Why you should make your wishes known, no matter your age

My grandmother is dying.  She is several thousand miles away, in a state at least a thousand, probably more, miles further west than I have ever been. 
 
I have never met her.  When I was younger I looked very much like her wedding photo.  She was thin and fair.  Now she is very overweight and not very pretty in photos.  Somehow my meds tranformed me; my resemblance now is much closer to my paternal grandmother, who was just as heavy.  The odd thing is that I look like a small person carrying a lot of extra weight, while my paternal grandma looked just right while heavy, but I look like her somehow.
 
I didn't just inherit my looks from her, or part of them.  Soon after my mother had seen me really sick she started to understand parts of her own childhood.  My father is/was undoubtedly bipolar too, but the genetics are on both sides.  I suspect there was little chance that at least one of my parents' children would be bipolar.  My sister seems to suspect this too, carefully refusing anti-depressants and other risk factors.
 
At some point after my mother was married my grandmother simply walked out of her own life.  She left her trailer door hanging open and never returned.  She still had 2 minor children. 
 
Over the years there were a few times someone parked near the house where I grew up and watched, then drove off quickly.  We had occasionally weird calls with nobody there (this was pre-computer calling; in fact this was with rotary dial phones). 
 
When I was about 20 my mom got a call from another relative to warn her that her mother was wanting to contact her.  Since then my mother has spoken to her from time to time, mainly out of guilt.  Nobody else agreed to any relationship with her.  I used to think that would have an appeal, but as it turned out, it did not.  She never cared to meet us, or acknowledge us, and she got her life back together many years before she called.  It was pretty clear she was calling because she wanted someone to be there in her old age, and it wasn't like she approached this apologetically or anything.  I spoke to her once, many years ago, because I answered the phone and it was her.  It was the oddest feeling ever.
 
Anyway, the last week or so has contained a lot of phone calls regarding this, and well, you don't do what I do without knowing what the last week or two of kidney failure looks like. 
 
My mother had to tell them today that if she codes that my mother can't sign a DNR due to not knowing her wishes.  Which means that at some point she's likely to get a call where she has to say that and what it translates to is that her mother will receive CPR, which is ridiculous at this stage of illness, but she has nothing in place to say not to do it, and CPR, while it can be good, will not be for her.  There will be broken bones and it will not work, and if it does she'll have brain damage from oxygen deprivation because she's not maintaining that well anyway, because of the dying.  Which means if she survives code one, she will code again.  I am praying the doctors realize the situation and don't aggressively do this.  Just the appearance of CPR, perhaps. 
 
Odd.  I emailed a friend to ask for prayers for a patient of mine facing something scary tomorrow.  I did not even think to ask for prayers for her.  It's strange, I find that I have anger in here regarding this, and it's basically anger that she gave me this disease (ok, genetics did, but she could have been an example of a positive rather than a negative) and never even faced me or any of her own grandchildren.
 
My poor mother.  I had a horrid childhood, and I have no clue what happens when my own father dies as none of us has seen him in over 10 years, but my mother's parents both just went on with their lives and didn't really bother about their children.  When my grandfather died I was at the end of my clinicals in Michigan and it was the dead of a really bad winter and it's hard to make a fast trip from Michigan in a really bad winter.  But his funeral also wasn't something I felt bad for missing as I didn't know him either, just really one visit per year at Christmas.  Yet he lived 3/4 mile from my "good" grandma who spent time nearly every day until she died a few weeks before I graduated high school.
 
This is a lot of thinking.  I always think it's sad when patients are doing this dying thing alone; it's so hard to remember sometimes it's got complex reasons behind it.

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