To End or Not to End
written by: Rashmi Luthra
Ahead of me was a task so terrible its anticipation had shifted my ground. So intimate that I had to do it alone. I drove to the hospital in a near trance, took the elevator to the floor where my father lay intubated.
The night before, the doctor had been direct, but gentle in the conference room at the hospital. A kind of room for business decisions, not for decisions of life and death. “Even if he lives, he will be like a vegetable. His brain was deprived of oxygen for too long when he aspirated. Think about it and let me know when you’re ready.” Ready? I would never be ready. Is one ever ready to stick a knife into one’s heart? A choice that was not a choice.
I couldn’t change the fate of being out of town for his last natural breath, but I could send him off personally. The least I could do for a father who had lived for his children.
In the room now, I approached the hospital bed as one would a temple. Papa, still tethered to drips, still breathing through a tube, the monitor still beeping news of his heartbeat. But still Papa, his eyes open as if to see me, even though vacant. Did he see me? Yes. Why else would the EMS have brought his pulse back?
I caressed his forehead, then left to find the attending physician. “I’m Mr. Lal’s daughter. I would like the process to begin.” He filled in the blanks, having been at the family meeting the night before. He knew the decision was mine alone, an only child, a mother with dementia.
By my father’s side again, I thirsted for a long, last look at a face that had been full of light, at his impossibly thick eyebrows, the sharp nose and ample lips, the golden-brown skin supple for a bit. I leaned over and breathed into his ear, “Papa, you can leave now. I’ll be fine. I love you so much. Bye, Papa,” putting on my best act. Asking him to leave this earth from a Midwestern U.S. town, so far from his history, his heart place, India.
A moment too soon, the nurses entered and removed the tube. He gasped for air at first, then started to breathe on his own. Each beep reassured me. “He is here, he is with me.” Within minutes the beeps fell into a flat line, its nothingness echoing the void inside. I slumped into a nearby chair, the anticipation giving way to an exhaustion so big I didn’t think I would get up again.
***
She refused the homemade chicken and the McDonald’s burger. She had stopped sleeping in her kennel, instead preferring to press against us in bed to get relief from the pain the swollen lymph nodes in her throat were causing. She had lost weight no matter how much I fussed over her food. But this was new.
The evening her legs gave way, I panicked. I called the vet, not wanting to hear the verdict. “If she’s refusing food, it’s time.”
“Couldn’t I try feeding her with my own hands? Couldn’t I try more tempting treats?” I knew the answer before it came.
Resigned, I gathered Fiorina’s fluffy whiteness in my lap. I asked my husband to drive, wanting to feel her as long as I could. I planted kisses on the way. “Thank you, sweetie. When the kids left home, walking you was my solace. When Papa left, I held you tight all day.”
We entered the clinic. I gave the word to the receptionist. The paperwork was done. “Would you like to be with her?” I stepped inside wordlessly.
Disbelieving, I focused on the shot that began the process. She kept her gaze on me, not knowing what was to come. I held her until stillness, then a bit longer, reluctant to relinquish her. We left with a cupful of ashes. Silence filled the journey home. That night we drowned in each other’s tears, not able to hold her tight.
***
She never liked a hubbub. She even had her own name for it, “rush and hurry.”
And rushed she had not been. My mother had ridden dementia for fifteen years. She had walloped anemia and hypertension. She had even thrown the middle finger at dysphagia, not having had a sip of water for five years. She had wrestled skin wounds. She had been in home hospice for two years and counting. She had lulled me into thinking she would beat death itself.
She met her match from a fall in the shower and a wound that refused to heal. Dr. Sheck had always struck a positive note, but that day he switched hats to become the bearer of bad news. “The skin is sometimes the first organ to fail. The others will follow.” I heard but didn’t really.
“But we will do wound care, right?” He had never shaken his head like this before. A foreboding began to take hold in a corner of my mind.
I had ached for relief. I had witnessed Alzheimer’s slow but calculated theft of her magic touch in the kitchen, her industriousness, her resourcefulness, and finally her speech. First English, then Hindi, then even the native Punjabi, they all fled my mother’s tongue. I recalled her indulgence of my daughter, making an I Dream of Jeannie costume a day before Halloween to grant a last-minute wish. I remembered the individual caps for each toe she knitted for me, anticipating a long walk in the bitter cold.
I seesawed between wishing for the losses to stop and wanting to hold on to her presence, however diminished.
Dr. Sheck tilted the seesaw. “I think it’s time to start the process.”
The vigil began. I followed the morphine regimen to a T, charting doses meticulously. The steady rhythm of doses reduced the enormity of delivering my mother to death. I focused on the symmetry–mother tends to child, child tends to mother. I rested my eyes on her beautifully proportioned features, marveling that even then her beauty could not be stolen. A beauty of body and spirit I wanted to behold intensely. Soon it would be gone.
Every afternoon the hospice nurse announced the end. Every morning my mother defied prediction. Fifteen years of dementia. Now ten days without food and fluids. A marathoner, my mom.
All marathons must end, and on the tenth day, as I prepared yet another morphine dose late at night and returned from the kitchen to administer it, I noticed the stillness in her neck.
I shut off the lights, briefly shielding myself from the finality of the moment. I knelt and pleaded with the darkness. “Never again let me decide.”
- To End or Not to End - September 7, 2026
