KING GEORGE, Va. (AP) - Lynne Jenkins suspects she’ll live with the guilt and grief from her brother’s death from COVID-19 for the rest of her life.
Motley “M.B.” Self of Westmoreland County died Oct. 10 -Jenkins said she’ll never forget “10-10-20”- and as his medical proxy, she was responsible for making his health care decisions at the end. When it became clear that he couldn’t overcome the virus, the way he had dealt with congestive heart failure and kidney and circulation problems, she had to tell doctors to take him off a ventilator and stop treatment.
Because she couldn’t risk exposing herself and her family to COVID-19 -and quarantining for two weeks- after one 15-minute visitation, she didn’t see him in the hospital. He was alone in his last days, including when he drew his final breath-and that breaks her heart.
“Every day I go to work and come home, and then I fall apart,” said the King George County woman who works with elderly patients as a home health care provider. “I hope my children and grandchildren don’t ever have to make that decision for me. I don’t want that for my boys, let me tell you, it’s hard.”
Jenkins contacted The Free Lance–Star because she wanted to speak for those who can’t be with their families as they die from COVID-19 in hospitals, nursing homes and assisted living facilities. She doesn’t want anyone to think there was anything special about her or her brother; she just wants others to know the life-and-death aspect of this pandemic is made even worse by those who don’t take it seriously.
“People need to realize it’s real, it’s not a joke,” she said. “If people want to be with their loved ones, they better wake up. It’s sad when someone has to die by himself, no one holding his hand, no one saying it’s OK.”
Even health care workers trained to help patients during their last moments struggle with the realities that COVID-19 presents.
“I’ve been practicing for almost 40 years, and I’ve never encountered anything as difficult as this,” said Dr. William Anderson, medical director of Mary Washington Hospice and Palliative Care Services. “Family members in this situation need a whole lot of support. They need to know we’re struggling right along with them.”
‘JUST A SHOCK’
Jenkins called her big brother “M.B.,” short for Motley Booker Self, and others, like her two sons, simply referred to him as “Big Unc.” He never married or had children and had asked her in 2018, when his health problems began to worsen, if she would accept responsibility for his medical decisions.
Jenkins was the only daughter of four children born to the late Katherine and Motley Booker Self Sr. The family had lived in Oak Grove, and that’s where M.B. Self had remained. He was a construction contractor for Ingleside Nursery for years until he became a self-employed craftsman, making cabinets and swings, bird feeders and toy chests.
“He loved woodworking,” his sister wrote in a text. “Everyone in Westmoreland County has something he made. Lol.”
Jenkins knows that people often say it’s the other health issues that kill a person, not necessarily the virus, but she doesn’t buy it. He’d been living with heart problems, and his kidneys weren’t bad enough to require dialysis. He’d just been to a Richmond hospital, where he was treated for a flare-up of both, then was sent home.
And that’s when things went downhill. A few days after his discharge, Self was coughing up blood. A Westmoreland ambulance came to his home, and first responders suggested he go to Mary Washington Hospital, his sister said.
After he was admitted, a doctor called Jenkins to tell her Self had pneumonia and needed emergency dialysis. Later in the evening, a nurse called to ask if anyone told her he also had COVID-19.
“I literally dropped my phone. I said, ‘No, ma’am, my brother doesn’t have that, he just came out of the hospital,’ ” she recalled. “It was just a shock.”
Jenkins doesn’t know how her brother contracted it. He had tested negative while in a Richmond hospital, then she and other family members helped him get settled back home again.
After he was re-hospitalized in Fredericksburg, it quickly became clear he couldn’t beat this opponent.
The majority of patients who died from COVID-19 this spring in hospitals statewide were older and sicker with the type of chronic conditions Self suffered, according to data from the Virginia Hospital & Healthcare Association.
Determining if the virus or underlying issues are the cause of death can be complex, said Anderson, who fills out a lot of death certificates as a medical director for hospice. He looks at the factors and timing-was COVID-19 at its peak when the person died, or had the patient recovered from it, then died months later?
“It varies in each case and can be a difficult decision,” he said.
But Anderson also has seen the virus push people over the edge. Those weakened from heart disease, lung problems or even dementia tend to have “a certain amount of functioning reserve,” but COVID-19 pushes them over the edge.
“There’s no question about that,” he said.
‘THE DEATH PROCESS’
Nurses and doctors called Jenkins regularly to explain what was happening, and she’s grateful for their kindness and calming manner. She wishes she’d had the presence of mind to write down their names, but all she remembers are a few nurses: Heather, Myra and Alyssa.
Heather helped Jenkins arrange a video chat with her brother; when Self told her he needed to be put on a ventilator, Jenkins saw the fear in his eyes.
When she said her final goodbye, Heather again held the tablet close to Self, who already was unconscious, and told him she loved him and that he was going to beat this virus and come home.
“I believe he heard me,” she said.
Jenkins can’t help but wonder what he was thinking. Was he scared to be alone? Was he brave? Did the medication make him comfortable? Did he hear his brothers, Happy and Paul, and his nephews, Lee and Dan, on the video chat? Did he know how much they loved him?
“My list can go on,” she said.
In and of itself, grief is hard enough, but COVID-19 has robbed people of the experience of “shepherding their loved ones through the death process,” said Colette Brooks, owner of Thriveworks counseling service in Fredericksburg.
She hopes that Jenkins and others who’ve been through the same will realize it’s beyond their control to be at a person’s bedside during the final moments.
“Of course, she would have been there, if it were an option,” she said, but the fact that she didn’t have a choice doesn’t lessen the pain.
“It’s a unique experience that many Americans are dealing with right now,” Brooks said, “and I hope and pray that there’s some solace in that.”
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