Saying Goodbye

Question: What do all of these things have in common?

  • A bottle of Purell by the front door
  • Protein bars in the pantry
  • A partially filled pill box on the kitchen table
  • Reading glasses on the side table
  • An unopened letter on the desk
  • Protein shakes on the second shelf of the refrigerator

Answer: They will inspire unimaginable waves of grief when you realize that your father will never use any of them again.

Dad went into the ICU on Thursday. And even though he had been in and out of hospitals since December 26, it was different this time. He was in pain, unbearable pain, from peritonitis. When the Emergency Department doctors diagnosed him, I asked if it was curable. They assured me it was.

Except that it wasn’t. And three days later, Dad drew his last breaths surrounded by his wife, his children, and his pastors.

Dad was the epitome of love and compassion. He thought of others and how we could work together to make this a better world. When I was in high school, and questioning organized religion because of (insert myriad of reasons), instead of forcing me to attend services, he asked me what I would like to do to help others. So from then on, we worked the Samaritan Soup Kitchen downtown on Sunday mornings. I didn’t think much of it then, but later I realized what a sacrifice he was making to take me downtown every Sunday morning. He actually liked church. He liked the social aspect of it; he liked the faith aspect of it.

I was supposed to travel to Charleston on Thursday morning for a friend’s 50th birthday celebration. As I was getting ready to go, I went into his bedroom to say goodbye and noticed he was in incredible pain. We ended up calling an ambulance because I couldn’t transport him in my car without hurting him. He apologized, saying that he always ruined my trips. I laughed and told him not to worry about it – there were more important things. On Friday, from the ICU, he told me to go to Charleston, to be with my friends, it was important to celebrate relationships.

One thing he was clear about was that he did not want to be sustained by life support, and he had documented that thoroughly. We had discussed it on Saturday morning before I left for Charleston. His doctors had come into the room and said that if the infection didn’t clear up soon, they would need to remove the Tenckhoff catheter that he used to perform peritoneal dialysis. I looked at them and asked how he would be able to perform dialysis. They said he could revert back to hemodialysis. I shared that that wasn’t an option for him, since his blood pressure was so low. They said that CCRT, the continuous dialysis (which was apparently very painful and could only be done in the ICU) was the other option. From his bed, Dad shook his head and looked up at me with pleading eyes. I told him I knew that wasn’t what he wanted, and we wouldn’t let that happen. The doctors left. I reminded Dad that he was of sound mind and he could make the decision at any point to leave the hospital and we would engage with Hospice at home. He joked that he had never been of sound mind. He also said that if they told him he would have to be in this existence for a month, that wasn’t the life he wanted. I asked him if he would agree to the treatment for a few more days, maybe a week, to see if things got better, and then we could re-evaluate. He said that sounded like a good plan. He told me to be safe, enjoy my friends, and we’d see each other the next day.

So on Saturday mid-morning I went. Early Sunday morning I learned his condition had worsened, so I drove immediately to the hospital, praying the entire four hours I was driving that I wouldn’t get a speeding ticket and that he would survive until I got to the hospital. When I entered the ICU room, my Mom, my brother, and my sister were already there. I was overcome by guilt and sadness. He was fully on life support, exactly what he didn’t want. His eyes were half open and he was gasping for breath. I was gutted.

I leaned over, kissed his forehead, and told him I was there. He opened his beautiful blue eyes and said, “No way!” I repeated that I was there, Mom was there, Greg was there, and Ashley was there. The whole family was there and he was surrounded by love. Again, he said, “No way!” closed his eyes, and leaned back. We talked to him and told him how much we loved him, how much we appreciated all that he had done for each of us and for our community, how much we’ll miss him, how we cannot imagine living without him in our lives. I choose to believe he heard us. Occasionally he would squeeze my hand, or an eyebrow would raise, or a slight smile would pass his face. My brother left to get some sleep before his night shift.

And then the nurses asked to speak to us. I went out of the room. Before they said anything I blurted out, “He’s dying and he’s on life support and he didn’t want that and he’s in so much pain and we have to abide by his wishes and I don’t want him to die and he’s going to and is there anything you can do to cause him to be in less pain?” And then I collapsed.

They tried to tell me I was making a decision out of love. I was honoring his wishes and he was suffering and if we moved to “comfort care” they would have a lot more latitude with what they could administer.

I called his pastor. They ordered drip painkillers from the pharmacy.

We waited for his pastor to arrive. We waited for my brother to return. I checked his phone to see if anyone had sent messages that I could share with him. There were a couple, as well as about 300 spam and marketing messages over the course of one day. I chided him for subscribing to so much junk, then proceeded to read the offers to him, one by one. We laughed, and I hope he was laughing, too.

The pastor arrived. My brother arrived. The painkillers in a drip bag arrived. We said a prayer, holding hands. I explained to him step by step what would happen. I reminded him the first thing he told anyone when he checked into a hospital was that he has a full DNR (do not resuscitate) order. And that he didn’t want to live a life sustained by life support.

The nurses started the painkillers. “Dad, they’ve hooked you up to a stronger painkiller. You won’t feel the debilitating pain that you’ve experienced over the last few days anymore.” They stopped the blood pressure medicine drip. “Dad, they’re stopping your blood pressure medicine drip. Your blood pressure might drop.” They stopped the CCRT process which was cleansing his blood. “Dad, they’re disconnecting you from CCRT. I know how painful this was over the past few days, and you won’t have that pain anymore. This is what you asked for, and we love you so much.” It was 3:33 pm.

I had an idea that when someone is taken off life support, they die. But they don’t. The body keeps fighting, keeps breathing. The heart keeps pumping. We continued to hold his hands and tell him how much we loved him for the next 1 hour and 13 minutes. I was watching an artery? a vein? in his neck, mirroring his heart beat. I watched it slow. And slow. And stop. And I heard a guttural cry. I wondered where it was coming from when I realized it was coming from me. There is nothing that could have prepared me for him drawing his last breath. The tears would not stop flowing as I sobbed, heaving to breathe.

The nurses told us we could stay as long as we wanted. I don’t know if we stayed a couple of minutes or much longer. I do know that when I leaned over for to give Dad one last kiss goodbye, his body had gone cold.

And They Didn’t Charge for Parking…

Sometimes things in life have a way of sneaking up on you. A few pounds weight gain. The end of the month. A surprise ending in a movie. A heart attack wasn’t really something I would have put on that list, though.

In hindsight (now that we’ve read all the webMD pages about heart disease) he had every symptom. But we weren’t thinking in terms of, “Oh, could this be a heart attack?” He had shortness of breath. But he had also just climbed two flights of stairs to get to my house. He had weight gain. But he had also eaten out almost every night for the past couple of weeks, and indulged in an abundance of holiday goodies. His feet and legs were swollen. But we had spent the day walking around Biltmore House and had been on our feet for hours.

We were enjoying the afternoon together when he complained about shortness of breath, and that he might need an inhaler. I suggested we go to the newly opened urgent care center, less than a mile from my house. He insisted it wasn’t a big deal. I went online and showed him there was an appointment available in the next 10 minutes and encouraged him to put his coat on.

The staff at the urgent care center instructed us to go the the ER right away. He said it could wait until they got back to Winston-Salem, where they live. I suggested we go to the ER right away, because the staff at the urgent care center really had nothing to gain by recommending we visit the ER (I didn’t think they would receive kickbacks for ER referrals…). We all agreed to go to the ER. Then I realized I had no idea where the ER was. Fortunately, my first three months in town hadn’t necessitated a hospital visit. The urgent care staff told us to go to Mission Health Hospital. We thanked them and headed over. I dropped off my parents at the entrance to the ER, then parked the car. I was worried that I didn’t have a ticket or placard for the car, and wondered if it was okay to leave the car in the lot. I had this thought that people in emergency situations often don’t think clearly, or make mistakes they normally wouldn’t. The last thing I needed was to come back to an empty spot and a towed car.

The ER staff ran tests for several hours, then said he’d need to be admitted. He’d had a heart attack, and they placed him on medicine that needed monitoring.

A heart attack?

Granted, my knowledge of heart attacks is rare, and mostly from the media. I remembered Fred Sanford on Sanford and Son talking about “the big one” and clutching at his chest. There have been dozens of tv shows and movies where someone has a heart attack and immediately collapses. That hadn’t happened. We had walked around Biltmore House just that morning. Dad was moving slower than usual, but he’s also in his late 70s, so I gave him some slack. There are days that I move slower than usual, too.

So there we were, Christmas week, in a hospital room overlooking the Blue Ridge Mountains – dad in the hospital bed, mom in one chair, and me in the other. I asked the staff if I needed a parking permit and they said no, the lot I was in was fine. Every hospital staff member was outstanding. The doctors, the nurses, the nurse practitioners, the dietitians, the hospitalists, the administrative folks – every person answered our questions in a compassionate matter, smiled, and was, well, simply a lovely human. Maybe I shouldn’t have been, but I was pleasantly surprised by the care and quality of service that we received.

And we were so grateful. That this happened while we were together. That this didn’t happen while one of us was on our frequent travels. That I work for a company that didn’t blink an eye when I said, “I need to take the next few days off to help care for my dad.” That they have health insurance so that this unexpected event won’t bankrupt them. And, this may seem silly, but that we didn’t have to pay for parking (and my car wasn’t towed). Small things delight me.

They discharged him with instructions to follow up with his primary care physician and a cardiologist once he was back home. And to exercise more. And to eat a low sodium diet. We went to the grocery store and were surprised at how much sodium is in so many foods. We searched online for low-sodium recipes and foods. We talked about exercise routines. And we were thankful that we spent another Christmas together, even though it wasn’t how we expected.

Hospital View.JPG

Friday Night Lights

My godson is 18 and the captain of his high school football team. A lot of information to take in there. MY GODSON IS 18! How did that happen? Okay, topic for another post.

He’s the captain of his high school football team. I am so proud of him. He’s a good kid. He’s funny, he’s smart, he’s humble. I love seeing him lead his teammates. I’ve tried to go to as many games as possible this year. Until Friday, he had won every game I had watched this season. And they wanted to win Friday.

I love high school football. The kids are hungry. They play for the love of the sport.It’s a fun game to watch, no matter what the outcome.

You could tell that George’s team was nervous when they took the field on Friday night. They missed passes. They snapped the ball too high, resulting in a heartbreaking “Oh my goodness, really?” 4th down on the opposing team’s 10 yard line.

But they settled down. Going into the 2nd quarter they were down by a lot of points. And they came back. They ran the ball. They passed. They played hard and played smart. At halftime the score was tied. Yay!

The 3rd and 4th quarters were wrenching. The opposing team, Moreau, made a touchdown. Piedmont made a touchdown. Tie, tie, tie. Until. Until a minute left in the game. With Piedmont’s possession. They made the pass. They made the touchdown. They made the 2-point conversion. Woot! Woot! Woot! With 35 seconds left in the game, Piedmont was winning by one point. Yes.

And then. Moreau had not passed the entire game. They ran. They ran well. Really well. Well enough to score 40 something points. And then, they decided to pass. It was a good play. No one was covering number 47. He caught the hail Mary pass and ran into the end zone.

Ohhhhhhh.

But wait. There’s more.

Piedmont, with 35 seconds left on the clock, was determined to move the ball down the field. And they did. Until the very last play. Another hail Mary pass. The receiver caught it on the 1? 1/2? yard line? And was stripped of the ball.

Ohhhhhhh.

What a finish. So close. Yet, not. I literally felt my heart breaking for my godson. Oh, if I could just step in and take life’s disappointments for him. But I can’t.

Better luck next time, George. You played hard, and you played well. You’ve got a lot of people cheering for you, a lot of believers. You can do it.