Death by Morphine

 

Chapter 45

 Death by Morphine

Mariam was a Holocaust survivor.

When Mariam was ten, she and her sister were two of many German Jewish children who were saved by the Kindertransport (1938-1939). They were placed on a train and shipped off to Britain, where they never saw their parents again. 

Dear DD was the caregiver for this lovely lady for a time. Mariam was a mathematician who knew about numbers but didn't know how much money she had and didn't care. It just came to her. She apparently had enough, as she was in a retirement home and had BOUGHT her apartment. On top of that, they charged her $5,000 to stay there and be given care. Plus, she had private caregivers.

DD was her caregiver on the night shift. In the evenings, they would go to the roof and watch the sunset, where Mariam would tell stupid jokes, and they would both laugh.

When Mariam was 16, the school hired her as their Mathematics teacher. From there, she moved to another teaching position and never wondered from where her next job would come. She had mathematical proof in her name that she and DD found reference to on the Internet. 

 She had a fascinating experience with non-repeating patterns. A company wanted a design on their toilet paper, and they decided that Mariam's technique with non-repeating patterns could prevent the pages from sticking together. 

The toilet paper company eventually went out of business, but Mariam kept a few rolls of the paper.  Friends would want some for a keepsake, and she would give them a piece. Sadly, she said, she left the toilet paper rolls behind when she moved from Britain to the U.S.

 Mariam had Multiple sclerosis, a condition she had for years with little effect on her except she was unsteady on her feet, thus the caregivers in case she fell. It was not a terminal illness.

However, hospice killed her.

We view hospice helpers as angels. Many are, some are not. A nurse in charge thought she was in pain and decided she needed morphine; thus, she suggested Hospice care.

Mariam had stated she would rather have pain than be drugged. A doctor on the premises declared her terminal. Her medical advocate held out for a time but eventually bowed to their sage advice and gave permission to place her in hospice. The nurse reassured DD, the caregiver, that they would never give Mariam more morphine than she needed. Her only family was two nieces who lived in Britain. They loved her, but they were reassured by Mariam's living facility that she was being tenderly cared for.

 However, the following day, after being placed in hospice, her bed was gone, replaced with a hospital bed.

"Where's my bed?" Mariam asked.

Mariam didn't know what hospice was. DD tried to explain. "I'm not ready to die," she said, "I don't want hospice."

 DD complained to the staff that Mariam was being over-medicated.

Within days, mouth swabs they use on a dying patient because they can't swallow appeared on her bureau.

Morphine suppresses breathing and can cause anxiety. Thus, patients are given a "cocktail" that contains not only morphine but an anti-anxiety drug that is so powerful it is used in mental institutions to calm out-of-control patients.

DD was home on her day off when Mariam died. But she got the call and has never taken a permanent client since.

After moving to the United States, Mariam visited Britain. Although the orphanage was gone, a tree she remembered from childhood was still there. She photographed it, and it was a cherished picture on her wall.

It was a dreary picture of a lone tree on the horizon of a mound, not something someone would feel worth keeping, but it was a treasure to Mariam.

We don't know what happened to it.

Mariam is loved and remembered by our family--although--I never met her, and now I hope by you. Gone but not forgotten.

 

If you are a writer you might enjoy my other blog, The Best Damn Writer's Blog on the Block.

https://www.bestdamnwritersblog.com/ 

 

 

 

 

A National Treasure

There is a photograph of a tree hanging in an elder’s apartment. To the casual observer, it is just an ordinary tree.

 

For the photographer, it is extraordinary. 

 

Long ago, this woman, the photographer, was a child in Germany as the Second World War broke out. The British government organized a rescue effort to save Jewish children under 17, waving visa requirements and placing them in a safe country in foster homes, farms, and orphanages. (1938-1940) Often these children were the only members of their families to survive. This was the Kindertransport.

 

This elder, the photographer of the tree, was around 8 years old when she was taken away from her family and moved to England. Outside the orphanage where she was placed grew a tree.

 

When she was grown, she revisited that orphanage and wondered if the tree was still there.

 

It was, and that is the photograph of the tree hanging in her apartment.

 

My daughter feared that when they were clearing out her effects, that inconsequential little photograph would be swept aside. Maybe it would be thrown away. It was old and not very alluring. And so, she wrote a note explaining its origin and pasted it to the frame. 

 

I don’t know what will happen to the photo. It was special to the lady, as many of our memories are unique to us and no one else. 

 

On Mother’s Day, May 9, this lady passed away. 

 

I have been angry, disheartened, and livid over the treatment of this woman—a National Treasure who survived the holocaust only to be killed in a “Retirement Community” where someone decides one’s fate.

 

This is a lesson to us that if we don’t take control of our own lives, someone else will.

 

This lady was a people-pleaser and took “authorities’ advice,” no wonder given her rearing.  It had helped her survive until now. 

 

I don’t know whether I will post this or not. I have gotten feedback on how righteous and wonderful Hospice is. Given the proper conditions, it can be, but it can also be misused.

 

I am writing this for I carry a deep sadness. I was under confidentiality, and many times in my brain, I wrote a letter. I wanted to tell her Rabbi. I will launch a complaint, although it’s a little late now. 

 

I wondered how much was a part of the lady’s life passage. I wondered how much she had set this up for herself. Could it be that she was guilty of having escaped the gas chambers? I don’t know. Those thoughts rattle in my brain. 

 

How much was my responsibility?

 

I just know that this rational mathematician went from lucid, laughing at puzzles, liking to see repetitive patterns in carpeting and plants outside to an invalid within the course of a week. She was a lady who enjoyed going to the roof and watching the sunset. During her school days, she was the star mathematician, and when she graduated at 16, they hired her to teach mathematics. In later life she had a theorem named after her. She was engaged to a doctor once, but when she talked about what she was doing, he seemed uninterested. “I can’t marry someone who shows no interest in my work,” she said.

 

I wonder if she was denied one of life’s spiritual moments. And that was to die under one’s own choices.

 

The caretaker who was with the woman 12 hours a day, four days a week for the past year pretty much knew her ups and downs.  The lady had some short-term memory loss, but in a moment of clarity she told her helper “I would rather have pain that be whacked out of my mind.”   However, she was whacked out of her mind.

 

Later on, she would forget she had any pain. Thus, the nurse’s assistant (not even a nurse) determined she could not decide for herself, and recommended Hospice. That way, they would have access to pain management. The patient, our photographer, had a Power of Attorney to decide for her. An in-house doctor, not her primary care physician, signed her to Hospice. The only family she had were nieces who lived in England. (They were from an older sister who was also on the Kindertransport, but who, in later life, killed herself.) The nieces loved their Aunt, but didn’t really understand what was going on.

The nurses said they had a meeting where they explained to the lady what was happening, but she did not understand. They asked her questions such as “Where do you plan to spend the rest of your life?” Well, she owned her condo. Why would they be asking such a personal question? She never consented or understood what was happening. 

 

“What happened to my bed,” she asked when they moved in a hospital bed. “My toilet is broken, and I can’t use it,” she said. No, a nurse taped a sign over it, “Broken,” so she would use the commode. Why? I ask. 

 

They limited her fluids because “It is better to die dry than wet.” Well, I consider not drinking to be torture.

 

She had a bladder infection that they would not treat because she was on Hospice, and they do no curative actions. So, they used morphine to numb the pain. She had a rash from sitting so long, and they treated it with powder, not an antibiotic that might have cured both the rash and the infection. 

 

Two cardinal rules were broken in this case. The first rule is that the patient be diagnosed with a terminal illness. The lady had MS, which is not a terminal. She had it for 30 years and had leg twitches and itches but was ambulatory.  The doctor said his wife died of MS. (With MS, doctor, not of MS.)

 

This lady stated emphatically that she was not dying and did not want to. 

 

The second rule is that the patient is given six-months to live. She was not.

 

Instead, she was given Morphine, Ativan, Methadone and Haldol (an antipsychotic drug used in hospitals to bring down a violent patient.)

 

Warning

“Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.” 

She was not psychotic, but apparently, they give Ativan and Haldol as a matter of course with morphine. I don’t know what else she was given, whatever she was taking for her MS.

 

Throw all that in a system, and it could turn a person psychotic, or kill them.

 

When the lady was delusional, the caretaker said she was over medicated, and she had seen that before when she came home from the hospital after recovering from a fall, but that time she regained her brain.

 

A Power of Attorney held out for a while until the “Doctor” convinced her that Hospice was the best procedure.

 

And what happened to the caretaker? She was mentored that she was not handling her patient's decline well.