“aj your mom killed herself can you come over”
On January 27th that was the Facebook message I received around lunch-time. I called him on the phone immediately, and by the tone of his voice I knew mom was almost certainly dead. I grabbed my medic bag, not because I genuinely thought I’d be able to save her with it, but because I was worried my dad would do something drastic before I got there. My mom was suffering from terminal cancer and had almost died a couple times before, so I’d long accepted the grim finality of what would eventually happen one way or another. The drive to my parent’s house about 4 miles away was the longest of my entire life, and I don’t think I was under the speed limit the entire time. I’ve seen a lot of ugly, horrible death scenes working Emergency Medical Services, but nothing could prepare me for the nightmare that was waiting in the dining room that overcast Saturday morning.
My mom was sitting in her wheelchair, slumped forward, while my dad sobbed and cradled her from the side. I threw my bag into a chair, and pulled on a black pair of nitrile gloves before rushing to her opposite shoulder. Her eyes, formerly a piercing shade of blue, were now glassy and dead. Clear fluids drooled from her mouth and nostrils. There was a ragged, charred hole burned angrily through the front of her old sweatshirt, and on the floor directly in front of her laid a black revolver.
I told my father that I needed to check for a pulse on the off-chance that my dad’s old .22 pistol hadn’t finished the job, but as my finger-tips searched for the rhythmic pump of an artery he said something which erased that tiny possibility from my mind.
“That’s the .44.”
I don’t know why I always confuse those damn guns, they’re both long barreled black revolvers but that .44 magnum with its cylinder full of hand-loaded hollow points is a literal, unforgiving handcannon. As a teenager I’d seen it knock fist-sized holes in deer and punch straight through engine blocks, making the outcome of a point blank shot to the heart of an emaciated cancer patient one of little speculation.
The next two hours seemed to drag on into an agonizing eternity. The local medical examiner liked to make it a point to personally show up to scenes like this, but she was on vacation and a prolonged interval of deliberation occurred before the funeral home could take custody of the body. I thought this was a particularly cruel thing to inflict on my father who clung to my mom’s lifeless body the entire time. As for myself, I told my wife when she arrived not to touch me, since I was using every iota of strength I had earned from long years in emergency medicine to hold it all together and human contact would send me into tears. This was a crisis, and it was my responsibility to manage that crisis. I could deal with my own emotions later, after things were under control.
So how did this all come to be?
My mother had a reputation as the “nicest” member of my family. Everyone that had ever met her was left with the lasting impression she was a genuine, sweet individual. My former girlfriends all loved her, in years gone by if I needed to talk I would seek her out for a private conversation. These talks were reassuring and seemed to ground me back into a place where I could make sense of the world again. She was a stark contrast to my domineering and volatile father, a man capable of accomplishing anything except taming his own explosive temper. I think she was the yin to my dad’s yang, the sort of balancing force that kept him slightly more reasonable and maybe helped channel his tremendous personal energy in constructive directions.
My mom was actually the reason my dad had gotten into cycling years ago, a tradition eventually passed down to me. She had even autocrossed, another McNabb past-time all of us competed in at some point in our lives. When my dad got back into motorcycles, she went on road tours with him, which I suspect represented the apex of their lives together.
Something eventually happened that challenged my own assumptions about her in a way I doubt I’ll ever fully resolve. My mom complained of neuropathy in her feet, which in retrospect is a frankly bizarre complaint from a healthy woman of normal weight with no medical issues or Type 2 Diabetes, but it was an isolated, minor issue easily ignored.
She had been seeing a chiropractor, but at some point the problems began to worsen into gait instability. Soon she had purchased an inversion table and was engaged in various corrective exercise regimens. Around the time she started losing weight the medical intuition of myself and her daughter in law kicked in. My brother’s wife was an LPN, I was an Advanced EMT, and to us the red-flags of something serious were unmistakable.
We advised her to seek out a primary care physician and get a thorough check-up performed to see if these problems were related to something beyond the purview of chiropractic charlatans. These recommendations were met with hostility. My parents had seemingly overnight become brainwashed by Natural News and Mercola.com. Orthodox, “allopathic” medicine was a topic of disdain for them, and my mom’s weight loss was explained away as a new low-sugar diet she had adopted. Suddenly the 12-packs of Mountain Dews we had all drank at breaktime working for my dad in the timber industry vanished. A perverse dietary Puritanism took hold and my mom, someone I had always respected as the most anchored person in my life was down insane rabbit-holes that were the laughing-stock of myself and my peers. I think as a kid you see your parents as the dependable rock you can anchor yourself to, and watching them go so far off the reservation was a deeply horrific experience.
Over the years things continued to deteriorate until finally she sought out the care of some alternative medicine group in Northern Virginia. They needed a certain number of diagnostics done in order to get involved, and I convinced her to use the hospital I worked out of for the testing. My favorite lab-tech did the blood-draws, my own surrogate family of medical practitioners attended to her at every turn and the truth finally came out.
She had multi-system cancer, on her spine, in her breast, and elsewhere. In fact, as I would later learn, she had known about the lump in her breast for a long time and had applied black salve to it. The group from Northern Virginia looked at the results and immediately steered her towards conventional treatment.
For a moment it looked like she would consent to some aggressive treatment that would bring back at the very least some quality of life, but she abruptly changed course in a move that didn’t entirely surprise me, and doubled down on eliminating sugar from her diet. CBD oil and cannabis was the new miracle cure.
The next year seemed custom-designed and expertly tailored to create a personal Hellscape for the individuals involved. My mom’s personality began to change from the THC, her body became fully cachexic, a withered skeleton draped in flesh, and one day after cycling over to my parent’s house she had a seizure in the living room. I held onto her in her wheelchair, terrified that I would be doing CPR on my own mom, and time slowed to a crawl. She eventually came out of it, and brushed it off as too much of her cannabis oil, but I knew the truth. It was a full-blown seizure and if I hadn’t been there she would’ve fallen out of the wheelchair and cracked her head open on the stone floor.
I fully expected her to die that summer, but she held on through the winter until that fateful day in January.
I guess I have a lot of reflections on this twist in the path of my life. There’s a lot I’ll never understand, like why my mom chose the course she did. Was it out of genuine concern for the finances of my family? Was it fear? Was she afraid to accept what was happening and did she try to hope it would just go away? I’m sad that my kids will never meet their grandma. I just want my old family home that I helped plane the lumber for seem okay again instead of haunted by the smell of death. I want a future where someday my son, me, and his grandfather all ride bikes together. It just all feels like sand slipping through my fingers.
The way she ignored the recommendations of her own son and daughter in law really felt like a slap in the face. My brother told me my parents seemed to think I cared more about being right about a serious medical issue than I did about the outcome, which is just about the most psychotic, alienating thing I could imagine. If their crack-pot “alternative treatments” had actually worked I would’ve been fucking delighted. The notion that people in her own family were more concerned about their own egos rather than the survival of someone everyone adored struck me as some form of projection and hurt my perceptions of how I was raised.
If I’m being honest here, my upbringing was not particularly loving and we were not as emotionally connected as many other families. Maybe this was an asset given my choice of careers, since disconnecting yourself from the horror of what’s happening around you can be priceless skill in EMS. I think it’s a costly skill though, one that makes you less human.
I think my background in medicine was a double-edged sword. On one hand, we’re used to death. We accept it and we know life goes on for others after someone dies. On the other hand, we develop an intuition about the health of our patients and how likely their survival is, which made the protracted deterioration of my mom unbearable to watch. When every instinct in your body is telling you your own mom is on the threshold of death and you have the professional history to trust your grasp of the situation, just looking them in the eyes is hard. I left my parent’s house in tears several times leading up to her death, the last time I saw her alive it was like a knife twisting in my guts and I know I cried that night.
The impotence in changing this outcome was maddening, the sense of an impending catastrophe you can’t change would give anyone a Cassandra complex.
Why wouldn’t you see that your son had your best interests at heart? Wasn’t it my job to save people?
Speaking of my job, I went back to work the following week. Late winter is always hard, but I needed to put on my uniform. The mantle of my vocation seems to carry strength in itself, something about the polished boots, the duty to answer the call seemed important to me. I worked two back to back calls involving futile CPR, once on a woman my mom’s own age whose husband had passed away a few months prior. Maybe that was too much. I had trouble getting the images of death and blood gurgling from open mouths out of my head.
But the following Saturday another personal crisis emerged. My therapist said helping others was a good coping skill and this was a potentially deadly situation with two lives at stake, so I did what duty required. I’d like to think I handled it pretty well but I know the stress fractured me around the edges.
I’ve thought a lot about death. I remember transporting a patient in his late 90s, a former funeral director. He had beaten cancer himself before, but when it came back, he declined treatment, knowing his life was full and reaching the final end. His family took care of him until his very last days and he was surrounded by loved ones. When people get close to death, sometimes they talk to the ghosts of the deceased. The man laying on the stretcher kept murmuring about “snow on the ground”, referring to the first funeral service he had ever conducted several decades ago in the winter. His unseeing eyes pivoted towards the faces of the long-dead men who dug the graves for the bodies he interred, and he seemed to speak to each of them in turn.
It was deeply sacred experience and I felt the very air in the ambulance would explode if I disturbed the final moments of a man who had buried so many.
My mom’s last days were nothing like this. It was an ugly, hateful, senseless, traumatic horror. It wasn’t an end, it was a theft. A friend of mine killed himself in my early 20s, and like that event, it will always be a ragged hole torn through the fabric of my history. It was a life not only cut short, but dragged out into a protracted, torturous conclusion marred by suicide. The struggle had scarred everyone around her, and she finished it with a final act almost intentionally cruel in how it would maim the psyches of those close to her. Maybe I was more equipped than others to handle this sort of calamity, but my dad certainly had no experience of it. My own brother thankfully had extricated himself from the impending disaster before it befell us, and I don’t begrudge him for not being there.
There’s still a lot to process here. I think Chuck Palahniuk is right, when your parents die, there isn’t anything left that can be done to hurt you. As per my experiences in EMS, I will always measure my current challenges versus the images of my mom with a .44 magnum round torn into her chest. I also feel as if the potential Hell waiting in the future can exceed anyone’s imagination, so maybe it’s a wash after all.
For myself and others, I wish that death can conform to the words of Marcus Aurelius and the dying undertaker in my ambulance:
“You have embarked, made the voyage, and come to shore; get out.”