The Truth About Butterflies: A Memoir Read Online Free

last dialysis.  I asked Dr.
Akwari how long Nicole could survive without dialysis.  She caressed the back
of Nicole’s bony hand and said, “Even though she’s not eating or drinking, her
body is still producing toxins that are not being removed.”  I remembered the
hospital dietician explaining it to me once. 
    When the
body doesn’t have food, it begins metabolizing its own muscle, and the
byproduct of muscle breakdown is potassium. “If your kidneys work, you just pee
out the extra potassium,” the dietician had said, “but if not, the potassium
builds up in the blood and can be very dangerous to the heart.” 
    I’d had the
conversation with the dietician because the month leading up to December 6, the
day Nicole’s heart stopped, Nicole had been in and out of the hospital with
cardiac complications due to high potassium.  The doctors believed she was
intentionally eating high-potassium foods with no regard to her health.  I
insisted that she wasn’t because I had rid the kitchen of potassium-rich foods,
and I was the only one buying groceries.  Nicole was hardly eating anything
anyway and was spending most of her time in bed.  “Then how come when she’s in
the hospital a few days, her potassium comes down?”  The nurse practitioner
Reba had asked.  I couldn’t give her an answer because I had no clue why it was
happening.  This seemed to further validate her claim that Nicole was doing it
intentionally.  I guess it was possible that when I left for work each morning,
Nicole would throw back the covers, call her friends over, and have an all-out
potassium party, but it was highly unlikely.
    The
situation had bothered me, so when the dietician came by to see Nicole, I asked
her why Nicole’s potassium would be high at home, but stabilize once she was in
the hospital.  “What does she eat at home?”
    “Hardly
anything.  I’m lucky if I can get her to eat some crackers.”
    The
dietician thumbed through Nicole’s chart.  “It looks like she’s at least eating
a little bit while she’s here in the hospital.”  She turned to Nicole.  “You’re
not eating at home?”
    “No, when I
eat my stomach cramps really bad.”
    “It doesn’t
cramp when you eat here?”
    “Yeah, but I
get dilaudid in my IV, so even though my stomach hurts I can tolerate it.” 
    “Well, that would
explain it,” the dietician said.  “If she’s taking in nutrition here at the
hospital, her body is no longer metabolizing its own muscle.  How long has she
been not eating?”  I told her that it had been a gradual process.
    The previous
January, the endocrinologist had diagnosed Nicole with gastroparesis, a
complication of diabetes that makes digestion difficult and painful.  Nicole’s last
attempt at a meal had been Thanksgiving.  From November 22 until December 6, she had
refused almost all food.  Her thin, tall frame was nothing more than a skeleton
with a layer of flesh.  Regardless of what the doctors believed, I knew that
Nicole wasn’t eating potassium by the fistful.   
    As Dr.
Akwari explained that the toxins would continue to strain Nicole’s respiratory
system, I knew that Nicole’s struggling to breathe was not a threshold I was
willing to cross.  When Nicole and I had talked about either of us being in
this situation, she had said, “Mommy, I don’t know if I could let you go.  How
would I know when to do it?”  We’d had this conversation as Terri Schiavo’s [1] case unfolded in the
media. 
    Like we had
on so many occasions, we sat in the car in the driveway after coming in from
dialysis.  At dusk, rabbits would come from their burrow, and we’d count the
pairs of ears we’d see bouncing through the tall meadow grass that grew in
abundance along the edge of the property.  We’d sit and talk, sometimes for
hours, on different subjects, each of us raising the philosophical bar for the
other.  But that particular spring night, we talked about Terri, who had passed
a