“This is Andrew,” he said, answering his cell phone.

The nurse in the long-term care facility where his mother Grace lives said, “Your mother just hasn’t been herself today.  She won’t eat.  She won’t drink.  She’s very lethargic.  Her vital signs are normal.  Her temperature is normal.  Her blood sugar is normal.  We can’t find anything wrong.  The doctor said it’s your choice: send your mother to the hospital for a work-up?  Or run lab tests here and run a line to get some fluids into her?”

Andrew had long since signed a DNR (Do Not Resuscitate) order for his severely impaired mother; he had been her health care representative for nearly 12 years. Knowing that she could never recover, he found it an easy choice:  “No, don’t send her to the hospital.  It would simply disorient her.  That alone could cause a steep decline, regardless of anything that actually happens there.”

“I agree,” the nurse said quickly.

“Could you check her mouth?  Is it possible that something is hurting her, so it’s uncomfortable to eat or drink?”

“I’ll check that,” the nurse replied.

“But she didn’t fall or anything?  Nothing out of the ordinary happened?”  It had gotten to be routine for him to get calls saying that she had fallen – typically, she apparently tried to stand up and wasn’t able to do it, and gently slid off her upholstered armchair down onto the carpeted floor.  She never got injured, but the facility was complying with state law in calling to tell him about these incidents.

“No, nothing.”

The call closed, ominously, with the nurse confirming the best number to use to reach him. They never ask that, Andrew reflected. Of course, every bit of contact information for him appears in a dozen different places in their records, so they had no need to ask.  Unspoken was the explanation for why they’re asking now:  in case they needed to reach him urgently.

Andrew alerted his siblings. And he wondered, “Was that The Call?  The one that means the end is near?”  He started thinking about flight schedules, clean laundry, and appointments to cancel, and wondered when he should decide about buying a plane ticket.

A few hours later, he called for an update.  After getting fluids for a couple hours, Grace had opened her eyes and started talking to the nurses, although as usual, she couldn’t be understood.

The next day, the young nurse called again, saying, “Your mother is a hundred times better! I was so scared yesterday!”

“That makes two of us,” Andrew said, and clipped his phone back onto his belt, where it always stays on, as he is always expecting to get The Call.