my grandma died

pt 1: getting to the hospital

My grandma died. My dad’s mom, that is. I always knew her as Nan, a nickname chosen before she moved in with us 20 years ago. One day she was fine, and later that day, she was dead. She passed. Either way, all at once she was gone.

The first warning I got was early that morning. My dad messaged our family chat with concerned news of her sudden hospitalization. We knew she was scheduled for some standard follow up from a recent surgery, so my brain didn’t immediately jump from irritating complication to never hearing her voice again.

Then I got a text from my friend, Joan, who works at our local church. She was so sorry to hear that my grandmother was doing poorly. She’d just put through arrangements for our priest to give Nan last rites. That jolted me from questioning if I should go home or not.

I texted my sisters that I was heading back to where we’d grown up but had subsequently left, each in our own time. My youngest sister messaged that she was going to be there — she had to be there. My younger sister called, and I told her what Joan said.

That’s when it struck me that this was the end. I didn’t have any new information, except for the sound of my sister’s sobbing sputtering through my earbuds.

I stood there listening to her cry and stammer that she’d book the first flight out. I hung up because I couldn’t reciprocate her emotions, and it felt intrusive to eavesdrop on her private grief that I didn’t really feel. Besides, I had to pack.

I was comparatively blank, because my relationship to my grandmother was quite complex. She lived with my family for 17 of the past 20 years, and not all of that time was familial bliss between the two of us.

Still I must have been assuming that she would pull through, because I only packed sweats. There couldn’t be a funeral if all I had to wear was joggers and a hoodie. Later this fit me in with the rest of the family — material evidence that none of us were prepared whatsoever.

I turned off the heat before I left in case this was a false alarm and Nan was all good and I was back soon. As I locked up and kicked the doormat straight, I didn’t think I’d be back soon.

It was a two hour drive home. On the way my older sister visiting Colombia called, and I told her my worried prognosis. I said that she didn’t have to rush to make it — things would be ok. If they weren’t, she wouldn’t make it anyway. I’d call her later with updates. But I also said that she should figure out how she’d get back, in case getting back was for a funeral.

For the rest of the drive I listened through Hadestown from start to finish and blamed myself for the traffic. What if I just barely didn’t get there in time to say goodbye? That’d mean my sisters flying in wouldn’t have a chance. My aunt wouldn’t make it either.

Covid testing delayed my hospital entry, involving a thermometer at my forehead and a few questions to make sure I wasn’t knowingly bringing a fatal contagion into the ICU. The attendant attached a paper bracelet with the date on it around my wrist. 10–30. It was makeshift jewelry I’ve worn before at pub crawls or for carnival rides. This one was dire though, tight and irritable.

Walking through the lobby, I couldn’t quite remember the last time I saw Nan. We were so concerned with her getting Covid that I only saw her twice this year. I think it must’ve been when she came for lunch during my sister’s last trip home. I was only in town because my sister was. I didn’t particularly come down to visit Nan.

I can’t remember the last thing we talked about. She mentioned some kooky story about how she’d been talking with her boyfriend’s mom. Incredulously, I demanded details — turns out she meant Mary, mother of God. My dad was not as amused as I was by Nan’s sacrilege.

But that was from the first visit with her this year, and those couldn’t have been the last words we exchanged. Was it a goodbye or mundane “I love you” or “see you later” — something routine?

My dad met me just past the lobby security. He took me up the stairs, scanning us into the ICU with his hospital ID. He’s a doctor here. People know him. They know about her, they know about me.

I walked past the nurse’s station full of compassionate glances and what I assumed were sympathetic smiles hidden behind surgical masks. From their central monitoring booth, they were able to look into all rooms at all times, transforming the bedridden patients and visitors into stoic exhibitions.

I stood inside the doorway only for a few seconds. There were wires everywhere. The lucky ones were racing from machines flanking the bed till they disappeared beneath pristine white blankets covering her from clavicle to toe. The unlucky ones displayed prominently against her pallid skin, sinking their rosy tendrils into her neck.

A nurse needed to get past me to the computer near the window. Apparently my grandma had coded this morning shortly before my dad messaged us, and she’d been unconscious since. The nurse was recording her latest numbers into a digital chart. Four blinking boxes demanded to be filled with intel measuring what vitality remained in my grandmother’s body.

I sat down at one of two chairs facing Nan near the foot of her bed. My dad sat beside me. It was harder to see the tubes jutting into her from there, since her legs were elevated so high. That suited me fine.

I expected to be overwhelmed by the silence. I generally don’t like quiet.

But I didn’t find silence, not even one punctuated with a blip —blip — of a heart rate like in the movies. Instead, the room was thrumming from a technological symphony keeping her lungs breathing and her heart pumping and her kidneys filtering.

After the nurse had fussed around the room a bit, my dad explained a missing sound that I wouldn’t have noticed. An empty bag hung from her bed, waiting to collect urine, but remained disquietingly empty. Her body would have to do that on it’s own, he said. The emptiness was a bad sign.

My vantage point by her feet gave an unobstructed view of the machinery she was the subject of. Everything was on wheels, accompanied by a foreboding impermanence. Everything, that is, except the chairs we were sitting on and the cabinet in the corner that doubled as a toilet.

My dad didn’t know what to do with himself, I think, so he began explaining the equipment. Maybe it offered him some element of control — to be knowledgeable about what was happening around us.

The monitors helpfully displayed blinking numbers when her stats fell from normal range:

Heart rate

Blood pressure | invasive systolic/diastolic (mean)

Oxidation rate

Breaths per minute

Blood pressure | non-invasive

Body temperature

Blood temperature

Dad’s explanations seemed stilted, so I’d chime in with questions to break his worried look and the monotony of the humming medical apparatus.

Her heart rate didn’t look like I might expect because the pacemaker was forcing that pattern.

Her blood pressure readings were not identical because the invasive vs non-invasive methods were different. The invasive reading was more accurate and less optimistic.

Her legs were elevated and she had special boots on to prevent clots and sores.

Her body temperature was being controlled by that heating unit on the floor, a huge plastic pipe running under her blankets. “We generate heat through muscle movement,” he said, “and she can’t move.”

The blood temperature was being set to right about average for the human body. Keeping her blood non-acidic was what that dialysis machine does.

I asked about her breathing. 26 breaths per minute seemed pretty reasonable, wasn’t that some proof of possible recovery?

“Well,” my dad said, “the machine pumping air into her lungs was set to 26 breaths per minute, so that’s actually being done for her.”

I missed the ignorance I had before the conversation — or better yet from last night.

My own mom wasn’t there, she ran off to pay Nan’s bills. It was the 30th after all; rent was due. I found it reassuring that my parents still thought she’d be back in her apartment tomorrow. It held the air of utmost importance, as if they could will her life back into being by completing a chore. They wouldn’t pay for November’s rent if Nan wouldn’t be around.

Back in the hospital, I learned the nurse’s name was Erin. Erin was keeping everything tidy, turning Nan every two hours, swabbing her mouth every two hours. Erin talked to her every time she’d do something. “I’m just gonna swab your mouth out, ok?”

But Nan couldn’t hear Erin. She just — wasn’t there. I didn’t know how else to think about my grandmother, devoid of her vitality and zaniness, more a body than a person.

Erin fiddled with the tubes, and dings joined the pulsing and blipping from the monitors. I had this sunken sense that we were waiting for the numbers to drop irreparably low and blink out.

A question I couldn’t ask was if all this work was only to keep her alive until my aunt and cousin could get there — or maybe if luck held my sisters too, flying in an hour after them. The people who really need to see her.

They’re all on their way Nan, I thought. Hold out for them, please. I don’t know if they will forgive themselves like I can.

Nan’s eyes were slightly cracked open like she could be looking at me. But she wasn’t. I pictured her waking up — I’d heard that some people get a spurt of energy in their last hours. I hoped she saved that for them, so someone important besides my dad could be there to talk to her and hear what she had to say.

I didn’t feel like Nan’s soul was gone, for whatever that’s worth. Although what would that feel like? If she didn’t get better, maybe it was gone after she coded that morning — after her lapse into unconsciousness, once she opened her eyes for the last time. Or if she did get better, this was just a dramatic sleep I didn’t recognize, soul fully intact but undetectable by the machinery or my inexperienced gaze.

The pressure of her life and death became too much, and I had family to pick up and rush back here to see her anyway. So I subtly asked my dad if I should head out. I had to get away from the room with a mourning son who knew too much medicine to convince himself that his mother was still there, alive with us.

Who are we kidding here? This production of maintaining Nan’s body isn’t doing any good — was I the only one with that refrain echoing against my skull to the mechanized, metronomic whirring? Doesn’t Dad know yet that she can’t open her eyes again and call him Magoo? Doesn’t Erin know Nan can’t hear her? Why is no one being honest about what’s happening? Why can’t we say anything? She is dying or worse.

I felt my pulse against the paper bracelet.

No.

My dad couldn’t have thought things were that bad. I was assured as much when he told me I should go to the airport.

“You’ll see her again after,” he said. “You’ll have time to come back and everything.” Ok. My doctor dad would know better than me, anyway. Maybe this wouldn’t be the first time someone died on me. I’d walk back in and she’d be sitting up and chastising me for coming all this way for nothing.

Just in case, I still said “Bye Nan! I’ll be back as soon as I can.”

And I hurried out of her room, drove away from the hospital where life was being driven into her body.

That was the last time I saw my grandma alive. I didn’t know that then— but we so rarely do.

— a grandchild