Another blow

My brother Dan reports his wife Karen is in hospice. Her decline has been rapid and the latest symptom was the loss of the ability to swallow. Her doctor said not to bother with a feeding tube.

Dan works for an international company. His first foreign postings were in London and Paris, where his daughters grew up. After a few years at home and their daughters now grown Dan and Karen took a posting to Malaysia. From there he visited contacts from Australia to South Korea. Karen accompanied him on every business trip, as he worked she explored whatever city they were in. One year my Christmas gift was a donation to an organization in Cambodia dedicated to removing land mines.

Two years ago Karen had a few weird memory incidents, then had a seizure. They were in Singapore at the time so were able to use its fine medical facilities. The diagnosis was a brain tumor, a particularly nasty form of cancer. Karen went through the surgery, the radiation, and the chemo. The doctors pronounced her one of the few lucky ones to survive this kind of cancer. Her hair grew back.

This past winter they accepted a new assignment, a posting to Munich, Germany. They looked forward to exploring Central Europe the way they had explored Southeast Asia. About three months ago, shortly after settling in, Karen began feeling sleepy and showing signs of unsteadiness, first in walking, then in standing. The cancer was back. This time not as a tumor, but as a "fog" through her brain. Surgery was not possible. There wasn't one small area for radiation to strike. And in her frail condition chemo did more harm than good.

Karen was soon in a wheelchair. When they went for a doctor visit and Karen couldn't hold her head up the doctor sent her to the hospital. At the end of her time in the hospital Dan's visiting mother-in-law made it clear Dan would not be able to care for Karen on his own and recommended a nursing home. When Karen couldn't swallow the home said they were no longer able to care for her and recommended a hospital able to handle hospice care (quite close to Schloss Nymphenburg!).

After Dan got past the "Who is paying for this?" he discovered the staff at the various care facilities have been wonderful, providing care well beyond the job. He contacted an English-speaking Methodist Church and their pastor has also come to sit with them. His employer has firmly told him his first priority is his wife.

Dan was quite scared when he realized Karen couldn't swallow. He remembered well my stories from last summer when Dad's swallow reflex was damaged and had a feeding tube installed.

Coming so soon after my brother Tim's death at the end of May (Karen was already unable to travel so they did not attend) and less than a year after Dad's death this is hard to take. My sister Laney said it well: Enough! Stop! We don't want any more deaths in the family for at least 20 years! It is one thing to say goodbye to a father in is late 80s. It is quite another to say goodbye to a brother just a few years older and a sister-in-law who is a few years younger.