Circling the Drain

I am not sure why it matters, really. After all the years and all of our many moments together, it wouldn’t make much of a difference to him one way or the other. It will still matter to me, though. It shouldn’t, but it will. Let’s blame it on my irrational humanity.

“This is my grandson. He is my rock, you know. He is a doctor too. He is my translator; after you leave, he’ll explain everything you say so that I can actually understand it.”

He has been to the hospital 4 times in the last 8 months; I have been there with him every time. I tell him that an MD doesn’t want to hear that I am a DPT, but I think he likes to tell them that that I am a “doctor” out of spite (and a bit of misplaced pride).

Since his wife passed away nearly five years ago, he has lost over 50 pounds and his health has been in a slow, if not purposeful, decline. He has had multiple falls, fractured his pelvis, shredded 10-inches of skin off his forearm, and flirted with more nurses in hospitals, rehabilitation, and home than he could possibly remember. Each time he has bounced back stronger than his 95-year-old body rightly deserves.

He isn’t necessarily thriving, but he still lives at home and (for the most part) on his terms. My mother takes him to his MD visits. A privately-hired aide supervises his shower twice weekly. Prepared meals are delivered to his home daily. He accompanies friends out to lunch weekly and hosts regular visitors. He tells me he thinks he is doing “pretty good” for his age, which he would confess isn’t saying much when he considers how everyone that he once knew of similar age has long since died.

Last night, my phone rang. The ringtone on the phone belonged to my mother and when I looked at the time [01:17] I knew it couldn’t be good news. Of course, he was in the hospital again. This time he required an emergency surgery for a hernia.

There was no time to taper him off the blood thinner that he has been taking since his stroke 6 years ago. The pain was getting worse. He was vomiting bile. There was no other choice to be made: he was going under the knife.

I asked one of his physicians, over the phone, “What kind of hernia are we talking about here and what is the surgical prognosis?”

It could be a simple hernia,” she replied, “or it could a strangled gut. We won’t know until we get in there. To not treat it is a painful way to die even with comfort measures. A surgical fix could be simple and a totally reasonable risk even with his advanced age and and medical problems.”

I assured the clinician that I wasn’t second guessing their expertise, only acknowledging the limits of my own and hoping for perspective. After the call ended, I sat at the edge of the bed, and – now awake – I tried to remember the last time that I visited him.

I had seen him 2 days earlier when I visited to hang new decor on the wall of his new retirement-community studio-apartment. I surprised him with a large map of the state of Virginia, where he grew up as a youth. I had hoped it would serve as a conversation-starter when guests visited his room. I recalled him standing up from his recliner on 3 separate occasions to walk to the map and point out places that he had traveled to with his family as a young boy. Most importantly, I remembered giving him a hug before I left and saying, “I love you.”

Tonight, I publish this posting from his room in the hospital’s ICU. He is fortunate –  it was a simple procedure after all. He has spent the entire day sleeping (but it is sounds better if we say that he is recovering). He is still in a lot of pain, but he is resting soundly and tomorrow they will get him out of bed to stand and walk. He has already quickly dismissed his male nurse at shift change after meeting the attractive young woman who will be caring for him for the remaining portion of the evening.

After a few more days recovering in the hospital, he’ll get to go home. Next week, he will receive home care until he is as strong as can be. Next month, he will have returned to his baseline. Sometime soon after, he will return to the hospital once again. We will bring his do not resuscitate (DNR) documentation with us and be certain that one of his two health care proxies are present or nearby throughout his stay.

I have now asked myself the same question 3 times before. Not too long from now, I will be asking myself the same question again. Maybe the next time will be the last.

“What was the last thing I said to him?”

 

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