Getting better, slowly better, at knowing when things should end

A radio interviewer asked a celebrity a question as I was listening in the car this weekend:

“Are you good at knowing when things should end?”

“Absolutely not!” I shouted to the windshield as if the question had come to me. I don’t remember the interviewer’s or the celebrity’s names. But I can’t forget the question. The fact is, again and again, I hang on long after the time has come to make a change. I know this, and I’m not proud of it.

Get rid of the ties

For example, my wife was after me for years to sort through and get rid of my neckties, piled onto a clothes hanger in the back of my closet. The only time I touch them is when they slide off the hanger and onto the floor in a jumble of shiny stripes and polka dots that must be untangled and gingerly reassembled onto the tenuous pile where I’d hung them.

Truth be told, I have enough ties to neatly fill four hangers. If I ever wear a tie again, it will be one of only a few favorites from the collection. So why can’t I admit the time for treasuring neckties should end?

And that’s among the most trivial of the examples I could mention. With the progression of Evelyn’s diseases, more serious issues are before me.

Decide your goal

A couple of weeks ago, Evelyn tumbled out of her wheelchair and bumped her head on the floor. In spite of a welt arising high on her forehead, the hospice nurse assured me on the phone that she seemed to be fine.

“But she hit her head,” I said. “Shouldn’t we check for a brain bleed?”

“Well, we certainly can do that, Mark. It’s totally up to you. You just need to decide what your goal is.”

I wasn’t ready for goal-setting. All I could remember was her family doctor’s insistence that we check for brain bleed if she ever hit her head since she was taking blood thinners to prevent clots. We’d gone to the hospital before with head bumps, and I couldn’t decide we wouldn’t go this time. This was an emergency!

So they sent her to the ER, and I met her there where she wriggled and wrestled with the sheets for four hours until the testing confirmed, “No brain bleed.” I tried to entertain her two more hours before the medical transport came to take her back to Artis.

After Evelyn was settled there, I asked the nurse on duty, “Do you think I made a mistake sending her to the emergency room?”

“Well, that’s certainly up to you, Mark,” she replied. “You just have to decide what your goal is.” She and the hospice nurse were operating from the same playbook.

She explained the only remedy for a brain bleed is brain surgery. Did I think Evelyn was a candidate for such a procedure?

 Some things should end

Last week we had a checkup  with Evelyn’s neurologist; the appointment had been on the calendar for six months. In my mind I had answered the nurse’s question, but I would pose it to this wonderful physician before I firmed my conclusion.

He explained that the surgery, through a hole cut in the skull, was invasive and delicate, without the assurance it would remove all the bleed or preserve brain function. The recovery was long and difficult, even for a younger person in good health. He would never recommend brain surgery on Evelyn.

And so, if we’re not going to treat a brain bleed, there’s no point in ever checking for one again.  We might send Evelyn to the ER someday for something, but not to test for a brain bleed.

The very fact of deciding to receive hospice care was an admission that some things should end. Now I was taking one more move toward understanding that.

 I see it. I hate it.

But the steps don’t come quickly. Our neurologist is a dynamic young man we came to love and rely on after only one appointment several years ago. At the end of this visit, he said, “Now, we love to see you guys . . .”

“But you no longer need to see the patient to decide how to treat her,” I interrupted.

He agreed, and offered a telehealth visit in six months. I can visit with him via my computer screen, and we won’t need to drag Evelyn into and out of her wheelchair and keep her occupied during all the waiting times at the office 45 minutes away. I managed it this time only with the help of an aide.

Taking Evelyn to see her neurologist, who has been something of a lifeline for us, has come to an end. I see that. And I hate it.

Slowly, sadly

Am I good at knowing when some things should end? No. But as we continue to cross one finish line after another, I’m slowly, sadly getting better at it.