One Moment in Time...Josephine Bonanno, 1924-2011

     June 27th did not begin well at all.  On that morning I received a call from the Intensive Care Unit doctor from Paoli Hospital asking to arrange another family meeting for the next day.  Once again, my sisters Stephanie and Lisa and I hashed out what we might hear at that meeting.   We already knew instinctively that Mom's recovery was slow to nil. 

     When I arrived at the hospital that afternoon, the doctor came into the room and sat with me on the couch. She explained that the daily chest X-rays, which had once shown improvement in her lungs, had now begun to show decline.  Nutrients and medicines administered through the feeding tube were just sitting in her stomach and not being absorbed by her body at all.  It was increasingly difficult to keep her blood pressure up and her fever down.  She said the news was not encouraging.  I agreed to prepare the gang for the meeting so they didn't go in blindly. 
    
     My mind was such a jumble of images:  On one hand, there was Mom laying in the bed struggling to be understood with the tracheostomy on her neck, with swollen hands that we would massage constantly, and with droopy eyes that could hardly stay open after many medications and insufficient air intake.  On the other hand, there was this regal woman who dolled herself up nightly to dine with her friends at Wellington, her independent living facility, and who took pride in boasting of her status as Mom, Grandma, Grandmom, Mommom, Sister and Sister-in-Law, Aunt Jo, Friend.....she loved being loved and she loved loving back.  In the background of these images in my mind were sounds similar to the many beeps, honks and toots of every car horn one could think of, and these sounds probably entered my mind as a result of the countless machine noises in the hospital.  At that point, I was ashamed of myself for what I was thinking...I either wanted her to get up and walk out of that hospital room and continue to wow everyone who was blessed to meet her, or pass away on her own.  I wanted it to be like the last time she was in the hospital, and she wouldn't let us take her home until I had gone to her apartment to get her curling iron so she could do her hair.  I wanted to see just one more regal entrance, one more gathering at which she could be a presence.

     When I got to the hospital on the day of the meeting, Mom, who was not able to speak throughout her ordeal but mouthed words and needed a lip reader, mouthed to me as clear as could be, What time is the meeting?  "Huh?" I answered.  The doctors were in here and you were supposed to be here with them!  Dumbfounded, I assured her that I was not supposed to be there until the afternoon and that the doctors would be at the meeting.  This was my first clue that she had more than an inkling of what was going on.

     The meeting time had arrived.  The doctor repeated with my sisters present what she had told me the day before, and that the options were to continue with what we were doing for a few more days hoping for an unlikely change, to transfer her to a long term care facility where she would most likely need the ventilator for an extended time or even for the rest of her life, or to change the focus of her care to making her comfortable.  It had become obvious that she would never return to her friends at Wellington, and that she would no longer have the active lifestyle she knew, and most of all, that she would be uncomfortable.  We were blithering messes.  We wanted our Mom back.  We didn't want to call those that were closest to her to come and say goodbye to her.  It wasn't fair.  We were going to ask her if she wanted to change the focus of her care.  What if she thought we were giving up?  Would she give us that frustrated wrinkled-brow?  Would we understand her intent?  Would we be riddled with guilt because we weren't sure what she was trying to say?  We were assured that they wouldn't hasten death or cause death, they would just make her comfortable.

     We all went back into her room, the patient advocate talked to her about her comfort level and asked if the she was comfortable with the assisted breathing apparatus.  She shook her head no. She also answered negative when asked if she had any pain.  The advocate explained to Mom that her care focus needed to be changed, gave her all the options, and asked her if she wanted to focus on comfort.  That's when all our doubts and fears were addressed and all our insignificant questions were dismissed, and all the important ones were answered.  Without hesitation, Mom smiled and nodded at the professional's question.  She was then asked if there was anything she wanted.  HEAVEN!  She mouthed, again clear as day.  For the first time in weeks, we felt a sense of relief!  We stared at her smiling face for a couple minutes, and couldn't help smiling ourselves.  She then raised her hands from her sides and mouthed with such happiness and conviction, MY DECISION IS MADE! 

     A couple times during the day, Mom was asked if she wanted the hospital chaplain to come to her room.  Indeed she did, and the hospital chaplain was wonderful.   But she kept mouthing the name of a priest who had become a staple in her life as a result of  his affiliation with a Catholic college program my daughter Karen was involved in, and because his mother lived at the same independent living facility.  Again, I repeat, this woman tried to get us to understand her for a month to little avail, yet today, she was deliberate and clear in stating her desires, and she said his name distinctly several times in a couple of hours.  After we made several phone calls, this great man rearranged his life so he could grant Mom's wishes.

     Soon the room was filled with everyone who needed to be there, save the grandchildren whose geographic proximity wouldn't allow it.  She had become so peaceful and radiant in those couple of hours, yet she was still our Josephine, taking in everything and sharp as a tack.  She panned and scanned the crowd from one end to another and just beamed mouthing I love you all.

     Father suggested that we speak with her privately, one at a time.  When it was my turn, I said "Hi Jo!"  It's something I said to her often.  "You've been fighting for so long."  She nodded.  "You don't have to fight any more."  She grinned and nodded with clear and peaceful eyes that were even more beautiful than a month before when she was in better health.  I assured her that Steph, Lisa, and I and all the grandchildren and great grandchildren would be fine.  Again, she nodded and smiled.  She had indeed made a decision she was ready to carry out.

     When everyone was back in the room and she had been annointed, and all the prayers had been said, and the semicircle of her folks had formed around her again, I asked her if she was ready to get the uncomfortable stuff removed.  One last direct communication:  she shook her head no and began scanning the crowd again, saying I love you several times.

     The second time I asked her if she was ready, she nodded.  Within minutes she was more comfortable with the morphine button nearby, and her children holding her hands.  She still looked adorable as she pointed to the morphine button as she felt she needed it.  She smiled and took in her surroundings until she finally fell asleep.

     The overnight vigil included Aunt Rose,who was my father's sister and my mother's partner in crime at Wellington.  Also present were Lisa, Stephanie, my daughter Karen, my wife Jackie, and myself.  Just before six in the morning on Wednesday, June 29th, Mom passed away, and it was peaceful.

     Thoughts enter my mind of Mom reconciling with Dad and with my sister Janet, whose loss she survived but never quite recovered from, and finally with her Mom and Dad in heaven.  The magnificent sendoff at the hospital is replaying repeatedly in my brain.  All these thoughts are comforting.  Though they are not comforting enough to mask the sadness and grief, I am sure that in time we can all heal knowing that Mom's sendoff was as she wanted it.



Mom and Lisa met Josh Groban after Lisa redesigned
 his 'Awake'  album for a contest and won!

Celebrating Janet's 60th birthday in 2009.
 Top L to R: Me, Mom, Steph. Bottom L to R: Lisa, Janet.

Mom and Me
Memorial Day 2010

    Mom was a survivor.  In 1994, at 69 years of age, a mass was discovered on a muscle in her leg.  She was told to get her affairs in order, and that she had the most agressive form of cancer in that muscle.  The muscle was removed and within months, she was walking normally and cancer free.  In April of 2005, she was diagnosed with chronic lymphoma. That same week my sister was diagnosed with pancreatic cancer, and it was decided that my father needed more care than Mom could give him at home, given her condition.  He entered the dimentia unit of a nursing facility and passed away six months later.  She survived radiation and chemotherapy, as well as well as other treatments and medications.  She always made herself look physically beautiful during all these trying times, and was never anything but strong and courageous. 

     To have friends from all facets of one's life, even without Facebook, is a gift.  From her oldest and dearest friends and cousins, who were her extended family from South Philadelphia, to her youngest great grandchildren, to her extended family of the last six years at Wellington, it's been a hell of an 86 years filled with friends and family, smiles and tragedies, and throughout it all.....love.

    Thanks, Mom.  We are who we are, and we're all together because of you.  That in itself is the greatest gift.  Rest in peace, lovely lady..............