November persists and does as November does. On Saturday, we watched my father's last labored breaths, and though the drug cocktail (morphine and ativan) he was on in the final moments was supposedly designed to increase comfort and ease the transition (to what none of us knows), it was still jarring to watch the breath drain out of his worn-out lungs. Because the lungs, for whatever reason, were the things giving out, which meant that he was fully mentally present, but sedated at turns, in all of it...the hospitalization, the two weeks of ventilation that was hoped to give him a chance to recover after trouble breathing but did not do so in the end, leaving him completely trapped on the machine.
The UTI infection that landed him in the hospital and made him incredibly weak set the stage and a bacterial infection in the lungs caused, they believe, by asperated food that led to pneumonia. In a normal person, probably not a death sentence, but in an 81-year-old man already frail and thin and so very weak, it meant the end. An end we, and some very hopeful hospital staff, tried to prologue with medical technology, but ultimately failed. We'd been warned about tough decisions--to take off the ventilator and hope he pulled through, or to leave him bed-bound in a nursing home on it forever. The latter, not an option, especially since it already felt like we were pushing the bounds of what he'd have wanted with the ventilator in the first place--because for a minute, it seemed like getting off it and getting better was still an option. He often spoke with the horror of my great-grandmother Chloe's last few months bed- bound in long term care, and wanted anything but. But for a couple weeks, we believed recovery could still happen, the original infection that had weakened him cured by antibiotics. But the strain on the body--the weakness, the malnourishment, made him a sitting duck for other nasties. That acknowledgment, that it wasn't going to happen, which slowly sank in Saturday morning after the doctor's final trial off the machine failed, was the hardest part.
So on Saturday afternoon, with some of the family around in the form of cousins and his remaining siblings, we said goodbye without trying to seem, to him too much, like we were saying goodbye, chatting about western tv shows on the set above, endless pharma commercials, and chocolate chip cookie recipes (whether milk chocolate was an acceptable alternative to semi-sweet or dark) as he slowed and drained. He'd been awake for a few moments, wide-eyed and clasping our hands with a tenacious grip, having come out of the sedation they'd mostly kept him under the past two weeks, but unable to speak, to only gesture with his hands--to wave us away, I swear, or maybe just to wave goodbye. Then motioning for someone to raise the bed. He stared for a while at the ceiling as the drugs fully kicked in. Maybe a half hour. I was turned talking to my aunt and when I looked up and his chest had stopped moving and moments later, the nurse confirmed his pulse was gone.
I count myself lucky or unlucky that I lost my grandparents early--some early to cancer, or to freak accident-induced blood clots like my grandmother-- most of them in childhood with the exception of my paternal grandfather who we were not particularly close with due to distance and divorce (he later succumbed to fast spreading cancer). When my mother died, it felt unexpected, though she was riddled with so many cascading health problems (the heart attack, legs ravaged by a latex allergy that failed to heal, the deep infection in her foot that led to delirium) in the months before her heart gave out. I was convinced she was getting better, up to a point, but she was not. The end was therefore completely a surprise and not a surprise. I was also not there to see it happen.
My dad, for most of his life, despite the same seizure disorder my sister has, was pretty healthy right up til the last few months. His pain in his legs and back (he called it sciatica, though the doctors believe it was more like arthritis) had gotten worse in the past year, necessitating a cane or walker, but he was still reasonably spry. Though recently, the falls had become more frequent and while not injured, he had trouble getting up the last couple weeks he was home. Once, he was rescued by the Amazon delivery guy when he fell trying to get up the steps. The next time, the EMTs. His appetite had taken a plummet and though he talked often about food on the phone weekly, was not eating enough of it, rendering a man who had always been thinner than the rest of us, much too thin. All of these things made him frail and vulnerable, and in classic Bowen fear, convinced he had cancer and not wanting to know (he did not). My sister tricked him into hospitalization by promising a routine doctor visit. He was doing well a couple days in, but then stopped being able to breathe on his own due to secretions building up in his lungs.
With a family of people taken out by a host of other things, he is perhaps lucky to have lived to be 81, when I suppose the body just begins to give out like a well-used car. If the other ailments don't get us, the steady unwinding of our internal clocks will get us all the same despite our best efforts. There is still the sense of unrealness, even though unlike my mother, I was there to see it happen. I hope this means he will not turn up in my dreams later, not knowing he's gone, which happened for a good year after losing my mother. Also that usual strange relief wave that comes as the backside of grief--that the very worst thing that can happen has already happened. But mostly both hating and marveling at the body's machinery and the unfairness of an active mind caught within its cage of it and unable to stop its failure even with medical machines and hospital professionals and still the expiration date marked on all of us.
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