My dad, David White, died on Sunday, September 12, 2010 at 10:10 PM. I found out the time later–I didn’t think to look at the clock when it happened. He died after five days in the hospital, after two weeks of being unable to eat, after nearly 25 years of congestive heart failure following a heart attack at age 49. He died at the end of three days of dying. I still called him “Daddy.”
People asked if he had been sick. Well, yes, he had been. But he had been sick for so long that we sort of took his illness for granted. When he went into the hospital the previous Tuesday, no one was terribly worried. My mom called in the evening to tell me that she had taken him to the emergency room because he was still so nauseous that he could not eat. When I had dinner with them the week before, he had eaten very little because his stomach was upset–he never got any better. Mom said, “Don’t come down. They admitted him after we waited in the emergency room for four hours [that was unusual--his heart condition usually rated more attention]. The doctors are trying to get the nausea under control. I’ll call you tomorrow night and let you know how he’s doing.”
You see, my dad went into the hospital normally once or twice a year, usually for either dehydration or excess fluid on the lungs (it’s the lasix tightrope walk–ask any racehorse). The doctors would change some of his meds, re-prescribe others, and eventually send him home with an equally well-stocked pharmaceutical larder. We thought this would be the same kind of incident, even though, after a June hospital stay, we were told the incidents would become more frequent. He finally accepted a wheelchair (which he never used after it was delivered) and oxygen at home to ease his breathing.
Mom called on Wednesday and reported he had a better day–he had even been able to eat some cream of chicken soup (apparently the dietitian had overlooked his heart condition and had not prevented the soup from reaching him). I was once again hopeful and promised to leave school early on Friday to spend some time with him.
When she called Thursday night, the news was not so good. The nausea was back. The dietitian had cracked down on his food choices. No more cream of chicken soup (too high in fat, not on the heart diet). No potatoes or other high potassium foods (the result of a misdiagnosed kidney condition earlier in the year). My mom argued with the nutritionist–my dad wanted the soup (it had tasted good) and he was going to have his soup, either from their kitchen or from hers. He got his soup, but he could barely eat any of it. She said I had better come down on Friday.
On Friday morning I got to school a little early to prep for a meeting. My cell phone rang as soon as I entered Tudor House. It was my mom, “You need to come down now.” I picked up my husband, John, and a suitcase and we headed for the hospital an hour away.
Daddy had been moved to the Cardiac Care Unit at Mercy Hospital (I still call it “TM” as in “Timken-Mercy” even though the name changed several years ago). He had just been settled in the room when I got there. My sister and mom were both there. Both had been crying.
My dad had no blankets covering him.
The lack of blankets startled me more than the breathing at first. My dad wore a heavy down coat most of the time–even in the summer–over his standard t-shirt, long-sleeved shirt, sweater vest, and sweater, all the result of a permanent chill because of poor circulation. The fact that he was not heavily bundled up and apparently not cold was a bad sign. The good sign was that he was lucid.
“The doctors said there’s nothing they can do but keep him comfortable.” Mom was that blunt.
The CCU staff was wonderful. His cardiologist had cared for him since Daddy’s heart attack in 1985 and Dr. U was the one doctor my parents trusted implicitly. Even he acknowledged the end of the road–my mom said he was almost in tears. The doctors suspected the nausea was being caused by one of the heart meds that was keeping him alive and there was no way to address the situation. They would have had to stop all of them and restart them one at a time to eliminate the culprit. That was not an option.
Daddy’s breathing became more regular as the nurses got his anxiety under control. But his condition worsened. He asked for pain medicine in the afternoon–one of the side effects of worsening congestive heart failure is pain in the extremities as circulation weakens in the body’s attempt to keep the vital organs functioning. His nausea also increased and he began vomiting more frequently.
I must make a confession at this point: I’m squeamish. I can’t deal with blood or vomit. My sister was a real trooper when Daddy was actively sick. I, wimp that I am, ran for the washcloth and the nurse. At some point while I was out my sister changed the channel from “Law and Order” to “The Kardashians.” It’s weird what details stick with you. It was the first time that I saw that particular show–it added to the unreal nature of the weekend.
We stayed until late Friday evening and then went back to my parents’ house for the night. My mom stayed at the hospital. Sometime that night my parents made a decision.
On Saturday, my dad’s symptoms were about the same. He slept more and was frequently sick. At one point, when my sister and mom went for lunch, he woke up for awhile and talked to me about the natural gas explosion and fire in San Bruno, California that was being covered on the news. We discussed the suspected corrosion of the pipes as a possible cause.
There were a lot of things I wanted to say–but I couldn’t get the words out. I wanted to thank him for all the understanding over the years, for his constant patience with my mom’s health, for welcoming me home when my life fell apart (more than once). As usual, I connected with him via the news and missed that emotional piece that neither of us seemed to be very good at. The opportunity passed. That’s my biggest regret.
Friends and relatives visited. At some point one of the nurses brought in a heavy looking round magnet on a cord and hung it from a hook on the wall. I knew it was a magnet because it stuck to the wall on its side, looking like a bright blue doughnut.
Later Saturday afternoon, my mom asked us all to come out to the waiting room. She told us that she and my dad talked Friday night and made the decision to stop his remaining meds. The doctors said that, once that happened, Daddy would die within a short period of time. They would increase his morphine to continue to keep him comfortable. He would lose consciousness, his blood pressure would drop, and eventually his heart would stop. We understood that he was suffering and that nothing could be done and this was the remaining course of action. Were we OK with it? Yes. Did we want to be around when the meds were stopped? Yes.
Sunday morning, early, we all gathered at the hospital. He looked around at us and said, “Well, I’m ready if you are.” Daddy kissed us all and told us that he loved us. I thanked him. The nurse turned off the IVs, except for the one with the morphine. He closed his eyes and slept. We stayed close by. It felt somewhat morbid to sit and wait. But I knew I had to stay and bear witness.
After a couple of hours, my dad woke up. He looked around and seemed to be rather surprised to see us. He put his head back against the pillow, “What’s taking so long?” My mother looked thunderstruck (I now understand what that expression looks like), “Well! What at kind of a question is that?” My brother-in-law tried to be philosophical, “These things aren’t in our hands.” Me? I burst out laughing, “Well, you’re the math guy.” He seemed to think about that and slept again. Aside from answering nurses’ questions, he didn’t speak again.
Morning became afternoon. The nurses brought us coffee, cookies, and some fruit. Daddy’s blood pressure remained steady. It declined a bit and then rose again. My husband and I began to think it might be another day or so. Later in the afternoon, we made the decision to drive home to the east side of Cleveland to get more clothes and necessities. On the way back to Canton, we stopped and got some Chinese food. I got back in the car and found messages from my sister:
5:51:45 PM Last bp reading 62/17 but they switched arms HR still 70
5:54:01 PM Ill update u in 10 min
I feared I would miss being at my father’s bedside because I was hungry and that I would have to bear that burden of selfishness forever. I replied:
6:24:35 PM We’re on our way back.
More messages on the return drive:
6:27:33 PM He seems the same it may have been the changing arms Hr still 70
6:43:51 PM We’ll be there ASAP
6:45:22 PM K i know ur mom wants u to b here
We arrived at the hospital before 7 PM–Daddy was still with us. My mother and sister continued to cry intermittently. Daddy’s blood pressure continued to drop. One of the nurses closed the door to the room and pulled the drape part-way across the windows to give up some privacy. I sat near his feet, on his left side, my mom on my right, holding his hand.
There was nothing to do but watch the numbers fall and listen to his breathing grow more shallow. After 9:30 the alarms went off more frequently. The nurses silenced them–there was no help to summon. Just after 10, it became clear that it would be any minute. The final alarm went off. The nurse took that big blue magnet and placed it on Daddy’s pacemaker to disable it, in case it fired (someone had told me earlier what it would be used for).
Daddy was gone. We sat with him for awhile, waiting for the doctor to come and make the pronouncement (some things are not done until someone declares them done). The nurse came in to tell us the doctor was delayed. We waited awhile longer, saying our goodbyes. Then we escorted my mom off the CCU floor for the last time.
I so wish I had had the courage to have the difficult talks with him: about his illnesses, his final arrangements, his funeral. But I didn’t. I understand all the reasons people don’t talk about those things: it’s a reminder of mortality, it’s morbid, it’s rude. But I should have asked him how he was really doing. He told me basics about trips to the doctor–but not about the slow decline over the years. We could see some of it. But we never talked about the fact that he was Dying.
In the end, lacking his wishes and input, we improvised–we did the best we could. I guess that’s how we go through life, despite our best plans and intentions. We made the funeral arrangements, I immersed myself in a tribute video for the wake, I had a memorial placed in the football program for the high school whose games he attended for over 35 years.
It’s been 3 years now. Daddy’s ashes still sit on the mantle of the fireplace he built. I wrote most of this shortly after the funeral. It took this long to be able to edit the piece without crying–too much. I think of him with every great science news story, or when some some politician we spoke of gets his comeuppance or I get to travel some place new and wonderful. Or when I call my mom and get the answering machine and hear my dad’s voice, still taking calls.
Given our mutual uncertainty about the hereafter, I don’t think much about “heaven” in connection with my dad’s afterlife. I’d like to think he’s sharing another dimension with Albert Einstein and Carl Sagan, finally understanding all those equations and theories that he strove to understand in this life.
Love you, Daddy.