The Hardest Conversation

Words Jonathan Bach

The door closes behind me. As I get farther down the driveway, moonlight replaces the glow from our porch lamp, illuminating the snow underfoot. I just need to get outside and breathe for a minute.

It had been roughly eight years since my mother was diagnosed with end-stage renal failure. Translated across the medical terminology: a person’s kidneys aren’t working normally and can barely help the body anymore. Mom had been in the hospital recently with seizures from a heart infection. Now that she was back at home, she wanted to have the “end-of-life” conversation with me.

It is a talk for which I am not prepared, so I respond by getting up and walking out the front door.

I knew I didn’t want to see my mother go, and to talk about the possibility of that happening felt frightening. From when I could first toddle, we’d been best buddies. When I was small, she and I would snuggle up on the living room couch in the evening and watch her favorite after-work primetime dramas. As the years passed, with the patience only mothers can seem to muster, she encouraged me through a fervent Obi-Wan- Kenobi phase, a bike racing phase, and a jazz musician phase, complete with harsh fortes coming from our piano.

For her sake, I should turn back and go inside, but for a time I just keep walking.

We were living in Montana when she was diagnosed. At 11, I didn’t understand that lots of families go through bouts when a loved one has a bad disease. As her kidney failure worsened, we relocated around the United States in search of adequate medical care. We moved to Bend, Oregon, in 2008 and finally found the care for which we had been searching. Though our situation continued on imperfectly—Mom’s visits to the hospital still occurred often—the turbulent waters seemed to calm themselves for a time. But one phone call shattered the semblance of stability I had attained: In the winter of 2013, during my sophomore year at the University of Oregon, my dad called to say Mom was in the hospital again—and this time it was bad.

Dad, a steel-hard man who’d been through years of his wife’s medical ups and downs, said something to the effect of, “You may want to come back home. Your mother’s not doing too well.” He said she was on life support and was having seizures because of a heart infection. She was immunocompromised, the doctors had said, which meant her immune system was weaker than the average person’s, making it easier for infections to take hold. While hospitalized, she was incoherent and could hardly eat.

That winter break, in a hospital room that overlooked the city, I saw her convulse and seize as she fought her heart infection. She was in the hospital, and then in rehab, for roughly three months. But then, as if God had decided to grant us a midwinter miracle, she began to recover. She slowly regained her ability to speak and move. She relearned how to hold a fork. During the recovery, a therapist would have her take a small bite of food and swallow to help her wean off liquid protein shakes. She eventually came home from the rehab center to her beloved cats, two dogs, and her family.

The moon is out. I get down our long driveway and know I should turn around.

I’ll only realize later, after she has fought off this latest challenge to her health, how difficult it must be for someone who is staring out over the edge of a perilous cliff to say, “I don’t know how much longer I have to live.” And watching her through the ensuing years, I’ll learn that when adversity comes your way, you have to try and roll with the punches, even if some hit with more “umph” than others. But that insight awaits.

On this night, I crunch back through the snow to the porch. Open the door. Walk past the familiar staircase in the house that had finally become home and go into the room where they brought her after she had arrived from the hospital. I walk to her bedside where she sits waiting for me. I sit beside her and say, “Let’s try again.” Her frail body has been beaten by infections and seizures, so I hug her carefully. She is still the same tough woman I’ve always known. She is still my mother. And now I am ready to listen to what she has to say.

illustration by Natalie Greene

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