Death isn’t a concept that I’m unfamiliar with. I have spent my entire professional life with cancer patients—both adults and children. I’ve held hands as people took their final breath. I’ve cried with families. I’ve talked with patients and their loved ones about shifting from “cure” to “best quality of life,” for whatever time remains. And in one of my jobs, I even had to pronounce a patient deceased—something I will gladly never have to do again.

Because of this, I thought I could compartmentalize things when my mom was unexpectedly diagnosed with end-stage liver failure. I thought I could handle it, slip into eldest-daughter mode, and stay steady. And for several months, I did—until the very end.

There is nothing that can compare to sitting next to someone for hours or days waiting for them to die. Time becomes unrecognizable. You want it to pass because the waiting is agony, and yet you don’t want it to move at all. It’s the most emotionally intense contradiction I’ve ever lived through, and I was not prepared for its weight.

Before the end, I need to give a little context. My mom was never a drinker—aside from the usual late-teen, early-twenties experimentation—so liver failure wasn’t something any of us saw coming. It arrived out of nowhere, both medically and emotionally. The time from her diagnosis in early December to her liver transplant was less than six weeks. There was no time to mentally or emotionally prepare; we were simply thrown onto the transplant train and told to hold on.

The transplant itself did not go as expected. Midway through the surgery, they realized they couldn’t use the donor liver. My mom spent eighteen hours ahepatic (without a liver) and was not expected to survive. For perspective: without a liver, your blood can’t clot. Most people don’t make it more than a couple of hours.

But she fought.

After thirty units of blood, medications to keep her blood pressure up, and clotting factors to slow the bleeding, the team got a call about another liver. She had just started to crash when they rushed her back in and, somehow, managed to save her and complete the transplant.

Unfortunately, that was only the beginning. She spent three weeks intubated and sedated, and another five months in the hospital or a rehab facility. The ordeal took a profound toll on her body. She needed a feeding tube, and she was on dialysis for most of that time. Eventually, her kidney function improved enough that she came off dialysis—but it was never fully restored.

So when she was finally able to come home, it felt like a miracle I didn’t think I’d get to see. She and my dad moved in with me, my then-husband, and our three feral young children. It was chaos—pure, wild chaos—and it was beautiful.

There is something profound about caring for someone on the downward slope of their life, especially someone you love. You are pushed to your absolute limit, stressed and exhausted, but you also get to spend intentional time with them. Most of life is spent moving from one thing to the next, surviving instead of living. But when you’re caring for someone who is dying, you are forced to slow down. To be present. To be intentional. And that? That is the greatest gift.

Altogether, my mom was probably with us for six to eight weeks total, though not all at once. She was rehospitalized several times with infections that knocked her down again and again. She never regained her strength and needed to use a wheelchair, but that didn’t stop us from making the most of the time we had.

We went to the ocean whenever we could. My mom loved the ocean. She used to insist on winter pilgrimages just so she could “reset” by the water. Luckily, I live less than two miles from the beach now, so she was always close to the thing that grounded her most.

At home she read with the kids, played Legos and dolls, colored, watched their favorite movies. Once she even let them color her hair with hair chalk—it looked like a rainbow had exploded across her scalp. I still have a photo of that day; the smile on her face was unforgettable. We also talked. Really talked. About her life, her dreams, the things she never got to do. She told me how traumatizing the transplant and ICU experience had been, and how she never wanted to be intubated again.

The relationship between a mother and daughter is its own complicated landscape—uniquely close, uniquely charged. We’d always been close, but during those weeks I understood her in a way I never had before. As women, we grow up thinking we know our mothers, holding opinions about what we would have done differently. It’s easy to forget they are human, too, shaped by circumstances we never saw and wounds we never understood.

There were things I had misconstrued. Things teenage me had held against her without ever considering how they impacted her. Getting to unravel those old knots together,to really connect and understand each other, was a gift I will be forever grateful for.

But like all things, that period of quiet living didn’t last. We stayed in the eye of the hurricane, living intentionally, holding tight—until the storm hit again.

Over those weeks, my mom’s pain increased to a level nothing seemed to touch. There were moments when she was so ready for it to be over, begging for it to just stop. One night she called me from the hospital, sobbing. She was exhausted from the pain and from nights without rest. She told me she didn’t think she could do it anymore.

I recognized the emotion in her voice. There comes a point when a person realizes they no longer want to fight for more time or to claw their way back to whatever their baseline once was. My mom reached that point in that phone call. She wanted the pain to stop. She wanted the suffering to end.

I braced myself, helped her breathe as best I could, and silently ran through the list of things I needed to prepare. I knew the end was coming. I just didn’t realize how quickly.

Toward the beginning of August, she was readmitted again with pneumonia and a UTI. She was very sick, and her kidneys were beginning to fail again. They stabilized her just enough to transfer her to a rehab facility for a day, but within forty-eight hours she was sent back to the ER.

When I met her there, she was confused but still able to talk. She reaffirmed what she’d told me before: she didn’t want to be intubated again. At that moment she was stable enough to be transferred into Boston on BiPAP—essentially, high-pressure oxygen.

My dad and I drove in after her, stopping quickly to grab something to eat. During that fifteen-minute window, I missed a call from the ER. When we arrived, she had been intubated.

We learned that her code status had been temporarily updated for a procedure, but no one had changed it back. The ER team didn’t know she didn’t want to be intubated because the chart didn’t reflect it, and they made the decision that would save her life in the moment.

Walking into the room and seeing her hooked up to the machine she never wanted again was heartbreaking. I still remember the coldness of the room, how impersonal everything felt. We stayed for a while, then went home.

My dad and I returned over the next two days, but she wasn’t improving. On the second day, she was more awake. She looked directly at me, and I could see it in her eyes. I knew what she wanted. At one point she mouthed, “stop, please,” and my heart sank. Her eye message I could rationalize away. But this, I couldn’t. She didn’t want to be on the ventilator anymore.

I paused, looking around the room at all the tubes. The ventilator breathed for her with a soft, mechanical whoosh, forcing her chest to rise every few seconds. I wanted to be selfish in that moment. I wanted to pretend I didn’t understand, to let the machine keep her here a little longer. I wasn’t ready to lose her. I needed her. My kids needed her.

But then I let myself think it through. If she survived this infection and came off the ventilator, her kidneys were bad enough that she’d have to go back on dialysis. She wouldn’t be able to return home. She’d end up in the hospital indefinitely or one of the few rehabs with in-house dialysis, all of them hours away from us. And she had told me how much she never wanted to go back to any of those places.

I knew this wouldn’t be the life she wanted, if you could even call it living.

So I took her hand and whispered that I loved her. Then I called the doctor, and we had a family meeting.

I had sat on the other side of this meeting dozens of times. I knew what to say, how to hold space for families, what questions to anticipate. But none of that mattered when it was my mother. Everything I knew—professionally, emotionally—evaporated the moment I had to make the decision myself.

Taking my own mother off the ventilator meant accepting that she wouldn’t survive more than a day or two. Likely only a few hours. Still, I signed the paperwork. We called my sister, got everything in place, and then they removed the machine.

For a few minutes, she was with us. Smiling. Peaceful. Free. We said goodbye. We told her we loved her. And then we prepared for her to die.

We waited through the night, and she was still with us the next morning.

My dad was exhausted, so he went home to rest. My sister and I stayed. We spent two nights in that limbo, and it was the hardest thing I’ve ever done. As the hours passed, she wasn’t awake anymore. She would open her eyes briefly when someone repositioned her, but otherwise she slept. I genuinely didn’t know what to do with myself.

So I did everything.

I wrote.

I read.

I colored.

I tried watching something—couldn’t tell you what.

I took a walk, grabbed food, called my friend, played her favorite music.

I kept trying to stay busy because when I wasn’t busy, the agony swallowed me. I wanted time to pass quickly, but I also didn’t want the end to come. It’s a paradox so powerful it feels like your body is splitting in two. The only other time I’d felt something even close was during the birth of my first baby—when I was desperate for the pain to be over, but equally terrified of the moment that follows.

I was living in that in-between: wanting her to die so she could finally be at peace, but not ready to lose my mom.

Eventually, I realized nothing could distract me from the reality surrounding me. So I put on her favorite music, sat beside her, and opened my laptop. I read her my poems. I wrote her eulogy and obituary. I told her my favorite memories growing up. I reminded her of her favorite stories about my kids. Hearing is the last sense to go. I wanted to make sure that if she was still listening, she left this world knowing how deeply she was loved.

Shortly after this, she took her last breath. It happens so quietly you almost miss it. One moment she was breathing; the next, she let out a single exhale and didn’t inhale again.

I sat there in the early morning light. I looked at the sunrise and realized she would never see another one. She used to call me in the mornings while I drove to work, telling me she was looking at the same sunrise as me. It was her way of staying connected across the distance.

I never realized how much of a gift that would become years later. Now, whenever I see the sunrise, I think of her and feel close to her—wherever she may be.

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