Angel in the Storm

The angel held up a warm torch light as an arctic river swept along the hillside in darkness. Torrential rain and wind drenched and pulsed through tall Bamboo stands. A few hours earlier we watched by daylight as the stand swayed like seaweed thrown wild and undulating by strong chaotic currents.

Our hospice care team had good reason to believe a combination of Judy’s age and metastatic breast cancer, was now causing her rapid cognitive decline or that she was simply entering the end times. Judy was speaking daily of her parents as if they were still alive and she needed to find them. Various children were waiting to be called in for supper. Phantom entities might enter her place nestled in the hills and take stuff. Her main concern however was the desire to get home; “I need to get home!’ became a consistent plea..

On this night, she was comfortable and unconcerned as we faced the wild weather together. She cozied with her soft furry comfort pillow in her hospice bed set up to face the outside world I sat nearby on the floor where a candle flame served as a single focal point. It flickered and threw out a warm cape of light softly landing on the coffee table. The candle rose from a heavy pewter candlestick with the outline of an angel in side view. She was one of a pair, Judy''s daughter gifted her. Like magic the flame seemed to brighten and dim in sync with the beautiful bansuri flute music pulsing from my laptop. The candle was set up as a safety measure, in case the lights went out. It served as a sacred space holder.

Earlier in the day, I’d pulled out the colored pencils I kept on hand and sketched the silver angel profile while Judy dozed. Later I encouraged her to add color. I'd outlined a few easy flower power shapes on the angels dress to make it easy for her to collaborate. She chose deep orange and red pencils, I turned away to prepare a nosh. When I returned I noticed she had spontaneously added her own ideas; a set of fiery freestyle tail feathers had emerged and swooped freely from the angels backside.

This should have been no surprise because at heart Judy was always more of a freestyler than a color-in-the-lines kind of woman! She'd worked in publishing, created a small artists gallery in Santa Fe, taken her kids solo to grow up in Mexico for a few years, and written her own book on fun with kids in the city, it was called Kidding Around in San Fransisco. That was before her two rounds of surgery and chemo for breast cancer.

Jusy had envisioned her next iteration would be as a travel and tour guide escorting small bands of adventerous women to sacred sites across the globe. It turned out her beloved daughter and her did get to the Greek Islands to do some of her bucket list visits.

Falling back into her dreamland, I noted Judy's chest rise and drop easy while our angel sketch seemed to illuminate more or less with the candles pulse. I saw a phoenix rising there and wondered how far it might take her.

I fixed myself some tea, and googled some of the more peculiar symptoms while the bansuri carried on. My search brought me to explore Korsokoff's Syndrome.

I learned, "Korsakoff's syndrome is a disorder that primarily affects the memory system in the brain. It usually results from a deficiency of thiamine (vitamin B1), which may be caused by alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy."

I also discovered it is one of the reversible dementias. Later, I revisited some cliff notes from Oliver Sack's controversial case study collection; "The Man Who Mistook his Wife for a Hat". Perusing case studies of a neuroscientist required another cuppa and I read deep into the night.

While Judy's cognitive health declined markedly her body remained fairly robust, she was stable on her feet, had appetite, and conversational interest. From what I have seen her cognitive issues were not end-time visitations or more generalized memory problems.The nature of Judy's 'brain fog' was centered around comprehension and sometimes confabulation. An example of difficulty with comprehension might be that, one saturday, after 50 years of cooking for a robust tribe of family and friends, she held up a beautiful kitchen knife and asked her daughter, "What in the world is this supposed to be?" Sometimes, she'd begin a story and realise part way through she was making it up. She herself was flabergasted.

I took a trip back east and during that time Judy experienced some frightful delusions, one involved thieves in the night who must be found, her loving and respectful daughter eventually followed her wishes to call the police. Judy was admitted to MGH to check for standard crazy making issues like UTI's, severe dehydration and the like. After finding nothing conclusive there and aware brain metastices were likely, her daughter finally relented to advice from all the various hospital staff to move Judy from her place to a formal memory care facility.

My work with the family appeared suddenly over.

It wasn't.

The phoenix rises when it rises.

Judy wasn't done yet and neither was I.

I asked her daughter to please insist they treat her for Korsokoff's Syndrome. Her Mom had increased her consumption of wine significantly after becoming more isolated, letting go of her job and facing the rigors of chemo.

Her daughter, a social worker, grinned at me and raised an eyebrow as we sat at her Mom's kitchen table. I repeated, in a straightforward way, tell them very firmly Kim, "She needs to be treated for Korsokovs" , if you tell them that, they have to do it, or they will be liable, if you later find issues with her Thiamine levels." O.K. Dr. Char", she warmly joked with me. "What did they say I asked her a couple days later?" via phone. She told me the Doctor said, "Don't you think it's a little late for that?".

Two and one half months later, in late July, Judy was released from memory care, no one there thought she had any memory issues. Judy had a drainage tube put in her lung and the facility didn't want to deal with that. Hospice would care for her at home although the drain would fail eventually.

Kim called wondering if my daughter and I were available to caregive at her place in San Fransisco. I said I yes, I was available and happy to hear the good news of her moms mental acuity. Kim added, there's one thing tho Char, it's weird, she doesn't remember you at all, or Haley or anything about those months at her place in Larkspur last winter and spring. "Nothing?" I asked. "Nothing!" I've been over it and it's a total blank. "Wow. Well that's not actually a problem for me. We'll start over," I assured her.

It was a miracle to witness; the angel in the storm, the phoenix flickering by candle light, the return "home" Judy made, becoming more at home in herself, and at home at her daughters. I became party to both her poignant yearning and it's fulfillment, here on earth the story before the next story before the next story unfolded as she prepared to traveled into life-after-life.

I left Kim, a sketch of her Mom curled up and comfy in bed the day of the storm, a call and response poem Judy and I wrote near the end of her life, a piece of this very story and the sketch of the Angel in the Storm.