Prolog: Joann Gottlund—Wife of Scot

Jo Ann Gottlund (55) (everyone, including the Feds and the State, call her Joann) and I started living together in May 2003 with our friend and roommate Bill Walker. Joann and I were married on October 27, 2004, her mother’s birthday. Thus, our wedding was sort of a birthday present for Joann’s mother, Mildred.

Joann was raised in Modesto, California and spent much of her adult life in Monterey, California, as a Registered Nurse practicing at Community Hospital of the Monterey Peninsula (CHOMP), and the Visiting Nurses Association (VNA). She has an adult son named David who lives in Sacramento, California, and works in the environmental protection field. Joann and I first met in 1997 and became friends. We lost touch a time later and didn’t rediscover each other until May 2003.

By the time Joann and I started living together, she was already considered "end stage" and terminal. As with many terminal cases of the non-cancerous variety, a definitive prognosis wasn’t possible. Everybody reacts differently to disease, and emphysema is manageable over the long term with careful care. Joann’s liabilities were her cardiac problems and extreme anemia relieved only by blood transfusions, causing her to not recover fully from each illness episode she encountered. Throughout the three years we have lived together, she has been in the hospital four times, sinking lower each time.

As Joann fought her own battle with life, so did Joann’s mother in Modesto. In Mildred’s case, she was simply getting old and nature was taking its course. Still, Joann and Mildred were a great source of companionship for each other, talking on the phone every night for an hour or so. In the end though, Joann and her mother, Mildred, would be in a horse race for who would succumb first. Unfortunately for Joann, her mother passed on January 11, 2006, at the age of eighty-four.

The last three months have seen Joann deteriorate faster than any other time and sink lower with each predatory illness she would contract. The day after Christmas 2005, Joann went into CHOMP unable to breathe because of a bad case of pneumonia. She was in hospital for two weeks before the antibiotics controlled her pneumonia and she could come home. She stayed on antibiotics for another three weeks without improving. Joann was also under VNA care during that time where they monitored her several times a week to see how she was progressing. The Joann’s condition was such that VNA was in for the long haul and about to install a remote monitoring unit when Joann went into the hospital once again.

Her mother, Mildred, passed away in January and that left Joann without anyone to talk with at night while I worked. From my viewpoint, she seemed to lose some of her determination to live. "Deflated," might be a good word to describe her mental state.

February 9, 2006 was the last time Joann went to CHOMP. This time it was a condition known as "wet lung," where fluid collects in the usable portion of the lung reducing the ability to get oxygen and expel carbon dioxide. She was placed on heavy antibiotics again, but five days later Joann’s doctors told her that any further treatment was pointless. They were sending her home.

Because Joann was under VNA care, I talked to her nurse and case worker about her coming home and how I would have problems taking care of her if she fell. My back, after three surgeries, isn’t the best and I worried that I wouldn’t be able to get her to the bathroom, shower or kitchen if I needed to. The caseworker told me about "home hospice," a plan by where Joann is essentially under hospice care with all the support benefits that provides yet can stay at home.

I talked to her doctors before they released Joann, and they agreed that it was the right time to put her under hospice care. Moreover, it was what Joann wanted: to die at home and not in a place of strangers.

Joann came home on February 14, 2006, Valentines Day.