Forgetting How to Die 

Because hospitals treat death as a failure of modern medicine, Felicidad Gomez couldn't die with the dignity she deserved.

There's a five-foot-tall altar in the living room of Portia Jocson's Fremont home. A line of devotional candlesticks stands guard before a statue of Our Lady of Lourdes, clothed in a powder-blue robe and topped with a crown. Looming above the Madonna and a host of rosaries, a three-foot infant Christ dominates the centerpiece, a ruby lamé gown hanging from its body. Sitting at the dining-room table, almost in the shadow of her Redeemer, Jocson weeps for her mother: "She was our rock. She held us together, she taught us to be dignified. She taught us to live, to be happy people."

Jocson's mother, Felicidad Gomez, had an ironclad will to survive and sacrifice for her family. In the Philippines, despite her limited education, she had taught her own parents to read and write. Then in 1970, Gomez fled the regime of Ferdinand Marcos, along with her husband and four of her six children. Within a year, her husband was dead, and she found herself in a foreign land with a fifth-grade education and barely any command of English. So Gomez set out to build a new life for herself. She spent years on the swing shift caring for the elderly at an Oakland rest home, and relentlessly instilled an immigrant work ethic, the value of education, and a tenacious family loyalty in her children, who include two doctors, a nurse, and an Intel engineer. After years of struggle, Gomez spent her retirement babysitting and cooking elaborate sausage dishes for her 30 grandchildren and 27 great-grandchildren, moving from the house of one child to the next every few months, filling their kitchens with the smell of roast pork.

Years ago, back in her ancestral village of Hagonoy, Gomez' family donated the land on which the local church now stands. This year, her family financed Hagonoy's festival of Our Lady of Lourdes, and in February, Felicidad Gomez led 28 members of her clan back to the village for the month-long fiesta, at the end of which she promised to sponsor the 2010 festival. On March 5, Ash Wednesday, Gomez flew back to Union City. On March 7, she celebrated her 79th birthday with a surprise party.

The stroke hit Gomez March 8 while she sat with her friends at the mah-jongg table.

She was rushed to the intensive care unit at Fremont's Washington Hospital. And here, her daughter says, is where her dignity ended. Jocson has worked as a Kaiser nurse for 25 years, and her brother Reynaldo Torres is a local doctor, so the numerous complaints they leveled in a recent letter to the hospital's administration carry a little more weight than those of the average citizen. According to the letter, Washington nurses and physicians repeatedly expressed contempt and insensitivity toward the grieving family, casually dismissing their plaintive appeals and treating their mother like an inconvenience. When Jocson asked a nurse to improve her mother's blood pressure with medication, the nurse replied that the attending physician said he "does not have time to deal with this crap." When Gomez was finally declared brain-dead, the neurophysician gave the family the news by striding into a waiting room -- filled with young children whom the family had spared information about their grandmother's true condition -- and proclaiming it to the rafters. When one of Gomez' granddaughters was holding her hand and speaking what comfort she could summon, a nurse sauntered by and, according to the letter, "told her it was useless since she was already dead." The granddaughter burst into tears and fled the room.

But it was when the family tried to say goodbye to their matriarch that Jocson claims the hospital staff was at its worst. Dozens of family members were stuck in the Philippines, cleaning up after the festival. When Washington doctors said that there was no hope of recovery, Jocson asked them to keep her mother on life support for 36 more hours, while the family assembled for the last rites. One nurse, Jocson claims, grumbled that "the hospital does not take care of dead people," but said he'd think about it. The next day, as aunts, uncles, and grandchildren crowded into airport terminals on the other side of the world, hospital staff announced that Gomez' ventilator would be shut off at the end of the day shift. Jocson had planned for a San Francisco priest who had grown up in her mother's village to conduct the sacrament; now she couldn't even find a Catholic hospital chaplain. What family there was gathered at Gomez' bedside, silently murmuring their prayers. Five minutes into the last prayer they would ever say for their mother while she breathed, a nurse walked into the room, surgical gloves and instruments at hand, ready to pull the plug.

"It was not money that she had given to us," Jocson says of her mother. "It was herself that she gave to us. It's her services, her love, her care, her wisdom, everything. And no money in this world can buy it. So for me, in the last time in her life, she cannot even be given the last rites ... it was too callous, too cold. Being on the other side of providing care, and being the receiver of the care, it is a very humbling experience. I thought to myself, 'God, I hope I didn't do that to people throughout my career.'"

Due to regulations that protect patient confidentiality, hospital spokesman Chip Brown won't comment directly on the case of Felicidad Gomez. He can only point to his hospital's brain-death guidelines, which stipulate that "except ... for unusual humanitarian reasons, all forms of medical intervention (e.g., intravenous lines, ventilator, and so forth) should be removed after the physician has pronounced the patient dead." But just what constitutes an "unusual humanitarian reason" will always be an unanswerable question, as are most of the unpleasant issues inherent in palliative care. Was the Gomez family's request for a little more time really that unreasonable? Or is there something ghoulish about keeping a brain-dead woman's heart beating so her family can be nearby when it finally stops? In a region such as the Bay Area, which grows more diverse by the day, what should a hospital do to accommodate the panoply of mortuary rituals and religious beliefs of its grieving clients?

Unfortunately, the East Bay's medical establishment cannot begin to tackle these questions. Not because they cannot be answered, but because modern medicine has become so adept at prolonging our lives that it has put aside all questions of how to make our inevitable deaths meaningful.


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