In early 2007, just after Mom received the diagnosis that she had end-stage liver disease and would need a transplant, she began working with physical and occupational therapists to improve her strength. But, she would only do the work while she was with the therapists - either in their offices or at our home. Eventually, they stopped seeing her because Mom wasn't making any progress. (Seems like mom needed more visits, not less; but that's insurance for you.) This pained me a great deal. I wanted more than anything for her to get better. I felt like she'd given up. At one point, I even threatened to throw her out of my house for a lack of trying. I told her that I wasn't going to sit idly by while she wasted away. I couldn't be a party to that. Like I said, it was very painful. By the time Hunter and Grace arrived, in March, 2008, mom's health was extremely poor. She was incapable of walking or even standing without assistance. This made the fact that she was on diuretics (for blood pressure - especially in the hepatic artery) and diarrheals (or laxatives, to remove ammonia from her colon before it entered the blood stream) all the more of an issue. There was no way for her to get from the bed to the bathroom by herself. By June, 2008, there was no way to care for her at home. She stopped taking the diarrheal (lactulose) during the day so as to avoid soiling herself while James was at work. This led to a build up of ammonia that caused an encephalopathic episode which put her in the hospital. While she was in the hospital, James and I made the decision to move her to a nursing home (on the advice of a very insistant nurse). It was very hard to watch Mom's health continue to decline. It was especially difficult to think about Hunter and Grace never having the opportunity to get to know, first-hand, what a wonderful, creative, loving person she was. At times, thinking about this made me very angry - angry at mom for not trying harder to get well. Over time, that anger made it difficult for me to be around Mom. I began (subconsiously) avoiding her. And, I dragged my feet when we did go to see her. When I explained all this to the chaplain at the nursing home, during Mom's last week, he explained to me that God is our Father, and that perhaps He was reminding Mom what it was like to be loved unconditionally by a father through my interactions with the twins. This was especially poignant because my Mom never really knew her birth father. He left when she was two or three years old. And, her relationship with her adopted father - the man I know as "Grandpa" - was such that she never referred to him as "Dad." This touched me deeply. Tears flowed out of me uncontrollably. It was as though I'd been allowed a quick glimpse of God's master plan. It was at once extremely emotional and deeply calming. After all, by the time her liver disease was diagnosed, it was already classified as "end-stage," meaning that her liver had completely failed. At that point, she was already too sick to muster the energy to exercise in order to improve her condition. In the end, when Mom passed, I actually felt happy. A deep feeling of peace came over me. Rather than feeling sad, I felt grateful for the time we had.