Final Trip [Part 3]

project 005 (2)

 

The backyard of my parents’ home is back lit by the setting sun. The oaks, elms, and evergreens and even the lawn seem to glow a yellowish orange, as if they are working overtime to catch every bit of light before the world falls into darkness. I am sitting in the sunroom, on the couch, watching the gloaming unfold. My father who has spent the better part of the afternoon having an animated conversation with himself is asleep and I am sorry he is not awake to enjoy the pretty scene unfolding outside these windows.

I think about the word “gloaming” and wonder about its origins. It is so close to glowing and that is what the backyard is doing right now. I go to the dictionary on my iPhone and look the word up and find that is from middle English and is related to the word glooming as in when the darkness sets in it becomes gloomier. I love word play and so does my father. Family legend has it that he learned English by going to Ronald Coleman double features and reading the English dictionary. A testament to that is that one of his favorite possessions is an old copy of the Oxford English Dictionary that he keeps on display in his office. He and I often have long speculations and discussions about the origins of words. No more so than during the last two years when he was desperate for mental stimulation of any kind. It was a game, albeit very nerdy, that we loved to play together.

I turn to tell him what I had found out only to come to a triple realization. My father was asleep. That even if he wasn’t asleep his current mental state would not allow him to comprehend the origins of words and finally that I would never have these types of conversations again with Pop. It is  the final realization that cracks me like an egg and the pent up emotions of the afternoon spill out of me. It is a silent cry as I don’t want him or anyone else to hear my anguish, but my face is awash with tears, my nose dripping , and my throat feels as if I had swallowed a grapefruit whole.

I cannot tell you how long my private pity party went on but it is interrupted by Didi, one of my father’s home healthcare aides. She tells me in her soft Haitian accent that she needs to prepare my father for the evening…his diaper changed, catheter drained, bed sores dressed and the like. I ask if she needs help and I spend the next twenty minutes helping her move Dad around his bed as she did all the difficult tasks like changing his fouled diaper and dressing his sores. It leaves me too much time to look at what the ravages of this disease has done to my father’s body. He has almost no muscle left, his skin lays limp and sallow, against protruding bones and joints that look far too big for this withered body. He looks for all the world like the images of the inmates at Nazi concentration camps, a fate he barely escaped, not the happy grandfather being cared for by his family at home.

The site of his withered body fills me with anguish; my strong father, my hero, reduced to this? When Didi no longer needs my help, I kiss my father on the forehead and say “I love you Pops” and immediately find my way to the kitchen and pour myself a drink.

 

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The surgical waiting room and the waiting room of the Intensive Care Unit is a shared facility at Overlook Hospital. It is made up of two rooms and more closely resembles a break area in an auto plant than hospital waiting room. The first room is made up of heavy tables and chairs that belong as props in “That 70’s Show” as they have grey Formica tops with accent pieces made of wood veneer. They are scattered about a room made bright by a skylight and accented by a sideboard that has Formica to match the tables and chairs and there is a payphone that too is a relic of a time gone by. The other room is a more traditional waiting area. Here the lights are turned low and its grey tone is matched by a carpet that has seen a marathon of pacing. Tables, couches and chairs ring the room and no doubt looked worn and old even when they were new.

The mood here is much the same as it was in the Emergency Room. People would not be here unless someone they cared about was in a desperate circumstance. The difference is that in most cases the initial shock of knowing that a person they love is on the brink has left. By now they know the score. They have some idea of what to expect. For some it means hope and for some it means prayers and secret deals with god to get their loved one through the next few minutes, hours and days.

Mom and I entered this area 6 hours previously full of hope. After all, Dr. Knightly told us that Dad would be back walking in six months and this really nothing more than a little carpentry work to help Pops achieve his goal. I have tried to relieve the anxiety and boredom of waiting by teaching my mother to play scrabble on the computer and when that fails tournaments of solitaire where we try to beat each other’s score. But nothing works. Every tick of the clock seems a little slower than the tick before and adds just a little more anticipatory tension to our moon. This increases logarithmically when we sail by the 4-hour time we have been told that the operation would last.

When the Dr. does finally meet with us, we are strung tighter than a tennis racket at the US Open. He informs us that the operation went as well as could be expected for a man Dad’s age. That it had taken longer than anticipated because they had to stop at several points when his blood pressure fell so low, they were forced to pause until it could be raised. Mechanically, they had stabilized Dad’s cervical spine by placing a series of plates and screws. That everything looks good for Pops to make a full recovery but only time and extensive rehab would be able to determine if, and when, he would walk again.

Dad never walked again.

Long stints at rehab facilities such as the Kessler Institute and Runnels Hospital and Rehabilitation Center followed. Invariably, he would be making good if not great progress in getting his feet back under him when he would develop an illness born of the cure. There were urinary track infections from a catheter. C-Dif, a bacterial infection of the lower intestine, that required a fecal transplant to cure.  Several pneumonias and colds. Each of these illnesses required hospitalizations. Each negated any progress he had made in regaining his strength that would allow him even partial mobility.

Eventually, the decision was made to bring Dad home and set him up in the Master bedroom. It was large enough for us to create a “suite”. There would be a place for sleep, a work area and a bathroom that was large enough to accommodate his wheelchair. Home health care workers, visiting nurses, and me, on weekends, could give Mom a helping hand. Medical care would be provided by us taking Dad to Summit Medical Group which was nearby.

This worked for several months. Then one morning in December Mom found it difficult to rouse Dad. When he is taken to the hospital where it is discovered his kidneys are failing. This is not entirely a surprise. In 2000, he had been diagnosed with non Hodgkin’s Lymphoma which was localized around one of his kidneys. Chemotherapy and radiation had beat the disease down but in the process it had severely damaged one of his kidneys. The healthy kidney has worked overtime ever since and now it was kidneys showing signs of shutting down. His nephrologist, Dr. Gelber, is a kindly, well-spoken, and patient man calmly explained to Pops that he needs dialysis. Without it he will die. Three days a week he will have to go to a dialysis center, be dialyzed and then returned home. Dad questions his diagnosis, the protocols and is generally dismissive of the idea. He says he needs to think it over.

When the Dr. leaves he announces he does not want to do this. It is too much. It would mean an ambulance coming to the house three days a week. Him being carried down 2 flights of stairs in doors and ½ flight outdoors, then transported for 30 minutes to an hour to the dialysis center, 6 hours there,   and then returned home. He did not want to live his life that way. We plead with him to reconsider. We beg him to think not of the inconvenience but of the life it would maintain. That is not his time. This argument goes on for a long time with both side sides being testy. Eventually, we manage to convince Dad to test the protocol for six months and to re-evaluate.

 

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It is a beautiful June morning when we arrive at the Summit Medical Group to see Dr. Gelber for a regularly scheduled check-up. He tells us how well Dad is doing. His blood work looks excellent and the dialysis is working extremely well. This is when Pops stuns us. He tells the Dr. he no longer wishes to continue with the treatment. He claims that he never believed that his kidneys were malfunctioning, and that the dialysis is superfluous. Gelber uses logic and scientific fact to persuade him that he is wrong. I used emotion and indignation as attempt to divert him from the path that will result in death. . Mom appealed to his intelligence. We nearly harmonized we were so in tune with each other.

Dad remained adamant that he did not need dialysis any longer. He, a man who had dedicated his entire life to science, did not make an argument based on data but feeling. It was confusing and upsetting and I was about to launch into a more impassioned expression of my upset when Dr. Gelber interrupted me by asking Pops “Do you understand what will happen to you if you decided not to continue with dialysis? That you will likely go into a coma and we may not be able to revive you. That even if we can revive you we may not be able to get you back on dialysis. And that you will die without dialysis….”

Pops, paused for a second, and then looking Dr. Gelber in the eye replies “yes.”

Gelber then replies with resignation “Okay” and proceeds to tell my parents about what they can now expect. I am only half listening as I am enraged. Furious with my Dad for being so stupidly pig headed that he cannot see that he needs to have the dialysis to live…not listening to reason…not listening to those who love him. I am livid with the Dr. for rolling over so easily. Isn’t he supposed to promote life not allow someone to willfully take his own?”

It is not until a long time later that I understand what happened in that room. Dad was not telling the Dr. that he did not need dialysis anymore. He was letting his physician know that he had enough. The three times a week of being carried up and down three sets of stairs, the hours of boredom as his blood was cleansed, the tortuous trip back and forth to the clinic in ambulance and the exhaustion that followed had robbed him of a life. He was telling the Dr. that he was getting sicker not better. That he was ready to face what is next because what was here was no longer tolerable for him. But he was telling it to the Dr. in a way that would spare hours of us arguing for life, trying to change his mind, and perhaps succeeding. Hours of pain and heartache we would all feel that he thought to spare us from.

Dr. Gelber got it even when Mom and I did not.

Thinking back, my father’s performance that afternoon was the greatest act of courage and compassion I have ever seen. Even as he was leaving us, he was teaching us how to be brave and how to really love the ones you care about.

That weekend, my sister and her family came to our parents’ home. It is a splendiferous late spring day with warm temperatures, light wind with a French blue sky dotted with cotton ball clouds. I have brought some of my father’s favorite foods from Barney Greengrass in New York City: Lox, Sable, Whitefish salad, Pastrami, Chopped Liver, and bagels. My sister has brought cake and cookies. We feast and delight in each other. Cate and Oliver, my sister’s children, charm my dad with pictures they have drawn and with their hugs. After lunch we sit outside on the deck enjoying the day and basking in the glow of Pops who is reveling in every moment of this day.

Later, we are sitting in the television room when Dad becomes confused and irrational. The march towards the inevitable has begun.

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After I eat dinner with my Mother, and she retires to her bedroom I go and pull up a chair next to Dad’s bed. His mouth open, as if in mid snore, and his breathing is labored. I hold his hand and find myself feeling like the little boy I once was, when holding his hand had protected me from the world. It makes me feel lost and sad but glad I could be here for him and for me.

For Jews, the time between life and death is considered extremely sacred. It marks the conclusion of the person’s journey on earth but also tis the beginning of the soul’s eternal life in heaven. I have been told that at the moment of passing every positive thought, word, or deed that occurred in this person’s life is concentrated into a pristine spiritual light and then this light is revealed to the world and to the heavens where it continues to shine and effect those in heaven and on earth. I want to be here for Dad’s moment. I don’t want him to be alone.

My thoughts are interrupted by Didi. She tells me that she believes it is time for Dad to have a little morphine as it will help with his breathing. She cannot administer the medicine as she is not a nurse so that tasks fall to me. It is not a difficult task. Just placing a few drops of a liquid into Pop’s mouth but my hand is shaking so badly that I am embarrassed by my performance.

After my embarrassment with the morphine I reward myself with several fingers of Woodford Reserve bourbon and take it out to the front steps and sit. After 45 years it is a familiar view. The manicured lawn with two gigantic old oak trees that pepper the ground with acorns in the fall. I see the houses where, as a child my friends lived. I am convinced in the moment that if I squint hard enough and listen carefully I would be able to see and hear echoes of one of the endless games of street baseball or football that were played there.

I walk into the yard and I feel a profound sense of gratitude to Pops for the fortunate life he made for us here. Here we were safe and free to explore. Here we learned to learn. Here we were loved and cherished. I look up in the night sky and see Orion and a few other constellations whose names I can’t recall and say a prayer. I ask god to show mercy on Pops. That he has suffered so much the last couple of years. That he has done so mostly with grace and humor. Please take him tonight so his suffering ends and the endless exploration begins.

When I walk back in the house, I can see that Didi is examining my father. Checking his pulse, his breath sounds. I ask her “How is he doing.”

In her rich Caribbean accent, she replies “He is about the same.”

Not wanting to say the obvious out loud. “Are we okay for a while? Can I catch a few hours of sleep?”

“You’ll be fine.”

I go to the television room which is directly adjacent to the sunroom where my father is ensconced. I collapse on the couch pulling a blue green mohair blanket over me and tucking a pillow under my head. Sleep comes quickly and is dreamless.

Didi wakes me around 1AM. She says “Mr. Paul, I think your father needs more medication.” Barely awake I stumble to the kitchen and getting the morphine out of the refrigerator I measure out a dosage which I administer with greater ease than before.

I ask, “How is he doing?” She tells me that his breathing has become more labored, but she still does not think that anything will be happening tonight. I return to the couch and surprisingly, as I am not an easy sleeper, I fall back into a dark sleep. Later I would begin to believe that this was a father’s gift to his son.

Several hours later, I am awakened by Didi nudging my shoulder. She whispers “ Mr. Paul I am so sorry. Your father is gone.”

The first emotion I feel is shame. I feel like I have let my father down in not being there for his final moment. This morphs into anger with Didi for letting me go to sleep thinking there was time and not waking me when she saw he was in extremis which turns to shame for being angry at Didi for anything as she has done more than her share to ease Dad’s passage.

However, when I walk into the other room, and see my father’s lifeless body all those emotions are replaced by overwhelming grief, sorrow and self-pity. I stand over him overcome. For a few moments I say nothing because my brain has ceased operation and when it resumes all I can think to say is “Oh, Pops” and kiss him on the forehead and sob as if I am  in a silent movie.

When my crying has subsided to just a few tears Didi puts her arms around my shoulders and says, “He is in a better place.” While I have my doubts that there is anything beyond this place,  I pray now that there is. I thank her for her kind words and being so gentle and caring with my old man while he was alive. She gives me a nod of acknowledgement and lets me know she needs to call her supervisor so she can come and certify Pop’s death and clean the body.

It seems wrong that anyone needs to do anything right now, but I tell her to go ahead as I have my own grim task to take care of. I need to tell my mother. I walk up the flight of stairs that leads to Mom’s bedroom and knock on her door. Without waiting for a response, I say “Mom, he’s gone.” I hear a guttural sob and she tells me that she will be downstairs in a few moments. I reply in a whisper worthy of a sleeping household “I love you “and return to the sunroom where my father is waiting.

I am standing next to the bed that holds my father’s remains when Mom arrives at my side. She looks at him for a moment before breaking into sobs. I put an arm around her and try to provide her with comforting words. “He got to die at home and what a blessing that is.,” “Think of his journey and how lucky and fortunate it was for him to make it here.” And, “He loved you so!”

Of course, none of this ameliorates Mom’s pain and saying them gives me no comfort at all. But they were words that needed to be said anyhow because they were the truth.  Dad, was born into abject poverty in Vienna before the war. They lived in a one room apartment with a bathroom down the hall and where the icebox was the ledge outside the kitchen window. His family managed to escape to the States months after the war began. He went back to Europe to fight as an officer. When he returned home, he became a distinguished and noted scientist and raised three children who adored him and pampered 4 grandchildren who loved him more.

The love he held for my mother was fierce and unique. The fact that a Park Avenue debutante would fall head over heals in love with a penniless immigrant speaks volumes about both of them. While my father tried to recover from his illnesses he would often reminisce about their early marriage. He told me, for example, when my brother was only months Dad had been transferred to Denver from Illinois. My parents  had decided that until he could find them a place to live that my mother and brother should live with her parents in the city. He told me he missed them so much that the time they were apart were the loneliest times he could remember. And, how he had never been happier to see anyone, when shortly after July 4, 1956 when David and Mom had walked off the plane in Denver he had never been happier…which is how I learned, by doing the math, when I had been conceived. They loved to fight often screaming to make their point and was only as an adult that I realized that this was how they expressed themselves and drained the toxicity from the marriage. They knew each other’s buttons and when to push them. But they knew each other’s strengths. When, during the last days of Pop’s lucidity, I promised Dad that I would be there for Mom. He said “Don’t worry about her too much. She is far tougher than you think.”

At that moment, standing next to my father’s lifeless body, she demonstrated her toughness. . She dried her eyes with one of the Kleenex that she perpetually kept in her robes and said “I need to call the funeral home” and left.

I retreated to the couch next to the bed in which Dad lay and began to think of how I wanted to memorialize him. It was difficult. Every new sentence I would create in my head, each cherished moment recalled would produce tears of self-pity and sadness. Thinking that I would not be able to share my words with him, made me sob.

Eventually, I wrote “He escaped the holocaust. He fought a war. He was married to my mother for nearly 60 years. He raised three children and cherished 4 grandchildren. He was my father, my travel buddy, my friend, and always my hero. This morning he passed quietly into the next world. I am grateful for his life, his love, his legacy, and his peace.” And weep some more.

The doorbell rings. It is Didi’s supervisor. She is very straightforward even bossy considering that it is 4 AM and my father lies lifeless a few yards away. She tells me that she needs to fill out the paperwork required by the state to issue a death certificate and then she and Didi need to clean the body as after death all of the sphincters relax. This is far more information than I need to know and when she asks to be alone with the body I readily accept and disappear into the TV room.

While waiting for Didi and her boss to complete their grim task. I debate with myself about calling my brother and sister at this hour to share the news with them. On one side it is so early and waiting a few hours will not change the news and perhaps it is better for them to sleep now because as later it will be more difficult. On the other hand, Marissa did say she wanted to be told of things as they happen. Thinking about it, I do not really have a choice and decide to call M first. The phone is picked up on the 2nd ring by my brother in law. I am happy it is him answering the phone because I did not relish the task of telling my baby sister that her Daddy has died. He is British and takes the news stoically but his rush to get me off the phone tells me how difficult the news is for him to hear as I know he both admired and loved Dad.

Next, I call my brother and I am not surprised at all that his phone goes directly to voice mail. I leave the grim message. Him not answering the phone is yet another log on the flames of anger I am feeling towards him. Already stoking the fire is his inattentiveness to Pops while he had languished these past few years and his refusal to quit a tennis game and pack his vacation home early to come and have a final goodbye with Dad yesterday. These are hot flames and I know that over the course of the next few days and perhaps even years they will be difficult to extinguish let alone control.

The doorbell rings again. At the door, are two somberly dressed men who look like they are out of central casting for morticians. They express their condolences to Mom and me and asked to be taken to where “your loved one is resting.” I find their wording cloying and offensive but lead them to the sunroom where Didi and her boss are just finishing up their tasks. I introduce the two groups to each other and realize both are in the business of death and wonder how people can deal with these things every day and remain sane. The undertakers ask for privacy as they need to “prepare:” the body for transport. I am not sure exactly what this means but I want no part of it.

Didi , her boss, Mom and I retreat to the kitchen. There they explain the paperwork of death. How “Dad”, because he was in hospice care, does not need to have a Dr. examine him for a death certificate to be issued. How, even though “Dad” died in the home, that does not to be disclosed should we want to sell to property. I stop listening. Not because the information she is sharing is not valuable. It is. But her continued use of the word “Dad” I am finding ridiculously hard to deal with? This was my Pops. Not hers. But I tamp that down. She is trying to be kind and helpful and being angry with her would make her feel bad now, and me later. She asks my mother to sign some papers and they leave with Didi giving hugs to us both as she exits the front door.

The morticians, the men in black, as I have nicknamed them in my grief addled, sleep deprived brain, have completed their task. They too come to the kitchen table with their paperwork of death. They need my mother to acknowledge that they have been authorized to cremate the body and wish to know what kind of “receptacle” my father’s “remains” shall be placed in. These terms annoy me. They seem unfeeling and clinical when referring to Pops. He deserved special words.

Signatures and approvals received, the men in black wheel my father, now shrouded in a black body bag and resting on a trolley, out through the dining and living room and down the front steps. I follow them as they make the short walk down the slate path that leads from the stoop to the driveway. They place the gurney, with my father’s body in the back of their hearse. I watch as they drive down the street I use to play on and disappear into the last vestiges of the night.

I think “Dad’s last trip.”

Then, in the cold and dark of the pre-dawn, I cry the cries of a child unbidden by age. They come in gasps and soft cries. They make my chest heave and deny me the ability to speak or even swallow. At that moment I do not believe there has anyone ever who has been sadder than I am at this moment. It takes moments which seem like hours to compose myself.

As I turn to go back in the house. I see a lonely star just above the treetops. It reminds me of the Kabbalistic belief that at the moment of death every positive thought, word, or deed that occurred during a person’s life is concentrated into a pristine spiritual light and this light is revealed to the world and in the heavenly sphere where it continues to shine above and below.

Perhaps that wasn’t Pop’s last trip after all. Tomorrow I will go looking for that star again to make sure.

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About 34orion

Winston Churchill once said that if you were not a liberal when you were young you had no heart, and if you were not a conservative when you were older then you had no brain. I know I have both so what does that make me?
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