Stroke of Halacha

Her mouth is always open and her tongue is coated with some orange substance. She is in a semicoma. Only now and then she seems to be aware of her surroundings. She cannot speak or communicate; she cannot respond to verbal suggestions; her right side is paralyzed; and she has an oxygen tube going into a tracheotomy in her throat. Every 20 minutes or so there is a loud gurgling of fluid in her throat and esophagus, and she struggles to keep it from filling her throat, possibly slipping into her lungs, risking pneumonia. All this is from a stroke she had in February, a month before her 82nd birthday.

My mother is in a nursing home now. Every month or so she has to be taken to the hospital for a week.

My sister and I live in Los Angeles and my mother is on the East Coast. In February when we went to see her, right after the stroke, the doctor immediately asked us if she has a living will. We said no. So the next step was up to us. As the doctors said she would not get better than she was now, we had the option to not let her struggle beyond what was necessary. We could sign a piece of paper called a DNR/DNH that said do not resuscitate or rehospitalize, thus ending her suffering as soon as one of her major functions — breathing or heart — stopped. It would be over.

My sister and I had a lot to grasp and didn’t sign any papers.

The fourth night after her stroke, my mother stopped breathing. They called our hotel room and told us, “Your mother’s breathing has arrested, and we are putting her on a ventilator.”

I thought “God wanted to take her and we stopped him.” Should we have taken this opportunity and let her slip peacefully away?

In May, I went alone, to visit her for 10 days. When I walked into the room, she was looking at the ceiling with the one eye that still had sight (her other eye had gone blind since I was there in February). And she has also deteriorated in other ways. I talked to her and told her family news. I read to her from Readers’ Digest. I sang old songs to her that she knew and cherished all her life. I read Mother’s Day cards to her. I sang the “Shema” to her every night.

As I watched her, day after day, I felt more and more compelled to sign the paper. To let her go. On the ninth day I put my head on my mother’s chest and I cried and cried. I even placed her hand on my head pretending she was able to comfort me.

I wanted to let her go, but I knew my sister would never agree unless a high enough rabbi approved. So I called a rabbi in Brooklyn who was recommended as acceptable to my sister. And, as cold as ice, he declared, “As long as her body responds to it, you must resuscitate.” That was it. I pleaded, but my points were disregarded. He said, “You wanted Halacha. This is Halacha.” And he seemed determined to end the phone call.

When I came back home, my sister and I met with our own rabbi. He called another higher rabbi on speaker phone. This particular higher rabbi was better. He was warm. He bothered to explain. And tell us about people in similar situations. I checked to make sure he’d had the experience of looking into a struggling face, such as that of my mother, before he was so able to declare that she must be kept alive.

Our rabbi and the one on the speaker phone concurred with the one in Brooklyn. According to these rabbis, Judaism doesn’t deal with “quality of life.” It only deals with signs of life: if the organs are working, and if there are machines to help with the job, then there is an obligation to keep her alive.

My sister told me that I couldn’t be sure that she is only looking at the ceiling. “Maybe she is reviewing her life, or atoning for things she’s done wrong.”

“What could she possibly have done so wrong that she has to be forced to live through this?”

My sister said resignedly, “I guess God will take her when He’s ready.”

I said, “How can God take her when you keep bringing her back with machines?”

At the end of the discussion, I rushed out of the synagogue without my sister. I got into my car and sat crying over the steering wheel. My sister appeared at my car door. I rolled down the window and declared between sobs, “I can’t stand it, I can’t stand it.” My sister got in the passenger side. She said, “Don’t you think I had questions, too? That I care about her suffering, too? That’s why I went to the rabbi. Because I’m not qualified to make such a difficult decision. There are men who’ve studied Torah and life for 3,000 years who’ve drawn this conclusion.”

I went home still upset and unsure. It seemed to me, we were just adding one more suffering person to the world.

And there it stands. No papers are signed and my mother continues this way.

Miranda Pollack has worked in a nursing home in New York and at a veterans hospital and two assisted-care facilities in Los Angeles.