One morning last month I was on my back with a needle in my arm donating blood when my cell phone rang. It was news that my sister had been hospitalized in New Jersey with internal bleeding. She had received four units of blood.
Fortunately I was able to head east a couple of days later to be with her and her husband, David. Clara had had bad health all her life. She had spent much time sick as a child, often in the hospital. She developed a disease of her muscles that caused gradual but serious weakening over the past decade. This is in addition to other health problems, including asthma and two types of painful arthritis.
We spent a few days last June with Clara and her husband in Princeton. It was clear that her health was deteriorating and that she needed hospital care. I stayed with her a couple of hours while the admissions clerk searched for a room. Finally I had to leave to catch a plane to Europe where we sang with the Durango Choral Society.
Clara did not live at her home in the intervening months. She spent weeks in the hospital, then a rehabilitation center, then assisted living center. She was fortunate to find a wonderful woman who stayed with her during this time as her aide. Lidiya, an immigrant from Ukraine, entertained Clara with stories of her past, her family and her culture. Clara told me joyfully about the longest trip that she had taken for months to visit Lidiyaâ€™s home in northern Jersey. Lidiya took her mind off her pain and miseryâ€”what an angel of mercy she is! Lidiya wrote about Clara: â€œShe really was a gracious lady and very interesting person. Also lovely, sunny and sweet.â€
What I feared was true. Claraâ€™s husband, David, and I were walking into the hospital when we encountered one of her doctors. This kind man showed us on the CT where the blood had collected, and also how damaged her lungs were. The scan also showed other signs of deterioration caused by the aging process and disease. She was not the beautiful older sister I had known as a kid growing up.
Surprised to see me (she didnâ€™t know that I was visiting), Clara smiled briefly, but her energy and strength were short-lived. I could see marked decline since we were last together in the fall. Clara was bedridden and barely moved except to turn her head to talk. At mealtime she needed both hands to lift the small bowl of soup. She ate very little. She was in a private room at the end of a hall, she said, because the pain was so severe that at times she screamed out loud. I didnâ€™t need to be a doctor to know that her condition was dreadful.
David told me that Clara had asked about hospice care a year and a half ago. Hospice was not appropriate then, but the time had come. David and I talked it over, and then I suggested to Clara that it might be appropriate. She agreed.
Her doctor agreed that Claraâ€™s condition was hopeless, and that comfort was the best that he could offer. He talked it over with her, determined that she was alert enough to be able to make the decision, and started her on narcotics. The next day I received a call that my dear sister had died.
Writing runs in our family. Our mother decided in third grade that she wanted to be an English teacher. Our father wrote dentistry texts and Clara was a freelance writer. She wrote many articles for magazines and newspapers, as well as two published novels. I was always interested in science and did ok in English in school. Clara gave me a remarkable opportunity twenty-five years ago: did I want to try writing for a new magazine, Womenâ€™s World? I submitted a trial article and was selected to compose some of the Gynecologist Columns. She occasionally offered suggestions to improve my writing. Soon I realized that with the word processor I could reach many more people than by just seeing patients in the office. In other words, the pen is mightier than the speculum!
On Claraâ€™s suggestion I approached the Herald with an idea for a book, which turned into this column. Sixteen years later people are reading it both here and outside of Durango.
Please join me in thanking my sister for empowering me to write. Please also join me in mourning her years of illness and recent death.
Â© Richard Grossman MD, 2011