What Do I Do on the 31st Day?

I stare at the prescription bottle with instructions: Take once a day. Pill count-30. Refill until this date, the following year. I have a heart condition, Hypertrophic Obstructive Cardiomyopathy (HOCM), and I need the pills to decrease the blood pressure to and from my heart.

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Drifting Along the River’s Current

“What can I do to help you all right now?”

After pausing for a few seconds, the palliative care nurse turned toward me.

“Our guest in Room 5 is active, and I haven’t been able to get in touch with his children.”

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Why We Had a Steel Band at Mom’s Memorial Service

Charm City Steel, the five-piece band, pick up their sticks and in rhythm tap out a fetching tune on their huge steel drums. This is the preamble to a special program to celebrate and remember my mom, who died of advanced dementia at age eighty-seven in my home. The music lifts me as people wander in.    

It is Mom’s memorial service, and she asked for this. It was ten years ago out of the blue, between steel drum dance tunes while vacationing together in Maine. She pointed at me from across the village green and said, “I want a steel

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She Left before the Snowmageddon

Her spirit left the week before, and her body lay inside her casket shrunken. She died on January 29, 2019 and her family would need to let her go. She had lived eight years with Alzheimer’s and, despite a valiant effort and family support, Sue Insuk Kwak could no longer be trapped inside her body.

A week and a half before, I went to Seattle to see my mother for the last time. I tried to coax her to eat and to move, but at sixty-five pounds she was declaring herself no longer part of the living world. She was, quite deliberately,

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Destined to Be Fatigued

Crashing the car should have been the wake-up call.
The driver had fallen asleep at the wheel while driving a familiar road at midday. If angels exist, they were surrounding the driver’s car that afternoon. Because the car crossed two lanes of traffic when no cars were coming from the opposite direction. Because the vehicle headed toward a fenced-in spread of uninhabited land. Because the accident did not occur where homes line the road. Because the driver escaped with mostly minor injuries and did not harm another soul. And because the metal fence post that came through the windshield missed the driver’s head by just

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Closure 100 Days After

I was walking around the neighborhood with my mom as we discussed our plan to visit Grandma in Vietnam. My grandma was suffering from Alzheimer’s, uncontrolled diabetes, and necrotizing skin lesions on her back. We decided to plan our visit in three months’ time–knowing it would be a long, restless wait.

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At the Flick of a Switch

“I want to do something now. What can I do?”

My mother’s body and mind were restless, moving in their own patterns just like the gray, low-hanging clouds that morning in August. “Why don’t you tell me what you want me to do?”

She didn’t wait for my response but shouted, “Don’t you dare tell me what to do, I’m not a child!” while pounding her cane on the floor with such might that I could feel the vibrations in my stomach. Then she sank into her chair and fell silent, her eyes glazing over.

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How to Fire Your Doctor

Look your doctor straight in the eye. It’s okay to smile. Or not–it’s your choice.
Don’t mince words. When your doctor says, “I’d like you to try this prescription…” (or physical therapy or whatever) “…and come back in three months,” that’s your cue. By all means take the prescription, or the referral sheet, and then say, “I won’t be coming back. I’m going to look for a new doctor…”
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One week into a three week “staycation,” I enjoyed drinking coffee on the loveseat with my husband, holding his hand and pondering life. We sat in comfortable silence, but an inner turbulence unsettled me. He tapped his foot to some inaudible percussion. 
“I’ve got two weeks of vacation left, and I already dread going back to work,” I blurted without thinking, without self-editing. 
His foot stilled. “Then don’t,” he said.
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Let Him Go? Hell, No!

Several decades ago, my elderly patient, Mr. Waverly, coded in the ICU. Dr. Schiller, myself, and three other nurses tried feverishly to resuscitate him. Unfortunately, without success.
Fond memories flashed by of the patient I nicknamed, “My easiest patient with the sickest heart.” He struggled with uncomfortable abnormal heart rhythms and fainting spells, yet he never complained. While he confided in me about his fear of dying, he also made me laugh with funny cow stories from his dairy farm.
Minutes ago, Mr. Waverly and I had been chatting about his newest grandchild. Now, he was gone,

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The Hardest Decision

I prepared to let go and wished for more time. There was nothing left but to let my youngest son be at peace. Tomorrow we would unplug the machines.

His transplanted liver was failing, and he was too sick to get another. He coded three days earlier. Now, beneath the sedatives, paralytics and seizure medications, he was convulsing continuously.

There was no hope for meaningful recovery. As a physician, I knew it was the right choice. As a mother, I was heartbroken. How could I reconcile the rightness of the decision with something that felt so wrong?

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Single Steps

Sometimes, the answer is so small and simple it goes unnoticed at the time.

I had barely entered my twenties when my parents died, within two years of one another. Well-wishers inundated me with questions about whether I would keep the family homestead, continue my education or change jobs. Should I donate my parents’ clothing and furniture and start a new life in a smaller place? After all, the old status quo was gone, never to return.

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