Tuesday, April 11, 2006
One year on since Dad's death
Now for something extremely personal. It's been a year, but I still remember the details clearly. The second Tuesday in April. Last year it was the 12th. This year it's the 11th.
Regardless, it was the second Tuesday in April, about 5:30 p.m. when Mom called me at work last year to say that Dad was in an ambulance on his way to the hospital, and she was following. She was frazzled and my cell number was all she could remember. He had an aneurysm in his stomach, she said, and they were going to operate ASAP.
I didn't ask for more details. I told her to be safe, concentrate on her driving, and get to the hospital. I would call my sister.
My instinct said it was bad. Aneurysms are bad. Really bad. Right?
After a quick call to my husband, I got my sister on her cell phone. She was on the train, just coming into her station. Only about 10 minutes from the hospital where my Dad was headed. I told her what I knew. I tried to stress the urgency that somebody needed to get to the hospital right away to be with Mom, without transmitting too much of my own panic. My sister went right to the hospital.
I didn't cry until I told my boss. In the elevator on the way down, I saw two of my co-workers. I could barely hold my composure. I had an hour drive home, including a stop to pick up the dogs. I had appointments to cancel. I was worried, but knew there probably wasn't much information. I cried again on the expressway.
Picking up the dogs at their day-care was good therapy. They were so happy to see me.
Then my sister called. She'd arrived at the hospital and quickly found my Mom. Dad had been getting an ultrasound. He was flat on his back. His blood pressure was extremely, dangerously low. Internal bleeding. He was in a lot of pain. He managed to wave and mouth a quick "I love you" to my Mom before they wheeled him away for surgery. Doctors were giving him a 50/50 chance to survive the surgery.
A 50/50 chance? Strangely, that made me feel better. It was a better chance than my instinct had been telling me. But I remember it shocked my husband. He hadn't realized it was so serious.
For about seven hours, we sat in the tiny surgical waiting room. We saw others come and go. We ate dinner. We watched television. We exchanged as much inane gossip as we could. It was all about diversionary tactics at that time. In the wee hours of the morning the surgeon came to talk with us.
Dad had survived. He was strong. They would keep him sedated tonight and tomorrow he should wake up.
The aneurysm had been an abdominal aortic aneurysm. The major artery in the body, the aorta, had formed a bubble and then burst where it traveled through the abdominal cavity, right before it split into two branches to become the femoral arteries in the legs. They had taken out the Y section and replaced it with synthetic tubing. The problem had been that Dad had vascular disease. He'd quit smoking more than 10 years prior, but those years of smoking had damaged his arteries, causing them to lose their elasticity. As they'd tried to sew the artery to the synthetic tubing, the artery would just flake away, disintegrating.
He'd lost A LOT of blood, and that was why his blood pressure had gone so incredibly low. The circulation to his legs had been compromised, as had his kidneys. We'd have to wait and see what kind of permanent damage had been sustained.
At about 4 a.m. we finally got to see him in his ICU bed. His eyes were fluttering and he was trying to move. We tried to reassure him, told him to rest. With an "I love you" and a "goodbye" we went home to get some sleep.
My husband and I slept in a little bit, then picked up lunch for everyone and brought it to the hospital. Going to work was out of the question. Fortunately, our employers were understanding.
There was a lot more waiting involved, this time in the ICU. Dad didn't wake up. I worried about his legs, which were looking a little black to me. His potassium levels were high. His body was bloated with fluids. Toward afternoon, the doctors decided he needed dialysis. I canceled more appointments and stayed with my Mom into the evening. My previous optimism was starting to flee.
My husband and I brought lunch again. Dad was no longer in the ICU. The circulation in his legs was compromised again and the doctors suspected a clot in the artery repair. They were going to attempt to fix it in the Cath Lab using angioplasty.
We sat in yet a different waiting room. My sister ran into my Mom and Dad's regular doctor in the hospital. He was surprised to hear what was happening. No one had notified him. He prescribed some medicine for my Mom to help her cope. It helped.
The angioplasty wasn't working. They couldn't get to the blockage from his groin nor from his arm. We were brought into the Cath lab where we could sit with him for a while before they went back in to take care of things surgically. We were there for a few hours. Dad was sedated again, but this time it seemed different. His eyes weren't moving like they had been before. We held his hand. We talked with the technicians. We waited.
In the evening, Dad went back into surgery. We sat and waited in the tiny surgical waiting room again. Same routine. We watched television. We counted the people who came and went. Again, in the wee hours, surgery was over. Dad had survived. They were trying to stabilize him. We should go to the ICU waiting room and they'd let us visit him soon.
We waited and waited outside ICU. We started a list of all the procedures Dad had performed. He would want to know when he woke up. He was like that. "Doctor Dad" would want all the medical details. Still we waited. I sent my husband home. We felt optimistic again.
Finally they let us in to see him. They couldn't get him stabilized. He was even more bloated with fluids. His blood pressure was extremely low, his pulse was racing. When I noticed the crash cart parked outside his room, I called my husband and told him to come back.
We sent my sister home with a promise that we'd call if anything changed. She had small kids and needed to be there for them. Mom slept in the hallway outside Dad's ICU room. My husband and I slept on the floor in the ICU waiting room.
When I woke up, something was different. The doctors and nurses, who'd been so chatty the night before, were more quiet. Dad's blood pressure was still really low, but his pulse wasn't racing so bad. I called my sister to tell her that, basically, nothing had changed.
When I got back to Dad's room, Mom was crying. What had happened? They'd just told her that Dad wasn't improving and it was time to make some DECISIONS. They wanted to have THE TALK.
I called my sister back. She was in the shower. I told her husband what was happening. What should he tell her? Whatever it took to get her here safely ASAP.
There were basically three options, but they all seemed to have the same result. They could operate again even though Dad wasn't strong enough, they could continue to treat him as is, or they could do nothing.
Without an answer, the crash cart was opened. The nurse started administering drugs. The situation was degrading quickly.
This was the point where I realized that we all deal with trauma in our own ways. We were in a religious hospital, but we could find no comfort in religion. Mom wanted her regular doctor there. She wanted to hear the options from him, because she knew him and trusted him. She wanted to hear from HIM that doing nothing and letting my Dad die was the right choice, was the ONLY choice. It was her decision to make, but she felt paralyzed without that consultation.
My sister comforted my Mom. I explained to the nurses what was happening and what my Mother needed, then I went in and held my Dad's hand.
My Mom's doctor was located. It took him awhile, but he came to the hospital. The nurses were about at the point of needing to use the paddles when he came in, got the assessment from the doctors, and calmly explained that based on the information he was presented with, Mom needed to let Dad go. Mom kept calling it "pulling the plug," but in my view it was more a matter of choosing not to give treatment.
Then were were all in the room with Dad. The respirator was still pumping, but they turned off the other monitors and let us be with him. There was nothing special that happened that told us he had passed. The sedation had long since worn off, but he had never awakened. Dad just laid there in the bed like he had all night, and then the nurse came in and told us that his heart had stopped. They'd been monitoring from their station.
Then we left so they could clean up Dad. They pulled out all the tubes. Tried to make him look presentable. But after all the trauma he'd been through, the fluids he'd retained, he didn't really look like the man I'd known my whole life. The nurses were able to help Mom clip a lock of Dad's hair. We said our goodbyes.
We were empty, and exhausted.