Mama!!!

So happy to hear from you, I think about you every day and pray for you. I can't believe how long you've been gone already.

Miss you a lot.

Love, Andrea ♥ Monday, May 30th 2011. Daryl wrote : Miss you too. I think it is going to be a while longer. Grandma is now on what is called Palliative Care (end of life) but she was doing reasonably well to day. She gets up out of bed a little more than last week. We think the antibiotics are artificial supports for her though and if she went off them, she would not survive. We will hear from her doctor tomorrow. I am quite attached to my Mom, I think. But I have four lovely daughters who resemble her in their personalities each in their own way. The nurses all love her. They think she is so cute.

It has been beautiful to see spring come here. Grandma has a beautiful view from her private room and I see much more greenery here (and space) than from my windows at home in Montreal. Grandma sends all her love.

Mama ♥ Tuesday, May 31, 2011. Andrea Zoellner wrote : Hi Mama, ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

61

Papa says the best way to call you and Grandma is to set up a time when I can call your cell phone and you can hand it to Grandma. He says noon your time is best.

Please let me know how I can call you and also talk with Grandma.

Lots of love, Andrea ♥ Hi Andrea, I'll keep my phone open at noon everyday.

Mama ♠ Tuesday, May 31st, 2011.

Dad and I arrived at the hospital at 10am. Judy was already there. Dr. Mulloy, Dr. Snellgrove and a nurse (Alison) were in a consultation room and ready to meet us.

We sat down and Dr. Mulloy addressed the issues and our questions. He started by reminding us of what had been done from the beginning and on what dates.  It basically sounded like what one sees on the website http://www.nlm.nih.gov/medlineplus/ency/article/002941.htm and its link to Diverticulitis. There was a piece of new information and that was the issue of albumin levels. Mom is at 15 (the norm being 25). A level 15 (hypoalbuminaemia) is critical in terms of morbidity and has to do with malnourishment. See http://emedicine.medscape.com/article/166724-overview. A prognostic evaluation has been done and according to Dr. Malloy, over 20 persons have been consulted on Mom’s situation during her stay at the Foothills. Examples of evaluation scales used to estimate intensive care unit (ICU) prognosis and mortality are 1) the Acute Physiology and Chronic Health Evaluation (APACHE IV) and 2) Palliative Performance Index (PPI).

Dr. Mulloy apologized for putting Mom in the C1 level and has moved her back to the M2. He may still opt to do surgery if it will relieve any adverse symptoms of puss accumulation.

For more on these see : http://ajh.sagepub.com/content/27/4/243.abstract.

Next, Dr. Mulloy spoke of the critical issues facing Mom now. She is not immune to C-Difficile, Yeast infection associated with anti-biotics, and she has VRE Vancomycin resistance. Vancomycin is primarily effective against gram-positive cocci.

Staphylococcus aureus and Staphylococcus epidermidis and is used to treat C-Difficile.

For an understanding of Vancomycin doses see : http://www.rxkinetics.com/vanco.html. ♠ It is better not to get too much into these technicalities and to trust that God is in control because the human body is God’s invention. Dr. Mulloy said he « is a surgeon, only a surgeon » and microbiologists who major in infectious diseases or the Canadian Society for immunologists might offer us more help. He was fearful it would make Mom into a guinea pig however to attempt to assume more control over her immune system. Her real power is inner strength called from deep within her, the kind that says, « I have to do this or that ».

62 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

We were all charmed by the doctor’s calm and sensitivity, his smile and friendliness. We nevertheless had questions. Will the drainage tubes be removed ? No, not yet. The staples ? Yes, fairly soon. Does the TPN stay off ? Yes, It was Clare who requested it. Should we take Mom to a hospice ? No, It is not necessary, she is not in pain. She should stay here and get the full benefit of the nurses here. How long will she be here ? We have three weeks to see if the tipping point will come. Her prognosis is not good. She may go quickly but if she eats, she may have some strength. We three and Mom are in agreement. Mom will stay in her private isolation room until further notice.

Mom said, It’s OK. She had a little cry over it. She is treated well.

The doctor recommended Day Passes to get Mom to see home again. I looked up Handi Bus. Door to door service for $2.75 ! Dad, who drove a Handi-bus for many years, thinks Mom would find the ride too scary. He wants to wait for this kind of thing.

So does Mom. Dr. Mulloy wants to meet us again in two weeks. He is going on holidays for the month of July.

I have an open ticket with WestJet. I plan to stay to get Dad and Mom through this.

Mom had her hair washed today. Lovely Cynthia was there to do it. She asked if I could bring a soft wash cloth and towel since the hospital ones are so rough. Her nurses are charmed by Mom. They love her. She is still a joker. She speaks of the lovely pleasures of life like bedpans. When she woke from a nap and looked up at two nurses, she asked, « Am I in heaven ? » So today was a blessing. Mom went outside for a few minutes (reluctantly). Her friend Paulette Barky stopped in and brought flowers. Edward Ludwig called to encourage us and get news. Garnet is calling every night at 8 pm. to encourage me.

Hundreds of people are praying. God is not abandoning us. I had a heart to heart talk with Dad. He reminded me that this is not the only life there is. It is important to factor this into all our decisions. Wisdom, wisdom, wisdom.

Daryl ♣♣♣ Wednesday, June 1st, 2011. How long, Dr. Mulloy ? Are you angry at me, Clare ? Am I in heaven ? (Questions of Patricia Ann Martin).

The eye is highly overrated. Faith, hope and love remain.

John Piper lends some help to 21st century listeners with his sermon on "The just shall live by faith" (Habakkuk 2.4) and Eugene Peterson’s rendition of Habakuk 2.20 says,"But oh! God is in his holy Temple! Quiet everyone—a holy silence. Listen!" Let all the nations be still and know that he is God. His glory will fill the earth, not the glory of the Chaldeans. So in answer to Habakkuk's protests, God assures him that the pride of the Chaldeans will come to a woeful end (2:6-20) and that any in Judah who humbly trusts God will gain his life. The just shall live by his faith… The Chaldeans will come against Judah as God's rod of correction. But verse 12 expresses the confidence Habakkuk has that God will not utterly destroy his people. (Piper, October 1982, http://www.soundofgrace.com/piper82/103182m.htm).

Surgery is a boastful human affair. It is used by God to correct our imperfect mortal bodies and our gluttony or uncontrolled habits. It is a sort of rod or measuring 63 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

stick against our body’s corrupt ways. Cholesterol-filled blood vessels are not the norm.

Polyps and pockets in the colon are not the original plan of God. Aging and death are east of Eden. God’s excising is pure excising, ‘his hatred is pure hatred, infinite, severe’, says By John W. Wenham in The Goodness of God (London, Inter-Varsity Press, 1974).

The Holy Spirit is not a deceiving spirit. "And the Tempter having come to him said, 'If Son you are of God -- speak that these stones may become loaves. But he answering said, 'It has been written, Not upon bread alone does man live, but upon every word coming forth from the mouth of God.'' (Matthew 4.3-4). We are dependant on Scripture to interpret our lives, through the voice of the Holy Spirit. God, the Holy Spirit is a satisfying comfort to Mom’s soul even in God’s severity (weeding out what is rotten).

Scripture is not dependant on us to interpret it. Hope sustains us when Scripture interprets us.

The eye is highly overrated.

Roger Jones sums up in one page the philosophies that make meaning out of our everyday lives under the 21st century sun. See http://www.philosopher.org.uk/. Usually philosophers shoot themselves in the foot by claiming that language is highly overrated (ie. Albert Camut, Derrida, Sartre, Nietzche). Written text is visible. The eye that wrote what text witnessed in a context is highly overrated, some would have us believe everything is in the context, Carl Jung proposed, and that too is highly overrated. Both Philosophy and Psychology and now Sociology and Anthropology claim the Bible is highly overrated. Doubt has been decriminilized. It is OK to doubt. Action (movement through time and space) start and end with anxiety. It is the motor that drives humanity forward (unless the glory of God replaces it). My will or God’s will be done ?

Mom’s will, Dad’s will or the Doctor’s will or Judy’s, Carl’s or my will are rightfully left undone. Other family witnesses (Garnet, Jill, Don) are left even further behind. Now God’s will be done.

What is the eye that it should tell us what to do ? With technological eyes to guide us through our bodies, we are still left with seeing "only a reflection as in a mirror; then we shall see face to face. Now I know in part; then I shall know fully, even as I am fully known" (I Corinthians 13.12).

Mom’s white blood cell count is staying between 12, 000 and 13,000. Her albumin is at 15. In the avi video, Waking Life, by Richard Linklater, "A boy has a dream that he can float, but unless he holds on, he will drift away into the sky. Even when he is grown up, this idea recurs. After a strange accident, he walks through what may be a dream, flowing in and out of scenarios and encountering various characters.

People he meets discuss science, philosophy and the life of dreaming and waking, and the protagonist gradually becomes alarmed that he cannot awake from this confusing dream."

Retrieved June 1, 2011 from http://video.google.ca/videoplay?docid=7583894250854515095# Transcendance is not a dream we can awake from. God is transcendant and we know we are not God. We are not omnipotent, omniscient, omnipresent. God is not an invention that we made up and that had a beginning in humah history as the Liberal Arts faculties teach. God is good and like maggot therapy, he only uses corruption to clean out corruption - Chaldean terrorist therapy. What lies beyond what God reveals to us is worthy of exploration but is essentially occultic exploration. Cult is what is revealed.

Culture is what is developed within what is revealed. That is where reality and dream 64 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

meet ; where transcendance becomes what is seen through the eye of faith. Bacteria may be cultured so that we might observe them, study them and know them. Faith for the righteous person is cultivated so it can see Jesus, now through imagination (by the witnesses of Christ, the exact image of God), and later, by the immortal eye.

Carl Jung made all faiths relevant. Postmodernism is changing, I am told by Westminster Seminary professors in Philadelphia. It is when all worldviews become equally relevant that each becomes in fact equally irrelevant. Nietzche said, "what is the truth of language [ideas] but a moveable set of metaphors, metanomies, and anthropomorphisms, in short, a sum of human relations, which have been poetically and rhetorically intensified, transferred and embellished and which, after long usage seem to people to be fixed, canonical, and binding : truths [photos, film, paintings, drawings, poems, journals, etc] are illusions which we have forgotten are illusions, that this is what they are".

When Jesus said, I am the Way, the Truth and the Life, I believe humanity finally got the real thing. Humanity stands at the door and talks. Jesus stands at the door and knocks. Touch Christ and then make your conclusion, the disciple, Thomas, would tell us today. Doubt no more. The eye is highly overrated.

Most non-doubters today are recovering Jungians. In The Wanderer (Jung replaces Jesus, January 5, 1995) it is said that Jungian psychology only values the Chrisitan worldview, not for truths it reveals about man and God, but for its usefulness in mapping and exploring the unconscious. In Jungian thought, Christ loses his uniqueness as the incarnate Word and only mediator between God and man.

Mom is longing for that immortal eye that has been promised to her. Then when her overrated mortal eye moves out of the way and she has put on immortality, will she truly see him who is her saviour, the finisher of her faith.

I Corinthians 13 says, "If I speak with human eloquence and angelic ecstasy but don't love, I'm nothing but the creaking of a rusty gate. 2 If I speak God's Word with power, revealing all his mysteries and making everything plain as day, and if I have faith that says to a mountain, "Jump," and it jumps, but I don't love, I'm nothing. 3-7 If I give everything I own to the poor and even go to the stake to be burned as a martyr, but I don't love, I've gotten nowhere. So, no matter what I say, what I believe, and what I do, I'm bankrupt without love."

If only to love, like Mom, Daryl ♠ Thursday, June 2, 2011 Yesterday was a mixed time of joys and sorrows. I had a heart to heart talk with Mom about her nutritional responsabilities. She wanted to talk about her changing relationship with Dad, now that her health has become more of a responsability for him.

I don’t want Mom to trade her problem for the easy solution of dying. It solves all of Dad’s extra burden, she believes. She needs to work at feeding herself and caring for her bathroom needs and also keeping herself from self pity. Dad arrived just in time to remind her of his love for her. He brought three daffodils. Mom was ready to go for a walk and sat in the love seat in the hallway with Dad for a half an hour. I watched as 65 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

Mom and Dad went out for this date and I was thankful they could be together side by side. Then Mom lost her ‘drawers’ when she walked back to her room. She had a good laugh about that as one of the nurses quickly undid the tapes and whisked her ‘diaper’ away.

The drains for the puss have been removed today.

I have to deal with homesickness, boredom, fear of watching my Mom die, feeling responsible for Mom’s food intake and getting on with my commission when I get back to Montreal. The cost of coming back to Calgary is prohibitive so Garnet is asking that if Mom dies that we have a memorial service for her at the end of July when some of the family will be together in Calgary again.

I was thinking about the overuse of certain simple drugs that Mom was using before her colonostomy emergency. She took antacid tablets (a generic brand of Tums) daily and the maximum dose is 16 in a two week period. Her intake was way beyond the recommended use but she was using them for digestion and osteoporosous. In fact, I believe she was coating her colon with magnesisum and calcium carbonate which absorbed all the liquid and left her constipated. For years she was putting antibiotics on her skin cancer lesions and progressively weakening her immune system to antibiotics.

She did the same with antibiotic tablets like Novo-Lexin (cephalexin) 500mg 4 x daily.

The side effects for this anti-biotic included mood or mental changes and if they occur, she should CONTACT HER DOCTOR IMMEDIATELY the Walmart Pharmacy warned on the Personal Prescription Information Sheet. The stress of her very invasive skin graft for carcenoma brought on Mom’s dementia, Dad says. Dermatologists should be much more careful, especially with the elderly.

Today the white blood cell count is down to about 8, 500. Too many platelets however make it hard for Mom to miss her three doses of Heperin per day. She might need to give herself some little EpiPen - type doses of blood thinners when she gets home to avoid getting clots.

Temp. 36.9 Respiration 20 Pulse 92 BP 128/69 Oxygen 98% at room air Mom has eaten a few bites of muffin and a few tablespoons of yogurt, 3 bites of chicken and 2 bites of little baby potatoes and 2 tablespoons of canned peaches. Supper is still on the way and the nurse gave her a goal of 4 bites of each item and some Ensure.

Dad and Mom’s Chinese friend, Sam came in to see her. He brought a tan velvet neck pillow. It was perfect. He took a picture of her with it on. It was a perfect gift and I had thought of bringing my own from my suitcase. Mom has had trouble holding up her head lately. When Sam encouraged her to do her duty of getting better so she could minister to him and the Bible study group he was telling her not to give up. God still has work for her to do. She will be able to do it better when she comes home to support her husband and help him by loving and encouraging him with her words. This is his prayer for her. She took it as a message from an angel. Mom was overjoyed by being surrounded by angels (her wonderful nurses and the friends and family who are praying for her daily). Tears of joy flowed from her and she told the nurses of the surprises of encouragement she has received today. Sam is concerned for Dad and feels he is too 66 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

ambitious and needs to try to take less control. He needs to keep meeting with the Bible study group because it means fellowship and encouragement that he is missing to his own peril. Sam is very wise and knows that to laugh together is not enough, you also have to cry together if you want the full blessings that God has for us. Sam said to Mom that God is strong enough to hold her when she is weak. Like the strong bed that is holding her, he will not let her go. She was so glad they have met Sam and his wife Fu she told him. Sam works for an oil and gas geology research firm. His office is near the hospital and his home is near where Mom and Dad live. They were sent by God to my parents. They have adopted them into their family.

Dad is reading his own books. He has reached Ezekial in his daily readings and came to chapter 24.15. “I am going to take away from you your dearest treasure. Suddenly she will die…then you will know that I am the Lord.” Although Dad knows this refers to another person another time another place and someone else’s revelation from God, he nevertheless identifies with Ezekiel because Mom is his dearest treasure and above all Dad wants to know the Lord and how to love him and others. He is also reading, “The Fruitful Life: the overflow of God’s love through you” by Jerry Bridges. 2006 Colorado Springs: Navpress. He received this book when he retired as elder at Woodgreen Presbyterian Church. Dad has a full library of reformed theological books that have been used in pastoral care and sermon preparation over the years. He is also a trained Calgary Handibus driver since he exercised that employment for over 15 years. He also worked in a Chriatian Book store and counseled clients and employees. I am proud of the years of service my Dad has carried out in his various roles as teacher and pastor and in manual service to the handicapped of Calgary or his labour jobs as a strong young man, His hearing loss is a result of CMNS work in Kimberley for which he never received compensation. His family lived through the Depression and found life very hard in the forties and fifties but supported each other through it, but there was fierceness in their survival that sometimes ended in abuse. It softened Dad to suffering. I am humbled to be able to reconnect with my parents at this time of suffering. Even regular church building maintenance and ushering have never been ‘beneath’ Dad. Many of the people at his church are there because of his welcoming empathy and hospitality. I love my Dad. He is so underrewarded. Mom is the only reward he wants on earth and God is his help in time of trouble, when he can “see” him with the eyes of faith.

Nurse Amanda and Nurse-in-training Paula are on duty this evening.

Mom’s staples will have to stay in for a little longer because there is a section that has to be “packed” as they call it. It needs to heal from the inside out in other words. It is an area near the stoma for her ileostomy. The nurses regularily flush the IV lines to keep them clean.

Judy has been on Kijiji to search for bathtub seats and raised toilet seats ($20 and $10). There are walkers available to Mom and Dad (their neighbour, Juanita, has two to lend them) and there is certainly a lot of Ensure to take home. So it looks promising to get Mom home but she still wants to go home to heaven. Not her will, but yours, O Lord.

I think I will book the 7am flight through Toronto on June 10th tonight. I will take the risk if it looks like the tipping point has been reached in the next few hours and I ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

67

can safely return to Montreal with Mom’s permission. She must promise to rely on God’s strength and grace in her future weakness. If Mom’s will to live can get to the point of no return then we are are on the right side of that tipping point. ♥ Friday, June 3, 2011. Daryl wrote : Hi Carl and Judy, Sometime yesterday (and it was confirmed today) I think I saw a serious will on Mom's part to return to health and take responsibility for her well being. She is working hard at giving the nursing staff her full attention and asking them questions like she has finally come out of a dream. Her vital signs are good, Her incision is going to be a few more days before it is healed and her blood platelets are low so she needs to have some blood thinners for awhile. I am booking a flight for Friday June 10th and will go through Toronto. Since Mom is able to eat a little bit at each meal and she is starting to enjoy her food and understands the importance of nutritional requirements for each day, I am pretty confident we now may be on a postitve track. If by next Friday we see her even more improved I will be more confident still that it is the right time for me to go back to Montreal. If something happens that is life threatening, I will reconsider but for now I think it is safe. Mom's white blood cell count was 8.5 today and she is almost getting up to go the bathroom on her own. She really notices the nurse's concern for her and appreciates all they are doing.

Let me know if you have any doubts about my leaving. I think the steps to give Dad home support may be in place before I leave.

Love, Daryl  Reuter. com reports that Dr. Jack Kavorkian has died today at age 83. He apparently had heart failure or liver cancer or kidney complications, depending on who is reporting. The practice of doctors writing prescriptions to help terminally ill patients kill themselves was ultimately upheld as legal by the U.S. Supreme Court by 2009 because of Kavorkian’s activist position. “Kevorkian, a pathologist, was focused on death and dying long before he ignited a polarizing national debate over assisted suicide by crisscrossing Michigan in a rusty Volkswagen van hauling a machine to help sick and suffering people end their lives. Some viewed him as a hero who allowed the terminally ill to die with dignity, while his harshest critics reviled him as a cold-blooded killer who preyed on those suffering from chronic pain and depression. Most of his clients were middle-aged women.”

We want Mom to be waiting, and patiently at that, to define her life in a new way, not her own death. To die well is the biggest challenge in life. The Hebrew high priest who went in to the Holy of Holies once a year was never guaranteed he would come out alive. A cord was attached to his leg so that unauthorized people could pull his corpse out without entering the undefiled place. The flaming swords are guarding the very best relationship with God for the last moment of life. Can we see God and still live? Apparently not, and we didn’t even understand why, until Jesus demonstrated it for us. I am convinced Jesus, who is the last prophet, our high priest and king shows us God himself. He went to death, because God wanted us to know what we are thinking and 68 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

especially what we are thinking when we are dying. The prophet Daniel said to the King of Babylon about the dream no one could interpret. “I am not any more special as an advisor than anybody else, but God wants you to know what you were thinking.” Daniel 2.30 “As for me, this mystery has been revealed to me, not because I have greater wisdom than anyone else alive, but so that Your Majesty may know the interpretation and that you may understand what went through your mind.”

May you know, as you are reading this what you were thinking about your own situation. ♠ Saturday June 4th 2011.

The long slender-tailed tuxedoed magpies have appeared around Calgary. They have drawn my attention away from the slender necked-Canada geese that peck at the ground. Are robins the only birds nibbling at the spring worms? The worms, littered all over the sidewalks, have their season. I bought Mom a hummingbird feeder with a package of food. She and I hum to the hymns we both love. Without her dentures she makes me think of a little hummingbird. She may not open this gift until her 76th birthday on July 5th.

Mom’s vitals today were: Temp. 36.2 C. Pulse 96 (my own was 53 but that sound pretty athletic to me) Room Air breathing 100 (the best ever!)

Blood pressure at 108/65 (my own was at 112/74) Mom had another CT. at 12:45. She is so aglow with radiation from Telebrex and lamps. “Now she doesn’t need a night light in her room,” she says. A few puss collections remain but Dr. Mulloy said they are not a threat. The 29 staples on her abdomen came out today.

Carl phoned at the exact moment she was getting the staples removed and kept her distracted for the time it took to pick them out with tweezers. She didn’t notice the time go by. Carl’s band, The Meteors is becoming quite successful. They have Friday night bookings at one Lunenberg Hotel and a venue at the Yacht Club. He will send a picture to my email address of his band. I decided to make a poster for them from my Pages Application. [p.s. Carl’s reports in June go like this Rum Runner Restaurant : We had 65 people last night, rockin and a boppin! It was fun! The restaurant manager thinks we are sounding much better with our 50 songs. Next Friday we play the Yacht Club! It is fun having fun and getting paid for it! Imagine...

Yacht Club : 73 hungry people -53 songs from the 50's and 60's -having a wonderful venue to play at....priceless -getting paid at night's end....nnnniiiiicccceeeeee!]

They loved us....even called for 2 encores.....Pretty Woman, Orbison and Dream, Everly Brothers] ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

69

♠ Dr. Mulloy found humourous what Judy wrote on the white board: Eat-Walk-Go home. She brought a little teapot to Mom. We discussed whether tea is good for Mom to drink. Here is a good article I saw today on the relationship of tea with iron and immunity deficiencies etc. http://www.veetea.com/site/articles/Tea-and-Iron.

Judy, Mom and I talked about how our little children were rescued from cars and trains in spite of our neglect. We had some fond reminiscing about the years that have passed. Mom was continually saying “Thankyou, Sam!” for the soft neck pillow her friend brought her. Mom’s sister, Arlene sent a card. It got here before Canada Post closes down its operations while workers are on strike. Mom can’t control tears of thankfulness for all that is being done for her.

As I was going down in a service elevator to avoid the crowded main ones still operating, I spoke to a porter who explained how much they, as a medical support group, are exposed to bacterial infections and what they do to prevent it. They routinely report by a special marking system how many patients on isolation they come in contact with each day. If they become severely ill, at least there is a record of exposures. Bravo hospital workers!

I visited Gordon and Nancy Whitham today after I got home. They live very close to Mom and Dad. It gave me a good break.

This morning Dad left early to go the Foothills. He left a note that said some unkind words about the hospital. Everything can be reduced to ‘us against them’ but I find this view a little too simplistic. “They are bad and we are good,” can’t get you very far in human relations. The nurse on duty last evening asked Dad to give Mom a pill that was too big for her to swallow. After painstakingly getting Mom to eat her supper, she promptly vomited it after trying to take the pill. Having fasted all day, this little bit of nourishment was suddenly forfeited by a pill that may also have damaged her throat as it came up. A damaged throat can lead to infection and that is the last thing Mom needs.

Dad says he wants Mom out by Monday, live or die. As Mom is his witness (the Greek word martyrion comes to mind) they will have to manage without the Foothills Room Service. “They aren’t treating her for anything now so I want her to be comfy & cozy at home.” I called the hospital at 8 am and asked them to be aware that Dad is in no mood to cope with incompetency today. A nurse, one of the ones I admire the most, told me that she was glad to be forewarned. Dad hadn’t arrived yet. He called from the hospital at 10 am and said he would like me to bring the tea bags we keep forgetting. I asked if he had left the note. He said, “yes”. It also had a list of things to buy or pick up from the Red Cross. “I may add to it if I can think of anything”, he told me. I thought of my Dad as Quasimodo and Mom as Esmeralda. Dad’s fierce love for her is devouring, consuming. He wills to be with his beloved, the object of his love and life. He said jokingly, Mom ‘had a pretty good breaky’ (breakfast).

Dad’s sorrowful, tragic love for God is sometimes insufficient.

“Do not be deceived, God is not mocked; for whatever a man sows, this he will also reap. For the one who sows to his own flesh shall from the flesh reap corruption, but the one who sows to the Spirit shall from the Spirit reap eternal life. And let us not lose heart in doing good, for in due time we shall reap if we do not grow weary. So then, while we have opportunity, let us do good to all men, and especially to those who are of the household of the faith (Galatians 6.7).”

70 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

I had a hard time praying Dad would not reap the fruit of his anger and that he would not be kicked off the ward. I am so judgmental! The hospital doesn’t need that kind of punishment but yes, a nurse who forces her own agenda on a patient is in for some backlash. Mediation. I am not very good at this, I am finding. Nurse Rose gave me a cup of fresh cold water today. I will always remember the fresh taste of that water.

The last person who wants to leave Mom alone to take care of herself is Dad. I will step out of the way. Carl sent me a nice note today. Dad is so angry that he called Mom, but he didn’t return his call to Carl. Are not jealousies and rivalries the most destructive postures in any relationship? ♥ Carl wrote: Thank you, Daryl, for your updates. I am sure you are seen by many, at the hospital, as a saint. I know Mom has appreciated your company. Thank you for sacrificing your time, energy, and financial resources for her.

It certainly has been a roller coaster ride from my perspective - one moment she is on the edge of death, the next moment she is telling jokes with the nurses! No wonder I have a sense of humour - I get it from my mom and maternal grandmother!

My only concern after you leave is with Dad and his ability to heed the instructions from the medical support. He doesn't process information very well, partly due to his hearing loss but also because he is stubborn and takes short cuts. Perhaps this experience is a good lesson for him to be extra careful with his ailing and frail wife.

I will never forget all you have done for Mom. Have a restful journey home and wonderful reunion with your immediate family members.

Sincerely, Carl ♥ Garnet Zoellner wrote : Daryl, Thank you for sending this along. I'm pleased to read it and agree with Carl about all you have done and continue to do.

I'm thankful Carl wrote it as he did and will pray that he and Dad might find a way to begin reconciling. Garnet ♠VIGIL Sunday June 5th 2011 Mom has concerns about going home to be cared for by her husband and a home health care team. I posted a seniors' distress line phone number in the kitchen. Some of Mom's fears are legitimate. I do not want to take them lightly. I am not principally the one who will decide to send her home, so I also have fears. What are they? Does this have to happen? dehydration - kidney failure – coma ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

71

anorexia – weakness loss of muscle tissue- bed ridden state neglect – abandonment – loneliness – marriage failure - humiliation clumsiness - accidents – miscommunication among caregivers - further hospitalizations invisible infection – out of control fever - suffocation blood clots – stroke – heart failure misuse of medications (even over the counter ones) – poor hygiene or cooking salubrity.

WE ARE ALL AFRAID OF ALL OF THESE ! Why should I be afraid? Each day has only the cares we can handle (Matthew 6.34).

The end of life care team does not have to include all of us and we all do not have to be in sync with what is happening ‘on the ground’. After all is said and done, the will of God reigns. He will decide when to take Mom to her real home; when hospitality here, for his loved one, is inadequate for his purposes for Mom. I hate to say it, but our hospitality will eventually fail her. She will deserve better. For the time being, Dad is the suited caretaker. He has been her bodyguard for over 56 years. It is not time to abandon him now for someone better. His hands are gnarled and rough, his gait is crooked and slow. His ears leave many statements of alarm unheard, many conversations misinterpreted. (Mom hates being misunderstood). He cannot find the things he has stored away. It takes him three weeks to do a task he considers important. Yet, in spite of these minor handicaps, he has a duty and a vocation to care for his wife. Let no man ‘put asunder’ that right. We do best to help him fulfill his role and to dissuade him from his ‘me first’ habits. If he does not take it seriously enough and prods her to be someone she is not, she will tell him. I know her well enough to see that she can change him instantly. I spoke with Dad about the taming of the tongue. He knows he has to be pretty careful about what he says. Mom cries a lot every day now.

Mom weighed in at 91.3 lbs. today. She has a white blood cell count of 4.9. A count of 3.5 is considered low. From 30, 000 to 4, 900 is quite a drop. We tried to get her to eat as much as she could but she has an aversion again to food as if she has become afraid of eating. Slowly and progressively she needs to get back on a good eating track. I think the CT fast on Friday put things back a bit.

Today she was outside in the sunshine for about 15 minutes. She was sitting in a chair to eat breakfast and lunch. Judy said she had some nausea this morning and she thought the bottle of Ensure had been left open overnight.

Mom’s Congolese-born nurse, Rose, was working to day. She drives a busload of children to her Apostolic church Sunday mornings and then drives the parents to the worship service. She sings in a Black choir that congregates singers from all over Alberta. She sings alto and in French when in the room bringing her ice water. I usually talk to her in French in the hallway.

Tomorrow I will go in early. I am very tired since I did a lot of spring cleaning yesterday (windows and venetian blinds and curtains and floors). Daryl

♠VIGIL Tuesday June 7, 2011 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

72

Stanley Cup News: Boston Beat Vancouver in Boston (8 to 1) their first win in the finals.

Mom beat the bacteria. She’s coming home tomorrow.

There was a medical emergency on the C-train as I travelled to the hospital early this morning. It put workers 7 minutes late. Some called into the office on their cell phones. The beat went on for them. For a friend in the Montreal Metro, the heartbeat did not go on, I remembered, thinking of the faces of his widow and three children at the funeral my husband presided over.

Nurses’ assistant, Cynthia, gave Mom a sponge bath. “Oh! That was so lovely!”

Mom sighed. “They take such good care of me here”. Mom is amazed at how such a dishonorable task can become so honored.

Today was a day to take out the IV lines. One line for the CT agent was removed last night. The blood thinners made her bleeding more prevalent so Mom had to hold gauze against her puncture wound a little longer than normal. Today, she was reduced to Pip Taz (as Syreeta the nurse calls it) - a Piperacillan/Tazobactam antibiotic release given for 45 minutes at a time. Otherwise she is free from the tubing and can finally put her bathrobe on without obstacles and go for a walk without an IV pole. The nurses cheered her as she went past their desk this morning with Dad. Some of the nurses call her, “Mrs. Martin”. Saleema, a Pakistani nurse calls her, “Mom”. Others call her “Patricia” or just “Pat”. Her two sisters want to call her “Patsy” again and her 1937 Team Canada minor league hockey celebrity father was about to call her “Patrick” in July 1935 before he knew she was a girl. Bravo Patricia! You made it to the finals.

Bravo to the King of kings, he did not let your enemies triumph over you.

At breakfast, I took spoonfuls of sugared oatmeal, placed her large pills one at a time in each scoop and she managed to get them down without gagging: K-DUR 20 (potassium chloride in pill form), ZYVOXAM (linezolid) by Pfizer 600mg (an oral antibiotic) and PT 40 (pantaprotozole) - a little yellow oval pill used to treat or reduce the risk of stomach ulcers due to medications known as nonsteroidal anti-inflammatory drugs or NSAIDs, which irritate the stomach.

The nurse said Dr. Mulloy would be paged in the afternoon. Dr. Andrew Smith came by and heard that Dad had already contacted Dr. Mulloy from home. Dad called me earlier and told me the news “we’re going to get Mom back to the condo on Wednesday”. I was elated and felt privileged that I could be the first to tell Mom the news. Dad reassured me by saying he had Juanita’s walker, friends were going to find a toilet seat and swivel bath seat and he was looking into getting a wheelchair through the Red Cross. Dr. Mulloy will be in tomorrow to sign a requisition for the chair and send Mom off with prescriptions.

I looked at the calendar. It is son-in-law, Edward’s birthday on Friday. The Ludwigs will be moving into a new house in Ontario by the end of the month.

For breakfast: ½ c. of Earl grey tea, three scoops of oatmeal (with pills) and 1/2 slice of banana, 1 whole slice of toast with butter and jam (crusts removed) and ¼ of a cup of orange juice.

I thought I would introduce my idea to Mom about publishing this diary.

“Bootstrapsa” I then thought I would call it. She laughed at the meaning. She also encouraged me. “You should keep using your talents, Daryl.”

When Dad phoned at 11 am. and I told Mom the news of her imminient return 73 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

home, she responded with, “Did you tell Clare why I couldn’t come to the phone?” I assured Mom that Dad knew why she couldn’t come to the phone. Then she said, “I have to pee.” I managed to get the bedpan under her in our usual protocol.

She was comfortable again and I suggested we thank God for all the care he has brought to her in her hour of need. “Thankyou for the hospital staff and thankyou for the return to health and thankyou for the Woodgreen Church family and friends everywhere praying and having their prayers answered. Thankyou for Clare.” No “bootstrapsa”.

“Many are the plans in the mind of a man, but it is the purpose of the LORD that will stand”. (Proverbs 19.21).

Temp. 36.6 BP 121/69 97 Room Air Heart 83 ♣ Mom remembered the story of Joni Eareckson Tada, a quadrapelegic living in the U.S. who, all her life, has cheered on other disabled persons and sent a clear message that bootstrapsa is a myth. The Lord is our help in time of trouble.

(See http://www.joniearecksontadastory.com/) There are lots of children and babies in the hospital. I saw the little face of a seven motnh old boy in the elevator and felt homesick for little Adrien Zoellner my grandson in Verdun, Qc. I was reading in the Book of Matthew in Mom’s Bible today. If there are annoying demons who say “God is not good”, Jesus promises to throw them out (chapter 17 verse 17). He also says it is better to have a soft heart if you don’t want to be a casualty of divorce. Yet, there is rescue by way of divorce for the hard hearted. There is rescue from diseased body parts in Matthew 18. Mom and I reflected on this. The kingdom of heaven is our real home.

Nurse, Syreeta Brown, who was named after her mother’s favourite Motown Jamaican singer was given the privilege of estimating the extent of healing of Mom’s incision. When Syreeta treated this wound several weeks ago it was needing 8-10 inches of sterile tape. Now it only needs one inch. There will barely be any need for the tape when Mom goes home making it almost unnecessary for home nursing care. Two little staples were left in the incision, by accident. She pulled them out. Mom has no more bellybutton. From her carcenoma treatments of three years ago, she has no right eyebrow. Pretty mother who cannot stand the sight of her ileostomy bag. How can we cheer you up?

To take a bath is not Mom’s first goal. Although if she wants to go swimming again, she will need to let the dozen steri strips, that hold her incision tight, dry out and fall off before she may do so.

I opened my computer. Thankfully I still had the right password for the Internet connection. I accessed my gmail account and retrieved from an email Carl’s picture and poster of his band, a trio, in Lunenburg. The Meteors is their name and they play 50’s and 60’s songs. Carl is finally living a longtime dream of being a performing guitarist.

‘L’homme propose mais Dieu dispose’. How well does God do things? I need to make more plans also, but God’s will always prevails. I am looking forward to returning to my impossibly hectic life in Montreal.

Dr. Mulloy said if anything comes up, to phone him directly since he can bypass 74 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

Emergency and admit Mom to the 102 Ward immediately. How well does God prevail with his secondary means in our time of need? Our hope is in God’s primary means of bursting through the veil and coming to our rescue, and that took place in human history at the Crucufixion, Resurrection, Ascension and Pentecost of Jesus. His secondary means are the way he glorifies us as we produce the fruit of our trust in him love, joy, peace, patience, kindness, goodness, meekness, faithfulness, and self control.

Bootstrapsa comes from the Holy Spirit. Mom’s spirit has joined with that Spirit or vice versa. She is ready to say, “Into your hands I commit my spirit,” as Jesus said on the cross. The Spirit is saying to Mom, “You have good works that have been prepared for you to do”. Some are still left to carry out in your body - for a little while longer.

The day before yesterday, I went to the Hospital Administration Offices in the corridor leading to the Good Earth Café (they make good soup). I explained that I wished to publish a diary about my mother’s stay at the Foothills and I would like to know if I may use the Hospital’s name. I figured this would be my starting point after getting Mom’s approval to write Easy to Die - Hard to Say Goodbye. I was given the phone number for Communications (403-943-1208).

I also discovered the artwork in the Cancer Centre, which lead me to the Tom Baker Knowledge Centre and Library. Curious about the title, I read a small book, “What Should I say? What Can I Do? How to Reach Out to Those You Love?” by a U.S. author and widow, Rebecca (Becca) Bram Feldbaum. 2008 Pocket Books N.Y., N.Y. This woman gives all the best advice on how to do what Dad, Judy and I have been doing and what the Woodgreen Church Family has started and will continue to do upon visiting Mom. Then I found a medical document (2003 Health Press printed on demand with with Trafford Publishing, Victoria B.C.) “Living Well With an Ostomy” by Elizabeth Rayson. It was a very thorough study on the subject and I noted the author’s recommendations about diet myths. Maybe Mom can just eat what she ate before. She should eat more since undereating causes excess gas. She should chew well and drink plenty of fluids.  Maybe www.ostomycanada.ca 1-888-969-9698 or an international organization delaing with wound, ostomy and continence www.wocn.org 1-888-224-9626 will give more direction for this kind of self-control.

My thoughts concluded at the library where I decided to print up this diary and send a copy to Dad and a copy to the Tom Baker Knowledge Centre for reference by the patients and medical staff at the Foothills.

Tom Baker Knowledge Centre Library 1331 – 29th St. N.W. Calgary, Alberta T4N 4N2 1-403-521-3765 In the hallway of the Cancer Centre there was a write up (from the January 5, 2002 issue of the Globe & Mail) on Montreal abstract painter, 47 year old, Eric Dennis Waugh. The journalist reminded me that Picasso once sold his artwork through the U.S. Sears catalogue. “I wake up exhausted because I am creating all night in my sleep”, says Waugh. This sounds like every writier and artist I know, including myself. Who buys Waugh’s work? – the 15,000 pieces he had produced by 2002 ? - Private collectors, 75 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

galleries in the U.S. & Europe, American Express, and Hyatt Hotels. Waugh lays down a few black lines, injects a dash or two of colour, smears a clear gel medium over the acrylic paint and adds his trademark gold dots to the 10 paintings he begins or completes in a day’s work. I am writing my days’ worth of diary and returning to Montreal to paint (in oils on canvas) and photograph my pewter dishes that I hope to exhibit next year.

Bootstrapsa!

The librairian of the Knowledge Centre Library said to me this afternoon, “By all means submit your wrtiting to the library.The Library is serviced by the University of Calgary and there is not much being done in the testimony genre but many patients appreciate reading what others have gone through.”

Mom’s nurse, Adriana, suggested buying probiotic supplements to restore the lining of Mom’s intestines and stomach. I told her this is what I asked the dietician for several weeks ago. Her solution was to send more yogourt. Adriana said, “After all these antibiotics the flora in the digestive system needs to be restored.” I agreed with her and asked why they were not available in the hospital. She said, “There is no money for them.”

Dr. Mulloy prepared everything and spoke to Mom, Dad and Judy this morning.

It costs $1000.00 for 14 antibiotic/antifungicide pills Mom must take for a week after leaving the hospital.  Dad is waiting to see if these are covered by his Alberta “Blue Cross for Seniors” Plan or the Wellness Plan. I think it is, according to this website : http://profiles.drugcoverage.ca/en/default.asp?DrugID=483. Hopefully it will be. Garnet suggested there be an offering taken among the family members, if they are not. Judy arranged to have a wheelchair for 6 months. She will bring it to the hospital tomorrow morning. Mom is to be discharged around 10am. She will have a visit from a nurse Thursday to help her get back into home routine. Dad is to call Dr. Mulloy on Monday Dad and I switched bedrooms tonight and got sheets washed so Mom can return to her own bed next to him. I get the single bed now. He bought a mattress protector and incontinence pads and panties at WalMart. We are curious to see if Mom recognizes the condo when she steps in tomorrow. So far, she is unable to imagine it.

I will keep you posted about Mom’s return to Point of View / Millrise.

Daryl ♥♠ Hi Carl and Garnet, These are my last entries for the diary Wednesday, June 8th 2011. FREEDOM 55 for Mom and Dad 55 days in the Foothills Hospital was exchanged today for hospice care at home in Mom’s Point of View Condominium. Dad is now the chief caregiver.

At about 8:15 am. Dad and I arrived at the Foothills Hospital and parked. The first task Dad carried out was to go to the Hosptial outpatient pharmacy to fill out the prescription for ZYVOXAM (linezolid) by Pfizer 600mg. I Timothy 4.4 says nothing is 76 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

to be rejected. All things that were made were made for our good IF they are taken with prayer and thanksgiving. Not everything is profitable so we must be wise and we must be knowledgeable and that is why we need education and relationships with experienced people. We need to be resolved that although the old world is destined to futility the new one in Christ is nevertheless made for our good and God is presently making all things new for his beloved. We may take new things and evaluate them to see if they are redemptive and for our use in the purified world he is remaking for his glory and our salvation. Dad filled out a form to consent to paying the $1000 for 14 pills needed for a week of treatment at home. This antibiotic was made in the year 2000 and has been known to outdo ‘the superbugs’. Dad also paid $25 and this may be all he needs to pay if the pills are covered by a medical plan he adheres to with the Alberta Government. The pharmacist will verify this. My own research seems to indicate they are covered.

I went to Mom’s hospital room. I could tell Nursing Assistant, Cynthia, was in giving her a sponge bath, so I waited. When Judy and I are involved in changing Mom or washing her, she asks, “Did you girls ever think that someday you would be doing this for your old mother ?” I can’t say that I never thought I might be doing this. It seems to me to be normal and related to relieving suffering or improving the human condition, something I have been involved with for my entire adult life.

I helped Mom get breakfast. She was sitting up while her bed was being made.

Dad arrived and helped. Then we got her back onto the bed for she was complaining about fatigue.

Dad and I packed up her belongings. We took three bags to the car including flowers and vases. Judy was parked near the van and waiting to give us a wheelchair she had borrowed from the Red Cross. We all returned to Mom’s room until the IV entry lines were removed from her wrist and she had permission to leave. I went to the pharmacy to get some advice on probiotics.

Judy got Mom dressed (she still had her winter coat nearby) and Dad brought her downstairs in a hospital wheelchair. Before Mom left we took pictures of Cynthia and Aubrey, her special nurse’s assistants from the Phillipines. It was a tearful goodbye and phone numbers were exchanged. Dad thanked her discharge nurse, Rebecca who we knew over these past weeks. Mom actually signed herself out of the hospital but Cynthia said she had confided her fears to her. “Aubrey and Cynthia are very important to this unit,” Rebecca said. They depend a lot on these two competent assistants.

Mom stepped onto a little plastic footstool brought from home and made it easily into the front seat of the van where we had placed a pillow and blankets. Judy said goodbye and left. Dad and Mom and I stopped at friends’ who lent a toilet seat and a bath chair. “Did you think I would forget what that is? ” Mom asked when Dad passed Woodgreen Church quizzing her to see if she remembered that building. Mom commented on how beautiful the balcony flower baskets are at this unknown condo complex.

Mom didn’t say anything when we got into the apartment. It didn’t seem too familiar. (She asked later if they had just moved there). It has been 11 years since they moved into it. The wheelcahir went right to the bedroom door. Mom was tired. We got her straight to bed. She was too warm in her winter clothes and was thirsty.

I placed ‘Hilary bear’ next to her on the bed (from the young woman named Hilary whom Mom had babysat as a child). She smiled again because of her good ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

77

memories of taking Hilary to the Zoo or the Park and reading to her. Now Hilary is a civil engineer.

I took Mom’s bulky Attends off her and put on more comfortable underwear and a Poise pad. She was much more comfortable. I made lunch. Mom was not hungry. We all turned off the phone and had naps. Then I went to buy probiotics (to replace the good bacteria in the stomach and prevent anti-biotic related diahrea), Ginger gravol (for nausea), banana muffin mix and squash soup. When the cashier asked, “How are you today ?” I very nearly burst into tears. I stopped en route to pick honey suckle and apple blossoms for the table.

In the afternoon and evening, it was wonderful to just be able to lie next to Mom and quietly talk with her. Dad was like a kid again trying to make everything perfect. He has an incredible desire for order and facility of access for things. This whole incident forces a High Learning Curve on Dad but he is ready for the challenge. Generativity !

Feeling one is useful.

I researched books on caregiving before arriving in Calgary and I remembered Carol Gilligan’s research at Harvard applied to educational psychologist, Kohlberg’s theories from last year’s Ed Psych 200 course at Concordia. Women and men give care differently but some things about care are universal ie. developing trust, identifying with the needs and concerns of someone above one’s own needs and concerns, and having someone to be there when those needs arise. Safe, friendly environments are required.

Mom asked me how she got so sick. I explained everything as simply as I could.

She asked how I knew all this. Did I ask the doctors ? I explained that I have had a few weeks (7) to study it all and that I only know a little compared to all there is to know. It may happen to me someday.

I realize that Garnet and I should work out our own Personal directive (for non-financial matters) with co-decision makers Supported decision-making authorization (legal guardianship issues) Enduring Power of Attorney (trusteeship) and A notarized will (for financial and personal asset distribution after death) to accompany our olographed wills.

Lots of work to do when I get back to Montreal !

Love, Daryl ©Daryl Zoellner

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

78

♠ Thursday June 9, 2011.

At 9:30 am Sharon, a Calgary Health Care Worker, came to the condo to do a lengthy interview with Dad and to do an assessment of Mom’s wounds. She took into consideration Mom’s mobility, her environment and whether it responds to her needs.

She checked her nutrition and gave advice and marked down injested medications and medical supplements like the probiotics I bought for her. She talked to Dad about ileostomy products etc. and made sure he knows how to do the changes (without having to clean the stoma over and over again before placing the bag apparatus. She talked about financial ability to pay for care so Dad gave information about their household income. This will place them in the range of care available to them. The nurse was aggressive but certain. Dad was very cooperative and appreciated all her advice and help. He is cautious but looking for solutions. If home care is not carried out ethically there is a Patient Concerns address to which one may appeal.

Alberta Patient Concerns Patient Relations Calgary Health Region 10101 Southport Road Calgary Alberta T2W 3N2 I hope Dad remembers to take everything with prayer and thanksgiving. Only care that is approved will be provided free of charge. The coordonator arranges these services. If the recipient can leave home, community clinic care can also be given. There is also an Adult Day Support Program for people who are not connected socially. Sharon (the CCC) who came, suggested Dad could be in line for burnout. He could get Meals on Wheels and go to M&M prepared frozen foods. He is signed up to the Co-Op medical supplies store near here (403-252-2266) and he has Mom is being registered for a discount of 75 % off items for home care. Aids to Daily Living (www.Carex.com) advertises online products. Mom and Dad are friends with a couple in their condo complex who have gone through the same thing. The wife (Ruth) has an ileostomy also and she will give Mom good advice and empathy. How does Mom get help? She will have to learn to press TALK, memory, speed dial8 to get Dad’s cell phone from her ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

79

home phone (if he is across the hall in the exercise room). She will also have to use the whistle beside her if she needs him from another room in their apartment.

Where would Dad like his medical treatments and which ones would he want or not want?

Where does he want to live?

Who would he like to live with?

Has he made other personal and legal decisions?

What sort of burial or cremation does he want ?

What funeral arrangements?

All of these are based on values, beliefs and treatment options. All are to be examined according to existing medical conditions and sudden medical events (ie. stroke or heart attack).  Neglect of seniors is not handled legally but is handled more relationally in communities across Canada. http://www.cnpea.ca/canadian_laws_on_abuse_and_negle.htm. The police or a court can order a Protection Order, which requires a member of a family to stay away from the person being harmed or threatened. Other abuses, ie. financial have many other laws to regulate them. Problems experienced by older persons are often complex, multiple and interrelated. Between a charge of neglect or abuse and the court case, a senior may deteriorate. Most involved in these issues prefer that support, assistance and services be in place to prevent abuse or neglect crisis situations from occurring. ♣ Meals on Wheels has an acronym M : medications E : emotions (depression) suicidal gesture (increased cerebrospinal fluid concentrations of corticotropin releasing factor, a potent anorectic agent).

A : alcoholism L : late-life paranoia S : swallowing problems O : oral problems N : no money (poverty) W : wandering and other dementia problems H : hypothyroidism (insufficency of the thyroid gland), pheochromocytoma – (rare tumor of the adrenal gland tissue) E : enteric problems (malabsorption) E : eating problems (mechanical) L : low salt, low cholestoral diet S : shopping and meal preparation problems.

Sharon, the nurse today, focused on getting Mom out of bed every hour. Sharon quotes scripture verses to her like, I can do all things through Christ who strengthens me (Philippians 4 :13). Giving her peanut butter on her muffin, protein powder in her Ensure or turning supplement drinks into smoothies, giving homemade ginger tea with 80 ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

lemon and honey in it etc. for nausea are other feeding tricks. Mom’s own metabolism and will to live will hopefully guide Dad. So far she is getting to the bathroom as needed and has not had any accidents or wet Poise since she came home. She is taking the antibiotic and the probiotic. She has had a whole bottle of Ensure and a bit of muffin. In the mornings she has hypoglycemia until she eats something and raises the blood sugars in her blood. Her blood pressure is normal and her temperature also. Sharon asked if there were any firearms in the home. I think we know why.

Sam Zhao will drive me to the airport Saturday morning in Dad’s van since his own car is being repaired.

I will be thinking of Mom and Dad all the time back in Montreal and phoning. I have a good long distance plan.

Love, Daryl For future reference : Foothills Medical Centre General Surgery / Surgical Oncology Unit 102 1403 29 Street NW, Calgary, Alberta, T2N 2T9 Telephone: 403-944-1110.

Daryl Zoellner darylzoellner@gmail.com 6160 J-A-Cousineau Montreal, Québec H4E 4L7 Telephone : 514-767-3165 ♥ Post script correspondance:

Sunday, June 12, 2011. J. Clare Martin wrote :

Dear Family and Friends,

Today is the 4th day since Pat came home. She is still taking one antibiotic, 2 pills/day and is still being affected by it, causing a lack of appetite. The purpose of this is an attmpt to clear up the infections that were still left in her abdomen. The massive dosage of said treatment has killed most of her appetite for food, Thus we have a weak and very thin body and a mind that struggles to stay focused on reality.

Today she weighed in at 89 pounds. She did not eat much again today, and also struggles with vertigo from being in bed so much. When we try to get her up she feels dizzy and weak. Today she was sitting up for about 1.5 hrs and visited with a couple from our Chinese bible study group who have become very good friends.

They very graciously took Daughter Daryl to the airport for her flight home to Montreal. A lady friend from our condo stopped by bringing flowers and spent about 3/4 of an hour chatting with Pat in the bedroom. She has a husband with Alzheimers. We have discovered that another couple in our condo have gone through a similar experience as our, so we will talk with them about how they cope with the new waste management system. It was a pretty good day for Pat and a difficult day for me as I contemplate the long road of recovery for my beloved wife

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

81

and the amount of work involved in helping to get her through it. I also went through the downer frustration at seeing little progress being made. ♥ Monday, June 13 2011. J.Clare Martin wrote : Family and friends, Pat is still not doing very well. She can’t be upright for very long because she feels so weak and shakey. I get her up to the toilet and she can barely make it back to the bed. I am not sure if some of this is not psychological, “I can’t do it,” fear, or simply the result of weakness related to the lack of nourishment and exercise. Today I prepared a piece of white toast with apple jelly on it for breakfast, tried to get her up to eat it, but she sat up and said she couldn’t do it. I left it on the bed and she only ate one bite. I had a cup of coffee for her and she didn’t touch it. Since I am not a wheedler, there was no pleading etc. she has to decide if she will eat or not.

I had decided that I would try leaving her on her own for 2 hours and go to church leaving her the phone with instructions how to get me on our cell. Just as the service ended I got a call from her requesting that I come home right away. I was there in 10 minutes and she was experiencing the ileostomy bag leaking. I think the gas in the bag caused the leak, although it may have been that the seal got old and didn’t hold under a little pressure. The home care nurse came not long after I got home so we changed the whole thing and cleaned up the minor leakage stains. Her intake today was a jar of Ensure, one bite of toast and ½ small container of chocolate pudding with pills.

It was another frustrating day trying to get her out of bed. A couple times to the toilet was all we could do and they were under duress. I will discuss this with the home care nurse tomorrow, but only expect that she wiil blame me for not forcing her to get with the “program” (hers).

We will see how that works out. There are things that indicate the dementia is fogging her memory about current things, but most of the time we have good talks as well as reading scripture and praying together. I share your notes with her and she appreciates them. Sometimes my frustrations with her lack of response to urgings to walk and eat cause tensions and emotional upsets, but we work though them and continue the plan for the future, to get her stronger and more active.

IN HIM Clare ♥ Tuesday, June 14th 2011. Clare Martin wrote : Subject: Pat Update 3 Today was a better day for us here in Millrise. After a good sleep, we had brekie, Pat enjoying a small portion of Cheerios in milk while I had my rolled oats with raisins and milk. Pat had a bit of yogurt with a pill. We did a few personal things with Pat resting in bed. Pat did not want any lunch, but we got her working on a bottle of Ensure, which she finished in the afternoon. After lunch the Home Care case manager came, looked at the incision and put another dry dressing on it. We discussed having a care ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

82

giver come 3 times a week to help Pat with personal hygene items and other things like exercise including walking etc. A 1 hour nap in always helpful to restore the energy for the evening push. Our good friends Marg and Denis Cartwright provided some home made soup and cookies. Pat ate a small bowl of soup and a cookie. We did this in the bedroom with her sitting on the edge of the bed. It seemed to work ok for her. Several phone calls kept us busy and we listened to some nice instrumental hymns in the evening. There is some progress in all this, except that Pat does not do well with being upright or exercise. Perhaps a different leader will help. Again, thank you for your prayers. If volume means anything, we have lots of people raising their voices to our gracious God. I confess that this is a challenge to my faith because of the seeming silence and the lack of response from God. The accuser does try to use this to derail God’s plan and is pretty sly in his schemes.

IN HIM, Clare ♥ On Saturday, June 11, 2011. at 10:45 PM, Judy Simmons wrote: I had a pretty good day with Mom today. Guess no one has been able to get her in the shower since last week when I did so I got her in there today and washed her hair....she is a lot stronger since last week. Got her to eat a few bites of ham and cheese sandwhich..some Ensure...a cup of tea and half a cookie and and a whole apple juice box. I just have to distract her while she is eating and then she doesn’t talk herself into being nauseated which I think is all in her mind. I don't make a production of it and she does it. I got her to sit at the table to eat and then she went to bed for half an hour. Then she got up and watched T.V. on a chair for awhile. I think it kind of hurts Dad's feelings a bit that she is so cooperative for me… hahah. I know I should go visit them more but gas is expensively nasty in my car and every direction I drive there is construction so it takes an hour to get there. Dad is taking her to see Dr. Mulloy on Monday at his office down by Fort Calgary. I will meet Dad there so I can HEAR what he has to say.

Dad went downtown to get THEIR bus passes for the year and then he came home and took the van to get different kinds of ostomy bags for Mom (they should be easier to handle). Then he came home and decided to go get groceries at Superstore....so it was a productive day. I told him he should go golfing but all his errands tired him out.

Too bad ! It was a great sunny day for it.

How is everyone's health???? Daryl back...Carl legs????

Don is teaching in Fort McMurray again and will be home Friday night.

Judy ♥ Tuesday, June 21, 2011. Daryl wrote : Hi Dad

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

83

How is Mom's mental state? Here is a test regularily given in U.S. hospitals. The normal level (24) is not so clear anymore because highly educated people decline more rapidly than the less educated (27 can quickly move to lower levels).  http://www.oocities.org/travelnair/mini-mentalStateExamination.pdf ♥ Wednesday, June 22, 2011. A letter to Judy. Daryl wrote: Keep track of your gas expenses, Judy. What you require for these trips is probably a fixed amount (ie. 25$ a trip). If you continue to go once a week, it might cost 100$ a month. If we divided it up among Carl and I we could be looking at 50$ a month each to help you out. You have to agree to use your time without pay, I guess.

I agree about the cooperation being easier when Mom is distracted. I sometimes sat behind her instead of watching her eat when she was in the hospital. She didn't have to think about performing for me.

The nausea is a fear but not based on real danger. She never vomits now. The anti-biotics are not involved now.

I found a U.S. website called Hospital Elder Life Program (HELP). It was instigated by Sharon Inouye in the US in 2007 so that hospitals didn't make elderly people sicker and then make it impossible for them to return home. Here in Quebec, we have the CLSC (Local Centre of Community Services) - a community clinic in every neighbourhood that oversees hospital to home transitions, vaccinations, epidemic control, rental of equipment and outpatient care and other health situations that are not life-threatening. The HELP program pays attention to the confusion that occurs when elderly people come out of surgery and tries to diminish this and get seniors to remain autonomous and in their homes instead of having to depend on a health system that is increasingly impersonal and overloaded. If you noticed at the Foothills there were almost no English Canadians doing the service jobs. The type of hygiene they may have grown up with and understanding the type of hygiene required in a modern hospital means a huge learning curve for these workers.* A lot of the nurses come from first generation Canadian immigrant families and the number of languages spoken among the patients is increasing as people move in from other countries. The possibilities of lack of communication are increasing, and we are more in need of home care than ever for the simple reason that we need to understand quickly and without stress what is happening to the patient, not what is happening to all the workers around the patient.

You seem to know that Dad needs to de-stress too (ie. play golf). He will have to see himself as less important and less indispensable. Mom will hopefully recover some autonomy, and her body will stop canabilizing itself (consuming muscle to produce red blood cells because there is not enough food coming in). Then her weight will come back, she will feel better and she will sense that she is able to do things on her own without help. I understand this is what the nurse who comes 3x a week is working on also. I am glad for you being there, Judy. If money is the issue, don't stop because of that.

Daryl

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

84

[Judy reassured me that money was not needed at this time, just some restructuring of her family’s finances. Aren’t we all there ?] *Modern hospitals are being replaced by Postmodern hospitals. Postmodernism is a general and wide-ranging term. It applies the same relativism that George Harrison used to create his song, As My Guitar Gently Weeps to literature, art, philosophy, architecture, fiction, and cultural & literary criticism. ♣ When the same relativism is applied to present-day hospital care, personnel can be described by the term Mosaic Generation. Dr. Wayne A. Oppel explains why theology matters in the ritual of healing, as part of the following sociological commentary on the upcoming generation that will be working in Canada’s institutions. http://www.regent.edu/acad/global/publications/lao/issue_7/pdf/mosaic_generation_opp el.pdf ♥ Thursday, June 23, 2011. Clare Martin wrote : Hi All, The last couple of days have been pretty encouraging for me because of your mom’s progress in her attitude about her present situation and what she can do to improve herself. We have been talking about what she can do to get out bed... of always wanting to be in bed, or lying down. I have made a few suggestions, “wouldn’t you like to be up and doing different things?” (nothing specific, but « things you like to do?” She has begun to responded by saying things like “I should be up helping you do the shopping, ” or « it would be nice to get outside for a change.” And she surprised me by getting up herself and coming out to the supper table. So tonight, after we had supper in our dining room, I suggested we go for a wheel chair ride outside. She responded with “that would be great.” So we put a couple of house coats over her nightie, socks and slippers and a light tuque and went out for a walk. It was fairly warm, but she needed the warmth of the extra house coat. We both enjoyed it and came back with thanksgiving for the trees, green grass, and flowers. On the way back in the building we saw the lady whose husband has Alzheimers and chatted with her for a few minutes. Yesterday we had a chance to talk to the couple who went through some hard things about 4 years ago.

She had rectal cancer and had to have an ileostomy for almost a year before they were able to reconnect the original system. They are believers (Roman Catholics) whom we have gotten to know a bit. They were glad to share their experience and Pat especially was able to relate to Ruth’s ongoing problems with diet and the struggle to get rid of the waste from her bowels and rectum. She has been trying to eat more, but still can’t eat much each time. We keep her going with Ensure and any kind of snack she might like.

We are trying some different types of ostamy systems to see if they might be better. The bags are smaller but less cumbersome. They have a vent in them so the gas is not as problematic. So far smell has not been an issue, but I guess it can be. Judy is a good help to her mom by giving her a shower and washing her hair.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

85

The woman who comes Mon. Wed. and Fri. seems to be too easy with Pat & gives in when Pat doesn’t “feel well!” But that will probably work itself out in time. Today I went for a bike ride to pick up a few items at our local Great Can Super Store so I didn’t see what she did with Pat. All in all I am more encouraged by better expectations for the future.

I looked at the dementia test Daryl showed us. I will have to modify it a bit and try it on her. I have no idea what her score will be, but I’m not very attuned to modern analytical testing like this. How do they test for love and gentleness and deep committment to God and family? You can’t quantify the important things in life. Quality of life is found in being able to serve each other and love even the unlovely. And what is normal anyway??

Enough said tonight.

God’s blessing on you all. Dad ♠ Saturday June 25th, 2011.

On the phone today, both Dad, and then Mom were saying they were going to make every effort to go to Church. They might be in the presence of the Lord Jesus tomorrow, remembering the broken lamb that he was. They will be in the congregation of the multitude of witnesses past, present, worldwide and future, who will be praising or imploring God, the Father, Son and Holy Spirit from whom all blessings flow. Let everything that has breath praise him tomorrow ! Let praise go on until the full number of those who are being redeeemd has been brought in to live under God’s servant kingship, until all see him as he really is, whether they can stand it or not.

26th day home from the hospital Sunday July 4th, 2011 American Independence Day ♥ Clare Martin wrote (cc to Judy and Carl) : Daryl, No, she didn't make it to church. We were awake at 7am. I was up and showered and then got her up and helped her get showered and hair washed (1st time for me). We had to hunt for clothes that might fit, got a nice outfit on including shoes. She looked great with her shorter hair and clothes on. All looked like we were going to proceed to go. But after brekie she felt weak and ailing and so she wanted to lay down. We were early so she laid on the bed and went sound asleep. Woke her after 3/4 of an hour but she begged off and stayed where she was. I went to church by myself. The rest of the day was pretty much low key. She ate small a amount at lunch and more at supper but again had to rest so we didn't walk tonight. Tomorrow will be busy early as we see our GP. I will update him and see if he has any suggestions for the tiredness and feeling ill. We will see if he knows anything about c-diff. I am still encouraged by her progress but would like to see her get past the ongoing feelings of ailing and the seeming unwillingness to press on at times. She is still quite depressed by the ostomy being permanent and sometimes wishes

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

86

she were dead and cries. She recovers and goes on. It is hard for her, but she is also resilient so I hope she can get more positive about it.

Our love to each of you, Dad with Mom. ♠ Sunday July 10th, 2011 Mom made it to Woodgreen Presbyterian Church for the morning worship. She was greeted with joy and thanksgiving and her back almost had the strength to say seated for the whole service, almost.

So death is not the conclusion of this diary narration. I am not going to attach an epilog that says, “Patricia Ann Martin died on such and such a date.” So far, she is still in her present God-given 82 pound (37.2 kg) 75 year-old body. She is still moving from life to life and I believe, according to God’s promise to her, she will always go from life to life, from home to home, from morning to morning or from gardens to Garden, as is implied in the title of a book I translated for CEM France, by French author, Frederic Baudin. (http://www.cemfrance.org/books.htm.)

Mom was still with us on her birthday July 5th. She has successfully, by the grace of God, made 76 trips around the sun.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

87

©J.G. Zoellner

57th wedding anniversary July 31st 2011.

The Lover of her soul has not yet asked for her hand.

Wednesday June 3, 2015 8 :15 am He asked for her hand today. Dad and I had cleaned her up and changed her sheets and turned her onto her back. We pulled the covers up to her neck and she just slipped quietly away on us. I said goodbye to her toes and to her shins and to her knees and to her sharp hip bones which carried me along until birth and even after. I said goodbye to those weakend glands that gave me milk, those arms that carried me and hugged me and those shoulders that shrugged off my repentant culpabilities. I said goodbye to her lips and smile and to her nose and forehead with sun and laser scars. I kissed the last scar above her eyebrow and touched the hand on her chest again. I replaced the thick quilt over her face and said, God be with you until we meet again. I love you.

Saturday June 6, 2015 We had the memorial service Saturday June 6th at Woodgreen Presbyterian Church.

Kira on piano and Martin on trumpet opened the service with The Lord is My Shepherd

by Keith Green. Brad Jones Dad and Mom’s pastor lead the rest. He read beautifully the bio I wrote about her. He preached grace and the fact that God knows us by name. Our renown is his record of us. God had a relationship with Abraham and Isaac and Jacob.

He has a record of each of his own. Over 60 people attended, cousins of Dad’s and ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

88

Gordon, Nancy and Debbie Whitham (Garnet’s relatives) were there. I planned food for 80 so we had leftovers for Sunday after worship. Thankyou so much everyone who was there. Kira and Martin, you were so appreciated during this time.

Sunday May 31st God gave me a vision of balloons. I was looking up in the Woodgreen Presbyterian Church sanctuary and praying for my Mom one Sunday during the service. Mom had yet to pass into glory. She was receiving palliative care at home. I saw a gold helium balloon trapped under the wood veneered ceiling of the church. I thought of how much my mother’s faith had been tested in her life. She was gold. She was also full of the Holy Spirit and yet trapped and unable to join her spirit with the Father because of her mortel body. She had been economical. She had used up every part of her body to its capacity. Let her go to you, I prayed. I took a picture of the balloon. Mid-week God answered my prayer. He let her go to him. I came back into the church Saturday, June 6th for the memorial service. I looked up to see my gold balloon. It was gone ! Maybe the janitor had taken it away. I didn’t know where it had been taken. I took a picture of the empty ceiling. Mom was gone. We made a slideshow of pictures of her during her life. We set music to it. Take My Life and Let it Be. 1 Take my life, and let it be Consecrated, Lord, to Thee; Take my moments and my days, Let them flow in ceaseless praise, Let them flow in ceaseless praise.

2 Take my hands, and let them move At the impulse of Thy love; Take my feet and let them be Swift and beautiful for Thee, Swift and beautiful for Thee.

3 Take my voice, and let me sing Always, only, for my King; Take my lips, and let them be Filled with messages from Thee, Filled with messages from Thee.

4 Take my silver and my gold; Not a mite would I withhold; Take my intellect, and use Every power as Thou shalt choose, Every power as Thou shalt choose.

5 Take my will, and make it Thine; It shall be no longer mine.

Take my heart; it is Thine own; It shall be Thy royal throne, It shall be Thy royal throne.

6 Take my love; my Lord, I pour At Thy feet its treasure-store.

Take myself, and I will be Ever, only, all for Thee, Ever, only, all for Thee ♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

89

We also sang, What’ere our God ordains is right, from the new Trinity Hymnal.

During our weekend of memory of her, I had not yet seen the little cardboard box (the size of two shoe boxes) in which her 3 1/2 lbs. of ashes had been placed. That would be later. On Tuesday, Judy and I chose what would be our inheritance among Mom’s clothing and jewelry. Then I took her into the bedroom where our mother had died and pointed to the box in its clear plastic bag with handles. We stopped and hugged each other and we cried as I pointed to the bed where we said goodbye to her - Dad, Garnet and me. Mom lay through the night beside Dad until we were ready to call to have the beautiful well-used corpse collected. Judy wanted to lift Mom’s remains. How little the human body weighs without water ! Mom weighed about 60 lbs alive and 3 lbs. after cremation.

Tuesday June 23rd, when I was in Kelowna at my mother-in-law’s house, I zoomed in on my photo of the gold balloon. What a surprise ! There had never been just one balloon. There was a red balloon beside it, clinging to it, both wanting to go higher. O, how the Father loves us ! He sent a bleeding, dying saviour to accompany us to glory.

And so, we shall always be with the Lord. (I Thess. 4.17.) Whether we are in the body or out.

I was able to grieve with her, not just for her as she died. Psalm 116.15 was on my Dad’s lips as he saw my mother draw her last breath. Precious in the sight of the Lord is the death of his loved ones. We buried Mom’s remains on July 18th, 2015 in her hometown of Kimberley. There was an obituary in the newspaper on Thursday, July 16th, sent in by my brother who composed it well. It was Julyfest weekend and very hot. Aunt Elsie, her daughter Tanya and Aunty Dale, her daughter Paula and one of mom’s former neighbours and highschool chum came. Earl Betker, the first Christian brother who mentored my parents in their days of early belief was there, himself very frail. Judy and Don were there and some of the Simmons. Carl, our brother, sent a script to be read. The bronze plaque now over the grave says, The Lord cares deeply when his loved ones die (Ps. 116.15) from the Living translation of the Bible. And I believe he does.

♣QUOTE RESEARCH ♥CORRESPONDANCE ©PHOTO ♦ILLUSTRATION ♠VIGIL

90