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Sunday, January 31, 2010

No Matter How Hard

This is a beautiful piece I saw on Cross-Currents for those that don't read it, I chose to share it with you:

The article begins with the author’s many trips back and forth to the hospital during her father’s long, drawn-out illness; how she was tormented repeatedly by what appeared to be his imminent demise, death lingering around the corner, tauntingly, slipping maddeningly in and out of sight; and then, at last, how the final moments seem to arrive.
…[that] my father’s heart is weak, his kidneys are failing and his lungs are filling with fluid. For the second time in six months, he needs to have a tube inserted in his windpipe.

I nod, waiting for him to continue listing procedures and tests. Instead, he takes a small step back from the gurney and asks, “Does your father have a living will?”

I freeze. No emergency room doctor has asked me this before. I answer, evenly, yes. “Do you have durable power of attorney?” Yes.

Visibly relieved, he looks me in the eye and gently but pointedly asks: “Does your father want us to employ extreme measures” — he pauses one heartbeat for emphasis — “knowing that he is not likely to improve?” The two nurses flanking the doctor look at me kindly.

I smother my rising panic. I must stay calm. I need to think. The doctor has given us an opening, a chance to consider our options.

I know what I want: I want to stop the insane cycle of hospitalizations and heroic life-saving treatments. It is not helping my father. He is getting sicker. He is dying. And I am exhausted beyond belief. I have no energy for family or friends, and my career has suffered. I want my life back.

I am acutely tempted to answer, “Of course not — my father would not want heroic measures.” But I hesitate because I know it might not be true. In the past, he has wanted everything possible done. This night is different, but I do not know if his answer would be different.

I look at my father. It is hard to tell if he is conscious. No one else is looking at my father. Everyone is watching me closely.

Finally, I say out loud the only thing I know to be true. “In the past, my father has asked that everything possible be done.”

Then I bend over my father and ask him in a clear, strong voice: “Daddy, do you want to be intubated again? Squeeze my hand if you want to be intubated.” I wait, but he does not squeeze. Instead, he surprises us all by nodding his head. He is weak, but the nod is unmistakable.

One nurse grunts and rolls her eyes dramatically. The other mutters, “Oh, brother — here we go again,” and shoves a stainless steel instrument cart closer to the gurney. The doctor, more professional, remains impassive as he suggests I leave the room. “It is difficult to watch this procedure. Most patients struggle and flail, so we will have to use restraints.”

Yes, I know. I kiss my father on the cheek, tell him I will be back soon and head to the waiting room.

What the doctor and nurses do not know, what I hesitate to admit even to myself, is that I almost gave them the answer they wanted: the reasonable one. But I would have been terribly wrong.

My father never really recovered. He could never again breathe without a respirator, he never left the hospital bed, and he eventually needed dialysis and a feeding tube. Six months later he died of heart failure.

I suppose my father’s decision was a mistake. But it was his mistake to make, not mine. My role was to support my father, no matter what, and to tell the truth, no matter how hard.

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