You tell me how you feel after reading this:

This doesn’t include all the details, but does provide you with the truthful experience I had with my mother-in-law while she was in Swedish and the incredibly irresponsible manner they communicated with her surviving spouse about her death. 

Monday: I was at home when my father-in-law called me asking to take her to hospital as she hadn't been able to drink water or eat for more than two days.  I called her hospice nurse who met me at their apartment and agreed I should take her to the ER.  I knew she'd seen her oncologist more than a week earlier and she was told she would be getting a procedure done to help her swallow.  The hospice nurse told me likely this just will move the process forward.

At the ER, my mother-in-law was seen by the triage nurse within five minutes.   We explained her symptoms, that she was in hospice but her oncologist had ordered a procedure to help her swallow.  The triage nurse told my mother-in-law she would be called.  She and I went and found a place to sit.   She was not brought back into ER for more than four and a half hours.  The entire ER waiting room emptied twice while she waited.  I asked, then finally demanded, she be seen.  By the time she was taken, she had been lying on the couch with a blanket over her.  As I helped her sit up, she rightfully stated somehow every other person, two times over, had problems more important than hers, it seemed.

The initial nurse who took her back apologized to her and my mother-in-law meekly smiled, saying thank you in English.  My mother-in-law repeated, through a translator, her symptoms, and her oncologist telling her about a stent.  Tests were ordered and she remained on a gurney.  She went for a CT.  The ER doctor told her she would be admitted and given a stent to help her swallow and eat.  She was put on an IV.  That was 1:30 am.  I took a selfie of us to send to her son in China. 

She went to room 1041.  I went home.

Tuesday:  I went in about 9am the next morning. I was told by the nurse there was an issue getting onto the schedule for a stent and this might not happen for a day or two.  In the meantime, she was given pain medication and broth. 

It is important to note two things about her room.  The 10th floor is for surgery recovery.  Thus, she was in a room where the set up is for dealing with post-surgery needs.  Room 1041 is also the first patient room on the floor located directly across from and within view of the nurses station.

Her spirit was strong and she was trying to drink the soup to regain some strength.  She and I were both surprised she was able to swallow without vomiting.  She felt great relief at this and expressed hope to get this surgery Dr. Goularrte, her oncologist, had told her about.  That morning, a physician assistant came and explained about the surgery and the delay.  I was not there and a translator was used. 

On Tuesday afternoon, I asked to speak to the surgeon to ask questions.  The physician assistant came.  She was curt and matter of fact about the procedure.  She did explain that the scope they performed determined there was room to place the stent and it should make a difference.  She would likely go home the next day following the procedure assuming her progression from liquid to solid foods went well.    At that juncture I was not made aware that the stent may be temporary – just a stretcher to open the esophagus, then be removed. 

Wednesday: Waiting day.  Same protocol.  I was there in the morning for a couple of hours and returned in the evening  with two of her grandsons.  She also called her husband earlier in the day with the help of the aide who spoke Chinese.  The aide reported to the nurse and me what a bright spirit she had. 

The aide never worked with her again. 

Her husband never spoke with her again. 

During the call Wednesday, her husband said they talked about the surgery and the likelihood of her going home shortly after surgery, hopefully Friday.  She had recently spent $4000 on a two-month supply of an herbal supplement reported in Chinese papers to cure some cancers.  She asked him if the order had arrived.  He told her it had and he said she said "great."

Coincidentally, she asked her son and I to spend $4000 for the same pills, which, despite our strong objection, did.  In this family, money is saved and never spent…seriously.  The fact is she did this and she would not have done so without hope and belief of it working. 

Thursday: Surgery.  I was there during pre-op and post-op.  She was happy to be going for surgery and had great spirits, even smiling.  After, she was of course not smiling.  She was out of it and then emerging into pain. 

She was given pain management to help her relax and heal. She was getting up and walking around the room and was repeatedly told by nurses to not get up without calling for help.  I reiterated this to her.  She was bored and she was willful. 

Friday: I asked to speak to the surgeon, whom I had yet to meet.   The same physician assistant came.  The assistant said her pain was expected and hospital would be managing it.  She expressed that given the strength of her pain, the stent may be coming out and while with us, she checked the surgical note to see the doctor’s plans.  She said there wasn’t any notation and would get back to us.

She never did.  I never learned if it was coming out.  I have no idea if my mother-in-law was ever told.

She was given only broth Friday and she complained of pain.  She had eaten no food 1-2 days prior to coming into Swedish and received no additional nutritional food since the previous Saturday.   They increased her pain medication.  When she had to go to the bathroom, she was told to call a nurse for help.  She was fairly defiant about this and one of the nurses told me they found her trying to go by herself and chastised her.   I also told my mother it was for safety and to follow the nurses; they would come help her so she wouldn't fall and make her stent worse.

Friday evening came and she was out of it – either from pain or pain medicine.  I asked her if she saw the doctor and she said "No, of course not.  It is the weekend.  No doctors come on the weekend."  I brought her youngest grandson with me and she acknowledged him and asked him to come to her.  It was disturbing for him to see her so weak as she was normally a triumphant, boisterous presence.  Still, he sweetly climbed into her bed, half snuggled with her and we stayed maybe 20 minutes. 

I spoke to the nurse about what I was seeing – her persisting pain and not progressing to solids as was the regiment.  She looked in the notes to see if the surgeon had noted whether the stent was coming out.  She said nothing was noted.  I asked her if the doctor had been back to see her.  She said yes.   She said the pain was normal and she might go home the next day.  I passed on this information to her husband and told him then if he wanted I could bring him Sunday if she didn’t come home as I had a family conflict Saturday. 

Saturday: I couldn’t get to the hospital during the day as I had commitments with my kids.  I did get in about 4pm.  When I arrived, I stopped at the nurses’ station and said I wanted to speak with her nurse.  I then went into the room.  She said she was hungry.  An aide came in almost the same time and I asked her if my mother could have food.  She said food had been ordered and should be there soon.  I translated this.  I asked her how she was doing.  I didn’t know how to ask her if the stent was coming out or staying in.  I tried but was unsuccessful lacking important words and for whatever reason, Wi-Fi didn’t work in her room, which would have allowed me to look up the words online.   A hospital aide was in the room cleaning out the trash when the lunch was brought in.  I set up her tray and saw she was given congee with small bits of mushroom.  I ask the aide, "Is my mother-in-law already on solids?" I wondered what might have happened at breakfast and lunch for this progression.  The aide told me she didn’t know and I expressed my concern asking, "Shouldn’t somebody know?"  She said I could call the food department to find out.  She gave me the number and I called.  The person on the other end apologized saying they did in fact send up the wrong food.  I told my mother and she then requested two bowls of chicken soup. 

When the food came, she sat up and looked at the bowls.  The bullion was sitting at the bottom of the bowl and she said, "See, it is the weekend. See, no one cares."  I told her I was not happy the nurse hadn’t come yet.  She said, "It is the weekend. No one comes."  This had been a pattern all week.  

I stayed for maybe an hour then needed to get home to make dinner for my three sons.  This is one of those moments that haunts me.  Before I left, when talking about that lack of attention, I was feeling like I wanted to go complain.  But, I also wanted to make sure I had a nursing staff that was kind to my mother-in-law and had this belief that kindness draws more than anger. 

WRONG!

I said goodbye to my mother-in-law, gave her a hug and kiss on the forehead.  I went to her whiteboard and drew a red heart by my name and told her I’d see her later, but was not sure if I would be back the same night.

I stopped at the desk across the hall and told the same receptionist who took my earlier unmet request to speak to the nurse and said, “I know that I asked to speak to a nurse.  She never came.  It is okay, though. I need to go.  She just had two bowls of soup and may want more in an hour."

Those were the last words I said in hospital while she was alive.

When I arrived home, I decided to cook burgers on the grill.  It was a nice day with the sun still warm so I made myself a tall, iced Cape Codder and put on some jazz while I sat outside on the patio.  I went back in to get a serving plate when I saw my phone screen indicate I had three missed calls, two from a Seattle number I didn’t recognize.  I saw I had one voicemail.  I called my voicemail.

“This is Dr. Wong. Please call me.  I have urgent news regarding Han Zhen Liu.”

I heard the calm message and thought, "Finally the GI surgeon is calling me to talk about the stent staying in or coming out.  Her pain does seem higher than it should be and this must be to discuss game plan."

I called Dr Wong and after she said hello, I started in saying.  “Thank you for calling. Is this regarding her stent? I have been asking to speak to her surgeon."

She interrupted and said, ‘Sorry, no.  I have some grave news.  Your mother-in-law has died.  She hung herself.’

Time does stand still at these moments.  Am I breathing?  Am I holding the phone?   I looked around for some virtual witness to this incomprehensible statement.  No one.  Still, mute and feeling numb, I walked out into my back patio, staring at the billowing smoke coming out of the grill and said, "Sorry, I can’t talk." 

She said she understood.  I said  “What happened?” 

Dr Wang said in the same calm voice, “She was found hanging in the bathroom.”  Another punch.  I swallowed, looked out to find the farthest point I could see.

My response was not calm.  “Doctor.  Please don’t call my father-in-law.  He is old, lives alone, and has a bad heart."

Dr Wang, yielding nothing:“Okay, we will keep that in mind.” 

“I need to hang up and go to him.” My goodbye explained.

“Of course.”

I hung up and as I did, I saw a new voicemail message pop in.  My call log showed Baba was the caller.  Shit, Shit, Shit…..

I called my voicemail.  I heard my father-in-law almost screaming, crying, "Mama’s dead, mamas dead, mamas dead" over and over.  Then an assertive "Call little Tien." – and him hanging up. 

As soon as I heard him hang up, my phone rang with another Seattle number I didn’t recognize.

“Hello”  I said.

A female voice, also calm, "Is this Diane Tien?"

"Yes."   My mind was taffy and I was pulled to listen on the phone to a new voice. 

It was a woman and she told me her name and that she was the medical examiner. Then she said,  “I need you to come in and verify the body.  I am working and will be here another 30 minutes.”

“Umm, okay.”  I felt like a preschooler being told where to walk for lunch. “I will leave now.  I am about fifteen minutes away.”

Not fully processing anything, I knew I needed to leave quickly.  

I walked upstairs to my oldest son’s room.  “Son, I have some awful news to share.  Please know there is no easy way to say this.  Your grandmother passed away.  The hospital just called.  I need to go in and deal with a number of things and help Yeh Yeh.  I may not be home for a long time.  Can you finish serving dinner?  I'm not telling your brothers yet as I have to rush out.  I'm only telling you what is happening as I know you can handle it and I need your help.  Is this okay?”

My son said "Of course, no problem.  I am sorry, Mom.”   Blessed...

As I drove off my phone rang. It was the medical examiner asking,  “Are you on your way?”  

“Yes, I had to tell my oldest son to watch over his younger brothers.  I should be there soon,”  I said.

“Okay, I am done here and my shift ends at 10.  If you can not get here by then, it is okay.”  She ended with a softer tone.

My mind was racing.  I had no effing idea what she was doing. What would the medical examiner be doing? Was this CSI? 

I asked, “Was she hanging off the ground?”

“Yes, I was told it took four people to get her down.  They attempted to resuscitate her.”

“Okay, Okay,”  I said.  I thought, "Shut up."  Oh my God. I hung up.

I was now mid-span on the I-90 floating bridge with an ascending tail of red lights in front of me. I called my best friend Sandra. She said she was sorry, then as I talked and explained the confusion, she shouted at me through my speakers.  “Diane, do not go to the hospital.  You need to go to the living.  Your father-in-law needs you.  He is likely going to kill himself.  You need to go to him.”

Shit, I did not think of this.  “Yes, yes, of course,”  I said softly and told her I needed to hang up.  

His apartment was 10 minutes away.  I parked illegally and put my hazards on.  Forget the ticket.  I rang his doorbell.  No answer.  He's old and took a while so I called his phone.  No answer.  I tried for 5 minutes when my phone rang.  It was the medical examiner.  I recognized her number.   Before she talks, I said “I am at my father-in-law's.  I can not get there yet.  I need to make sure he is okay."

“Of course. Be where you need to be.  You do not have to come here.  I have to leave, however,”  She said with a kind, calm voice.  

I felt sick.  I wondered if I had dropped another ball, let the family down -- again.  I knew I couldn’t be in both places.  I hung my hope onto her last words:  "I will call you in the morning about 10am."

Jesus help me. 

I rang my father-in-law's phone and also the doorbell.  Nothing. 

I walked in circles in front of his apartment and hoped for a resident to come or go.  It was now 10:15pm and as he lived in a public elderly apartment building, the place was buttoned up.

I was still panicked and feared he had killed himself.  Then I remembered her keys!!!  Her keys were on her pants in the hospital.  The hospital was 5 minutes away.  I hopped in my car and called Dr. Wang to help me get her keys and mentioned the possible suicide of her husband.  I parked illegally in front of the hospital and took the elevator to the 10th floor.

Room 1041 was visible as soon as you entered the floor.  Her door was closed and there was a lunch cart, covered with a white tablecloth.  On top was a basket of plastic wrapped crackers and cookies and water bottles.  It looked like room service at a hotel.  I stared at this surreal visual representation of what happened.  I wanted to run in, swing door open but know I missed her, imagined a messy scene and literally shook my head to find my thoughts for why I came.

I needed her keys.  I went to the same desk and two different people were sitting there.  I told them I needed her keys.  They didn’t seem to know of keys but said they had her things for me.  They told me to come around, into the interior of the floor, which felt odd.   I saw her plastic personal belongings bag and opened it and heard sounds coming from the two women but didn't respond.   I found her long string with key and access card tied onto her pants belt loop.  I fiddled to get it off her belt loop as a woman walked up to me.

“Ms. Tien, I am Dr. Wang.  May I speak with you for a moment?” she said.

Preschooler mode.  “Ok, just a minute, I need to go.”  We went to a nearby conference room and she offered me a bottle of water like ones in front of room 1041.  “No thanks.”

“How are you?” she asked.

Alive is what I want to say.  “Not great.  I need to get to my father-in-law.”

“Do you have any idea why she did this?” she asked.

“Yes!, I do. I know why." I started to talk and each word tumbled out.  “She was treated poorly, worse over time and said to me yesterday and today, “Nobody cares. It is the weekend."  She saw me react repeatedly when I asked to see the doctor and no doctor came.  She is a scientist, a bright woman, and only the physician assistant came and didn’t have all the answers."  I knew I could go on and on and on but felt a surge of pain in my head and stopped.

“I need to go to my father-in-law.’  Then I shifted and said, "I need to speak to the translator.  I need to know exactly what he was told.’

Dr Wang looked at me calmly, “I know what he was told.  He was told, "Mr. Tien, your wife was recovering but I am sorry to say she hung herself.""

I couldn’t believe this.  I mean, I felt like I plummeted down the ten floors in that instant hearing this was the message conveyed to him.  I looked directly into Dr. Wangs’ eyes to cut through the painful details to the core of my worry.  “Do you know he is 90?  Do you know he lives alone, has a bad heart, has been married to her over 60 years?  I can not believe this is what he was told.”   I didn’t wait for any reply.  I got up and said “I need to go.”

“Of course," she replied.

As I got up to leave the room, a tall man dressed in a suit opened door to enter.  Dr. Wang introduced him as the Chief Medical Officer.

“Hi. I have to go to my father-in-law.  I don’t have time to talk to you, " I said, barely stopping my pace.

He said, ‘If you have any questions, call me."

I started walking to the elevators.  My entire body was shaking like a plastic anatomical skeleton with frayed rubber joints.  I pressed the down button and then, still shaking turned around.

I rushed back to the conference room where the man in the suit and Dr. Wang were sitting.  I opened door and said, “Excuse me, I do have a question. Is it your policy, your protocol, to call the spouse of more than 60 years, an elderly man who lives alone, and tell him over the phone his wife hung herself? It is my name on her board to call for all questions, issues.  I am her proxy.  I have been here every day.  Is this your policy?”

He said, “No, I am sorry this happened.  I don’t know."  He told me it had never happened in all the years he had been at Swedish.  He fumbled in his wallet and pulled out a card, took out a pen and wrote a number on it.  “This is my number, please call me at any time, with any questions.”

I left, and ran as I thought I wasted extra time to satisfy my anger.  I drove to my father-in-law's and used her keys.  I entered the apartment and called out to Baba with a gentle voice.

He was sitting at his seat at the table.  His face was swollen, his eyes completely shut.  He didn’t get up, didn’t say anything.  His sweatshirt had a whitish liquid on it.  I walked quietly to him, deeply warmed to see him alive and said, “Baba, Baba...”  I hugged him.  He didn’t hug me back.   I let go and sat across from him.

He finally said, “Did you call my son?”

The truth was, I had been in a constant panic and had only called his son, my ex-husband, once on the way to Seattle and didn't get through. 

I sat and opened my email and sent his son a message to call me.  It was urgent.

I called his son's two cell phones and told him to call his father’s home.  I sent another message 10 minutes later saying it was regarding his mother.  It was Sunday morning in Beijing.  My ex typically sleeps in as he is often out very, very late on Saturdays.

I sat with Baba.  I brought him some hot water and asked him to drink it.   He wouldn’t.  I sat back down and he asked me every 15 minutes if I had called his son. Each time, I replied, “Yes, he will call as soon as he hears the message.”

Finally about 2 AM, his son called.  He was driving.  I told him I need to talk to him when he had pulled over,. I told him I would wait.  He did. “I am going to tell you some really hard news.  I am sorry, truly sorry.  I'm at your Dad's right now.  Your Mom died last evening."  Like me earlier, he was silent, not responding but I could hear him breathing.  I waited for him to speak.  He didn’t, so I said, “Are you okay?” 

“Yes” He answered softly.  “What happened?  I thought she was coming home?” 

“This is really hard and I don’t know any details yet.  Your Mom hung herself in the hospital.”

“What?” he shot back.

“Yes, I know.  I don’t understand.  I saw her this evening, less than two hours before.  I learned the news and have been focused on your Dad.   He isn't well.  He was told what happened over the phone, before me, and before I could reach him.  He's in shock.  Do you want to talk to him?”

“Yes, but first, what do you know?” 

I told my ex-husband everything I knew.  My father-in-law never looked up, never asked for the phone.  I handed the phone to him.  The father sat listening, talking a little with tears streaming down from his eyes and both nostrils.  He pushed away a cloth.  He was drooling, his nose dripping.  They talked for more than an hour.  The father seemed to be just listening for a while and then I wondered if his son was still on phone.   Finally, he said his son wanted to talk to me.

My ex asked a few more questions and said he wasn’t sure when he could fly out.  He talked about later in the month.  I said, “No, you need to come. I'm seriously worried about your Dad.”  He said he would get on a standby flight, thinking he would be there Friday or Saturday – 6-7 days later. 

I told my father-in-law to go to bed, rest.  I told him I was going to sleep on the couch.  He said he would not go to bed until I left.  The battle began.  I won, put him to bed about 4am.  I went to sleep on the couch.

My ex arrived that Friday.  My oldest son and I stayed and watched over my father-in-law until his son arrived.  His social worker came to help.  He wanted to be left alone except for his aides to help cook.  It was a harrowing week until his son came.  We hardly spoke and yet I refused to relent my vigil to ensure he was okay. 

During all of this, Swedish had recently launched a major media campaign titled, "Extraordinary Care, Extraordinarily Caring."  Bus signs, 25-foot-high signs on front of the hospital which I saw for the first time en route to the funeral parlor.  Every elevator, every satellite office had these plaques with those words, this promise.   It was like a constant drumbeat of pain – they are still up to this day.