'A person should be allowed to die' Surgery's aftermath raises painful issue

November 30, 1991|By Mary Knudson

Lucille Melinda Tabor is lying motionless in a room at the Deaton Hospital and Medical Center in South Baltimore today. She grimaces at times and, during one recent visit, she looked for all the world like she was crying hard, but there was no sound except for a gurgle from her throat.

A pat on the arm and she stopped her heaving motions, closed her mouth, opened her eyes and looked at the visitor.

That was it. That is all she will do. She doesn't indicate whether she hears what visitors say or whether she recognizes staff or family. A feeding tube going directly into her stomach artificially sustains her. A nurse came in to suction the gurgling tracheostomy -- the opening in her neck to her windpipe -- and connect a supply of moist oxygen to help her breathe better.

"We don't know whether she feels uncomfortable or not, so we try to keep her comfortable," a nurse said in the hallway just outside her door.

She arrived at Deaton with the neurological diagnosis of persistent vegetative state, which means she has no ability to recognize or respond to surroundings, but could make some reflex actions, said Dr. Herbert L. Muncie Jr., Deaton's medical director. But "there's no objective way of knowing for sure what is going on," he said, adding that he, too, has seen her appear to "cry out."

This is life for Lucille Tabor, day after day after day, for almost three years now.

On Jan. 13, 1989, Mrs. Tabor, then 36, mother of a 16-year-old son, underwent surgery at University of Maryland Medical Center for a large brain aneurysm, an operation from which she never awoke but never died.

Her stunned family was thrown into the vise of a perpetual wake. A week ago, in the living room of their big yellow farmhouse in the foothills of Westminster, four family members -- mother, sister, nephew, son -- sat somberly talking about the pain they carry around inside.

"We live with death," says Mrs. Tabor's sister, Linda Chaney, breaking down into sobs. "There's no life. A person should be allowed to die. If it were years and years ago, before a doctor knew how to stick that feeding tube in her, she would have died.

"Sometimes," she pauses, then adds in a near whisper, "we go too far."

The farmhouse is full of memories of the real Lucille Tabor. "Littlebit," was her nickname because she was so small -- 4-foot-8, about 105 pounds. A picture of her in a wedding party shows her in happy times, with eyes sparkling. She liked to wear her black hair short and curled, and counted among her best friends dogs, cats, farm animals and children.

She was also a central member of a large, loving family. She lived next door to her mother in the yellow farmhouse duplex that sits at the foot of a winding dirt road. She loved to take walks on the 10-acre farm, but her family says she quickly ran out of energy.

As a girl she would come right home from school and go to sleep, remembers her mother, Hazel Scuikas. "She'd say, 'Mommy, why do I do like I do? Why can't I be like Linda [her more active sister]?' " Mrs. Scuikas says. "We never pushed her into any housework" because of her frailty. Family members now believe her energy was depleted by the brain aneurysm she unknowingly grew up with.

By the time Mrs. Tabor submitted to surgery, the aneurysm had dangerously ballooned out the wall of a blood vessel beneath her brain stem and was threatening to rupture and kill her. Already it was interfering with her movement, causing her to drop things on the floor and drag one leg as she walked.

Everybody knew the surgery was a gamble, and Mrs. Chaney says they were prepared for a 50-50 chance of success or death. Mrs. Tabor discussed with her family plans for cremation and services in the event that death won out.

But the family was not prepared for limbo between death and life.

Neither Mrs. Tabor nor her family talked about whether she would want to live on a respirator or by means of a feeding tube in the event science and nature collided to leave her on the brink of the living. Mrs. Chaney said no doctors or hospital staff members told Mrs. Tabor or her family about a living will or durable power of attorney for health -- documents that declare a patient's wishes about artificially prolonging his life.

"We went home happy"

After the operation, "they told us she had pulled through fine," her sister says. "We went home happy." The next morning at 5 a.m. she called to check on her sister and was told, "We can't get your sister to wake up."

A blood vessel still attached to the aneurysm had filled it with blood again so that it pressed against the brain stem and crushed it.

Attempts at reviving and rehabilitating her failed, and the family watched days become months and months turn into years.

They brought her home for Christmas once since she slipped into the coma, Mrs. Chaney says, hoping that "maybe she would respond to something she was familiar with." It was a bitter disappointment. "There was no response."

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