Wednesday, March 11, 2009
Last night when I got home from the hospital, I sat down to work and instead wound up obsessing about Dad and hospice issues. Among other things, this meant that I had to grade fourteen papers this morning before I went to work, but it was also a sign, I thought, that I should talk to him about it (which many people have been urging me to do).
So this evening when I went to visit, I asked him how he felt about going to the nursing home tomorrow (he's supposed to be transferred at 1 PM). He said he felt neutral towards both that and everything else. He's been sleeping most of the time, not eating much, and very lethargic, reporting some shortness of breath and pain even at rest: classic end-stage CHF symptoms. He sounds doubtful that he'll do well in rehab. So am I, although I'd love to be surprised. I asked him what he hoped for, what would make him happy. He told me that he wanted to be better, but that if he couldn't be better, he wanted to be out of pain.
I said, "So if there's a program that would focus on pain relief and quality of life, you'd be interested in it?" He said he would, and I told him about hospice, emphasizing that it didn't mean giving up, that he'd still be given his cardiac drugs for comfort, and that he could leave the program if he wanted to.
He thought it made sense. "I don't want to lie around being a test tube," he told me. "I know I'm going to die. I'm not afraid to die." I asked if I had his permission to request a hospice consult, and he said yes. So I'll get that ball rolling as soon as he gets to the nursing home tomorrow.
It was a huge relief to talk to him about it; I felt like we were no longer dancing around the elephant in the living room. I also feel like the last thing I can give him is the best possible death. He said, "I've lived a pretty full life," and I asked him what he most regretted not being able to do, and he said that he's sorry he never got to sail around the world, which was one of his dreams for years. That won't be possible now, of course, but I'm hoping that I can get him out to Pyramid Lake, which he loves, and maybe up to Tahoe for a boat ride.
I was afraid that he'd be hurt or upset if I raised the issue of his dying, but he said it was a relief. It's been hard to have good conversations with him with that issue in the way, and he said he feels better when he can connect with me.
While we were having our own conversation, the guy in the next bed was being informed by his doctor that he has 3-4 months to live. The physician did an exceptionally good job breaking the news -- she and the patient clearly feel respect and affection for one another -- but this man's much younger than my father, and he was in shock. I went to talk to him and his wife at one point, and when I came back, Dad (who felt very sorry for his roommate) said, "That conversation you had with him, were you being . . . what do you call it, what you do in the ER?"
"Yeah, I guess. Were you doing that?"
"A little bit. Not as much as I would if I were wearing my chaplain's badge; I mean, I didn't offer to pray with them. But when I asked him, 'How are you getting through this?', that's the quintessential chaplain question. You try to help people find their sources of strength." Dad nodded, and I said, "So, Dad, what's your source of strength?"
"You," he said. "And bits of life, like listening to the news on NPR."
I told him how sorry I am that his time in Reno has been so horrible. I so wanted him to be happy here and have fun, and instead it's been one bout of misery after another. I cried a little bit, and he pulled my head down on his chest and stroked my hair.
And then he went to sleep, and I came home for dinner. Gary and I went to the supermarket, where I was very spacy. But I'm glad the end-of-life issue is out in the open now.