Monday, May 04, 2009

Difficult Decisions

Patricia Smiley here…

My mother is approaching her 89th birthday and has recently decided she wants to go home to Washington State to visit her sister who is in advanced stages of Parkinson’s. She also wants to see her friends and meet the new pastor of her church.

My mother moved to Los Angeles in 2004, about a year after my father died. I took her back to Washington in 2005 on my book tour for False Profits, ferrying her around the state to see family and friends. She had a great time, but the trip was not without its difficulties. Managing luggage and my mother in a wheelchair was daunting. A flight attendant scolded me for taking her to the restroom in first class even though it was the closest facility to her handicap-designated seat. I worried she would fall in bathrooms with no handicap bars.

Here we are in the rain on our way to the Seattle Mystery Bookstore

Still, she wants to make the trip. I hesitate to say this will be her last journey to the place where she spent more than eighty years of her life, but in fact we all recognize the reality. The problem is her health is fragile. She is wheelchair bound, nearly blind from macular degeneration, has survived two heart attacks and has a host of other health problems, including diabetes. I have traveled alone with her in the past but realize this time I can’t do it without help. Before we could begin planning the trip we consulted her physician, a UCLA geriatrics specialist who is also a saint.

“I want to go home,” my mother said to him. “What do you think?”

I suspect she wanted him to say she was fit as a fiddle and cleared to jet away on the next flight. Instead, she got a more measured response.

“I have another patient who recently asked me that question,” he said. “He has terminal cancer and wanted to go home one last time. I asked him what was the worst thing that could happen if he went. He said the trip might be too much for him and he could die. So what’s he got to lose? The truth is either way he doesn’t have long to live. I told him to go because he would be traveling to a place he cherished to see people he loved.”

My mother, who has no interest in dying either in route to hallowed ground or sitting in the recliner in her living room, said nothing. Not wanting to ignore the elephant in the room, I asked, “Did he make it back?”

“Yes he did,” her doc replied.



He told her she had to have a high-altitude breathing test before she could get on an airplane. A worried frown creased her forehead. Later she asked me to find out what the test entailed. Blowing up a balloon, I learned. Wearing a mask that measured oxygen in her system.

“I’ve never been able to blow up a balloon,” she said. “Even when you kids were little I couldn’t do it.”

“Just give it your best effort,” I said. “There are no letter grades in this test.”

“I haven’t recovered from the last test.”

True. She has a chronic cough that won’t go away despite everybody’s best efforts. Just a couple weeks before, I took her for a pulmonary function test, which she couldn’t complete because she has such diminished lung capacity. The test was stressful and left her sore and exhausted. I could tell by her facial expression that the idea of taking another breathing test was almost as threatening as never seeing her sister again.

The following day she called my uncle to ask about my aunt’s condition. The response was not good. She is having difficulty swallowing. She cannot speak. She doesn’t recognize my uncle and would not recognize my mother, either.

“I have to take a breathing test before I can come to visit,” she told him.

“Why would you even think about getting on an airplane with this flu going around?” he said.

After she hung up, she said, “You know my uncle Bill died in the 1918 flu pandemic. Both my parents had it. Mom lost that baby boy she was carrying.”

“I know.”

“Maybe I shouldn’t go.”

I suppose she was looking to me for reassurance. I understand her desire to see her sister before she dies, and I am willing to take her on this last pilgrimage. I just don’t want to lose her on the way. So this is one decision she will have to make for herself. The test is scheduled for the first week in August. Hopefully, the H1N1 virus will be a distant memory and my aunt will be looking forward to her arrival. One can only hope.

So, what would you do under these circumstances?

Happy Monday!


  1. go for it, patty, or you will regret it.
    but august is so far away. is a train journey out of the question?

    i wish you both the very best and a good trip there and back.

    take good care of her, she looks like a wonderful lady. tell her "viele grüsse aus dem vaterland"


  2. I'm not sure. I think you just have to look at the situation itself and see where you're at in August.

    My mother in law wants to go to Paris "one last time." She's going to be 81 this month and has been very apprehensive about traveling the last couple of years. She's in good shape, though, still plays tennis three times a week. As a compromise, she and my father in law have invited us to come with them. She said it will make her feel more secure about the trip. I'm not going to argue.

  3. Sybille, thanks for the advise. A train trip could get us part of the way but we would have to drive about 150 more miles to our final destination. Something to think about, though.

    Since my mother is German, she'll appreciate your message. Dank.

  4. Wow, tough one. I like Sybille's idea of a train trip if you could manage it. The Amtrak Coast Starlight (I think that's what it's called) gets pretty good reviews.

    I guess if I were in your shoes, I'd encourage my mom to make the decision that was most comfortable for her, and then give her lots of positive reinforcment. I'd also try to help her avoid borrowing too much trouble before her doctor's appointment - worrying about that kind of thing can really take a toll.

    Good wishes to both you and your mom.

  5. Karen, why don't I go with your inlaws to Paris and you can go to the hinterlands of Washington with my mother? Isn't that what friends are for?

  6. Rae, that's excellent advice. My mom's stress level tends to spike from worrying about these tests and what she's going to be asked to do. I'll try to keep it low key and emphasize the fun factor.

  7. Maybe I'd sit down in front of the TV and watch A Trip to Bountiful again.

  8. Oh Bill, I loved that movie. Thanks for reminding me.

  9. Patty, I vote TRAIN....hands down. It's a lot less hassle than the hours of ancillary issues of flying. And a big plus is the TIME you'll get to spend together...ENJOYING the ride [can't say the "ride" on a plane is very fun].
    Go-Lo, I don't know how often you get a chance to have unrestricted conversations with your mum. What I mean is that even though you both may live in the same area, I imagine you have demands on your time which certainly limit how long you can speak with anyone.....

    Imagine, the leisurely train ride up the Pacific coast.....

    To me, that would be the trip to remember, and the one which I could never forget.


  10. Jon, as usual you are brilliant. I either see or talk to my mother every day but a leisurely train ride is sounding better and better. It takes several days, though, so I'm wondering about sleeping accomodations and refrigerating her insulin.

  11. Patty, I worry like a maniac (guess I inherited that gene) every year when my parents say they want to come out here - it's one long flight. Because my mother had a minor stroke a few years ago, the doctor doesn't give his blessing until results of "the tests" come through, which she can't have until about two weeks before she flies. Then he says, "Go. Enjoy yourself. But no walking at the airport, and make sure you're insured." Which came in handy when my dad fell while running in my brother's garden last December.

    So I would say, "go." But go having taken every precaution, having listened to all medical advice (and I know you will). August is a long way away - she may change her mind in another four months or so. She's a senior citizen, and though clearly a real trooper, she's also not stupid. I have a sense she'll know what's truly the best for her when the time comes.

    I should add that my mother's blood pressure is never good before the trip - as she said to the nurse, "How would yours be if you'd just paid for a flight to California that you might not be able to make?"

    And finally, having recently traveled down to San Diego on the train (from Ventura), I can say it was a great experience. Just a few more bucks for business class, and it was a lovely calm journey all the way. So I will add my weight to that idea.

  12. We share the same worry gene, Our J. I do depend on my mother to know her limitations but her urge to take this trip is powerful. Just driving her to get her hair done exhausts her for the rest of the day. I'm also selfish enough to worry about the responsibility I assume in taking her on this journey.

  13. Go-Lo, it's good that you get to talk to mum everyday....but spend the day together? ...I didn't take into consideration the insulin issue. But I bet you they'd be willing to refrigerate it in the dining compartment-----or you could have a small icechest [with those "iceless" icecubes]. Hey if mom wants to make it back to Washington, Mom WILL make it back to Washington----and back home to boot, I'm confident. You can see her strength in her I've heard about her tenacity in promoting your book!

    The idea is LEISURE....and going into or around an airport deflates that whole possibility.
    Plus, if you guys get your own sleep compartment, mum can rest whenever she feels tired...set her own pace.

    Patty, I say this for two reasons: 1) I travel by plane alot, and while I used to enjoy it, it is now a MAJOR pain in my _____.
    2) A few years ago, I had the opportunity to drive my mother, then 87, from NC to FLA. She and her Siamese cat were relocating to Central was quite a trip. I can't remember a time, since I was child, where I spent so much uninterrupted time with my mother....
    Lost time is never found.


  14. I know this is a hard decision for you to make. I work as a nurse in long term care and have done so for about 20 years. I find that being truthful about what you are thinking is the best thing you can do. If you decide to do a train or a car trip so be it. I really think you need to tell your Mom what you think and then have a discussion about what she really wants to do and if she really wants to go find the best way for both of you.

  15. A road trip? Hmmm. I have visions of Thelma and Louise, a convertible, a jaunty scarf, and a pair of Foster Grants.

  16. A Trip to Bountiful, Thelma and Louise......Thank God no-one suggested Throw Mamma Off the Train, or there'd go the suggestion to take Amtrak.


  17. Patty, I love the idea of this trip with your mother. As difficult as it sounds, I don't think you'd regret it. My first thought was train as well. So I looked up Amtrak: they do a direct thru trip from LA to Seattle that takes 34.5 hours. You can book three different types of compartments that comes with personal service. The most expensive one is the bedroom, but it has it's own bathroom facilities. I did a rough calculation with you at a AAA rate and your mum as a senior and Came up with $1990 for a return trip with bedroom on the train for two weeks in August. The link is below:

    I do this as part of my job with Bob. :-D Our last train trip was Washington DC and we so enjoyed that. Next is London to Torquay in England in two weeks.

    Hope it all works out well,

  18. Jon, you are hilarious. I promised not to throw my mother off the train.

    Marianne, thank you so much for the train research. Wow! That's a bit pricey, isn't it. Too bad we don't have that Naked Authors touring bus we've been talking about for the past couple of years.

  19. marianne, can i call you when i plan my next trip?

  20. James O. Born5/04/2009 1:51 PM

    First, You're a good daughter.

    My only experience was when I was young my father's aunt lived near by in an upstairs apartment she had been in for thirty years. She broke her hip and we moved her across the yard to an indenticl apartment on the first floor. She hated it and three months later we had to move her back.

    People get set in their ways and desires. These are tough choices.


  21. Yes, Sybille, let's make Marianne the offical Naked Travel Agent.

  22. Omigosh, I wouldn't even try to move my mother someplace else. That's why I have people watching her all day while she pretends they've just stopped by for a long chat.

  23. It's true that the overnight train can be spendy, but with your own place to rest in, sometimes the price is well worth it. And it's quality time, nothing to be taken for granted, says one who misses her mother daily.

    And if-and-when you do get up this way, let us at the bookshop know and we'll do whatever we can to make your journey to the hinterlands as easy as possible.

  24. Thanks, Fran. Our hinderlands are east of the mountains.

  25. Most of them are, Patty. And I have no idea how we can help, but if we can, we will.

  26. First, your mother is lovely, just like her daughter.
    I would risk the train. My mother moved in with me for what turned out to be the last few months of her life; although, we didn't know it at the time. I wouldn't trade the time with her for anything, I'm tearing up thinking about it.
    Second to that, I know my idea is not the same as being there in person, but is it possible to hook up a computer & video cam for both your mom and her sister? Is there someone on both ends who could manage to assist them with the technology? Would she be able to see the screen and hear the conversation well enough--not sure.
    The reason I ask is that I have been an expat for ages in Malaysia, Shanghai, Australia, and now Munich. Without Skype I would be making many more costly trips home to Ohio and Brisbane, Aus. to see our family, five childre/ten grandchildren and loved ones.
    My sis and I are very close and Skype daily-- now that I have retired and she is recovering from a recent surgery.
    Not the same as "in person, but it truly is the "next best thing to being there."'s free (minus the cost of a computer and mini cam, I guess). Only a thought.
    Enjoy every minute with your beautiful mother

  27. Fran, at the very least we will stop by the shop bearing chocolates.

    Expats, lovely contribution to the conversation. Thanks so much. And I love your blog. What a great life you have.

  28. Susan Williamson5/05/2009 8:41 AM

    Hey Patty,
    what about a car ride...takes longer I know...but it is time well spent...My mother is 76 and she is still working 40 hours a week...
    I wish you both well and have a good trip..I do think she really wants to go and this would be great for the both of you...

  29. Susan, a car ride might work. At least we could stop whenever we wanted and drive to the nearest ER if necessary. The downside is it would take several days to get there, which leaves less time to visit with friends and relatives. Too bad Scotty can't beam us up there.

  30. My goodness, Patty, are you and your Mum popular this week. That loveley lady (or, two of them) always does it. :-)

    The only piece of (wannabe) sagacious advice I might even think of adding to all of the above is to not wait until post-August, if possible.

  31. I just spoke with her, Jeff, and she seems to be backing away from the idea of traveling. I think she's afraid.