Posted by: scintillatingspeck | November 3, 2012

A crash course in denial and grief.

Don’t worry, Dad, it’s all going to be okay, we’ll take care of you.

Paul, you need to fight this.  You need to come home.

I’m not going to give up hope.  If there’s even a tiny chance… I’m telling you, he doesn’t quit, he wouldn’t want to quit.

What if I want to say a real goodbye, with him conscious?  Is that selfish?

I can’t believe this is happening.  A week ago he was his usual self.  This was too sudden.  I’m not ready.  I’m just not ready.

These are some examples of words uttered by family members today.

We spent most of the day at the hospital, where my father-in-law, Paul, lies dying.  He spent most of the time in sedation, since he’s on a ventilator.  A few times, though, he was brought out of sedation briefly; we knew he could hear us, telling him we love him– he could move his head a little bit, and open his eyes.  He waved his hand a tiny bit.  He tried to speak, but couldn’t, because he was intubated.  Tears emerged from his eyes.

My mother-in-law is in terrible shock.  Everyone is, but she is in particular shock.  Denial has been running deep for the past few days.  I understand.  Her husband seemed the picture of health only a week ago.  Nobody knew that his left anterior descending artery was 99% blocked, until after the heart attack.  And now he is losing kidney function and liver function, his heart is damaged and exhausted, he is in sepsis, and he is worsening steadily.  But up until this afternoon, my mother-in-law was still hoping that we could bring him home and that he would pull through.

We had a family meeting with a hospital staff member today.  He was clear, kind, and frank.  He made it clear that this would be a good time to examine our values and wishes, especially since Paul did not specify how he would want to be treated in this scenario.  He laid out in detail exactly what had happened so far, and the best-case and worst-case scenarios ahead.  The wildly optimistic best-case was not promising.

I am finding myself in the unenviable position of attempting to convince family members of the reality of irreversible decline and death.  Even now, even as I am writing this paragraph, my mother-in-law is saying, “But maybe he could have a heart transplant?”  I stop writing; I explain that he’s not a candidate for such a thing.  They have already told us that his existing blockages are inoperable, that surgery would be too risky.  There is zero chance of it happening.  My mother-in-law closes her eyes and looks ashen.  I feel terrible for shattering her hopes.  I have been shattering them all day, as kindly and directly as I can.

What shatters me, in turn, is her frantic grasping at straws, the reality that she may be prolonging his suffering, the doors that may be closing for him to be made comfortable and conscious enough to have a few last words with his family.

I am a student, today, of attending to the dying and attending to those around one who is dying.  The lessons are bruising.  I am “being strong,” whatever that means.  I am listening hard.  I am care-giving, moment by moment.  Every time I think I can’t handle any more, another jolt.  I was rubbing Lily’s head while at the hospital; she was tired and crying– and I discovered an engorged deer tick attached to her scalp.  Of all days to deal with a tick.  (Fortunately my sister-in-law carries around tweezers, so I carefully removed it, and arranged for a prescription.)

Tonight I would like nothing more than to run into the woods and cry my eyes out.  If only I could.

 

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Responses

  1. Oh, sweetie. How lucky they are to have you there. Sounds like a good hospital, too, thanks be.

  2. What a hard-knock schooling life can give us some times. I’ll pray for you.

  3. Thank goodness for the deer tick, something useful to do when modern medicine has taken away all the tending that any of us might normally be doing as a loved one fades away. It feels entirely abnormal to sit by helplessly, entirely abnormal to watch extraordinary measures being taken to prolong a life that isn’t what that person may have wanted. What we want to do is make a pot of broth that our loved one might take a spoonful. We want to bring in fresh flowers that he might have a few good lungfuls of sweetness to enjoy. We want to sing, pray, rock back and forth as we cry, to gather his loved ones near and talk about not only him but also what makes our lives tick so he hears that it goes on even as he fades away.

    Two years ago my vital, loving, energetic father had a massive brain bleed. It was entirely due to medications his doctor put him on as a “precaution.” Doctors at the rural hospital prepared to fly him on a helicopter to a trauma unit where they’d operate on his brain. My family members readied for the trip by car. I asked if there was any hope that he’d recover. Not really, I was told. He’d either die, or be vegetative, or maybe recover some function but probably not enough to ever go home. His worst nightmare. So then I talked my family into letting him stay, letting him sink into the oblivion that had already erased who he was. He had only a few hours left. It haunts me but I know it’s what he would have wanted. What would Paul want?

  4. Laura- the question “what would Paul want” looms large. He did not specify his wishes before he became unable to communicate. Now his treatment is being dictated by others. I desperately wish he could be released from his suffering. It’s not my call, as a daughter-in-law, although I’ve done my best to advise.

    I’m glad for your father’s sake, and for your whole family’s sake, that you were able to successfully argue for mercy. I would do the same.


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