The Most Important Meal of the Day

I was about to leave for the hospital when Trudy called to tell me the doctor was postponing John’s final arm surgery. “Your dad has pneumonia. And, his nurse - I really like her; she looks just like Geena Davis, but not as attractive, and shorter – she told me that they will probably have to put in a feeding tube.”

Later that day, John’s internist, Dr. Pacino, informed me that my father was no longer taking in enough calories to survive. He had lost about 60 pounds over the course of the year, and as he became weaker and more delirious, he ate less and less. The doctor explained that the only course of action, if we chose to act, would be to insert a feeding tube through John’s abdomen, which would deliver protein drink directly into his stomach. I asked Dr. Pacino if the feeding tube would help my father become healthier or improve his quality of life. He said that a tube would prevent John from dying of starvation, but that sooner than later he would be back in the hospital, probably with another infection, and then another, until one of them finally overtook him. Also, he informed me that even with nutrition from a feeding tube, John’s life would not be extended for very long, and he would only feel as well as he did on his best day within the last three months. I told the doctor that ultimately the decision was Trudy’s, but I was against prolonging my father’s life with a feeding tube, or any other life support measures.

By the time I arrived at his room, John’s lunch had been served and laid untouched at his bedside. I was trying to persuade him to take a few bites of pasta when he looked up at no one in particular and asked, “So, this guy who broke his bones. Is he gonna be OK?” Until then, I had been able to maintain a pretty upbeat, “Isn’t this hospital bit a kick?” attitude in front of John. But when he threw that out, I burst into tears. At the sound of my sobbing, he suddenly focused on me, widened his eyes and smiled. “What? What’s the matter? I’m all right. Everything’s all right. It’s ok.” Waving a spoonful of Penne Bolognese in the air, I started bawling, “Dadd-hy, you have to eat someth-hing or the doctor will shove a fee-heeding t-hube in you. And, and, and …that won’t be very comfortable.” Laughing weakly, he answered, “Alright. You don’t have to be so tragic about it.” And then he let me feed him the entire plateful of food.

A few days later, John was cleared for his last surgery, which was a moderate success. Immediately following the procedure, Dr. Stanovich proudly shuffled through the vivid digital photographs he had taken, which illustrated that although it was impossible to use John’s frail skin to graft, he was able to sew most of the wound closed. The small section that remained exposed was expected to heal on it’s own.

After wolfing down that one bowl of pasta, John went back to refusing food and continued to lose weight. He was scheduled for release to a critical care nursing home soon, so the internist pressed me for an answer about whether or not we wanted John to have a feeding tube inserted. I explained that my siblings and I were against life support, but our mother was undecided.

After a few tortured phone conversations and IM’s on the subject, Trudy seemed to begrudgingly agree that a feeding tube would do little but prolong John’s suffering. Or so I thought, until one morning when I walked into my father’s room to find him crying out in pain while an impatient intern clumsily jammed a tube up his nose. I grabbed John’s hand and politely asked her what in the fuck she was doing. Sighing loudly she complained, “Well, I’m TRYING to get this tube down his throat so we can get him to surgery. PLEASE RELAX, SIR.” A nurse nearby volunteered that the night before Trudy had given her consent. The purpose of the tube presently being driven up John’s nose and down his throat, she explained, was to expand his stomach in order to ease placement of the permanent tube that would be implanted directly into his abdomen.

Once she forced the tube in place, the effervescent intern left the room. John then turned to me and pleaded, “What are they doing to me?” Averting my eyes, I mumbled a vague explanation that they were giving him something to help him with his appetite. And then my cell phone rang. It was Trudy.

She spoke in the frightened little girl voice she puts on when she knows that I know she’s done something wicked. She admitted that even after we, as a family, had agreed not to do it, she ordered the feeding tube. “But,” she assured me, “they can always remove it. It’s easy.” When I said I thought it wouldn’t be easy for us emotionally to take away John’s life support, she replied, “Emotionally? I don’t get it.” When I asked her why she hadn’t told any of us that she had ordered a feeding tube, and why she hadn’t shown up for the operation herself, we got disconnected.

In a few minutes an orderly arrived with a gurney. Staring down at his clipboard he asked, “Is this John B?” My father frowned and answered, “I used to be.”