Friday, October 30, 2009
One of the things that will always stand out in my mind about my father is his willingness - his need, actually - to drop everything to go to a funeral for a family member - no matter how distant the relation. It has left my mother shaking her head more than once how he would jump in the car and drive six or seven hours to Kentucky for the funeral of a cousin. It isn't hard to explain if you know him well enough to know how deep his sense of duty runs. But if you know him as well as I do you have to admit that there is more to the story.
My brother died today. Michael was my father's first born and though he has spent the better part of his life many, many miles from us, today is the first day he is truly gone. I was born one week to the day before Mike's 22nd birthday. The years and distance between us kept us from ever being close. But the older we got the more evident it became - to both of us - during our occasional visits that it was only an accident of fate that we weren't closer.
When I was growing up, my oldest brother was more of an idea - an ideal, really - than a presence in my life. A blank canvas that I could paint onto what I wanted. Even as I grew to know him for who he was, I still remember vividly the hero I made him in my mind. In a way, that is the story of his life. Perhaps it is a story common to some degree to the eldest sibling in any family - my father included. His intellect, athleticism, good looks and self-confidence made it that much more natural that we would all dump our hopes, our values into him. It was a burden that stifled him and eventually caused him to strike out on a path that would take and keep him apart from us. He was the prodigal son.
When he returned it was an event. And with each return visit - right up to his last - just eight weeks ago - it was amazing to me - amazing - how he had shed the baggage of his past. Who does that at the age of 62? Don't you just at some point decide "this is my baggage and I'll carry it?" He could have stayed away. He could have harbored bitterness and resentment. Instead he let those things go and let us see the man he really was rather than the one we would have him be. That man may not have lived up to the image I created in my head and heart, but I would have liked to have had more time to get to know him.
When my father was just shy of his 12th birthday his mother died in child birth. His mother remains to this day one of the single, greatest influences on his life. He was not allowed to attend her funeral. At 22 he was in Italy during the war when his younger brother, Denville, died. They had gone through a lot together growing up - especially after their mother’s death. He could not be there for his funeral. When he was in Germany 12 years later he got word that his father had died. Though it was not unexpected there was no way to make it home for his funeral.
The last couple of days he has read the paper and been pretty alert. All-in-all he is as good as he has been in weeks. He remains bedridden but at this rate there may even be a chance that he will soon be able to transfer to a wheelchair with minimal aid. Only time will tell. But despite that he suffered a loss today. A loss that I had presumed - consciously even - that he would be spared at this point. The loss of a child.
When Michael was here in August we all came to see him. My sister, Sharon, brother, David and I all came to my parents' house to visit with him and my dad. We always make it a point to get group photos during these visits and this was no exception. Even then, before my dad had an acute bout of congestive heart failure, it was hard not to think this would be the last time we would all be together. It didn't hang over us like some melancholy cloud of despair or anything like that. But the feeling was palpable just the same.
"Am I going to need to buy a new suit?" Michael asked my sister referring to what seemed to be our next inevitable family gathering. I like to think of myself as a bit irreverent. But I couldn't hold a candle to Mike. My brother died today. And my dad will not be able to go to his funeral.
Of Good Days and Goodbyes
Monday, October 26, 2009
By the time I was getting ready to go home Sunday morning I wondered out loud to mom, "Have we screwed up in reverse?" At the outset of my dad's decline into hospice care I asked for prayers even though I wasn't sure what prayers to ask for. That time was as confusing as it was emotionally trying. Once we were in place with hospice the confusion was over. We had a focus - my dad's comfort - and emotionally we could start to deal with the reality of his passing rather than the tension of "is this one 'the one.'"
There have been ups and downs since then. What I never expected was that it would be the ups that would be so remarkable. We aren't treating him anymore. No more diuretics and aggressive meds. I gave him his pills Friday night. I put them in his mouth but he refused the water. Did he want juice? No. There was some momentary confusion about what he wanted before it became clear he wanted the rest of the pills. He's always been one to just put the whole handful in his mouth at once and wash 'em down. There are only 3 small ones now we explained. Down they went. Maybe we were giving the drugs too much credit. Maybe we weren't giving his body enough. Either way, it's hard - for me at least - to know what to feel when he improves so much.
My niece, Arrow, his oldest granddaughter, arrived from Ottawa Thursday morning. It is a trip that was planned since the summer but a week before her arrival it seemed a stretch to think he would make it to see her and meet her 18-month-old daughter, Kyla, for the first time. By Saturday morning, however, I was suggesting we ask him if he would like us to get him out of bed and into his comfy chair where he could visit with the family a little more. He said "no" initially. Later when he realized how many of us were there - 3 children, 5 grandchildren, 3 spouses and a (very active) great-grandchild - he warmed to the idea. It was a bit of a project but my sister, Sharon, is a nurse and has spent the better part of her adult life working in elder care facilities of one kind or another. She ran the show and before long he was in his familiar post, his recliner in what he once dubbed "the useless room."
We all gathered around for a pre-dinner visit and I poured him a beer. His first in nearly a month. It was only then that I realized how long it had been since I had seen him smile. Really smile. Not the smirk when he delivers a "Roy-ism" or a grin he manages for company coming to pay their respects. He later admitted it really hadn't tasted quite right but there was no denying the pleasure of that brief moment when he could enjoy playing patriarchal host to his family. It wasn't long before the din of multiple conversations and small children playing, mixed with the partially-finished beer, took its toll. By the time my mom gave him an envelope from his congressman - kind of like a birthday present - he barely could keep his eyes open to read the letter accompanying his Good Conduct Medal. That medal was missing from his uniform array and it was important to him to replace it so he could be buried with it. He slept soundly as we ate dinner.
By the time we moved him back into the hospital bed that has been home for almost three weeks I thought perhaps we had worn him out. Maybe even pushed him over the edge. If so I was OK with that. It had been worthwhile. Arrow came in later to say "goodbye." They were going to be driving through the night to let Kyla sleep on the nine hour trip home. It wasn't easy to pry away. "This will be the last time you'll see me, you know" he said to her in that tone of his that carries authority even as he speaks gently. This has been especially hard for her. Her whole life she hasn't been able to be around as much as the rest of us. This visit was important to both of them and they had both overcome several obstacles to make it. In more ways than one it was a long goodbye.
But now it was the next morning and he wasn't closer to dying it seemed but closer to being well. If I were visiting him in the hospital and they were saying he was coming home today it wouldn't have seemed like a stretch. His color was good and even the skin around his face seemed to be more taught. Had we caused this by getting him out of bed? And should we be happy for him or not? While we were moving him around he asked several times "how did I get like this?" Each time it seemed to be more of a surprise than before that he could not assist even a little as we picked him up and transferred him. My mom and sister tried to explain to him how and why it was he was so weak - the events and the physical deterioration. But I think it may have been a rhetorical question. He never intended for his end to be like this and once when we were moving him he said, "I dislike this intensely." It was a rare moment of bitterness. Now that he is noticeably improved it is hard to be happy thinking this state of affairs could be prolonged. It is hard to be sad for my own selfish reasons. I hated to leave when he was like this but we had an important congregational meeting to get to back home.
Early on I said we weren't going to start reprogramming every detail of our life for "what if's." We would go on as close to normal as possible and plan the way we would otherwise. When circumstances dictate that we alter our plans we will. But I hated to leave when he was like this - so "normal." "You can come visit me at Fort Custer," he said. "Absolutely," I replied without hesitation. The absurdity broke the tension.
So people ask me how he's doing and I tell them "pretty good." "Oh, that's good," they say reflexively. Good for who? I'm confused again. But the selfish me agrees and I can't find it in me to hope for anything less.
By the time I was getting ready to go home Sunday morning I wondered out loud to mom, "Have we screwed up in reverse?" At the outset of my dad's decline into hospice care I asked for prayers even though I wasn't sure what prayers to ask for. That time was as confusing as it was emotionally trying. Once we were in place with hospice the confusion was over. We had a focus - my dad's comfort - and emotionally we could start to deal with the reality of his passing rather than the tension of "is this one 'the one.'"
There have been ups and downs since then. What I never expected was that it would be the ups that would be so remarkable. We aren't treating him anymore. No more diuretics and aggressive meds. I gave him his pills Friday night. I put them in his mouth but he refused the water. Did he want juice? No. There was some momentary confusion about what he wanted before it became clear he wanted the rest of the pills. He's always been one to just put the whole handful in his mouth at once and wash 'em down. There are only 3 small ones now we explained. Down they went. Maybe we were giving the drugs too much credit. Maybe we weren't giving his body enough. Either way, it's hard - for me at least - to know what to feel when he improves so much.
My niece, Arrow, his oldest granddaughter, arrived from Ottawa Thursday morning. It is a trip that was planned since the summer but a week before her arrival it seemed a stretch to think he would make it to see her and meet her 18-month-old daughter, Kyla, for the first time. By Saturday morning, however, I was suggesting we ask him if he would like us to get him out of bed and into his comfy chair where he could visit with the family a little more. He said "no" initially. Later when he realized how many of us were there - 3 children, 5 grandchildren, 3 spouses and a (very active) great-grandchild - he warmed to the idea. It was a bit of a project but my sister, Sharon, is a nurse and has spent the better part of her adult life working in elder care facilities of one kind or another. She ran the show and before long he was in his familiar post, his recliner in what he once dubbed "the useless room."
We all gathered around for a pre-dinner visit and I poured him a beer. His first in nearly a month. It was only then that I realized how long it had been since I had seen him smile. Really smile. Not the smirk when he delivers a "Roy-ism" or a grin he manages for company coming to pay their respects. He later admitted it really hadn't tasted quite right but there was no denying the pleasure of that brief moment when he could enjoy playing patriarchal host to his family. It wasn't long before the din of multiple conversations and small children playing, mixed with the partially-finished beer, took its toll. By the time my mom gave him an envelope from his congressman - kind of like a birthday present - he barely could keep his eyes open to read the letter accompanying his Good Conduct Medal. That medal was missing from his uniform array and it was important to him to replace it so he could be buried with it. He slept soundly as we ate dinner.
By the time we moved him back into the hospital bed that has been home for almost three weeks I thought perhaps we had worn him out. Maybe even pushed him over the edge. If so I was OK with that. It had been worthwhile. Arrow came in later to say "goodbye." They were going to be driving through the night to let Kyla sleep on the nine hour trip home. It wasn't easy to pry away. "This will be the last time you'll see me, you know" he said to her in that tone of his that carries authority even as he speaks gently. This has been especially hard for her. Her whole life she hasn't been able to be around as much as the rest of us. This visit was important to both of them and they had both overcome several obstacles to make it. In more ways than one it was a long goodbye.
But now it was the next morning and he wasn't closer to dying it seemed but closer to being well. If I were visiting him in the hospital and they were saying he was coming home today it wouldn't have seemed like a stretch. His color was good and even the skin around his face seemed to be more taught. Had we caused this by getting him out of bed? And should we be happy for him or not? While we were moving him around he asked several times "how did I get like this?" Each time it seemed to be more of a surprise than before that he could not assist even a little as we picked him up and transferred him. My mom and sister tried to explain to him how and why it was he was so weak - the events and the physical deterioration. But I think it may have been a rhetorical question. He never intended for his end to be like this and once when we were moving him he said, "I dislike this intensely." It was a rare moment of bitterness. Now that he is noticeably improved it is hard to be happy thinking this state of affairs could be prolonged. It is hard to be sad for my own selfish reasons. I hated to leave when he was like this but we had an important congregational meeting to get to back home.
Early on I said we weren't going to start reprogramming every detail of our life for "what if's." We would go on as close to normal as possible and plan the way we would otherwise. When circumstances dictate that we alter our plans we will. But I hated to leave when he was like this - so "normal." "You can come visit me at Fort Custer," he said. "Absolutely," I replied without hesitation. The absurdity broke the tension.
So people ask me how he's doing and I tell them "pretty good." "Oh, that's good," they say reflexively. Good for who? I'm confused again. But the selfish me agrees and I can't find it in me to hope for anything less.
Will
Monday, October 19, 2009
This was a very important weekend to my dad. It is difficult to explain how important unless you are one the initiated, indoctrinated, inner circle members of the society known as "Barbershoppers." It wasn't like your child's wedding or even as weighty as his college graduation. A graduate degree. Maybe that gives you an idea. None of us siblings have one of those but I imagine if one of us were going through a graduation ceremony to get some class of graduate degree he would want to be there just about as much as he wanted to be in Kalamazoo this past weekend.
Ironic since that (Kalamazoo) is where we were two weeks ago today and it was not a pleasant experience. This was different, however. I was directing a chorus in contest for the first time. Barbershop singing is the activity my dad and I shared as I grew up. He used to say, "Beats hell out of little league" when talking about it. One of many Roy-isms. It has been a connecting thread for us for 30 years even when there were miles between us. I've directed choruses plenty of times over the years but never in contest. On top of that my quartet, still a pretty new ensemble, just got a new baritone. It was a little like acquiring Wayne Gretzky on your minor league hockey team (not sure dad would get the analogy, but he'd look it up). We landed an international gold medalist baritone and while we knew we couldn't win with just six rehearsals under our belt we were going to make a splash. Proud fathers don't miss weekends like this.
Hillsdale isn't on the way to or from the Detroit area from Kalamazoo. OK. Hillsdale isn't on the way to anything except Hillsdale. But my quartet - wives and kids in tow - went nearly 100 miles out of their way yesterday to come to his bedside. A small consolation prize for him but the best we could arrange given the circumstances. When I talked to my mom Saturday night after the contest was over she warned me not to dawdle getting there the next day. The previous 24 hours were not good. I was hoping she wasn't holding back anything like "come now." But I decided she wouldn't do that. We got the troops together as efficiently as possible Sunday morning and I spent the preponderance of the ride preparing myself for the possibility that he might not be able to enjoy even this small gesture.
I couldn't have been prepared for what I encountered, however. Simply put, he was more himself than I have seen him in quite some time. Maybe even since before this summer which was a difficult one. I had asked my mom a few days ago if there was any predictor for what made a good day or good hour (not that the two are that different for someone who isn't awake more than a few hours a day). Certain times of day, certain times after eating? Nothing. Those times have been unpredictable and sometimes even inconvenient. If he's up to talking at 1:00 in the morning you just have to accept that for the gift that it is. But I don't think this was just a gift. This was a show of will and determination. If you know any of my father's life story that is not a stretch. If he set out to will himself to any particular task, no matter how outrageous, I wouldn't advise betting against him.
I allowed my mind to wander for a bit. He could rally. If he really wanted to do it he could rebound. He really could set his mind to it and get back on his feet. Why not? If his strength of will could bring him back this far why not all the way where he was before? That's when it hit me. You know. Like that final scene of "The Sixth Sense." This is where he has been for a long time. The only thing between him and the ground has been his will for... damn. Has it been that long? Three years?
That's when he went right to the brink with a really bad pneumonia. He was in the hospital and even the doctors could see he was giving up the fight. I even got that call everyone dreads - "you better get here soon." But he changed his mind. He fought back. Well, that's what I thought. He didn't decide that day to keep going. He has been deciding every day since then. Someday soon he will make a different decision.
This was a very important weekend to my dad. It is difficult to explain how important unless you are one the initiated, indoctrinated, inner circle members of the society known as "Barbershoppers." It wasn't like your child's wedding or even as weighty as his college graduation. A graduate degree. Maybe that gives you an idea. None of us siblings have one of those but I imagine if one of us were going through a graduation ceremony to get some class of graduate degree he would want to be there just about as much as he wanted to be in Kalamazoo this past weekend.
Ironic since that (Kalamazoo) is where we were two weeks ago today and it was not a pleasant experience. This was different, however. I was directing a chorus in contest for the first time. Barbershop singing is the activity my dad and I shared as I grew up. He used to say, "Beats hell out of little league" when talking about it. One of many Roy-isms. It has been a connecting thread for us for 30 years even when there were miles between us. I've directed choruses plenty of times over the years but never in contest. On top of that my quartet, still a pretty new ensemble, just got a new baritone. It was a little like acquiring Wayne Gretzky on your minor league hockey team (not sure dad would get the analogy, but he'd look it up). We landed an international gold medalist baritone and while we knew we couldn't win with just six rehearsals under our belt we were going to make a splash. Proud fathers don't miss weekends like this.
Hillsdale isn't on the way to or from the Detroit area from Kalamazoo. OK. Hillsdale isn't on the way to anything except Hillsdale. But my quartet - wives and kids in tow - went nearly 100 miles out of their way yesterday to come to his bedside. A small consolation prize for him but the best we could arrange given the circumstances. When I talked to my mom Saturday night after the contest was over she warned me not to dawdle getting there the next day. The previous 24 hours were not good. I was hoping she wasn't holding back anything like "come now." But I decided she wouldn't do that. We got the troops together as efficiently as possible Sunday morning and I spent the preponderance of the ride preparing myself for the possibility that he might not be able to enjoy even this small gesture.
I couldn't have been prepared for what I encountered, however. Simply put, he was more himself than I have seen him in quite some time. Maybe even since before this summer which was a difficult one. I had asked my mom a few days ago if there was any predictor for what made a good day or good hour (not that the two are that different for someone who isn't awake more than a few hours a day). Certain times of day, certain times after eating? Nothing. Those times have been unpredictable and sometimes even inconvenient. If he's up to talking at 1:00 in the morning you just have to accept that for the gift that it is. But I don't think this was just a gift. This was a show of will and determination. If you know any of my father's life story that is not a stretch. If he set out to will himself to any particular task, no matter how outrageous, I wouldn't advise betting against him.
I allowed my mind to wander for a bit. He could rally. If he really wanted to do it he could rebound. He really could set his mind to it and get back on his feet. Why not? If his strength of will could bring him back this far why not all the way where he was before? That's when it hit me. You know. Like that final scene of "The Sixth Sense." This is where he has been for a long time. The only thing between him and the ground has been his will for... damn. Has it been that long? Three years?
That's when he went right to the brink with a really bad pneumonia. He was in the hospital and even the doctors could see he was giving up the fight. I even got that call everyone dreads - "you better get here soon." But he changed his mind. He fought back. Well, that's what I thought. He didn't decide that day to keep going. He has been deciding every day since then. Someday soon he will make a different decision.
A Day in the Life
Thursday, October 15, 2009
Many people ask me, "how’s your dad doing?" I hear it many times a day. It is the way people show they care and, as I wrote previously, I am truly humbled by that. But there isn’t a good answer. I usually say, "he’s dying." Is that too much reality or not enough? I mean, we’re all dying. It’s just that most of us have things that are more important to us. Things that define our existence more accurately than that, especially since that is one thing - the one thing - we all have in common. For him, it is his most defining task at hand. And as we are learning day by day it is not a quick process.
So allow me to bring more reality to my answer. He is eating, though only enough to maintain a certain comfort level. He sleeps a lot. Probably more than your typical newborn. I would guess 20 hours a day give or take. It is hard to gauge because sometimes he is awake for very short periods and sometimes he’s awake but not quite engaged with his surroundings. He can converse but it wears on him quickly. And as I have said a number of times, he isn’t really altered. If you’ve ever woken him from a sound nap and talked to him before he is totally aroused (as I have many times in my life) this is what he is like most of the time when he is awake. In that sense he seems almost normal. He manages the occasional "Roy-ism" but not very often. He can have visitors but don’t expect any stimulating conversation. This is how he has been since returning from the hospital - which is marginally better than when he went in two weeks ago.
He isn’t ambulatory at all. This is by far the biggest change most people would see in him since returning from the hospital. He is now totally dependent. Oddly enough I don’t find that to be the biggest change. Before going into the hospital he got himself out of bed and dressed every morning. That and getting himself to the kitchen table to the continental breakfast that awaited him was exhausting. It took a while to recover. After which he would read the morning paper. As my brothers and sister can attest, this is a long-standing morning ritual. Woe to the person who misplaced the newspaper or even failed to reassemble it in its proper order. And that is the biggest change in my father. He doesn’t read the paper - or even watch the news anymore. He has lost his interest in the outside world. He has traded in his stock.
The last three years in particular have been marked by bouts of pneumonia that usually result in a lesser capacity for activity than before. A "stair step" type of decline. He’s done with that. He’s reached the last step. How long he will stay on that step is completely unknown to anyone. But he isn’t interested in sustaining it. The next acute problem he has will be his last.
There’s a line in "Shawshank Redemption," a movie we both enjoyed, that says "Get busy living or get busy dying." I have known people that seem to go through life in a way that seems to be focused on their demise. A long, drawn out march to their own death. For a man that has faced his own mortality more times than anyone else I know - on and off the battlefield - this has never been my father's way. For over 87 years he has been in the business of living. Now that he is in the business of dying it doesn't really seem appropriate to talk about how he is so much as how he was. Not because I'm anxious to have him in the past tense. Because no matter how long he lasts like this it will never be "how he is."
Many people ask me, "how’s your dad doing?" I hear it many times a day. It is the way people show they care and, as I wrote previously, I am truly humbled by that. But there isn’t a good answer. I usually say, "he’s dying." Is that too much reality or not enough? I mean, we’re all dying. It’s just that most of us have things that are more important to us. Things that define our existence more accurately than that, especially since that is one thing - the one thing - we all have in common. For him, it is his most defining task at hand. And as we are learning day by day it is not a quick process.
So allow me to bring more reality to my answer. He is eating, though only enough to maintain a certain comfort level. He sleeps a lot. Probably more than your typical newborn. I would guess 20 hours a day give or take. It is hard to gauge because sometimes he is awake for very short periods and sometimes he’s awake but not quite engaged with his surroundings. He can converse but it wears on him quickly. And as I have said a number of times, he isn’t really altered. If you’ve ever woken him from a sound nap and talked to him before he is totally aroused (as I have many times in my life) this is what he is like most of the time when he is awake. In that sense he seems almost normal. He manages the occasional "Roy-ism" but not very often. He can have visitors but don’t expect any stimulating conversation. This is how he has been since returning from the hospital - which is marginally better than when he went in two weeks ago.
He isn’t ambulatory at all. This is by far the biggest change most people would see in him since returning from the hospital. He is now totally dependent. Oddly enough I don’t find that to be the biggest change. Before going into the hospital he got himself out of bed and dressed every morning. That and getting himself to the kitchen table to the continental breakfast that awaited him was exhausting. It took a while to recover. After which he would read the morning paper. As my brothers and sister can attest, this is a long-standing morning ritual. Woe to the person who misplaced the newspaper or even failed to reassemble it in its proper order. And that is the biggest change in my father. He doesn’t read the paper - or even watch the news anymore. He has lost his interest in the outside world. He has traded in his stock.
The last three years in particular have been marked by bouts of pneumonia that usually result in a lesser capacity for activity than before. A "stair step" type of decline. He’s done with that. He’s reached the last step. How long he will stay on that step is completely unknown to anyone. But he isn’t interested in sustaining it. The next acute problem he has will be his last.
There’s a line in "Shawshank Redemption," a movie we both enjoyed, that says "Get busy living or get busy dying." I have known people that seem to go through life in a way that seems to be focused on their demise. A long, drawn out march to their own death. For a man that has faced his own mortality more times than anyone else I know - on and off the battlefield - this has never been my father's way. For over 87 years he has been in the business of living. Now that he is in the business of dying it doesn't really seem appropriate to talk about how he is so much as how he was. Not because I'm anxious to have him in the past tense. Because no matter how long he lasts like this it will never be "how he is."
Iceland
Sunday, October 11, 2009
What a difference a week makes. Last Sunday when I visited my dad in the hospital we were worried that he wouldn't recover from the acute congestive heart failure. He was hopeful that a heart catheterization the following day would give him some relief and allow him to make it to the barbershopper convention then two weeks away. He was weak but he was sitting up in bed talking my oldest daughter's ear off. We were on pins and needles that this time he might not make it through. There were a couple of ways in my mind that this could have turned out. This isn't one of the ways I envisioned.
How did we end up here? Well, it started 68 years ago. From September 1941 through December 1942 my dad was deployed to Iceland. This was hands down the most grueling assignment he ever endured. The monotony of the menu, hard labor and long hours of guard duty drove men to suicide - several per week. Often he would have to take an eight-hour shift on guard duty after unloading cargo from ships the previous eight hours. Sleeping on duty was grounds for court martial. So this 19-year-old tobacco field hand from Kentucky that had never developed a smoking habit started lighting cigarettes to stay awake. If the smoke failed to keep him up the butt between his figures would eventually burn down and jolt him awake. Inevitably he started smoking them.
He escaped Iceland by applying to Officer Candidate School. It was a brilliant move really and so typical of him. One of the most enduring themes of my father's life is self-improvement. I would never accuse him of being perfect but status quo is certainly not his style. So he got the hell out of Iceland but he carried a lot of baggage with him. Lucky Strike, indeed.
Some 35 years later he improved himself again by quitting his smoking habit cold turkey. He left one un-smoked in the last pack of his last carton and walked away from a very powerful addiction. I can still hear his bellow. Several times a day at first and then less and less frequently (but still every now and then years later) you could hear his voice carry all over the house - probably all over the neighborhood: "I'd wrestle a TANK for a fresh Lucky Strike!"
No tank ever dared to take up the challenge and so here we are almost 35 years hence. He never touched another cigarette but they never quite stopped ravaging him. He managed a polite smile for a couple of visitors today but not so much for us. I'm quite sure he would rather take on that tank right now than what he has to endure. I know the details of a few of his many wartime engagements. If he displayed half the courage then that he does now it is easy to understand how he survived for so long and excelled at so many things on and off the battlefield.
But this courage is different in ways both subtle and profound. It takes a certain kind of courage to be faced with a difficult choice. Then there is the courage to accept something you have no choice in. I would have said the later is something my dad was no good at. But after all this time he's still teaching and I'm still learning. And Iceland sure is a hell of a place for a soldier to be stationed.
What a difference a week makes. Last Sunday when I visited my dad in the hospital we were worried that he wouldn't recover from the acute congestive heart failure. He was hopeful that a heart catheterization the following day would give him some relief and allow him to make it to the barbershopper convention then two weeks away. He was weak but he was sitting up in bed talking my oldest daughter's ear off. We were on pins and needles that this time he might not make it through. There were a couple of ways in my mind that this could have turned out. This isn't one of the ways I envisioned.
How did we end up here? Well, it started 68 years ago. From September 1941 through December 1942 my dad was deployed to Iceland. This was hands down the most grueling assignment he ever endured. The monotony of the menu, hard labor and long hours of guard duty drove men to suicide - several per week. Often he would have to take an eight-hour shift on guard duty after unloading cargo from ships the previous eight hours. Sleeping on duty was grounds for court martial. So this 19-year-old tobacco field hand from Kentucky that had never developed a smoking habit started lighting cigarettes to stay awake. If the smoke failed to keep him up the butt between his figures would eventually burn down and jolt him awake. Inevitably he started smoking them.
He escaped Iceland by applying to Officer Candidate School. It was a brilliant move really and so typical of him. One of the most enduring themes of my father's life is self-improvement. I would never accuse him of being perfect but status quo is certainly not his style. So he got the hell out of Iceland but he carried a lot of baggage with him. Lucky Strike, indeed.
Some 35 years later he improved himself again by quitting his smoking habit cold turkey. He left one un-smoked in the last pack of his last carton and walked away from a very powerful addiction. I can still hear his bellow. Several times a day at first and then less and less frequently (but still every now and then years later) you could hear his voice carry all over the house - probably all over the neighborhood: "I'd wrestle a TANK for a fresh Lucky Strike!"
No tank ever dared to take up the challenge and so here we are almost 35 years hence. He never touched another cigarette but they never quite stopped ravaging him. He managed a polite smile for a couple of visitors today but not so much for us. I'm quite sure he would rather take on that tank right now than what he has to endure. I know the details of a few of his many wartime engagements. If he displayed half the courage then that he does now it is easy to understand how he survived for so long and excelled at so many things on and off the battlefield.
But this courage is different in ways both subtle and profound. It takes a certain kind of courage to be faced with a difficult choice. Then there is the courage to accept something you have no choice in. I would have said the later is something my dad was no good at. But after all this time he's still teaching and I'm still learning. And Iceland sure is a hell of a place for a soldier to be stationed.
Solo Flight
Thursday, October 8, 2009
You know how chemotherapy is basically just a load of toxic crap that we hope kills a cancerous growth before it kills the patient? I really think this may have been what was happening to my dad with his treatment. I think it was killing him faster than the primary ailments. Don't get me wrong. I'm not criticizing the medical care he has received. In fact, I have a much greater respect for the difficulty the modern practitioner faces. With so many treatment options and so many maladies to treat in one body, at what point does treatment become a malady of its own? I'll stick to computers, thanks.
There are many ways he seems better now. It would be really easy to look at him and see someone that is actively recovering. And we had some really good time today. He ate well - which is to say he had as much nourishment as the previous two days combined - and conversed pretty freely. With fatigue, however, his conversations become... garbled, for lack of a better term. He replaces nouns with other nouns or with nonsense words. Most of the time there is context: "Can you put a wall over there so I know what time it is?" Other times... not so much: "I need a pleedasees for my digiment." Huh? The really interesting thing is he used to stall for those words. Now he just plows right through with confidence.
You might think that would be unnerving for us or hard to take. But it really hasn't been, though I can only truly speak for myself. He isn't altered. He is clearly himself and his spirits are high. Not joking or whooping it up but clearly not depressed or cynical. There have been many illnesses that he has faced that have been more emotionally difficult for those of us trying to care for him as we watch him struggle to regain or retain certain standards of independence or dignity. Since that really isn't the goal now the time we spend conversing - or decoding as the case may be - is less burdened in some way I can't quite put into words.
I left just before dark tonight. This is my mom's first night alone with him since going to the hospital. We did pretty well together last night. I was worried about not having Sharon with us but we not only managed, I think we excelled. But the fact of the matter is there are some things she cannot do for him alone. He doesn't have the strength to lift his own weight. Sure, there are 24-hour numbers, a Life Line service and a whole bunch of us that sleep with our phone ringers on maximum. But alone is alone and this is the first time she's been this alone caring for anyone this infirm. 48 hours ago she would have come unglued. I would have come unglued watching her come unglued. This isn't easy, but it isn't 48 hours ago, either.
You know how chemotherapy is basically just a load of toxic crap that we hope kills a cancerous growth before it kills the patient? I really think this may have been what was happening to my dad with his treatment. I think it was killing him faster than the primary ailments. Don't get me wrong. I'm not criticizing the medical care he has received. In fact, I have a much greater respect for the difficulty the modern practitioner faces. With so many treatment options and so many maladies to treat in one body, at what point does treatment become a malady of its own? I'll stick to computers, thanks.
There are many ways he seems better now. It would be really easy to look at him and see someone that is actively recovering. And we had some really good time today. He ate well - which is to say he had as much nourishment as the previous two days combined - and conversed pretty freely. With fatigue, however, his conversations become... garbled, for lack of a better term. He replaces nouns with other nouns or with nonsense words. Most of the time there is context: "Can you put a wall over there so I know what time it is?" Other times... not so much: "I need a pleedasees for my digiment." Huh? The really interesting thing is he used to stall for those words. Now he just plows right through with confidence.
You might think that would be unnerving for us or hard to take. But it really hasn't been, though I can only truly speak for myself. He isn't altered. He is clearly himself and his spirits are high. Not joking or whooping it up but clearly not depressed or cynical. There have been many illnesses that he has faced that have been more emotionally difficult for those of us trying to care for him as we watch him struggle to regain or retain certain standards of independence or dignity. Since that really isn't the goal now the time we spend conversing - or decoding as the case may be - is less burdened in some way I can't quite put into words.
I left just before dark tonight. This is my mom's first night alone with him since going to the hospital. We did pretty well together last night. I was worried about not having Sharon with us but we not only managed, I think we excelled. But the fact of the matter is there are some things she cannot do for him alone. He doesn't have the strength to lift his own weight. Sure, there are 24-hour numbers, a Life Line service and a whole bunch of us that sleep with our phone ringers on maximum. But alone is alone and this is the first time she's been this alone caring for anyone this infirm. 48 hours ago she would have come unglued. I would have come unglued watching her come unglued. This isn't easy, but it isn't 48 hours ago, either.
Training Day
Wednesday, October 7, 2009
Last night we were pretty exhausted, of course. We ordered pizza and were all in bed before 10:00. Once my mom, Sharon and I had assembled at the kitchen table this morning we discussed what we had to do before the hospice team arrived at noon. Showers were highest on the list of priority. I was able to fill a prescription and run to the store. My mom was finally able to talk to her best friend, Carol, which provided her first real chance for catharsis. Little did we realize the utter conga line of caregivers that was about to descend upon us.
The hospice director (a former student of my dad), the primary nurse that will be assigned, two nurses’ assistants, Tami, two neighbors (one with home-baked bread and fresh flowers) and the equipment manager *cha, cha cha*. The minute we sat down after that my mom said she wasn’t sure we could stand the peace & quite and Tami returned from the store and the equipment manager returned with a baby monitor we requested.
Truly, the people I have met over the last 36 hours of my life have been some of the best I have met in the previous 40 years. This sounds like hyperbole. It is not. They are competent, efficient and do their jobs - even if it is "friend" or "neighbor" - with a willingness... strike that... with a joy that can only be experienced. Thank God for all of them!
The question we are asked most often is, "how long?" We wish we could answer that. A day? A week? A month? Anyone who knows Roy Tipton well knows that he is not in a state that he would wish to persist long and that is the only measure we have. He does experience some pain on occasion. We have pharmaceuticals for that with a fairly liberal mandate for their use. We don’t want to suppress any lucidity he is likely to display from this point on but those moments seem like they will be fewer and fewer from this point on. But we really don’t know that, either. It just feels so.
My mom is anxious, and has said as much, about being able to do what is necessary for him. I suppose anyone not trained for it would be. There has been a lot to absorb in a short amount of time on top of the emotional experience. There are many, many people to call for support but she has a lot ahead of her no matter how many of us there are, no matter how long this process is to take. She is overwhelmed but holding up well. I doubt it will get easy for her but she will get a routine and that is her refuge.
As Sharon leaves for home I will stay on for at least another day hopefully to help my mom settle in to that routine. We will just have to see how "day two" goes when it arrives.
Last night we were pretty exhausted, of course. We ordered pizza and were all in bed before 10:00. Once my mom, Sharon and I had assembled at the kitchen table this morning we discussed what we had to do before the hospice team arrived at noon. Showers were highest on the list of priority. I was able to fill a prescription and run to the store. My mom was finally able to talk to her best friend, Carol, which provided her first real chance for catharsis. Little did we realize the utter conga line of caregivers that was about to descend upon us.
The hospice director (a former student of my dad), the primary nurse that will be assigned, two nurses’ assistants, Tami, two neighbors (one with home-baked bread and fresh flowers) and the equipment manager *cha, cha cha*. The minute we sat down after that my mom said she wasn’t sure we could stand the peace & quite and Tami returned from the store and the equipment manager returned with a baby monitor we requested.
Truly, the people I have met over the last 36 hours of my life have been some of the best I have met in the previous 40 years. This sounds like hyperbole. It is not. They are competent, efficient and do their jobs - even if it is "friend" or "neighbor" - with a willingness... strike that... with a joy that can only be experienced. Thank God for all of them!
The question we are asked most often is, "how long?" We wish we could answer that. A day? A week? A month? Anyone who knows Roy Tipton well knows that he is not in a state that he would wish to persist long and that is the only measure we have. He does experience some pain on occasion. We have pharmaceuticals for that with a fairly liberal mandate for their use. We don’t want to suppress any lucidity he is likely to display from this point on but those moments seem like they will be fewer and fewer from this point on. But we really don’t know that, either. It just feels so.
My mom is anxious, and has said as much, about being able to do what is necessary for him. I suppose anyone not trained for it would be. There has been a lot to absorb in a short amount of time on top of the emotional experience. There are many, many people to call for support but she has a lot ahead of her no matter how many of us there are, no matter how long this process is to take. She is overwhelmed but holding up well. I doubt it will get easy for her but she will get a routine and that is her refuge.
As Sharon leaves for home I will stay on for at least another day hopefully to help my mom settle in to that routine. We will just have to see how "day two" goes when it arrives.
Another day, another roller coaster ride!
Tuesday, October 6, 2009
Last night was a very difficult night. It started with some delirium and faded into a fitful sleep that continued over the next 14 or 16 hours. Around 1:00 or so this afternoon a new doctor arrived, Dr. LaPenna. This is the partner of the doctor that saw him yesterday, Dr. Campbell, whom we liked quite well and spent nearly an hour evaluating him and also was the doctor that did his pacemaker surgery six years ago. This doctor, seeing him for the first time, listened to his heart and lungs and said he can go home. We almost collectively fainted.
The problem is that this ward is the Cardiac Short Stay - virtually an outpatient care facility. Excellent as it is, it really isn't configured to make patients comfortable. To the doctor’s credit he listened as we explained that simply going home was not acceptable. Several very attentive people and a couple of hours later we were talking to a palliative care team.
In the meantime his condition improved considerably. He was as lucid as he has been and even demonstrated as much strength as he has had in a while; lifting his arms entirely over his head unaided, etc. He was quite coherent and able to express his end-of-life wishes fairly articulately. When he was asked what he wanted to do he didn’t miss a beat replying that he wanted to die at home. He wasn’t aware of all of the options available or even how hospice was able to help. After some explanation, however, he was agreeable to the concept. His spirits were quite good, though, and the “old Roy” that we are all used to was in full display. Some of the questions and discussions were understandably difficult for the rest of us but he was neither maudlin nor depressed in any way. He was surprised to hear that he had such a restless night and that he had been so delirious. His feeling was that he had “a pretty good night.” All the better, I suppose.
The palliative care doctor, Dr. Trexler, was pretty optimistic that there were meds that would prevent the restlessness and any agitation he might experience. Despite our dismay at having been sent to Borgess at all, the staff has been nothing less than outstanding at getting hospice set up. At around 2:45 we called, Tami, my mom’s cleaning girl, to see if she could be at the condo by 3:30 to take delivery on the hospital bed. By 3:15 she called back to say the room was cleaned and ready and the queen bed was disassembled and stowed in the closet!
By 7:00 we were back at the condo and all but completely settled in. My mom rode in the ambulance and Sharon drove her car for her. David will come tomorrow evening to take Sharon back to Kalamazoo. It is hard to know what is next but whatever it is it seems much easier to face in this setting. It is certainly more comfortable for those of us providing care, especially my mom and that is no small part of this process. Thank you all for all of the prayers and well-wishes. I am truly humbled by the outpouring of support.
Last night was a very difficult night. It started with some delirium and faded into a fitful sleep that continued over the next 14 or 16 hours. Around 1:00 or so this afternoon a new doctor arrived, Dr. LaPenna. This is the partner of the doctor that saw him yesterday, Dr. Campbell, whom we liked quite well and spent nearly an hour evaluating him and also was the doctor that did his pacemaker surgery six years ago. This doctor, seeing him for the first time, listened to his heart and lungs and said he can go home. We almost collectively fainted.
The problem is that this ward is the Cardiac Short Stay - virtually an outpatient care facility. Excellent as it is, it really isn't configured to make patients comfortable. To the doctor’s credit he listened as we explained that simply going home was not acceptable. Several very attentive people and a couple of hours later we were talking to a palliative care team.
In the meantime his condition improved considerably. He was as lucid as he has been and even demonstrated as much strength as he has had in a while; lifting his arms entirely over his head unaided, etc. He was quite coherent and able to express his end-of-life wishes fairly articulately. When he was asked what he wanted to do he didn’t miss a beat replying that he wanted to die at home. He wasn’t aware of all of the options available or even how hospice was able to help. After some explanation, however, he was agreeable to the concept. His spirits were quite good, though, and the “old Roy” that we are all used to was in full display. Some of the questions and discussions were understandably difficult for the rest of us but he was neither maudlin nor depressed in any way. He was surprised to hear that he had such a restless night and that he had been so delirious. His feeling was that he had “a pretty good night.” All the better, I suppose.
The palliative care doctor, Dr. Trexler, was pretty optimistic that there were meds that would prevent the restlessness and any agitation he might experience. Despite our dismay at having been sent to Borgess at all, the staff has been nothing less than outstanding at getting hospice set up. At around 2:45 we called, Tami, my mom’s cleaning girl, to see if she could be at the condo by 3:30 to take delivery on the hospital bed. By 3:15 she called back to say the room was cleaned and ready and the queen bed was disassembled and stowed in the closet!
By 7:00 we were back at the condo and all but completely settled in. My mom rode in the ambulance and Sharon drove her car for her. David will come tomorrow evening to take Sharon back to Kalamazoo. It is hard to know what is next but whatever it is it seems much easier to face in this setting. It is certainly more comfortable for those of us providing care, especially my mom and that is no small part of this process. Thank you all for all of the prayers and well-wishes. I am truly humbled by the outpouring of support.
A New Problem
Monday, October 5, 2009
Things seem to change by the minute so it is hard to know what to report but I will start with the good news, limited as it is. The doctors do not believe he has had a heart attack. He has also been much more comfortable over the weekend. He is, of course, quite weak. We visited last night and he was in good spirits and even talked at length which surprised me. He was most concerned that everything stay on track so he could be moved to Borgess and have the heart catheterization. He was moved this morning and my mom and sister, Sharon, met him there.
At this time they are unwilling to perform the heart catheterization. He has a Do Not Resuscitate order in place and there is serious concern that he would be able to survive even this limited procedure. His blood pressure has been quite low since he was admitted and his kidneys show signs of buckling under the strain of the diuretics. This leaves us in what I can only describe as an uncomfortable holding pattern. There is no clear plan for treatment but he is also somewhat stable.
He is also now experiencing some confusion. This may be a symptom of a lack of oxygen or signs of something else. No one is quite sure at this point but for the moment it may be a small blessing as he is not truly aware that the heart cath is not scheduled; I think that would agitate him. That may be an inevitability, however, as he has always seemed to return to lucidity.
It is hard to know what to pray for at this point but prayers are needed.
Things seem to change by the minute so it is hard to know what to report but I will start with the good news, limited as it is. The doctors do not believe he has had a heart attack. He has also been much more comfortable over the weekend. He is, of course, quite weak. We visited last night and he was in good spirits and even talked at length which surprised me. He was most concerned that everything stay on track so he could be moved to Borgess and have the heart catheterization. He was moved this morning and my mom and sister, Sharon, met him there.
At this time they are unwilling to perform the heart catheterization. He has a Do Not Resuscitate order in place and there is serious concern that he would be able to survive even this limited procedure. His blood pressure has been quite low since he was admitted and his kidneys show signs of buckling under the strain of the diuretics. This leaves us in what I can only describe as an uncomfortable holding pattern. There is no clear plan for treatment but he is also somewhat stable.
He is also now experiencing some confusion. This may be a symptom of a lack of oxygen or signs of something else. No one is quite sure at this point but for the moment it may be a small blessing as he is not truly aware that the heart cath is not scheduled; I think that would agitate him. That may be an inevitability, however, as he has always seemed to return to lucidity.
It is hard to know what to pray for at this point but prayers are needed.
The First Signs
Thursday, October 1, 2009
Most people reading this know that Roy has had emphysema for years and increasingly over the last two years he has used oxygen at home and later even when he left the house. This wasn't an easy transition but it was increasingly necessary as he was dealing with the effects of chronic congestive heart failure.
For the past couple of weeks his CHF had been getting the better of him. His weight was elevated indicating he was retaining fluids which further prevents the heart from pumping adequately. As you would expect, this makes him even more tired and weak than usual. The prescription for this is a diuretic drug causing frequent urination. It had seemed to be doing its job as his weight came down and his strength seemed to return. But today 911 had to be called because he was unable to get himself up or dressed.
He is not doing well. His legs have swollen significantly and are causing him a great deal of pain. The cardiac doctor, Dr. Owusu, has identified an arterial fibrillation, aortic stenosis and and slightly elevated troponin levels, indicating a possible heart attack. He has ordered a heart catheterization which will take place on Monday, October 5 at Borgess Hospital in Kalamazoo. He is quite ill.
Most people reading this know that Roy has had emphysema for years and increasingly over the last two years he has used oxygen at home and later even when he left the house. This wasn't an easy transition but it was increasingly necessary as he was dealing with the effects of chronic congestive heart failure.
For the past couple of weeks his CHF had been getting the better of him. His weight was elevated indicating he was retaining fluids which further prevents the heart from pumping adequately. As you would expect, this makes him even more tired and weak than usual. The prescription for this is a diuretic drug causing frequent urination. It had seemed to be doing its job as his weight came down and his strength seemed to return. But today 911 had to be called because he was unable to get himself up or dressed.
He is not doing well. His legs have swollen significantly and are causing him a great deal of pain. The cardiac doctor, Dr. Owusu, has identified an arterial fibrillation, aortic stenosis and and slightly elevated troponin levels, indicating a possible heart attack. He has ordered a heart catheterization which will take place on Monday, October 5 at Borgess Hospital in Kalamazoo. He is quite ill.
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