One day after...

It was this time yesterday , this time yesterday, when mum breathed her final breaths...

She was gasping, her mouth half open. There were a few gargling sounds coming from her throat. The very symbolic sound of the coming of the end. I hugged her, I held her still, I lay on her chested and felt her last breaths. She was still warm, but I could feel her body was cooling down... I held her, but she was inevitably slipping away from me.

And she was gone...

Crash

Almost forty eight hours without proper and long sleep. Another exhausting day taking care of mum's funeral arrangements after her passing. So many traditions to abide by, so Manu customs to adhere to. Even now we cannot say for certain when the cremation will be and when mum will be interred at her final resting place (they are two separate events...). It all depends on what is a "good" day for mum to be cremated and interred, and what is "good" depends on mum's zodiac sign, day and time of passing, and the alignment of the heavens. It is a lot to consider, a lot to be aware of, a lot of taboos to avoid. As if losing a loved one is not already burdensome enough.

Have been too tired to feel sad or really mourn. Though, today while sitting in the car heading to the funeral home with my brother, it moved me so close to tears to see him suddenly just shed tears. He said he was missing mum, and it feels like she's just gone to sleep and will wake up soon. He said it's so strange how these past three months he was constantly by her side, and how this three weeks or so he would visit her daily at the hospital. Now it's all over... Now she's no longer at the hospital or in her bedroom. It is as if we half expect her to be lying there resting, as she did for much of the past two months in bed...

"Looking out the car widow," brother said, his cheeks had the markings of two wet streaks, "Taipei feels so empty. There is nothing here for us anymore..." It was only when he said it out that I realised the same. This is my birth-town and was my childhood hometown. It was a place I would return to every single year almost because my parents were here. Now both dad and mum have moved on, so what is left here? An empty home full of things and belongings of two people who have already gone, an empty home full of memories of what once was but is no more. What else is there here for me, for us?

Brother asked me whether I'm sad and why don't look too sad. "I think it's because I know we have done everything we could. Nothing more could have been asked of us. And it all come to a beautiful end..."

Those are true and real reasons, but was I just comforting myself and trying to be unnecessarily brave? Brave for who's sake? My own sake, because I have no shoulder to lean on and no one I can really cry to? Brave so that other people will not hurt if I don't cry?

Mum is back home now. A temporary altar has been erected in her honour in the dining room. There is a giant portrait of mum on the altar, and before the portrait of mum's smiling picture. Mum told me once, a few months ago when I commented how beautiful the picture on her national health insurance card is, that she wants to use that particular picture for her funeral. And I've fulfilled her wish.

Seeing mum smile back at us is not at all scary. In a way comforting to know mum's spirit is back home and with us (at least that is the local belief...). From today till the day of the funeral, we will just do as she used to do before: get up, wash, have breakfast and dinner, and wash again before "bed". We will have to offer her water to wash herself with, offer her favourite foods and drinks and fresh fruits. It is as if she were still with us, and we can bow to her, talk to her as we wish to. Relatives and friends have the opportunity to come to our home and pay respects to her altar by offering incense or white envelops containing money (another tradition).

We'll make the altar beautiful and dignified so that when people come, they can see what a wonderful life mum has had, and that her passing need not be overly sad...

The morning after

I sudden woke up, barely three hours after I lay down to sleep. I did not dream, I don't think, but just slept all the way through. I am still very tired, but my mind refuses to rest anymore.

Almost twelve hours after mum passed away. Memories are still fresh in my head. Memories of those final moments, and of the whole day yesterday. It seemed like such a long time ago, maybe because of the lack of sleep, and I am afraid if I don't sit down and write things down, they will escape me...

It's strange to open my inbox and see emails from two friends who wrote to check up on me and wish my luck, little knowing that in the time that they wrote and I read their emails, so much has already taken place... I have already begun the process of writing to friends. Friends in so many places, to whom I am forever indebted for their support and encouragements over the past few years...

Slowly, we have to start picking up the pieces and plan the funeral. Local traditions and customs play a large part in the mourning process, and very soon the priest mum wanted to organise the funeral will come and start making an altar dedicated to mum('s spirit).

A busy time of organising and taking care of mum's affairs is about to begin...

I wish I had a fresh body and mind to face it all.

Finally home

Three in the morning. Finally home. In mum's room, where I'll be spending my first night since my return here seventeen days ago. I'll be sleeping on her bed, on the bedsheets and using the blanket she used prior to entering the hospital three weeks ago. It's bizarre to think she went in and never came out again, at least not physically.

It's been a long seventeen days, and long evening. Almost two hours of chanting followed after we accompanied mum to the morgue. It was long, and brother got stung a lot by mosquitoes. But the chanting according to Taiwanese traditions will make it easier for mum to leave this realm and enter the other world.

Not sad. Strangely stoic, and haven't shed a tear yet. Maybe I'm just too tired now to feel. Too tired because last night was so rough for mum, and I slept only at three, and only for a few hours. Now to think of it, the memo the doctor gave us yesterday did say the last twenty four hours is the greatest struggle. Too tired also because since her passing at eight in the evening, there's been so much to take care of. So much paper work involved in checking out of the hospital, and then following traditions by accompanying mum to the resting place of her body until the actual funeral. It's not even sure when that will take place, within two weeks or so, but it all depends on which day is a "good" day for a funeral. And we've got the priest figuring that out.

I called my "little" uncle, mum's youngest brother, the one sibling mum is closest to. He happens to be in Vancouver. He said he will arrange to come back for the funeral, even though he just arrived there yesterday to be with his family. On Skype, I could see he was so saddened, his face in a deep frown. It even looked like he was close to tears. But his voice was calm, and he told me not to be too sad. I felt very apologetic ruining his holiday and reunion with his family. But he needs to know, for he cared and loved his sister so much...

And I called my ex, who happens to be on holiday with his parents, also in Vancouver. I hesitated a lot before contacting him. I don't know why I was most shaken when I was talking to my ex. Even more so than when mum breathed out her last breath before everything ended. I didn't know how to break the news. I didn't want to ruin his holiday with his parents, but he has a right to know, because he cares so much, and has been ever so supportive. He said before he'd (try to) be there with me at the funeral, but it's a lot to ask, because he's so busy at work. I guess I was shaken because of the uncertainties surrounding us.

Finally home. Surrounded by mum's things. I don't even know if I should be sleeping on her bed, for maybe she'll come back tonight. I did say to her before she passed away if there's anything to come back an visit. I also told her if there's something she wants to tell me, she can come back in a dream. "I won't be afraid..."

Because she's my mother. My mother I love so much, my mother whose hand I held and whose body I hugged as she left this world...

Pick up

23.11

Sitting here in a room, sitting right to mum's body. A chanting machine is playing in the background. mum's body which is covered over with a yellow piece of cloth with scriptures. Waiting for the hearse to come pick her body up and take it to the morgue.

I'm just in a daze. Not sad. Just tired. Not shaken, just strangely calm.

It is all so surreal.

Journey's end

20.05
It was beautiful. A beautiful end to a beautiful journey...

"Dear mama,

It's been hard on you. Please walk slowly to a better place... [xxxx]"

Condition

The machine can no longer detect mum's pulse. Even the nurse has difficulty taking her heart rate. Mum's still breathing, and there's a gasping sound every five, six seconds or so as she exhales. She's in a sleeping state. Even the nurse is unsure where people are at this stage in life. The carer joked mum is choosing her path, trying to decide which is the smoothest course.
"Being human is a lot of suffering," I added, "Go, go smoothly..."

"Stay here tonight," the nurse told my brother, "Watch her breathing, for that's the most accurate. At the end there will be a change in the breathing."

Tonight... Maybe this is the night.

We are all here with you, mum...

Nap

Just as I was lying down to take a little nap, my brother called.

"Mum's oxygen level dropped..."  He told me to stay put and to rest more before heading to the hospital. But how could I?

I lay in mum's bed by myself. The room was empty, just me and myself, surrounded by mum's belongings and scent. My head drifted to images of mum passing away... To all the things that we have to do and take care of. I saw myself crying in her bed. I saw her lying there in her coffin. I could not rest... My mind was ablaze with thoughts. My body for some reason sore and uncomfortable in whatever position I was in...

Time to get up and head to the hospital again...

Consultation

The doctor agreed to increase the morphine dosage and to give mum a sleeping aid. If need be, additional injections can be administered. It will reduce her anxiety and feelings of pain and discomfort. Mum has been extremely agitated and looking very pained and anguished for the past twelve hours. It was a very rough night with little sleep.

"I'm right by your side, mama," I told her earlier, "I'll hold your hand..." Mum looked at me and nodded. She said nothing, but she nodded. She looked, at least for a moment, calmer.

"From our observation, two, three days," the doctor said. Perhaps today the IV will be removed. The doctor also advised not to feed her anything, for from what he can see, mum seems to be eating for our sake and less because she wants to eat. "Frankly, her insides may have become more blocked. And it is causing her discomfort to eat and drink too much."

Brother and I walked out of the consultation room (beautifully called "Room where the hearts meet 會心室). We seem have decided mum's life. The doctor said the most they can do is make her sleep more, because by sleeping mum is escaping from whatever pain may be there, whether physical or mental. The body will take it's natural course.

Soon, soon, mum will no longer be gasping laboriously for air...

Keeping up appearances

In front of people, it is easy to say that things are alright. Are you going to tell them otherwise? Are you really going to tell them the extent of sadness and pain you feel deep inside at times?

A friend of mine who lost her mother last year wrote to me before about the emptiness and pain. Nobody, really nobody can understand fully what the pain feels like. It's so strong, so difficult to imagine if you are not the one having to deal with loss. Weeks, months, years after the loss, the loss is still felt. Maybe wounds may heal with time, but the emptiness will always remain. People are going to stop caring, people are going to start wondering why after a long while you still mourned are sad. Because they do not know how it feels like. They cannot possibly imagine the extent of the bond and the degree of loss...

My friend wrote me again, and I find a lot of wisdom in her words. True, there is pain and it is inconsolable. People wonder why you are hurting still, why
You cannot really move on even with the passage of time. But often the memories and images are so fresh, so raw and feel so real still it's hard to let them go...

I know now what that feels like. I now understand the meaning behind her words, behind her warnings...

Nightwatch

Sitting by mum's bedside. Almost midnight. She's been restless and agitated for over four hours. Even the evening nurse said she's never seen mum like this.

Mum has calmed down a little, but still not calm enough to fall asleep. She'd close her eyes only temporarily, and then open them again as if something is disturbing her sleep and keeping her awake purposely. I ask her what, but she doesn't respond and just looks at me and turns away...

In the background is soft meditation music mixed with the occasional mediation chant (Metta sutra... It's soothing and one of mum's favourite) . On the tv screen hanging on the wall in front of her bed, I've got slideshow of pictures displaying. Pictures of landscapes, train rides we've been on, of people and places in our memories and on our minds.

"Relax, relax..." I whisper to her, "Look at the pictures, the beautiful pictures and try to sleep..." I stroke her arm, rub her legs, gently stroke her forehead (...maybe I should sing to her instead?) But nothing seems to calm her down or put her to sleep.

The nurse just came in to give her a sedative, in addition to the extra dose of morphine that was administered around an hour ago.

Mum is still restless, still fighting something that's bothering her, either her body or mind...

but I don't know what.

Restlessness

Brother was crying on the phone. "It is such a difficult topic to bring up..." he said amid tears. I told him calmly I understand. How do you tell someone you want to up the dosage of the morphine, knowing very well that it may hasten the coming of passing? It is not that we want to kill her quicker. We just want to make her feel more comfortable and feel at ease, and go in a calm and peaceful way. I know mum would want the same, for she is suffering, in pain, in agony and trapped in a body that is dying ever so slowly. Must the suffering be unnecessarily prolonged, and for how much longer?

I told my brother I'll speak to mum about it. Mum may be dazed and confused, somehow when I ask her something in Taiwanese she seems to hear me and she does respond.

The doctor came by today and said mum may never leave the hospice ward. I knew this somehow already. I had a feeling. And I saw it in my dreams. The doctor gave us an excerpt from a book loosely translated as "Life's compulsory 10 lessons in life and death". In it, the chapter talks about what a person goes through mentally and physically a few weeks, few days and few hours before death. Within a few weeks, a "spiritual death" occurs, when the person becomes so tired and the body because exhausted. The inability to walk and the inability to go the washroom independently, and in many cases incontinence, will often cause the patient to question the meaning of life.

Within a few days of dying, the patient sleeps more and more, and in those brief waking moments the patient feels a lot of physical pain. Morphine is often used to reduce the pain at this stage, and partly because of the effects of the drug, but also partly because the body is getting ever weaker, the patient has more difficulty expressing herself, and is easily confused and forgetful. There may even be hallucinations, and nonsensical talking. This is where mum is now, I believe.

The doctor said she's going to go from six-hourly injections of morphine to a steady drip into her body. This way mum will feel more comfortable, and will be less susceptible to pain and discomfort, which can wake her up and disturb her sleep. Her body is "changing", as the nurses and doctor like to call it and I figured after so many times of hearing it, the word is just an euphemism for dying. As it "changes", the body rests more and more. Waking up every so often from pain or discomfort is a painful struggle for mum, for she has to expend what very little reserves she has left to fight the pain. A continuous flow of morphine will keep her continuously at ease.

The doctor recommended a dosage of 15ml per twenty-four hours. And an hour or so after the new regime went into effect, I could see mum become very agitated and restless, more so than ever before. Something was bothering her, but nobody could figure out what. Perhaps the dosage is not strong enough. Later the nurse revealed to me that specifically in mum's case, there are increase signs of internal bleeding that are related to progression of mum's cancer. This most likely is causing mum even greater discomfort and pain.

Calmly, I sat down next to mum. "Mama, brother and I discussed and we would like to increase your dosage..." I said to her. I held her hand as I said those words. Held her hand so that she feels the real intentions behind what I'm saying to her, so that she can feel and know that what I am proposing is out of our genuine concern for her wellbeing. "it's not that we want to make you go quicker, but we want you to be more comfortable. You've struggled long enough..."

Mum looked at me in the eyes. From the look I could tell she understood. From the look she agreed. Her nod and a very weak "Ok" confirmed it. Her agreement lifted a heavy burden off of my shoulders. I am her son, her own blood, and never did I imagine there would be a moment when faced with having to decide, or at least influence, my own mother's final moments...

I held her hand even tighter. "Let go, mama. Let go of this body, and let things take it's natural course..." These words were so similar to what I said to dad the moments before he left this world. The memory of that scene, four years ago, at this very hospital, merely a few storeys below where mum and I are now, made sadness swell up deep down. "This body is not ours... Relax. Let go of anything in your mind, let go of this body. Let go..."

Whatever happens in the next days or so, I will be by her side. And I will take her by the hand.

Confusion

Mum had such a confused and frustrated look on her face. She kept on calling my name: "Weiwei... Weiwei..." The way she called me broke my heart.

"What's wrong, mama?" what's wrong? Are you afraid? Don't be afraid. I'm here by your side..." I stroked her head, played with her hair. I grabbed her hand and held her hand tightly. "I'm by your side. Let go. There's nothing to hang onto. This body is not ours, what matters is the heart. Think beautiful things, beautiful memories. You've struggled long enough. Soon it'll be over, mama. Let go..."

I smiled at her, but inside I was tearing, and tearing apart. These words... These words... I spoke similar words to dad just four years ago, and now again, I am saying them to my dear mother. She can hear me, I know she can hear me, feel me, feel my touch, feel my love. I know she can. I know she can...

"Weiwei..." she cried out again, agitated and obviously in great discomfort. She didn't say anything else, just my name. Did she have it in her to say more? Did she have words or thoughts she wanted to empty? In the background mum's favourite cd was playing. Nana Mouskouri, perhaps mum's all time favourite singer. I found the cd while I was home briefly today. Perhaps there is a reason why after so many years, I happen to stumble on the long lost cd in the cupboard. Everything happens for a reason...

I held her hand even tighter, and kissed her fingers. "Don't be afraid, just let go..."

Mum's stomach gargled loudly, and on her face was an expression of pain and agony. "Let go, mama, just let it out..."

Sleepless at TVG

Sleepless till at least two thirty in the morning. My body was just somehow uncomfortable, whatever position I was lying in. My thoughts drifted to and fro, and for a moment I thought a lot of my ex, so I grabbed the phone and texted him.

We had a nice exchange of messages, joking and playing with words like we used to do, something we've not done for a long time, something I do miss.

Even so, still I could not sleep, and lay twisting and turning till I don't know when. My body felt agitated, uncomfortable, my mind was restless. Something was frustrating me, something was bothering my body, and I was sore and aching in my back.

Perhaps this is what mum feels like...?

Carer's story

"It's good your mum will pass like this..." the carer suddenly said as she was massaging mum's back and I was sitting by mum's bed side. "She's very fortunate to have you [all] around..."

The carer told me once that her own dad passed away from cancer, and that it was very painful for him. Tonight she told me more of the story...

"I was working in Taiwan then, and I asked my employer to let me go. I still had one month left till my contract was over," she recounted. Many overseas workers from Vietnam come to Taiwan to work for a period of three years, after which they can settle debts to the brokerage company that brought them to Taiwan. So the condition is to complete the term of contract, otherwise the employee is faced with a penalty. "I can always earn money, but I only have one father..."

She said she was eventually allowed to go back to Vietnam, and how she spent eight months taking care of her father. Her brother and sister were around, but they stayed only briefly. "In the end, it was very difficult to see. Everytime he eats, he would make a mess as the food would drool out of his mouth... He was in  a lot of pain. My brother and sister did not know how to take care of him. Sometimes the didn't even dare touch him..." the carer recalled and lowered her eyes. Mum had her eyes closed, but she opened them briefly, as if she was listening too.

"I remember the first time I returned to Vietnam, my dad and the whole family hired a car to come pick me up at the airport. As we live far in the countryside, it was rare for them to visit Hanoi, so we took a sightseeing trip together. The next time I returned to Vietnam, my dad was not there to pick me up. Not there any more..." Her voice became sad.

Some days ago, I walked with the carer home and passed through an underground walkway. It was an airconditioned walkway, and the corridor was clean and bright. There was even a bank and post office in the walkway. "Vietnam will never be so advanced!" she commented. She said she really likes it in Taiwan, despite being separated from her family and children. She has been in this country for several years, and has worked at a number of hospitals, and cared for a number of cancer patients, and she is amazed by the health care system and how attentive the nurses are.

"In Vietnam, you have to bribe everyone, even the nurse! They'll come and do the minimum. For example, they'll come and change your bandage, but they'll do it very roughly and do a bad job. Of course you can't bare to see your loved one suffer, so you pay them. And they'll treat you better..." I listened and tried to imagine what that is like. I know these places exist, and that so many in the world live in such countries where there is no proper health care system, where good health and sanitation and nutrition is reserved only for those who can pay. And I was reminded again how lucky I am, how lucky my family and my mum is, to be born in a country where the state really takes care of its own people.

Back to the hospice ward, to the sound of mum snoring... "It's good she is not in pain. She's very fortunate," the carer said as she continued to massage mum's back to prevent bed sores. Just then the nurse came in quietly and had such a gentle smile. She just came in to check if everything is alright, and how mum is reacting to the morphine that was administered about half an hour ago.

"Things are fine, thank you..." I said. And I truly am thankful, every single time, and every single day...

Decision

Mum's eyes were open wide and behind her eyes I could see feelings of discomfort. It has been six hours since the last morphine injection (into mum's IV port). "What's wrong? Are you in pain? Are you feeling bloated? Is something bothering you?" I kept on asking mum, but there was no response.
Mum lifted up her arm, took a long look at it in the air. I saw her arm was trembling slightly. Then she proceeded to lower her arm and  her hand reached for her lower abdomen. She scratched that area for a while. "Is there something wrong there? Are you feeling discomfort there?" I asked. Weakly, she nodded.

I went to the nurse and asked for another morphine injection. The evening nurse began to explain that with mum's condition her body needs to rest, and the discomfort and pain she may be feeling as soon as the effects of the morphine wears off is disturbing her sleeping pattern. "She is so weak now, on her last reserves. Her body needs good, deep sleep. Every few hours when the morphine wears off, she wakes up and has to fight against the pain. It takes a lot of energy and strength." Earlier today, brother was alarmed by how much mum has been sleeping ever since the regular morphine injection began last night. The doctor then suggested to go back to a "need" basis, whereby morphine would only be administered when mum feels pain.

The evening nurse is a lady in her fifties, with greying hair and a kind motherly face. She explained to me, from her experience, it is more important that the patient gets good rest, and having to wake up to pain, or wake up because of pain, is very difficult on the body. "The morphine will make her sleep better. It may be that she is sleeping so much because her body has reached that stage. But the morphine will ease the pain, and also help the patient to breathe easier as well less the patient's anxiety." Sometimes, if the body has rested enough, the patient may wake up feeling refreshed and can be very clear minded.





"From your experience, do you think mum has reached that end stage?"

"It is very possible. But sometimes you have to let go. And it may not necessarily be a bad thing that she is sleeping a lot. The morphine will keep the pain controlled so that your mother is comfortable. Sometimes we have to think of what the patient would like, and not about what the family wants..."

I understood what she was saying. Though I am wary that the regular morphine injections will make mum more and more drowsy and less and less coherent, the bottom line is I do not wish mum to be in pain or have unnecessary suffering. I told my brother if he has anything he wants to say to her, do it soon, otherwise there may be a point when mum cannot respond any more. Now, she barely answers when you ask her a question. The nurse said it's because she's using every ounce of energy left in her body to deal with the pain and discomfort she is feeling that she does not have the energy to respond.

"But she can hear you. She can still hear what you say, so you can talk to her. And her mind is still very clear and conscious. There are a lot of things we do not know yet, but the brain is still functioning and inside her mind she is dealing with a lot of issues and emotions, even though she is silent and does not respond when you talk to her," the nurse said.

I discussed with the nurse for a good while about whether to go back to regular injections of morphine. My feeling is yes, but it is too big a decision to make on my own. I know mum would like to be as pain free as possible; she told me that before many times. "I still need to discuss with my brother..."  I said.

I called him. He picked up and was very anxious, for he thought something was wrong. He has been very edgy (and moody) these days because of mum's continual decline. It is really affecting him a  lot, I can see that, and he does not seem to know how to deal with his emotions, so he gets frustrated and angry easily. Plus, he has a kid to take care of, and doesn't really sleep well because the baby wakes up during the night.

I explained to him mum's pain and what the nurse recommended, and he agreed to the regular morphine injection. He wanted to come back to the hospital, and asked if I wanted to return home to sleep, for I have not spent a single night at home since my return two weeks ago. "It's alright, I'll stay here," I said. I feel safer and more certain this way. And without passing judgment on my brother, I think mum also feels more comforted having me around, because I am more caring and attentive, and I touch mum a lot to reassure her. "I will call if there is anything..."

Mum is sleeping again. Sleeping and not feeling much discomfort anymore. Just as the way it should be...

Bath

As soon as the nurse and volunteer wheeled mum to the bathroom, I quickly took off the old bedsheets and started to change the sheets and make her bed. The volunteer came back in and seemed amazed I was doing this. "You should come volunteer here! You do this so well!"

Moments later, in the bathroom, I began to wash mum's face and shampoo her hair. Again the same volunteer complimented me: "Where did you get a son like this? What did you teach him to be like this? It's so touching to see how attentive he is. It's even better than having a daughter!" The nurse agreed and said things to that effect too.

Mum smiled gently and didn't say anything. I didn't say anything either, and just kept soaping mum's face and giving her a scrub. But deep down inside I felt that comment was somewhat unfair.  And there have been occasions when mum would say: "Before he was born, I wanted a girl and bought everything pink thinking it would be a girl!" To which often these aunties would say: "He's better than a girl! He's like having two girls!"

I've heard it all before, compliments like these, but it always stings when people imply that only girls can be attentive and caring. I am a boy, and (without tooting my own horn) I am by nature caring and attentive. These are natures not reserved for a girl, for these are simply human natures that any person, boy or girl, can possess, just as a person can be mean and ill-minded (I can be too!) When people make comments like those above, they seem to imply girls are the more caring gender, whereas all boys are callous and uncaring and unfeeling. But I am sure there are plenty of other boys who would do what I do, perhaps even more, to make their parents happy and comfortable. Though special, I am certain there are other boys who would help bathe their own mother when they have become ill and infirm.




I kept on washing mum's body, rubbing off the accumulation of dead skin, and massage her head to make her feel at ease and comfortable. "It's just as it should be..."

Nothing more, nothing less.

Wednesday 27 June 2012

Woke up to the voice of the nurse: "Are you feeling shortness of breath, auntie? Count to ten slowly and breathe normally..."

Mum had her mouth open. She was gasping for air. Her mouth has been open more or less since last night
when they began administering morphine at regular intervals. The night nurse even asked me whether she should give her the dose at midnight, which I agreed to so that mum would sleep right through the night. Mum was not awake to make that decision. I made it for her, hoping it is the best decision for her.

This morning, mum was in a calm state. She looks restful, and dozes off very quickly. When the carer fed her, she did not throw up. She did not urinate for over ten hours. When I asked her whether she's in pain, she shook her head. She can hear us, but she can not seem to muster any energy to speak.

"It's soon..." the carer said to me, "One of these days..." The carer has been with a number of cancer patients, her own father included, and she told me last night mum is the most peaceful patient she's ever had. The nurse said an open jaw means mum's very relaxed, very relaxed. The nurse reassured me that things are going to be alright. Mum's lips are dry and chapped from breathing through her mouth too much.

I sat by mum's side most of the morning. We didn't speak much, we haven really spoken in a few days now. Now, when I ask something, mum responds with a nod or a shake of get head. Sometimes she would scrunch up her face in disagreement or to express that she really doesn't want something.

I looked at the calendar. It's Wednesday 27 June. Could this be the day...?

Dream: ex and his dad

Such a strange dream that left me so tired when I woke up...

I was invited to a sleep over at my ex's place, and his dad was there (strangely not the mum). I was somehow responsible for making a nice meal, which i did. It was some kind of mash (potatoes?) with a lot of fresh greens.

I saw my ex waiting for me in his bedroom, waiting for me to join him for the night. He smiled at me beautifully, and my heart was pounding and swooning...

The next moment I was in a room chatting with his dad. He asked me about what I do for work, and I mentioned I'm taking over a job from a colleague (this is true in real life, or at least I'm waiting for the confirmation to do just that...) My ex's dad knows this colleague for some reason, and he started to complain about him, and at one point began to cry. Why? Because this colleague insulted the Queen and my ex's dad was very hurt by that... (dreams don't really make sense, do they?)

I woke up with such a terrible headache...

Visit of old friends

There are a couple of college friends mum is close to and has kept in touch throughput these years. Four of them shared a dormitory, and another guy made the group complete. Every single year, they would organise a reunion, and I have accompanied mum to a couple of these events.

Of the four girls (mum being one of them), one passed away a few years ago. Breast cancer. Another became estranged from the group because as soon as she hit middle age, she seemed to have a mid-life crisis and became very flamboyant, and started dating other men. So that leaves mum and another close friend (who happens to be from the same hometown as mum, and who was with mum when she visited me in Canada back in 2008) and this guy.

The two came to visit mum at the hospital (with the uncle's wife, that made three people). They saw me in the corridor, as I was temporarily out of the room to get something. The auntie who is closest to mum (the one who came to Canada back in 2008), saw me and gave me  a big hug. "It's so good to see you again! It must be very hard on you..."

We quietly went into mum's room together, and there was already a big gathering, for the baby entourage had arrived (my brother and his whole family), and my cousin was also there too. Mum's friends sat themselves at mum's bedside. Mum looked at them weakly, and tried to smile. But she could not.

"You just rest, and let me do the talking!" said the auntie. She has always this very funny way of talking and expressing herself, and she often makes mum laugh whenever they get together. For the last couple of years, since dad passed away, this auntie would take the train from the southern part of the country just to come see mum and have a meal with her, and then return home again in the evening. That is true friendship, true and lasting. Mum told me that when they were in college, this auntie used to loan mum her dresses so mum could go on dates. Mum could not afford fancy things or afford to eat at fancy places, but this auntie was and has always been very kind and generous.

They sat around and did a lot of talking. The auntie got out pictures and showed mum her latest trip to Barcelona and thereabouts. There was a lot of laughing and talking, but I could see on mum's face that she was very tired. She did not say much, and when she did, it was more in response to questions about her condition.

Was it me, or did mum look sad? All these years, she always loved seeing these old friends and could chat with them for hours and hours, from lunch to afternoon tea to dinner. But now, mum could not really share in the excitement and fun of reunion. Her body is too weak, her mind too clouded by fatigue and traces of morphine... I held mum's hand and tried a couple of times to hint that perhaps mum is tired.

Mum's old friends stayed half an hour or so, and then got up to leave. "You take good care, and rest well..." They left with smiling faces, but I could sense deep down they were sad. So many years of friendship between them, and now perhaps they are visiting mum for the last time.

Once out of the room, the auntie hugged brother and me. "If there is anything, please let us know. We are all here." The auntie told brother something about arrangements afterwards, but I did not quiet catch what.

I bowed slightly as they entered the elevator and thanked them for coming all this way to visit mum. Though mum did not say much, I know she is very happy deep down, and very touched. 

Dream: at the airport

I had to lie to the US immigration officer that I was going to New York for a few days. I was so scared she'd ask me why I was going and which flight I was taking. But I wasn't taking any flight, I just needed to get inside the terminal building.

She didn't ask which flight, just how long I was staying. "Two days," I said, but I swear my eyes betraying I was lying. I never have been a good liar. She didn't ask anymore, and let me through.

Mum and I had agreed to meet inside the airport terminal for some reason. Where exactly I do not know. Was it gate 53? Or gate 46. Or was it just before baggage claim? I don't remember. I walked from gate to gate looking for her in what looked like a cross between Montreal and Vancouver airports. It was such a bizarre feeling.

But I couldn't find mum at all. She had somehow disappeared....

Pain and morphine

"Doctor, the pain in the stomach...?"

"I just felt her abdomen, and it's bloated from the retention of liquids. We haven't done any scans yet, but most likely the cancer has progressed in the intestines, causing the swelling and occasional pain," he explained, "We can give her some morphine. Small doses to start with. It'll make her feel better." I thanked him, and he bowed his head gently before walking away.

I walked back into the room, and mum was languishing in bed. Today, more than ever, she has been very restless and asked to have her body shifted several times due to sores. Mum has become so weak that she cannot even shift her own legs, let alone turn her body so that she's not lying on just one side. These are signs, I fear... (but then again, I am not a trained medical expert...)

As the carer took half a day off, it was just my brother and me taking care of her. For much of the afternoon, mum lay there in bed with a lot of discomfort. At one point the nurse did come with a syringe containing the painkillers (3mg of morphine) which she injected into mum's IV. Mum felt a bit better, and within an hour or so fell asleep.

Mum spent most of the day in a state of waking moments of daze or sleep with her mouth open. At one point, she opened her eyes and saw me sitting by her side. She whispered (maybe not intentionally, but what sound she manages to muster these days is no more than a whisper): "I know it's been hard on you seeing me like this..." Mum's voice is almost inaudible now, and every-time I really have to strain close to her ears to hear her. I reassured her I would have it no other way. "I know, I'm very lucky. Even the monk said so..."

"Isn't this the best you could wish for? So many people who care about you, so many people coming to see you. You're with your children and grandchild. What more would you like? Would you like the president to come see you?" I joked. (It really was a joke, for the current president is an incompetent fool who's policies are jeopardising the survival of my homeland. He is not welcome here. I'd lynch him and shout abuse at him if I had the chance...)

"Would you like to go home?" I asked her. I told her about the dream I had the other day, the dream in which I was by her side at that final moment and when i said "Let's go home..." Mum weakly shook her head. I asked again whether she would like to be at the hospice or be at home "when that moment comes". 

"Here... I don't want to scare any of you..." mum said weakly.

"You won't scare us!" I said. By "scare" she means that she doesn't want to appear in her spirit form and frighten us after she passes, for according to local beliefs the spirit of the deceased will remain in the place of death for some time, often "haunting" the place until  the spirit can find a final resting place. "It is your home, you can go back to if you want to, if you feel most comfortable..." Mum dozed off before she said anything else. I held her hand for a little longer before I let go.

While talking to a nurse, I learned that fluids collecting in the stomach ( the medical term is ascites) may be caused by the thinning of blood vessels which cause whatever fluids in the circulatory system to escape into the body (whereas normally the fluids are contained in the blood). Another possible cause may be due to liver disease, and failure of the liver to process and reabsorb the waste fluids of the body. Both possibilities may explain mum's bloated stomach, for since last week the nurses have been unable to draw any blood from her veins, for they have become too dehydrated. It is also likely that mum is suffering from liver disease, as the bile fluids are unable to completely come out of the body, and the build of bile is not only causing jaundice, but also affecting the normal functioning of the liver...

Does it matter what the real reason is behind mum's latest complication? The reason we are at the hospice is not to treat, but to alleviate pain and suffering. And the first administering of morphine is a step in that direction. A worrying step, because I have seen before what morphine can do to her mind.

For most of the afternoon, I was pensive, a little shaken and saddened.  Mum ate next to nothing today. The bloatedness of her stomach and perhaps the morphine made her have even less of an appetite. The few moments when mum woke up, she is lost and confused, more than ever before.
At one point, just a little after six in the evening, and after sleeping for two hours or so, she woke up and murmured: "Why are you here? Go to sleep! It's still so early..." She thought she had slept all the way through till the morning. An hour later, she woke up, opened my eyes and saw me sitting by her side. She said: "It's so late already! Go to bed. Don't sit there..." Is it the morphine, or is it her malnourished body and brain that is causing her to have difficulty comprehending time and what is happening?

I do not know. But this is the way mum is now, and her condition seems to be deteriorating rapidly.
I sense a new stage of illness and difficulty has come.

Brother's touch

Brother sat by my side. We were sitting by mum's bedside, watching her sleep, watching her slip in and out of sleep and that half-conscious state of mind. Mum breathed heavily, and her mouth was half open. Her lips, in the span of only a couple of days, have become so dry that I have to regularly apply lip balm on them to keep them from chapping even more.

Mum opened her eyes slightly. I smiled at her gently, and wanted to reach out to touch her arm. Unexpectedly, brother called out: "Mama..." It was a sad and desperate call. A call out of hurt, out of deep concern and anguish. I turned to look him. His eyes were red, and a little moist. I saw him reach out his hand and touch mum's. I withdrew my hand, to give him a chance to express himself.

 My brother rarely touches mum, even though at times I urge him to. The other day, I joked with him: "How come you can touch your baby, touch your wife, but are embarrassed to touch mum?" But today, at that moment when he reached out his hand to touch mum's hand, it was such a touching sight. It was not even a grasp, but it was a start. Mum and son touching one another. Could there be a more beautiful connection?

Letter from the ex

My ex wrote to me finally today, several days after I wrote him telling him how confused I am about what he feels toward me and what he would like from me. I wrote him at times when I am sitting next to mum, I so wish I could tell her not to worry about me, because there is someone who will care for me, who will love me no matter what happens. But is that someone my ex? How can I tell mum something I don't even know is true?

He wrote back, saying he has always care, he still cares, and he cannot care any less. He said how these few months apart made him realise so much, and how lost he was without me, his "best friend, rock and confidante", and how he longed for me so. When I was back in Canada last month, though there were feelings of anger and disappointment because I shut him out during perhaps the most challenging period of his life, as soon as he saw me, hugged me, and smelled me, he realised he never escaped my charm....

It is touching, so very beautiful and touching to receive an email like that. But it is also frightening too... Why does he feel so strongly toward me? What have I do to make him feel this way about me? And how does his feelings compare to feelings he has for someone else? Why me? Why after all the disappointments and arguments, the silent treatments and ignoring his calls, does he still feel this way toward me? How sincere is he really, and can he show me how much he really cares and wants to be with me?

Maybe I shouldn't be asking questions. Maybe I should just be glad that I am loved, and that there is someone who cares so much about me. But I need someone who will do more than tell me he loves me and wants to be with me... I need and want someone who will be there for me, who will support me and carry me through the most difficult of times. Is he this someone? Can I tell my mum I have such a someone in my life, and that she can go in peace?

My ex's email has two installments, and there is another one coming. I am not sure what else he will write, or what else he feels he should let me know. Maybe he's just telling me all these things in the first installment, and will use the second installment to tell me all the reasons why he is not able to be with or cannot be with me now. Yes, there is a deep seated pessimist within me, but in any case, I shouldn't get my hopes too high yet...

Dream

There was a city, it looked like San Francisco, with a beautiful red bridge spanning a broad river. Suddenly a flood came and the entire place was obliterated. There was nothing left but rubble and a rotten stench...

In another segment of the dream, mum looked healthy and well, and we were riding the airport metro (due to be partially completed in 2013...). The train was so fast, and we rode it for so long. I was very excited and took a lot of pictures

Suddenly, we arrived at the station and got off. Three men jumped on me and rubbed me of my iPhone which had all these precious pictures on it. I got very upset, as began kicking them all in the balls. They fell one by one to the ground. One of them I saw was dad...

The process of dying

How long will it last, the process of dying? Nobody really knows for sure. It could be days, weeks, or even months. I am ashamed to admit it, but why is it that at times I want it to happen sooner...? Why is it that my mind is afflicted by all these terrifying dreams and images when I close my eyes to rest?

Mum had diarrhea today, five times no less, which is very strange as she has not been eating much. In fact, she has been eating less and less every day. I may prepare something for her for lunch, and when I head home for a few hours to nap and return to the hospice in the evening,  the same food is still there. It's happened for several days already, even today.

Though tonight I happily brought a feast to the hospice, partly because mum's youngest brother came to visit (second time this week...), mum threw up almost as soon as she took a sip of chicken soup. She did not eat the wontons I left her for lunch, and she barely ate any of the turnip fried rice or boneless chicken she so enjoyed just last week. Her taste is changing, her metabolism is changing. Her body is changing...

I sat with her for an hour or so before bed. Just sat next to her, held her hand in mine, and closed my eyes. I could hear her laboured breathing and the 'hiss' of the oxygen tube. In the room hung the scent of lavender and camomile, a new fragrance that one of the very kind and gentle nurses introduced me to. Mum did not say much, and if she did, it is almost a whisper (almost, so not even a whisper...): "I am so tired...." she manages to say, and I had to lean in close to hear her words.

I do not tell her why she is so tired, but even if I do not say anything, I think she knows it herself. She is the one with the body that is slowing down, she is the one in the body that is soon to stop functioning. So perhaps mum knows better than anyone else. All I can do is sit by her side, hold her hand like i often do, and meditate quietly: "Namo tassa bhagavato arahato sammaasambuddhassa..."
I repeat these words often, silently in my mind, and wish mum peace and happiness, peace and happiness...
  
I end with the text I read to mum just before bed. It is very pertinent to our circumstances and what we are going through, and I could not have put it better myself:

The Great Teacher saw that all sankharas [conditions of the body and mind] are impermanent, and so he taught us to let go of our attachment to them. When we reach the end of our life, we'll have no choice anyway, we won't be able to take anything with us. So wouldn't it be better to put things down before that? They're just a heavy burden to carry around; why not throw off that load now? Why bother to drag them around? Let go, relax, and let your family look after you.

Those who nurse the sick grow in goodness and virtue. One who is sick and giving others that opportunity shouldn't make things difficult for them. If there's a pain or some problem or other, let them know, and keep the mind in a wholesome state. One who is nursing parents should fill his or her mind with warmth and kindness, not get caught in aversion. This is the one time when you can repay the debt you owe them. From your birth through your childhood, as you've grown up, you've been dependent on your parents. That we are here today is because our mothers and fathers have helped us in so many ways. We owe them an incredible debt of gratitude.

So today, all of you children and relatives gathered here together, see how your parents become your children. Before, you were their children; now they become yours. They become older and older until they become children again. Their memories go, their eyes don't see so well and their ears don't hear, sometimes they garble their words. Don't let it upset you. All of you nursing the sick must know how to let go. Don't hold on to things, just let go and let them have their own way. When a young child is disobedient, sometimes the parents let it have its own way just to keep the peace, to make it happy. Now your parents are like that child. Their memories and perceptions are confused. Sometimes they muddle up your names, or you ask them to give you a cup and they bring a plate. It's normal, don't be upset by it.

Let the patient remember the kindness of those who nurse and patiently endure the painful feelings. Exert yourself mentally, don't let the mind become scattered and agitated, and don't make things difficult for those looking after you. Let those who nurse the sick fill their minds with virtue and kindness. Don't be averse to the unattractive side of the job, to cleaning up mucus and phlegm, or urine and excrement. Try your best. Everyone in the family give a hand.

"Thank you..." mum said weakly when I finished reading for the night. I smiled at her, and gripped her hand. She responded and tightly held onto my for a brief moment.

"Alegria
I see a spark of life shining
Alegria
I hear a young minstrel sing
Alegria
Beautiful roaring scream
Of joy and sorrow,
So extreme
There is a love in me raging
Alegria
A joyous,
Magical feeling..."

Another feast

Ever since I've been back, I've become the one in charge of catering, at least for the most part for dinner. Sometimes I brew some kind of soup or broth when/if I go home to shower and nap, but for the past few days I'm so uninspired and mum's appetite has been steadily declining.

So it's mostly take out I buy. Not just at any food stall on the street, but I've been going to restaurants around us mum has frequented in the past. Taiwanese, Shanghainese, Sichuan cuisine, there are three or four fancy places mum liked to eat at, and I know more or less what she likes to order. I just order, usually some kind of fried rice or noodle with a number of savoury dishes. The price always shocks me at the end... Taipei has become so expensive, but really, if every meal could be the last, what does it matter? As long as mum can eat a little, as long as mum can taste a bit of that taste that she used to so enjoy, then it is worth it.

Tonight: boneless boiled chicken, stewed sea cucumber and pork tendons in brown sauce, gingko braised tofu, stir fried kankoon, bamboo chicken soup, Sakura fried rice and dried turnip fried rice.

It's going to be another feast!

Nap

Feel so much like (excuse the language...) death. I came home to take a nap, and it turned into a three hour sleep beset by dreams and images.

There were many scenes. In one, I saw lying in bed very fearfully and telling me that she saw dog- and cat-headed human beings come to get her. These persons with animal heads are in local mythology guardians of the underworld. On occasion, on the brink of death, the one who is about to leave this world can see these creatures. Are they real or imaginary, who knows. But in the dream, mum saw them...

The nurse told me once when the patient sees something frightening, to reassure the patient that those things are mere illusions, and that we are by her side. So in the dream that is what we (brother and I) did...

Even so, in the dream I felt such uncontrollably tears and sadness I have not yet felt before... I saw myself crying, crying so terribly heavily by mum's side; something I had tried and tried to avoid till now.

What is wrong with me that I have been beset by dreams these couple of days...?

Something is going to happen soon. I can sense it.

It's all good

(Liberty Times, 240612)

"sometimes, you feel very lonely; sometimes, you feel being by yourself is great.

Sometimes, you like to have someone keep you company; sometimes, you then feel the need to take care of someone else's mood is so tiring.

If it is so, then just let things be then. When you have a lover, be grateful there is someone to love you; when there is no lover, be grateful there is no one to bother you.

Being on your own has the liberty of being on your own; when there are two people, there is the give and take of two people. So darling, it's all good, no matter when, it's all good."