The Long Goodbye

Today at around five o'clock in the evening I got the call from hospice that my dad had died

.

It was anything but an unexpected death, which I suppose is obvious from the fact that he was in hospice. That was my doing. As his legal guardian, it fell to me to make the decision to move him out of the ICU, where he had spent the past nine days, and into a hospice, where the pretense that he might possibly recover would end, along with all the futile, painful interventions that maintained that pretense.

I've been shuttling back and forth from Bellingham to Tucson frequently in the past year, along with my sister. Last spring, or early last summer, I forget which, my stepmom called us and said she couldn't care for him at home anymore. We were unsurprised.  Frankly we wondered how she had been managing for the past several years. Dad had a stroke in 2002 that left him hemi-paralyzed, and his health had described a slowly declining arc ever since.

The visit that followed my stepmom's pronouncement was pure hell, a hell that illuminated for me every single thing that is wrong with American health care and the American way of caring (or not) for the elderly and disabled. My sister and I had to make one awful, wrenching decision after another. Dad resisted with all of his strength facing the truth that he needed a level of care that could not be provided at home, and he used every tactic at his disposal. In the end we left him in the local veteran's hospital on a psych hold, and I started emergency proceedings to become his legal guardian.

There followed several months of bureaucratic nightmare waltz. Dad was transferred from one facility to another. I think he went through five placements in a fewer number of months. He was in and out of the hospital. I, formally instated by a judge as his legal guardian, received midnight calls from emergency room physicians asking me what I wanted them to do.

"If I do nothing, he's going to die," said the voice on the other end of the telephone.

This happened more than once.

Those awful episodes were interspersed with weeks of semi-recovery in various nursing homes. The nicest one had chickens and a nurse who helped him plant some seeds in pots in the small courtyard. Dad was always a gardener.  I don't think there has been a single year of his adult life he didn't have some sort of garden, even in these latter years. My brother-in-law built him raised beds in his yard in Tucson, beds he could plant and weed from his wheelchair.

That reminds me, of course, of all the time he and I spent dreaming about a little five-acre farm. During the years he lived with me and my daughter in the blue house in Seattle. It was a game we played, the "Self-Sufficiency" game.


The self-sufficiency game (love you, Dad)


This time, this last time, the call came that dad was in ICU again, and nobody was really sure what was happening. The first doctor I talked to said he thought it was a pulmonary embolism; the next one said septic shock. Shortly it became clear that whatever the precipitating event was, dad was extremely ill and not very likely to recover enough to make it back to the nursing home. Not that anyone was willing to come right out and say that - but that's a post for another day.

My sister and I both flew down. Dad was in and out of consciousness. We spent a week more or less at his bedside. It was clear, to me anyway, that he was declining, but oh so very, very slowly. It was only after we both had flown home that he became entirely unable to eat or drink, and it was when they started talking about a feeding tube that I said "No."

"Get me hospice," I said.

My mother and my brother have both named me as their medical power-of-attorney, as did dad a couple years ago. I'm not entirely sure why this duty has devolved on me, but I believe that in my mom's case at least, she sees me as the child "most likely to pull the plug." She has made it clear to all of her kids that she has zero desire to hang around in agony one minute longer than necessary, but I'm the one she has designated to make it so. She trusts me to kill her. I can't help but wonder - in dark moments like this one - if my family sees me as unfeeling.

Sometimes I wonder the same thing about myself.

This is the second spring in a row that I have had to fly to Tucson during kidding season. For two years in a row, I have left my husband and kids, who are not experts by any means, to cope with goats giving birth and getting the kids off to a good start. Last year there were complications, and this year I anticipated more complications. Flopsy was once again carrying a ridiculous number of babies, and I knew they would need active help. I did all I could, which was to ask knowledgeable neighbors if they could be on standby, and give their phone numbers to my husband.

Even as I sat at my dad's bedside in the hospital, even as I interrogated his cardiologist or his nurse, I was thinking about Flopsy and her quadruplets. I couldn't help it. Dad was manifestly in good hands - being cared for by people far more qualified than myself and obviously good at their jobs. The same could not be said for my goats. I wanted to care only about my dad, to be in one place completely, at his side and nowhere else, but that just wasn't possible. Not for me. Maybe it never is possible for anyone, and I'm being unreasonably hard on myself. How would I know? This is the first time I'm doing this. Thank all the gods I made it this far.

Luckily, the goats gave birth without major complications and the neighbors came through in spades. Mental note: I need to by a few Starbucks gift cards. In fact, I was sitting outside in the fragile evening sunshine enjoying the sight of seven little goatlets prancing about the lawn when the call came. Dad had passed away quietly, deep in a morphine dream, without pain or agitation, after two weeks of hospitalization.

My dad was a fighter. He did not Go Gently into that Good Night. He resisted every step of the way, with courage and stubbornness. There are certainly easier ways to live and to die than the ways he chose - or the ways that fell to him though fate and genetics - and for my part I hope I find those easier ways. But I admire him his fighting spirit. No one can say he didn't do his damndest to the very end.