“How are you feeling?”
“Not good,” came weakly in response to the cardiologist’s question.
“Are you in pain?”
“No,” my father answered.
“Are you uncomfortable?”
“Yes.” I knew there’d be a follow-up to that question.
I helped my father out of his sweatshirt, at the nurse’s instruction, just before the doctor entered the room. The nurse had taken his vitals and checked his bag of medicines assuring the pills and dosages were according to her chart. As I pulled the shirt over his head I looked down at his bare chest, the scars, the bony shoulders and jutting collar bones, the sagging breasts, the outline of the defibrillator under the pale skin looking more like an old flip phone covered in flesh. I knew dad was cold so I covered his naked shoulders with the sweatshirt. I sat down in the chair situated in back of his wheelchair to wait for the doctor.
“Do you want this to be over?” I asked.
There was a slight hesitation then a faint, breathless but clearly spoken “Yes.”
He knew what I meant. It was time.
My father never improved after the new heart valve was installed at the beginning of July. The valve made his heart stronger but dad never really recovered from the procedure and he never felt right. Throughout the summer as my father was getting increasingly weaker and frustrated in his lack of improvement, I broached the subject of a nursing home. He was having more and more difficulty getting around, he was walking slower always short of breath and he could no longer drive. He was frustrated and often took out that frustration on Joyce. He was short with her. She was feeling just as defeated, unable to will him better, feeling less appreciated for her sacrifices and struggles, not that she was asking for thanks. Dad quashed the idea of a nursing home. He would rather just go directly to the funeral home, he said. No intermediate moves. He continued to grow weak, his energy increasingly diminished. With each passing day he lost interest in working toward recovery, improving his strength and stamina. The rest of him was beginning to give way. His breathing was labored because fluids were building up around his lungs and stomach, pushing against his diaphragm, making the heart work harder. He was frustrated, angry and miserable. He would tell Joyce he wished he had a gun.
At Thanksgiving I mentioned again the possibility of a nursing home and both he and Joyce were adamant. Dad was still able to maneuver around the house albeit feebly. No, they would continue to manage.
Now nearing Christmas as the doctor asked how he was uncomfortable Dad looked at him searching for the right words. Would he mention the constant fatigue, the shortness of breath, the difficulty in getting to the bathroom before another bout of diarrhea, the loss of appetite, the lapses in short-term memory? My father, always a man of few words, said, “I can’t do anything.” That summed up the past year. He was a man always busy: driving, mowing the lawn, shoveling the snow, painting, puttering, cleaning, organizing, fixing this, repairing that, helping a neighbor or a friend. Now, five months after a new valve was inserted into his artery intended to renew his lease on life, he couldn’t do anything. He was spending his days drifting in and out of sleep cocooned on the couch, exhausted from brushing his teeth. He could no longer climb onto the bathroom scale and stand steady enough to weigh himself. He didn’t have the strength to shave. He hadn’t taken a shower in weeks. His distinctive shuffle prevalent over the summer and into fall had taken on a stilted, desperate lurch, one step, two steps, bracing against some object for support before the final, tactical push to the couch where he could finally give into gravity and collapse, calling it a day. Once prone he would continue his struggle, but now with the Buffalo Bills blanket that would keep him warm.
I mentioned to the doctor that Dad and Joyce needed help. Dad had become powerless and Joyce could no longer go this alone. I knew that if Dad fell Joyce would never be able to get him back up. The doctor talked about hospice and what that meant and would entail. No more x-rays, no more blood tests, no intervention. The key would be to let the natural processes play out and hospice’s goal would be to make Dad comfortable. We nodded not daring to look at each other.
The cardiologist would work with Dad’s primary caregiver and hospice and things would be settled in the next few days, although Christmas would get in the way. I helped Dad back into his sweatshirt and coat and then wheeled him out to the car. He struggled into his seat, I helped lift his feet up over the threshold and then wrapped the seatbelt around him. Joyce followed up with the front desk as I folded up the borrowed wheelchair and took it back inside. We had accomplished something today. We were enlisting assistance, asking someone for help, something my father and I weren’t used to doing. We had direction even though the direction was toward an end.