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Mom has stage 4 breast cancer.  In other words, it is not curable, and it will kill her if something else doesn't get her first.  In general, half of the people who receive her diagnosis die within 18 months...for her, that would be this April.  Mom shows every indication of living past that point, but I'm not sure how long:  there has been definite progression in the last few months. 

Still, she's living on her own (83 years old and still looking barely old enough to retire), cooking her own food, making a point to get out of bed every morning and do something or go somewhere.  Currently, she has a goal of making one quilt top a week (she does gorgeous piecework, and it truly is what she lives for).  I've learned a lot from Mom, as far as not letting a shitty situation ruin the things that are important to you.

I have four older brothers and an older sister.  One brother and his wife live ten minutes from Mom, in the same small town.  Another brother lives about 90 minutes away.  I live four hours away, so does my sister, and the rest of the siblings are thousands of miles away.

So why are my sister, myself, and my best friend (who is also Mom's friend, and who lives nearly 5 hours away) the only ones who can be relied on to actually do things for Mom? 


By "things" I mean basic support.  Like making sure she gets to her oncology appointments, two hours from her home.  Or taking notes, and just being there with her at those appointments:  each one could generate bad news or yet another treatment decision.  Or making sure her quality of life isn't brought down by something stupid, like trying to re-fill the water softener salt on her own, or climbing on a chair to replace smoke detector batteries.  Or making sure she has fresh flowers to enjoy throughout the long winter months (my friend's idea, and a very fine one that Mom greatly appreciates). 

It's like pulling teeth to get the in-town brother to visit her even once a week - something he should have been on-board with well before the cancer diagnosis.  And apparently it takes at least two reminders to get the family out west to send flowers.

They have all made a few grand gestures:  guiding Mom through the initial grueling Mayo visit, renting her a cottage on the beach for a week, etc.  Greatly appreciated, all around.  But there's little or no interest in the day-to-day, outside of the three of us.

Mom has a friend in town who also does things for her.  She's a treasure - checking in on Mom daily and bringing in her mail during bad weather.  But Mom doesn't want to impose, especially on non-family, so this is of limited use for things like oncology appointments.

There are all sorts of family and personal dynamics here.  The two brothers who live closest also get along the worst.  And I think they're going to take it the hardest when Mom goes.  They disagree on every possible aspect of how/where/if Mom should be treated - it's her decision, but her decision ended up being influenced more by their anger at each other than by what was best for Mom, which strikes me as being Very Wrong.  Hurtful things have been said, between brothers and others; grudges are being held.  The brothers won't talk to each other...

...Which is why I've taken over the scheduling for oncology appointment coverage.  I handed it off to the in-town family for the winter, but they completely dropped the ball in January.  If they had thought things through a little more, or contacted me (which I had requested if there was any sort of problem), or if next-nearest sibling had stopped to think instead of jumping to conclusions about the request for help with transportation, then we would have been fine.

Instead, the January appointment was missed.  It would have been the first check of the usefulness of her latest med - which we all suspect is not working.  Re-scheduling - which should have gone through me if it had to happen at all - was left to Mom (who hates to deal with such things).  In the end, the appointment was re-scheduled to early March.  For stage 4 cancer, a six week delay is huge.

As a general rule, I've liked and respected all of my siblings, in the past.  And it is my natural tendency to give people the benefit of the doubt - the main reason I'm still on speaking terms with all the siblings.  But this is trying every ounce of my patience.  The times when the brothers really blew up at each other have been very stressful for Mom; that is a distraction that we could have spared her.

I can't reason with the brothers; things are too entrenched.  My primary goal is to try and avoid major incidents for the time Mom has left.  That means I will say thank you when they help, I will try to stay on everyone's good side so there's at least one person who can act as go-between when needed, and I will not rely on them for anything.

Housemate is coming down with a cold, and I do not want to deal with trying to find someone else to cover the already-delayed appointment - the scheduling is awkward, and I really want to be there to talk over a few hundred things with Mom and her oncologist (who is also a treasure, and greatly appreciates Mom and her outlook).  So, for the next few weeks I'll be loading up on every potential immune-system support I can think of.  And cleaning the remote control, and feeding housemate homemade chicken soup.



The last year+ have been the easy part; the hard part is still to come.  I am pessimistic that my brothers will set aside their differences long enough to see Mom out properly.  I'm considering my options for when we get closer to the end of this horrible trip:  weekdays there and weekends at home, perhaps (with sister or someone taking over on weekends); housemate can cat-sit (Picasso will pine, so I'll spend my days at home with a cat permanently attached to me), and boss has already been warned and will be very helpful, and there are even plenty of work-related tasks I can do from the road.

The only silver lining here is that I will spend more time with Mom than I otherwise would have.  Once she's gone, there will still be things I wish I'd said or done - it's inevitable and unrepairable; all you can do is prepare, minimize, and cope.  Are my brothers completely unaware of the regret they will feel later, or are they immune to it?

After she's gone...we'll see.  Part of me wants to say every bitter thing I've forced back down my throat in the last year+.  The rest of me knows that, at that point, it would only permanently break the family, and that seems counter to what Mom would want. 

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