Letting her go, planning ahead

Carol McConnell was department manager of Danbury Hospital's emergency room in Connecticut. She was a gregarious, outspoken, self-reliant woman who was devoted to her kids, daughter Kathie remembers. "She was always there for us."

But in January 1985, a car accident left Carol comatose with severe brain injuries. Her family was stunned, as were the colleagues who treated the well-liked nurse when she arrived at the hospital by ambulance that day. They performed surgery to save their co-worker, who was in her early 50s.

Kathie, who was in her late 20s at the time, recalls seeing her mom in the recovery room, wrapped in bandages. "I kept thinking, 'Where is she? My feeling was that she was sort of stuck between life and death."

Carol was eventually moved to a nursing home. Although breathing on her own, she was considered to be in a "persistent vegetative state" with no chance of recovery.

Convinced that Carol would not want to live that way, her husband and three adult children sought to have the feeding tube keeping her alive removed. Her doctors supported this step, but the nursing home administration opposed it, and a protracted legal battle began. Carol did not have a living will, but she had often expressed her wishes to avoid being placed on artificial life support systems.

My cousin, Stephen A. Wise, represented the McConnell family in a lawsuit challenging the nursing home's decision. The case eventually went to the Connecticut Supreme Court, which sided with the family and allowed the tube's removal. Stephen is a longtime advocate of the right to die and of living wills, which outline individuals' preferences for medical care if they become terminally ill.

Kathie moved her mother to the family's country home, a quiet setting on a dirt road. "I wanted her to get her dignity back and have a peaceful death," Kathie told me in a telephone interview not too long ago. In addition to having round-the-clock nursing care, "she was clean, and her hair smelled good, and there were flowers in her room and soft music playing." Kathie said her mother did not suffer physically during that time.

After about 14 days at home, Carol passed away. It was February 1989 -- four years after the accident and the anguish that it caused. "It was a relief to let her go and to know she was at peace," Kathie told me. "That was my goodbye."

It has been almost 20 years since her mom's death, and Kathie still misses her terribly. "It was a huge loss for us," she says. "She was the glue that held us together. ... We lost the feeling of being safe and accepted no matter what." But Katie believes that going to court was carrying out her mom's wishes, and that helps soothe her pain.

She's also comforted knowing that Carol is still remembered at Danbury Hospital. "One of my sons had to have emergency knee surgery there over Christmas break," Kathie wrote to me recently. "There were a couple of nurses still there who knew my mother, and they had so many wonderful things to say about her. It was really special to have my son hear about his grandmother. I feel so sad that my sons never knew her and that she never had the experience of knowing them."

Consider this . . .

Saying goodbye can mean letting someone go.

Discuss and document your wishes for medical care if you're facing a terminal situation. This includes preparing a living will and designating a health care proxy to make medical decisions if you can no longer make them yourself; these are often called "advance directives." Here is some information about planning ahead; see section 10.

There are various forms of living wills, including "Five Wishes," which covers your medical, personal, emotional, and spiritual preferences.