Wednesday, December 12, 2007

Purgatory

When I visited John a few days later, he wasn’t on a ventilator, but he was receiving oxygen. His feeding tube was still in place. He was so bloated that the skin on his face was unnaturally taught and shiny. He wasn’t wearing his teeth. His nephew Steve called, so I roused John and held the phone to his ear. He was mostly inaudible and incoherent, but at one point I did hear him mumble weakly into the receiver, “Well, I’m alive.” I decided then that I would not return to the hospital. I couldn’t bear to watch him suspended between life and death with that feeding tube. He didn’t need me. He wasn’t even there anymore.

The next night, Trudy left me a voicemail message that John wasn’t doing well and the doctors felt he probably wouldn’t make it through the night. Karla, Leo, Susan and I had a conference call about what to do. Trudy had not bothered to call them herself. Leo said he would go along with whatever we decided. Susan thought we should all go to the hospital. I decided that if John was unconscious, I wasn’t going to spend the last moments of my father’s life consoling Trudy. I couldn’t do it. As it turns out, none of us could.

Leo called the nurse’s station. John was unconscious. His condition was not good. And, he was breathing with the aid of a biPAP machine, a non-invasive ventilator. In other words, life support. Adding insult to injury, John had been instructed years ago to use a biPAP machine at night to control his sleep apnea. He had refused, because wearing the mask over his nose and mouth made him feel claustrophobic.

I worked up the courage to return Trudy’s call. She coldly informed me that she told the doctors not to intubate, but didn’t mention the biPAP. She told me the nurses were all rallying around her. She didn’t ask me to come to the hospital, and I didn’t offer.

In the morning, John was still breathing with the biPAP and he had been given medication to lower his blood pressure. He was unaware and not in pain. Later, Trudy called to tell me that John had pneumonia in both lungs and, without intubation, he was not expected to survive. The next day was John’s 87th birthday. I hoped he wouldn’t make it.

But he did. The nurse reported that John was still breathing with a machine, he hadn’t peed for days, his blood pressure was low and his potassium level was high. Trudy called to say Dad was going to have dialysis because his kidneys had shut down. If she didn’t allow it, he’d die. I told her to call the doctor and cancel the procedure. She promised she’d OK it, “just this once,” to ease John’s breathing. Afterward, they would take him off of all life support.

Late that night I saw Trudy online, so I asked her when they would stop the biPAP and feeding tube. She said the order would go down the next day, after the dialysis. Then she casually announced she had requested last rites be performed for John, “because he was such a strong Catholic all his young life and just in case.” Trudy says, “just in case,” like she’s making horn bets at a craps table. She really knows how to taunt me. I explained that there is no, “just in case,” in Catholicism. I went on to remind her that John had been a strident atheist for the last 50 years or so, and what she was planning to do was disrespectful of him. Her interpretation: “Mary, your father tried to make people believe he was anti-religion. He liked to have something to argue about.” I surmised that if he feared God he probably would have baptized his daughter and saved me from floating in Limbo for eternity. (For the record, the Pope “revised” the whole Limbo thing in April 2007.) Trudy signed off. I was glad to learn that she placed such faith in medieval Catholic rituals, and planned to hold an exorcism at her condo as soon as possible.

The next day, John was placed on dialysis, yet he remained on life support. The day after that, I called Trudy to get an update on when they were taking him off. She replied, “Oh, Golly. I’m on the other line. I’ll have to call you back.” She didn’t.

But she did send us all an enthusiastic email later: “I have good news! John is alert, the swelling has gone down and they are removing the biPAP (breathing) machine. He is talking and he told the nurse his birthday was the 16th! Mary, I know you are upset with me about this, but yesterday I called in a priest to do the last rites. He anointed John with oil, laid hands on him, prayed and sprinkled holy water on him. Believe what you may, but I know it had a lot to do with John doing better today.”

I told her I didn’t want him more alert, I wanted him to die. I asked Trudy what kind of God would want him to linger? Leo ordered me not to indulge her. Karla weighed in three hours later, just after visiting John. “When I walked into the room John was moaning and continued to moan for the 45 minutes that I was there. I walked up to the bed and called his name. He looked my way with eyes rolling in the back of his head and said, what I gathered to be, “Who is that?” I said, "Karla," and he continued to moan. I asked if he was hurting and he said yes. I asked where and he could not get words out but it sounded like mouth. I asked if his mouth hurt and he said “No, my (garble garble).” I asked several times and nothing he said was intelligible. I went to the nurses’ station and told Jennifer that something was hurting John but that I couldn’t understand what it was. She said that she would get his nurse. I went back to the room and said that it was Karla again and he said “Hi, darlin’.” He was trying to pull up the covers and I asked if he was cold; he said yes so I covered him completely. His face is covered with abrasions, most likely from the biPAP, but did appear less swollen.”

The next day, Trudy called me to find out when I was coming to the hospital. She professed that John had improved since Karla was there. I told her I didn’t want to see him that way and if he didn’t need me, I didn’t think I’d be back. She screamed, “He needs you! He was asking for you!” I asked her when, and after hesitating she answered sheepishly, “…Last night.” I asked her why she was so evasive with us all about the life support issue, so she stepped up her game. Pausing dramatically, she inquired, “So, you’re never going to see your father again?” I told her I didn’t know, and hung up the phone.

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