The doctors needed to consult amongst themselves. Hospice needed to weigh in and review my father’s needs and abilities. It wasn’t until the Friday before New Year’s that papers were signed and a schedule for service was agreed upon, a week after we had admitted we needed help. Hospice would begin their caregiving the following Monday, the day after New Year’s.
My father was ensconced, entrenched, enshrined, entombed on the living room couch, his favorite nesting place for the past few months and after hospice’s home visit he tried to get up to walk to the bathroom. He couldn’t stand. He called Joyce. Together they struggled to traverse the twenty-five feet from couch to throne. It took almost an hour. That evening Joyce’s daughter-in-law, Denise, a nurse, told them in no uncertain terms that he could no longer stay on the couch and needed to be in bed, to stay in bed and not try to move about the house. Joyce’s grandsons were enlisted to help move my father into the spare bedroom.
That Friday night and the following day his decline was rapid. The passing of 2016 into 2017 went unnoticed. Dad’s medicines were stopped and he was introduced to morphine. He slipped into a coma before I arrived home the day after New Year’s. As I walked through the front door hospice was just leaving, their first and only visit. Dad’s blue-gray eyes were open, the left one more so than the right. They looked ahead blankly, registering neither emotion nor recognition. He was unresponsive. A kitchen chair was sitting on one side of the bed, a portable commode on the other. An oxygen compressor was adding additional heat to the already stuffy room while its clear plastic tubes were providing scant capital for his overworked lungs. His mouth was open slightly, his dentures removed, his tongue jutting out a bit. A deposit of thick pink sputum was welling up and down around his tongue when he breathed. It sounded like he was snoring, but snoring underwater. This was the death rattle, the gurgling, burbling noise from the throat. It was the noise a snoring, drowning, dying man makes. Dad had pulmonary edema and bronchial secretions had been filling the tiny sacs in his lungs. That, mixed with saliva and blood, was filling his throat and trying to find an outlet up and out through his mouth. Denise was using a turkey baster to remove the fluid build up from his mouth and inside his throat. I asked why he wasn’t gagging when she inserted the plastic tube so deep to suction out the mucus. She said that the part of his brain controlling his gag reflex had shut down, that he could no longer feel the sensation and his body could no longer respond. He had also lost his ability to cough or swallow to expel the viscous fluid.
I helped Denise reposition Dad on the bed, bracing him onto his side while she applied a large bandage to one of the growing bedsores on his buttocks. We gently rolled him and wedged a pillow under his frame to relieve the pressure on that side. We tugged at the absorbent pad placed beneath him (other bodily functions had shut down), moving him up toward the headboard allowing his feet to firmly rest on the mattress. (A trait I share with my father, we don’t fit easily on standard mattresses.) Joyce and I took shifts donning latex gloves and using tissues to wipe the sputum from the corner of his mouth before it could trail down his chin. Joyce was praying to God to take her husband, to put an end to his suffering, our suffering. I was feeling claustrophobic, the closeness, the warmth, the stale air, the puffing oxygen, the gurgled breathing, the impending. I told Joyce to take a much needed break and spend time with her family out in the living room.
I kept vigil with my father. I sat alone with him wiping his mouth and holding his wrist, feeling his pulse, his remaining life. I spoke to him not knowing if he could hear me. I didn’t pray to God, I spoke directly to my father. I told him it was okay to go. I told my father I loved him. I told him he was a good father. I told him a joke. I cried. I wiped my eyes, then I wiped his. He wasn’t blinking and a salty crust had formed on one corner of his right eye. I didn’t want his eyes to dry out and the expressionless stare was breaking my heart. I gently moved the eyelids down as I’ve seen others do on television, but they wouldn’t stay closed.
Time stood still. The room grew darker and dad’s breathing grew lighter. His breaths were softer now and farther apart. The gurgling was coming to an end. The noise in my ears and in my head grew hollow, distant. I released my grip on his wrist and stood up. Joyce needed to be here now. I walked in a daze down the narrow hallway to the living room noticing noise and reality again, hearing one of Joyce’s grandsons talking. I choked out a request that she come into the bedroom for a minute. She quickly got out of the chair and untangled her oxygen tubes from around her legs. She followed me and as we entered the bedroom I told her it was time. We moved silently around the end of the bed. We drew near and stared down at dad’s face, his expressionless eyes, his open mouth, his chest and bulging stomach beneath the thin blanket. We moved closer and I saw a wince, a grimace, a sour contortion on his face. I don’t think Joyce saw it. It was brief and it reminded me of the face a baby makes when it needs to pass gas. The density in the room changed. The gurgling stopped. Dad’s chest stilled. It was January 2, the beginning of a new year and the end of a long, good life.