How do you decide?

How do you decide?

My mom called me at work today. She was in tears. She was at the rehab center with my grandma. While my grandma was trying to walk she had some kind of atypical heart rhythm. Her heart rate was dangerously high and her blood pressure was dangerously low.

When my mom called they were starting some sort of IV for my grandma and they were asking my mom if she wanted to sign a DNR. My mom couldn't even begin to fathom how to make such a decision. I'm not sure what was more upsetting for her... the fact that her mom was so sick or being asked to make that decision.

My mom wanted me to decide for her right then and there. I was stunned. When I was faced with my dad’s DNR I spent a solid week praying, consulting with doctors and chaplains, studying about his type of cancer, and even looking at his test results for myself. And all this research was done after months of praying that God would give me the wisdom to make this decision when the time came. But most importantly, while my dad was still healthy enough to discuss his wishes we talked about it for hours. It was never a pleasant thing to discuss and we always ended by agreeing that he was going to get well enough that we were really just wasting our time. But we knew that even if he beat the cancer, someday I might be faced with making that decision for him anyway.

So, when my mom called and wanted me to decide for her in a split second; I was clueless. Heck, I don't even know the first thing about my Grandmother's wishes. I don't know if she wants to fight until the bitter end, if she wants to fight to a point, or if she just wants to slip away at the first possible moment. I just don't know what she wants. I know what my dad wanted and what I want and what my ex-husband wanted while we were married... but not her.

It seemed to me, the best thing to do was try to give her some criterion for making the decision. I suggested she call the oncologist and get him to speak frankly about her chances of surviving the last two rounds of chemo. I said she should ask him just how positive was the last PET scan that she had. I encouraged her to get the input of as many doctors as she could.

Instead, she put a nurse practitioner on the phone. My mom just couldn't handle the advice I was giving her. I was telling her to take action and she wanted to be given an answer. I had a very nice discussion with the nurse practitioner. I asked her to call the oncologist and find out his opinion. She told me that she had seen the results of the PET scan and that it looked very promising. She assured me that she would help my mom get the information she needed (or that she could at least pass on to me) to help make the decision. As we were ending the conversation, the nurse practitioner said that my Grandma was responding to the IV and she was becoming more coherent and aware of her surroundings.

The nurse practitioner was happy, not only for the good response from my grandma, but also for the fact that they could now ask her what her wishes were. I encouraged her to make sure my mom had that conversation. Without some force, some serious outside pressure, that conversation just wasn't going to happen.

This evening my mom called me again. She said that they have moved my grandma out of the rehab center and back to a medical floor of the hospital. She said grandma was resting comfortably and they were going to do several tests tomorrow.

I asked my mom what my grandma's wishes were. My mom didn't know. She never had the conversation. I hope the nurse practitioner talked to my grandma. I hope she knows. Because I can't imagine trying to make this decision without the faintest clue about the person's desires. Deciding between life and death for someone else is an awesome responsibility. It almost killed me even when I knew what my dad wanted. But how the hell do you decide all by yourself?