Thursday, September 22, 2011

At Iowa Methodist Hospital My Mother Died from A Strep Infection of the Brain

All the kids now tell their friends "I love you." Girls my daughter's age, 12, all say "I love you." And so, sometimes, do boys my son's age, 10.  They say it when they part ways after school. They write it in e-mails, in text messages, on Facebook. "I love you." They even say it to their parents. "I love you," they say, and then head off to the movies. "I love you," they say, and then climb on the team bus. It's not something I did at their age, all those years ago, saying and writing "I love you" all the time, and it's not something that the other kids did, either, particularly not outside the home, the family, where love, as we then defined it, didn't exist. Outside the family, people 'liked' each other. Now they love each other. And they say so. Sincerely. With feeling. I've heard it. Authentic feeling. You can think it's a fad, but I've heard it: it's said with feeling.

Three weeks and three days ago my mother died unexpectedly at 71. She was in Iowa, visiting her boyfriend, which she did every year when the state fair was going. One morning he found her on the bathroom floor. She couldn't speak. Her eyes were open, but barely. An ambulance came and drove her to the hospital, to Iowa Methodist in downtown Des Moines (a city that is beige across the board and has terrible traffic at certain peculiar moments but then seems to empty out entirely), where someone ran a CAT scan and discovered a 'sizable mass' in her brain, behind her eyes. A surgeon went in and found an abscess there, 'encapsulated,' sealed off from other tissue, and immediately he drained it of built-up fluid and then bathed the area in antibiotics. The fluid, infected with something, was sent for tests. Hours passed. Night came. My mother remained unconscious, breathing with noisy mechanical assistance. A nurse said she saw her blink when spoken to sometime between four and five a.m. and rated her coma an optimistic '11' on a scale -- an official coma scale -- that runs to 15, for some reason, and starts at 3.

I got there a few hours later from Montana, fighting with my girlfriend the whole way. We fought while we packed, about which supplies to bring and what size containers of liquid -- three ounces or five -- can legally be carried on to planes. We fought on the plane over who was more uncomfortable trying to sleep bolt upright without a pillow. We fought all the way down a hall and up an elevator and down another hall to the CCU, accusing each other of failing to use the sanitizer dispensed from little pumps near all the doorways. Sometimes the sanitizer was a foam, other times it came out as a gel. I liked the gel. As it dried, it cooled my hands. It felt effective. The foam felt weak, a pleasantry.

The right side of my mother's scalp was grey and shaved and there was a run of black staples where she'd been cut. My brother and his wife were standing over her rubbing her wrists and stroking her smooth bare ankles. Everyone was saying the right things. Everyone sounded sweet and stressed and brave. Everyone sounded perfect. We amazed ourselves. We amazed ourselves in the way that people do when they find themselves rising to a grave occasion that they've always known would come someday but didn't practice for out of superstition, because to practice for it might attract it. It turned out that we didn't need to practice, though. We were natural born virtuosos of the deathbed.

Oh God, we were good. It kind of made me sick.

We all went home around eleven that night. My girlfriend and I had a room in a vast Marriott built around one of those plunging central atriums that ought to provoke more suicides than they do and are awkward places to eat breakfast, with all that disquieting space above your heads. I took an Ambien when I laid down and a few minutes later I had a vision of my mother walking behind my girlfriend at a distance of a foot or two but then, as the two of them passed by the TV set, closing the distance and merging with my girlfriend. It was a vision, not a dream, because I described it the instant after it happened to my actual girlfriend, who was awake and who responded by reaching behind herself to feel the space where my mother (I insisted) had physically, or at least visually, entered her.

At six in the morning the phone rang right on schedule and my brother right on schedule said get over here -- don't eat, don't shower, don't think, get over here -- and we, right on schedule, raced over in our rental car and there was the surgeon, all scrubbed and right on schedule, asking permission to go into the skull again and suck out more junk again, more goo, more fluid, he frankly didn't know what it was this stuff (necrotic brain tissue? ordinary pus?) but he sure as hell wanted it out of there this minute ("Your mother will be, if not entirely paralyzed on her left side..." That was in there too somewhere) except that we, the loved ones, right on schedule, and in accordance with the Health Directive kept by my mother always in her purse (she'd worked as a nurse all her life, she knew the truth; the tubes, once they go in, they tend to stay in) told him to please go away and let her die.

Right on schedule.

Which she didn't do.

First she punished us for a while with perfect vital signs until I started laughing, proud of her, proud of her savage creaturely momentum, her mad ungovernable pendulum persistence. Who knew that, despite her pose as my dear mother, my dear autodidact Gibbons-reading mother who once went to Hungary, then crossed it off her list, and then went to Egypt and crossed it off her list, and then learned Italian and crossed it off her list, and Latin and French and The Lives of the Impressionists and the Bob Dylan Songbook and Naguib Mahfouz, was actually, underneath it all, Lou Gehrig, a being of pure brute Newtonian pump and suck.

When it's over you go in a room and sign some papers with people who do their best not to let on that they did this only half an hour ago with people just as brave as you feel you are. (And maybe you are, but if so, then bravery's easy, not a virtue, a reflex, like drawing one's first breath.)

The test came back Streptococcus intermedius and I am afraid I have it and you do too and that it is one of those new mysterious bugs that most of the the time does nothing, just sits or circulates, but that some of the time (and perhaps more often of late, since everything bad seems to happen more often of late) can collect in your brain and destroy you in two days.

Which is why all the kids say "I love you" all the time now, even though, if you ask them, they don't know why. They think it's normal. They think it's what kids always said. It isn't, though. I was a kid once and I remember: We said other things.

Lots of things.

But what?

For Mildred Irene Kirn (Stein), 1940-2011


  1. What an incredible farewell to a woman so clearly beloved. To say that I'm sorry for loss seems...inadequate, somehow. But I am, all the same.

    The gift here, for all of us? That "I love you" comes naturally from the hearts and mouths of those who share you mother's blood.

    They will change the world.

  2. I think, when you enter your seventies, as I and my partner have recently, "I love you" begins to mean "Please don't die when you are away from me.". Your story about your mother's death is very beautiful and sad. Thank you for writing it.

  3. Words don't seem to be possible to do justice to this piece, your experience and honesty about it, and your message. Very, very powerful and moving, and of course, I am crying.

  4. Maybe people started saying "I love you" more after 9-11. I don't think it's like bike helmets and car seats, though. I think people genuinely don't give as much of a shit about the career real-life issues anymore.

    Anyway, you know I love *you* and I have been telling you that for decades.

  5. My father died in January, and your words remind me of the surreality of death. The small details that one notices. It's hard to focus your mind, and it latches on to things it might ordinarily miss. There are sights and smells, feelings from my dad's last stay in the hospital that I'll never forget. We also did hospice, at a facility and finally at home-my dad's ultimate wish, to die at home. It was incredibly strange to essentially be waiting for someone to die, let alone your father, but that's what it was. I remember when they came to take my dad's body. It was just a guy and his minivan, the seats down. I helped put my dad in the back and watched as this minivan pulled away, just another vehicle in traffic.

    All those memories seem strange, yet I cherish them.

  6. This comment has been removed by the author.

    1. I hope you didn't let the vitriolic response scare you. It seems to only confirm the accuracy of your remarks.

    2. This comment has been removed by the author.

  7. I noticed this with my granddaughter and her friends. I wondered where it came from. One commenter's suggestion that it has something to do with 9/11 and the apparent general disarray of the world makes sense.

    Youth used to be free of the vulnerability old folks were tuned into, maybe not so much any more.

    In any case, thanks for this fine piece of writing. What you were experiencing; it came through. Clearly.

    Jim Culleny

  8. GMc -- it's clever embittered little shits like you, with your pop contrarian psychoanalyses and suddenly stuffy bursts of verbal puritanism that come out of nowhere but the shared failed promise that you and yours have probably founded a lodge around, The Golden Order of the Snotty Sad Sacks, that keeps me warming up that bottomless coffee cup when I sit for hours at my desk. keep it it up -- you're the grit inside my pearl.

  9. Lovely and true words Walter or Walt -- and an apt rejoinder to GMc, btw. Very much 'get' the read and appreciate the depths from which it came --

  10. walter"walt"

    thank you. keep that grit grinding.

  11. Thank you for posting this. My mother died a few days after a massive, unexpected stroke. I too went through those agonizing days where she was unable to speak. It became clear that she was going to die but couldn't communicate except by nodding her head... It's such a difficult thing. I love you means a great deal more these days.

  12. I'm sorry for the loss of your mother. She sounds like a wonderful woman and the is a beautiful piece on the surreal experience of grief. We lost my kid's great grandpa last year in a similarly unexpected and abrupt way. Sometimes it still feels like it didn't really happen. Also, that's my hospital and my State Fair you described, which makes your story that much more touching for me. Thank you.

  13. My mother passed away this summer from sepsis. You describe the feeling of heightened awareness like love- death is another reality- it takes the witnesses on a journey. I wish more people would write about this experience watching a parent die because it is the most painful experience I have ever been through.
    Thanks Walter for helping me not feel alone with my pain. I was told not to let anyone tell me how to grieve.

  14. Do our real condolences translate through the most impersonal of mediums? I hope so.

  15. Walt, Last Saturday on his weekly Prairie Home Home Companion show, Garrison Keillor, who knew your mother so well, sang a lovely song about "Marine" where he lived so close to Milly and the rest of us in the mid-seventies. The video can be seen at
    It is no coincidence this "tribute" came so soon after her death.
    My mother died a year ago. She was also a nurse. Nurses are special. Milly was so very special.
    Thank you again for sharing your great gift. She saluted you, on many an occasion, for sharing that gift, you can be sure.

  16. There's a choice involved, I see that every time my grandfather gasps for air. It's tragic, in the sense that this is how we choose to file it in our brains. But I can almost imagine the burst of neurons and the white halo that is being fed through his ocular nerves. He's calm, aside from that. He thanks each of us for visiting, my mother says that sometimes - in the confusion - he's surprised to see her walk into the room. I can see the tiny bubbles of oxygen filtering upwards from the plastic cylinder hanging above his head, his thumb trembles a little has he struggles to find the buttons on the tv remote. Last night I dreamt that Manhattan was being attacked by an increasingly absurd series of 60's era Japanese monsters. They would crash through buildings, punching holes through them, sending crowds of people into a panic. At the end, though, the dream ended with a party, and a subtle resignation at all the carnage that had ensued earlier in the day.

  17. I just did a story on these same health care directives here in Idaho. The patient's wishes are tantamount although ultimately no one wants to be there. My mother is going on 96 in a nursing home in Florida. She was the same woman until about 93 and after that the dementia took over albeit not completely. Still, nothing is the same nor ever will be. I'll get there in January.

  18. Amazing. And your response to GMc was perfect as well. Happy I stumbled upon your blog....

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