Comfort Measures

CW: Death in hospice

Her mother stops breathing at 11:52, and Marta checks the flight.

She doesn’t decide to. Her thumb is already on the screen when she notices the room is quiet. The screen says F9 2660 · DENVER—ISLIP · ON TIME. Above it, in the bed, nothing is happening. No sound from the chest under the blanket. The oxygen hisses along on its own, feeding a face that has stopped asking for it.

Then a breath. Ordinary, almost bored. Then another. Then a run of quick shallow ones, like someone climbing stairs.

“That’s the Cheyne-Stokes,” Asha says from the door. She has a way of arriving in the middle of things without having been heard in the hall. “You’ll see it come and go now. Fast and shallow, then slow, then a pause. The pause can run thirty, forty seconds. It’s the brain letting go of the rhythm. It isn’t her fighting.”

“It looks like fighting.”

“I know it does,” Asha says softly, crossing from left bedside to right. “Bernarda, I’m going to move your pillow. There.” Two fingers under the skull, a slight lift, and a fold of the case. “I’m putting a fresh swab in the basin, love. Your daughter’s still here, and Francisco’s on his way.”

Marta has spent four years talking about her mother across her mother—at the pharmacy, with doctors and nurses and her aide, to Frank on speaker, and it has never occurred to her that Bernarda might be listening. Asha talks to her like someone whose mail still comes.

“If the pauses scare you,” Asha says, on her way back out, “count them. Out loud or in your head. Gives your mind something to do besides that.” A nod at the phone.

Then she’s gone, and the room reassembles itself around Marta: the vinyl recliner, its armrest scored with a white scar where her cardigan’s loose thread has rubbed the same track for hours. The whiteboard with ASHA RN written in blue marker that made the room smell like chemicals for half a day. The red outlets that mean the wall will keep breathing when the rest of the building doesn’t. A volunteer’s donated Bluetooth speaker plays a hymn to Altagracia that Bernarda had hated since her girlhood in Puerto Plata. Over the door, a clock with a second hand that always stutters at the seven—pausing as if deciding whether to fall, before lurching forward to the nine.

Bernarda’s chest lifts. Holds. Drops.

Nothing.

Marta counts. She doubts it will help, but it’s better than tracking the flight.

One. Two. Three.

Still counting, Marta reaches under the recliner for the overnight bag she packed in September, when the hospice called with a bed and gave her ninety minutes. She’s not looking for anything. She just needs her hands somewhere. Toothbrush. Reading glasses with one arm taped. Rosary in a Ziploc. And under that, the cardigan Frank sent three Christmases ago. It’s still in its tissue, tags on, because Bernarda was “saving it.”

Bernarda’s slippers are on the floor by the bed. Marta bought them at the CVS on North Country Rd. for $17.99. The right one split across the ball of the foot in the spring, and Marta has glued it twice with something from the junk drawer.

Four years fit into a bag like this. Nails clipped over a towel on the kitchen table, Bernarda saying, “No tan corto, mija,” not so short, as though Marta had a history of amputations. The pharmacist on Rte-347 who needed reminding, monthly, that yes, the new hydromorphone prescription had come through, no, they did not need to call the doctor again. Cream of mushroom soup coating the inside of the microwave—a forgotten lid, another step Bernarda no longer remembered. Sleet on Nicolls Rd. at 2:00 am, the night of the fall, Marta driving with the window down so the cold would keep her awake. Bernarda’s head tipped back into the kitchen sink, Marta working the conditioner through, Bernarda telling the faucet that Francisco could make her laugh before he could walk.

And the transfer. Bed to commode, last spring, Bernarda’s hand clamped on Marta’s wrist hard enough that Marta wore long sleeves to work for a week. That same week, from the hall, Bernarda telling Mrs. Peña from 4B: “Francisco calls every Sunday. He never forgets.”

The phone lights up on the bedside table.

Frank (12:10 am): Boarding. Tell her I’m coming.

Marta looks at it long enough for the screen to dim.

“He’s coming, Ma,” she says. “Frank’s on the plane.”

Bernarda’s mouth shifts around the cannula. The lips pull inward, then let go. Was it his name she tried to form? Or just the plastic tube shifting against her dry lips? 

Her chest drops and stays down.

Marta counts.

Bernarda was the one who taught her. Quarters on the kitchen table Sunday nights for the laundromat, stacked in fours, counted twice. Spoonfuls of cough syrup, uno, dos, the spoon held level. And when Marta cried past what Bernarda considered reasonable: Cinco. Cuatro. Tres. A countdown, delivered from the kitchen doorway with a dish towel over one shoulder. By three, Marta had always stopped. Not because she felt better. Because she knew what came after one.

Twenty-two. Twenty-three.

The breath comes back a wet drag, like a boot pulled out of mud. Bernarda’s throat works. Her right hand crawls across the blanket and closes on a fistful of it.

Marta is on her feet, and she’s counting the next silence before she’s aware of starting, fast, running the numbers together, one-two-three-four, because she wants the next breath to come before her mother’s face goes blank and waxen again.

Nine-ten-eleven.

The breath comes. Shallow, but clean.

Bernarda’s hand lets go of the blanket. Her forehead smooths out. The room settles into a quiet that feels, for a moment, like something Marta has done.

She sits. Her heart hammering, she tells herself it’s coincidence. Then decides to find out.

***

She gives the next pause a slow count.

One… Two…

Each number gets its full second, the way you’d count for a kid on the high board who hasn’t jumped yet. The silence stretches. At nine, her own chest tightens. At twelve, Bernarda breathes, a harsh scrape, air dragged over something raw.

Not the breath. The stillness. That is what she holds.

The next pause, she counts fast: twelve numbers in six seconds. Breath. Sooner.

Then she tries the clock’s stuttering second hand, letting it pace her. The hand hesitates at seven, hangs, jumps, and the breath comes just after, or just before. She can’t tell. Maybe the clock cheats. Or maybe the count only works when it is hers.

Each breath after a long silence costs something: Bernarda’s lips pulling back from her teeth, nostrils flaring against the tubing, the inhale a torn sound. She is not healing anything. She is only stretching the gaps between one breath and the next, and each stretched gap returns with interest.

Marta keeps testing—slow count, fast count, clock count—and each time she takes the returning breath as proof. The clock is the only one she isn't sure of. She decides the clock doesn't count and moves on. What matters is that the pattern holds. She has not yet found a way to make it break.

***

The proof would be leaving.

She waits for a pause, gets up on the sixth number, and steps into the hall—leaving the count unfinished. In the hallway, the air smells of bleach and wilted carnations from a forgotten arrangement on the linen cart. At the far end, the vending machine hums, its coiled interior lights glowing a sickly yellow. Somewhere down the corridor, a door sighs shut on its hydraulic arm.

Marta stands with her back to the door frame and counts nothing. Her eyes fix on the fire extinguisher’s bright red casing, and its chrome valve a cold bright coin under the institutional lighting.. She reads the evacuation map until her eyes blur. Twenty seconds… Thirty. The silence stretches. She has never been so aware of her own lungs.

Then a sound comes from the room, one she hasn't heard before. Not a gasp or moan, but a dry, papery scraping from her mother's hand searching blindly, skin against sheet. A ragged, panicked inhale, and in it, Marta hears the seven she never spoke. Almost as if her mother had reached for air before the count said she could have any.

Marta stands frozen in the hallway. She does not move when Asha passes her, does not help when Asha rolls her mother toward the window, wets her lips.

“There you go. There. Bernarda, I’ve got you,” Asha says. And to Marta, without looking: “Sometimes they settle when they hear us. Keep talking to her.”

“I just went for water.”

“Cooler’s the other way.” Asha tucks the blanket. “It’s fine. Sit with her.”

Marta sits with her. She takes a foam swab, dips it, runs it along the inside of her mother's lower lip the way she was shown in October, the way she has done it a thousand times since. Bernarda’s mouth is hot and dry as the inside of a glove.

Bernarda’s eyes open. Not all the way. Enough that the brown shows, wet and aimed at the ceiling.

“Frank’s on the plane,” Marta says. “He’ll be here by six.”

Bernarda’s fingers find Marta’s wrist. They press once, the pressure of a hand checking if a burner’s still warm.

Marta waits for the meaning to arrive, searching for a message or sign in her mother’s hand on her wrist. But the pressure is just pressure. A reflex. The body’s circuitry closing down, sparks firing where no one was home anymore.

“I’m here too, Mama,” Marta says. The words scrape her throat with an unintended serrated edge. She swallows, then adds softer, “I never left.”

Bernarda’s lips move. The shape is soft. Despacio, it could be. Slowly. It could be Francisco. Or it might be nothing, the purposeless twitching of a mouth that has already formed its last word.

Her chest drops.

Marta counts. Slower than before, because despacio is what she heard, and because the pauses are the only part of this that doesn’t seem to hurt. In the silences her mother’s face is almost the face from the photos, the one always turned a few degrees toward Frank’s side. It’s the breaths that drag her back.

***

Frank (4:15 am): Landed early!! Taxi in 20 min. How is she

Frank (4:19 am): Marti please answer

The phone buzzes on the bedside table during a pause—two short pulses against the laminate tabletop, a brief hold, then a third.

Frank (4:26 am): In the cab. Tell her 30 min.

Marta doesn’t reach for it. Instead, she watches Bernarda’s face. With each buzz, her mother’s eyelids flutter and a soft sound escapes her—not a word so much as an exhale in the shape of her brother's name.

She keeps counting.

Nineteen… Twenty…

She tells herself a phone shouldn’t be the last thing her mother hears. That’s true. It’s just not the only thing that’s true.

***

“Your brother just called the desk.” Asha’s voice spills through the doorway, bringing with it the scent of floor cleaner and recycled air. “He said he couldn’t reach you, and wanted me to let you know he’s on Nicolls Road, about twenty minutes away.”

“Okay.”

Asha’s eyes do a circuit: Marta, the clock, the phone, the bed. She notes the fresh swab in the basin, the inch of coffee left in the cup, the way Marta’s shoes point as if ready for flight.

Then she looks at Bernarda—less like a nurse checking a patient than someone bracing for what she already knows is coming. Bernarda’s breathing has changed since the last time she was in here. Each inhale is a small, ugly labor now, shoulders lifting to help. 

“She’s working harder,” Asha says, her voice low and steady against the machine’s rhythmic hiss. Marta nods, her gaze fixed on the thin cotton sheet over her mother’s chest. The fabric lifts into a frail dome with each breath, then sinks back into stillness.

“The pauses are long,” Marta says. It is not a question.

“They’re supposed to be,” Asha answers, and her smile is professional, but not unkind. She gazes at Bernarda’s mouth, slightly agape, the lips drying almost instantly after the last swab. “I know how it looks, but she’s not showing any signs of pain.” Then, she turns to Marta, searching for the part of her that needs reassurance.

“Do you want me to put your brother through if he calls again?”

Marta thinks about Frank’s voice and how it would sound in this room. She watches her mother’s eyelids flutter, the same involuntary reflex she saw before—so slight she might have missed it if she wasn’t already watching.

“Let her rest.”

Asha looks at her a second longer than the sentence needs. Then she sets a fresh swab in the basin, touches Bernarda’s foot through the blanket, and leaves the door ajar a hand’s width, as she has all night.

Marta gets up and pushes it closer to shut. Not completely, but enough to keep the space exactly itself: the bed and the chair and the clock and the hiss-pause-hiss of oxygen.

The room is a planet now, and Marta is the only gravity it has left.

***

She counts slow.

Bernarda’s fingers move against the sheet. Marta has been watching them do this for hours, a twitch, a small scrabble, the terminal restlessness the pamphlet warned about, and has filed it with the other things a body does on its way out. But as she watches closer, the movement resolves into a pattern. The fingers aren’t twitching.

They’re tapping.

Index and middle, a quick even rhythm against the cotton. Deliberate.

Six, Marta says in her head, and her mother’s fingers tap six-seven-eight in the time it takes.

Something catches in her lungs, and she feels her own pulse race to keep time, as if her mother is setting the pace. Nine comes out at the taps’ speed instead of hers. Bernarda breathes, a shallow, immediate pull, like a swimmer who’s been let up.

She tries again, slowing her count as the tapping accelerates.

Was the tapping a metronome? A countdown? A plea for Frank to come faster?

Her phone lights up, then goes dark, its screen flaring with a notification before dimming. Marta flips it over without looking, but the light leaks out under the edge, pulsing against the wood grain like a lighthouse beam.

Each time it flares, Bernarda’s eyelids shiver, then settle.

Marta’s own hands are cold, sweating just above the cuticles, but dry everywhere else. She lays her palm on the sheet beside Bernarda’s. Not touching her mother’s hand, but close enough that their warmth could, in theory, find each other.

***

“Marta?”

Frank’s voice tears into the room from the hallway, ragged and desperate, and in it Marta hears the eleven-year-old boy who used to search for her in the dark.

Bernarda’s eyes open. Her fingers find the inside of Marta’s wrist again, tapping a manic telegraph against her own lifeline.

Marta could match it. She could count fast, the way her mother is tapping—one-two-three-four—matching the rhythm until the next breath arrives, and then start again, and again, keeping pace with the taps until Frank enters. She has always been good at cues.

“I’m looking for Bernarda Rosario, my mother,” she hears her brother at the nurses' station, his voice cracking upward on the last syllable.

Marta tries to remember a single instance—just one—when her mother had counted down from five to stop Frank from doing anything. She finds nothing.

The tapping continues against her wrist. 

Marta closes her hand over her mother’s fingers.

Not hard.

Just enough that the tapping has nowhere to go.

“One.”

She says it out loud, her voice slow and level, like she’s counting for a kid on the high board.

“Two.”

The door shudders and light from the hallway pushes inward. Frank’s hand wraps around the door frame—the fat gold ring he bought himself at forty gleaming under the fluorescents like a vulgar sun.

“Three.”

Marta holds each number in her throat until the silence stretches thin enough to snap, then slowly releases it into the hollow space between her mother's gasps. 

In four years she has never taken her time with anything her mother needed.

She takes it now.