11 October 2008


Personal memories before I forget. Lisa's out watching the LSU game, so I have some time alone while I think I should remember...

Tuesday the 7th at around 4 PM at work, Bob calls me but I only get it in voice mail. He says that Dad has fallen and hit his head again (happened ~2 years ago, limited sense of smell since) and he only knows what Mom had said on the phone, but she was very upset. His tone and words ring something in me and I, uncharacteristically, think the worst. I quickly finish a pressing task and tell my boss that a family member is in the hospital and that I need to go see what the problem is. I can't look him in the eye as I say it.

Traffic is not bad and I fly from Norcross to Marietta, calling Lisa on the way and leaving out the concern in my brother's voice because I feel like I'm overreacting. Hospital is typical: parking lots have cryptic names that don't describe where you want to be, hallways and signs confusing.

I get to the room and see immediately that what I had hoped, that this was a bad-but-minor incident similar to the last time when he hit his head and it was bad but not in any way Serious, that I was imagining a panic in Bob's voice was not there. It was in a couple or three seconds seeing their faces. That's what sucked. I seldom panic, and I panicked when I got the call, and I hated that I was justified. Mom: "This is as bad as it gets." Or something like that. In response to my question. He's out. I slowly get the information of what happened and my brother repeats the doctor's description of "catastrophic damage" to the brain. That phrase assured me in a way. Assured me that there was no middle ground for any of us to suffer over and assured me that I understood what they were saying. That's less callous than it sounds.

Dad was working in the yard, Mom had been inside for maybe 30 minutes and went back out to see what he was up to. He was on his back in the driveway, face up, head pointed down, with blood over his face. The doctor said that was from internal bleeding. She says he didn't respond at all, and I suspect she knew what I'd known. Ambulance, etc.

Our certainty helped. Tuesday evening was grappling with how the doctor felt we should proceed. Well, it was grappling with the emotions too. Dad had a tube in his mouth for breathing, something stuck in his left ear to stop the blood from running out, and IVs of morphine and anti-anxiety medicine. The time that we were there included repeated clarifications of what his cognitive state was. It honestly wasn't until Wednesday that I was told that he was 4 or 4.5 on the Glasgow Coma Scale. Brain dead is 3; consciousness is 15. That certainty helps. But even so, we would get mixed signals. Why the medication? Why did one nurse say that "he's aware of us"? All I can assume is that they're hedging their bets. What if he can feel pain? The doctor was more certain: there's no coming back from this. They didn't even attempt surgery because of that fact.

Tuesday night with my brother at Mom's house. I drove home first to get clothes and etc. Was about to pick up Checkers for myself on the way in, but Bob called as I was in line and said he'd pick up pizza. I get there, he's still trying to find a place open, gets back, many calls and eventual success (sausage mushroom jalapeno). Lisa packed me a bottle of wine in a side pocket of my luggage. I don't open it while Mom's up because she hates to see me drink too much. Epic win with my brother because he's jonesin' bad for a drink. We talk about what's to be done but for the life of me I couldn't give specifics. I sleep on the couch and drift off to Prokofiev's violin sonatas (arpeggios at the end of the first movement of #1 has been described as a graveyard wind, beautiful, it's been in MP3 rotation for a month).

Wednesday at the hospital. Long. Lisa's there and it helps. It's difficult to control myself in the room with Dad. Outside, I can detach and plan rationally or joke around. You feel that you're getting over it and then you go back to the room and it's the same as if you had just found out. Worse, if you're away and don't feel like crying, you feel like a bastard for getting over it so quickly.

At some point, we decided to remove his breathing tube (well, remove the machine, the tube had to stay in). Mom had difficulty making that decision. More specifically, she had difficulty saying that decision. We were all clear on what had to be done and knew that Dad wouldn't want, as none of us would, to remain in such a state. Even with very understanding nurses and a helpful chaplain, it was difficult for us to understand how to proceed. Do we just wait? To their defense, they don't really know what is acceptable to us. Difficult all around, I guess. We finally realize that the next step is the breathing tube. Doctor's assessment is minutes or days after that. The nurses move him over in the bed so that my Mom can lay with him for his final minutes as the tube is removed. Once done, Bob and I leave. I think this is when we went down to the cafeteria and when Lisa came to meet us. I'm getting some events mixed up, even only a few days passed.

We return to the room ~30 minutes later. No change. Back to the family waiting room. At some point, we came to the realization that he might not pass and that he would require care for an extended period. They've been up front, but we maybe didn't consider it and clung to our certainty. Our certainty helped me deal with the situation. There was no "he might regain consciousness" or even "he may have limited function." Catastrophic is catastrophic, and we were lucky to have that. Others deal years with a specter of someone not-really-there. When his signs didn't change hours (?) after the breathing tube was removed, we dealt and came to terms with the reality of hospice. A nurse went over the options and my Mom lit up when she was told about home hospice care. He stays at home and a nurse visits periodically. Back and forth, phone calls, we set that up. It's late in the day, maybe 6 or so, and so we go home to make room for the hospital bed and prepare for Dad in the morning. Mom, and all of us, felt very good about this. However long it would be, she'd be with him. And Jake (their goofy Doberman) could see him and lick his hand.

Bob and I are leaving the house to pick up Chinese take-out (and wine) and I get a call. I'd almost forgotten to take my phone with me. One of the nurses had written down my number and called me as soon as she saw Dad's breathing (or heart rate?) had begun dropping fast. Grab Mom, drive fast and catch almost every green light.

I think Bob walked into the room first, because he tells me before I see it that we're too late. Inside, same bed, he's cleaned up and has no tubes or IVs. Waxy looking. Mouth a little open. Hair brushed and the matted blood cleaned out. Here's the certainty we were promised. This moment, and several before, I want to smile because it's nice to look at him because he looks peaceful. I don't think I manage a convincing smile, but it's there. Mom hates herself for leaving hours earlier, but I think she's over it. The previous morning, Mom and my brother had spoken to him.

That night, we stay at Mom's again. Out to pick up Chinese, I call Lisa. On the way to Mom's and the way to the Chinese place, I would practice the call in my head to make sure I wouldn't start crying. Fail. I get through the actual call pretty well and she comes up (Roswell) to stay with us for a few hours. The complex discussions of money, insurance begins. We get a call that there are four organ donation matches for his eyes. That is, simply, beautiful. I sleep on the couch again. Drift off to side three of The Lamb Lies Down on Broadway where our hero crosses over to death. Final song is a hushed ambient instrumental, maybe a minute long, called "Silent Sorrow in Empty Boats," in rotation for the past few weeks.

The certainty is gone, and now we have finances and loneliness to resolve. My father and I weren't close but shared many faults. I re-emphasize to my mother how infuckingcredibly lucky we are. Tchaikovsky Violin Concerto at the ASO last night was a perfect distraction to the week. I don't know that anything changes, but I hope that I can learn.


[ updated 22 Nov 2008 ]

Obituary in the AJC.

[ posted by sstrader on 11 October 2008 at 11:21:04 PM in Personal ]