“I’ll never know, Dad”
July 22 was the three-year anniversary of my father’s death. My father, in life, was a typical native Californian. He exercised every day. He ate tofu and, outside of M&Ms, he shunned manufactured products. He kept his weight down and, even at 75 years old, was remarkably handsome. Like many people with a high IQ, (his IQ was tested at 169), he struggled to interact with people. He had successfully conquered prostrate cancer 5 years earlier with surgery, radiation and a healthy diet. He never thought he was going to die.
He told me once when discussing death, “Before I get sick enough to go into a nursing home, I’ll just walk off into the mountains and die there. You girls will never have to deal with me in a nursing home.”
But he was wrong. Struggling with pain in his back, he entered the hospital in order to run some tests on Wednesday. He died in a nursing home just as Sunday turned into Monday less than 5 days later.
When I walked into the hospital room Saturday morning, I knew he was dying. He was dying with out a will. He was dying with out a living will. He was dying without ever expressing what he wanted his last moments to look like. Beyond cogent conversation, this man, who controlled everything, and everyone around him, was now completely at the mercy of the people he had spent a life time struggling with.
He used to tell me, “I don’t really care what you do when I am dying. I am dying. And when I am dead, I’ll be dead. Why should I care?”
Without a living will, the hospital set into motion the beginnings of chemotherapy. After much trepidation and conversation, my sisters and I declined treatment. The insurance company then sent him to the one place he did not want to go - a nursing home. He arrived at the nursing home Saturday afternoon. And then the drama began.
The nursing home admitted 5 people at one time, so it was (literally) 10 hours before received his doctored ordered pain medication. My sister and I were sent home upon his arrival by the nursing home. He was alone. Gasping for breath, unable to speak, he lay there for hours completely helpless. The nurses said that he almost died that night.
I arrived the next morning to a complete mess. Without pain medication and unable to breath through the nosepiece, his chest heaved for each breath. His suffering was palpable. He begged me, “Don’t leave me”. And I promised I would stay. Those are the last words he ever spoke.
Without a living will, it was up to me. Up to me to make certain that he received his pain medication. Up to me to tell the nurses over and over again that he was not to receive nutrition. Up to me to deal with his stunned and grief stricken sisters. Up to me to make the decision that would ultimately end his suffering – to give him the medication patch that would kill him. Because he refused to ever speak of his death, it was all up to me.
You see, I did what Michael Shiavo didn’t. I encouraged the nurses stick to doctor’s prescription for pain medicine even though I knew it would kill my father. My father hadn’t had a drink in over 20 years. My father never too pain medication and had no tolerance for it. Yet, I not only told them to put the patch on, I encouraged them to keep up the pain medication every 4 hours. He died with in 15 minutes of the patch taking effect.
Why? That’s simple. I didn’t want my father to suffer any longer.
And I live with the aftermath. The complicated relationship with my father was over. I will never know what he wanted that day. I will never know if he would have preferred to die at home or in the mountains. I live with the uncertainty because he believed that he would be in control every minute of every day until the end.
Sometimes I wake up in the middle of the night to wonder if I made the right decision. My grief and loss over the sudden death of my father will always be mixed with guilt, trepidation, and the haunting feeling that I might have made a mistake.
If you love your children, friends and family, spend 10 minutes to write out a living will. A living will allows you to dictate what happens in these last moments. Making the choice to not have a living will requires someone close to you to make all of those decisions for you. It’s a tremendous responsibility and a decision that will haunt them, as it haunts me, for the rest of their life.
Filed under: Going out on a limb
