chapter sixteen
WHILE I WAITED FOR my father to return from his CT scan, I sat in one of the uncomfortable chairs in his hospital room and talked to the nursing home’s medical director on the phone. I’d only spoken to the director once before, when my father had fallen over the holidays, and she sounded considerably more somber this time around. She told me that soon after I’d left that day, my father had complained of fatigue and asked an aide to help him to his bed so he could lie down. Even with the cane, my father kept listing to one side, as if his left leg could no longer support his weight. Alarmed, the aide had called over a nurse, who arrived just as my father crumpled to the floor. They’d called an ambulance and gotten him to the hospital quickly, where he was evaluated and given drugs.
“Will he be all right?” I asked.
“The doctors will have to see what the scan says,” the director said. “They won’t know the full effects of the stroke until then.”
“But he should recover eventually, shouldn’t he? I mean, he might need rehab but that’s to be expected . . .”
“Ms. Corey, I can’t give you a prognosis based on the very limited amount of information I have. You’ll have to wait and see what the neurologist says. I’m sorry—I know you want answers, but that’s the best I can do right now.”
I hung up and immediately started reading up on strokes online. The information was confusing and discouraging. What kind of stroke had he had? What part of the brain? Was it big or small? As I was reading through a stroke recovery discussion board, my phone buzzed. It was Rick.
“I’m in the ER waiting room,” he said when I picked up. “Where are you?”
“In my dad’s room—I’ll be down in a minute.”
I retraced my steps through the rabbit’s warren of hospital corridors, to a bank of elevators that chimed morosely every few seconds, depositing medical personnel, cleaning staff, and visiting family members. I took the elevator down several floors and stepped out into the main lobby, then crossed to the emergency wing of the hospital.
Rick was standing along one wall, a shopping bag full of clothes and toiletries in one hand and his motorcycle helmet in the other. It was a relief to see a familiar face in the anonymous and antiseptic surroundings, and I practically ran into his arms.
“Anne! Is your dad OK?” Rick asked, giving me a hug.
“I’m still waiting to find out,” I said, pausing a moment just to breathe in the smell of cigarette smoke and diesel that clung to his clothes. “Thanks for bringing me my stuff.”
As I took the bag from Rick, he looked around nervously. A woman with a bandaged head walked past, a child cried out in pain somewhere, and the automatic sliding doors kept admitting and expelling waves of hospital staff and paramedics. Rick fidgeted with his motorcycle helmet, transferring it from one hand to another.
“It’s not the most uplifting place,” I said, seeing him grimace as an old man gave a tubercular cough and spat into his handkerchief.
“I feel like I’m going to contract some disease just standing here,” he said.
“Let’s go upstairs,” I said. “I can try to get you a visitor’s pass.”
“That’s OK,” Rick said, backing away slightly. “I don’t want to impose.”
“You’re not imposing. You’re keeping me company until my dad gets back.”
Rick gulped, and I realized he’d gone gray. “You know, I think I should leave,” he said, pushing his hair back. His forehead was covered with a thin sheen of sweat. “I’m sorry. These places make me nervous. I think I might still have some residual PTSD from the war.”
“Of course,” I said, taking his hand. It was clammy. “Do you need to sit down?”
“No, no—I should be OK,” he said. He put his motorcycle helmet on. “I should go, though. Otherwise I’ll be joining the ranks of the ill and infirm here in the ER.”
“Yes—go home,” I said, walking him out. “There’s nothing to do here anyway.”
“I’ll call you,” Rick said. He dipped into the parking lot, and I lost sight of him in the darkness.
I trudged back upstairs and unpacked the bag Rick had brought. I brushed my teeth, changed into pajamas, and curled up in a chair with a blanket, dimming the lights so I could get some rest. I’d just begun to doze off when the room was flooded in harsh light and my father was wheeled in on a rattling gurney. I sprang up from my chair, light-headed and disoriented as my father was transferred to the hospital bed and hooked up to several machines.
“Dad?” I asked, looking at his slack face. His eyes were closed, and his nose and mouth were covered by a ventilator. He didn’t respond, and for a second I wondered if he was asleep.
“He’s unconscious,” a nurse said as she went through a checklist on a clipboard and then dropped it into a slot at the foot of the bed.
“Is he OK?” I asked her, trying not to hover while she yanked the safety rails in place.
“The doctor will be here shortly,” she said, barely pausing in her routine. Seeing my face, she softened slightly. “Do you need some water? I can get you a cup.”
I shook my head no and she left, closing the door behind her.
Sitting beside my father, holding his hand, I looked at his eerily still face and wondered whether he would ever wake up. The machines beeped monotonously beside me. I texted Lauren again.
“Dad’s in his room. Still waiting to talk to doc,” I wrote.
Lauren didn’t respond. She was probably asleep or, hopefully, on a plane. My phone was almost out of battery, and I wondered if I could buy a charger in the gift shop but didn’t want to risk leaving my father’s side while I checked, so I laid my head on my father’s bed and slept.
After what felt like hours, I was woken up by a brisk knock at the door and the gravelly voice of the neurologist on call. I leapt up, feeling my neck twinge painfully.
“Are you the patient’s daughter?” he asked, reaching out to shake my hand. He was dressed in blue hospital scrubs and New Balance sneakers, and he had a black exercise band around his wrist. On his head was a bandana-style surgical cap that made him look like Hulk Hogan.
“Yes,” I said, taking his hand. “I’m Anne. I’ve been waiting for you.”
“It was a busy night,” the doctor said. “Six-car pileup on the 10, plus a drive-by shooting in West Covina.”
“Oh,” I said.
The doctor pulled up some slides on the computer.
“What does it say?” I asked, staring at the illuminated slices of my father’s brain, gleaming like the surface of the moon.
“It doesn’t look good, I’m afraid,” the doctor said gruffly, putting on his glasses. “This is the site of the most recent bleed.” He pointed to a dark spot shaped like an ink spill. I blanched at its size. “But there are also several other areas that are cause for concern.” Now he pointed to some faint smudges I could barely make out in comparison.
“What are those?” I asked, my mouth dry.
“Based on the image, it looks like your father has been having ministrokes for quite some time.”
“He’s had strokes before? Are you serious? How could we miss that?”
“They’re easy to misdiagnose. Has your father been acting oddly? Any personality changes?”
“We were worried he might be suffering from dementia,” I said. “That’s why we moved him to an assisted-living facility this past fall.”
“The symptoms are often similar,” the doctor said. “Has he been falling?”
“He had a bad fall over Christmas, bruised his leg pretty badly. He told us he tripped. We’ve been trying to get him to use a cane ever since.”
“Those might have been triggered by the ministrokes. It’s hard to know. Weakness, loss of balance, confusion and paranoia—those are all signs.” He took off his glasses and put them in a chest pocket, then rubbed his eyes.
I took a shaky breath. “How long will he stay like this?” I asked, motioning to my father on the bed.
“It was a pretty severe bleed. We’ve got it under control now, but he’s in a coma. There’s no way of knowing when he’ll come out of it or what complications he might face if and when he does. You have a sister, yes?”
“She’s flying in now.”
“When she gets here, we can discuss next steps. Does your father have a living will?”
“I have no idea.”
“You should discuss with your sister what your father’s wishes would be—if he doesn’t improve.”
I swallowed. “And in the meantime?” I asked. “What do we do?”
“In the meantime?” the doctor said, closing out the slides and standing up. “In the meantime, there’s nothing to do but wait.”
*
THE NEXT DAY, LARRY came over with more clean clothes, my phone charger, and takeout Thai food.
“You’re the best,” I said as he handed me a bright orange Thai iced tea. “I’ve been eating crap out of the cafeteria vending machine.”
“You have to keep up your strength,” he said, dishing out some curry and pad see ew.
“You doing OK?” I asked. “Any news from Jack?”
“No,” Larry said, scrunching his nose. “But forget about me. My problems are stupid compared to what you’re going through.”
“How are my students doing?” I asked. Larry, the godsend, had offered to cover my classes so I wouldn’t have to leave my father’s bedside.
“You should’ve seen their faces when I showed up today. I told them you had a family emergency and that I was the sub, and people actually groaned. Groaned!”
“They were probably hoping class would be canceled.”
“Oh, no,” Larry said. “Not on my watch. Spring break’s not for another week. They will finish Daniel Deronda, even if it’s really the same novel as James’s Portrait of a Lady—just half as good and twice as long.”
I rolled my eyes. “You know what? Maybe I should just cancel class.”
My sister arrived at the hospital two days later, frazzled and unkempt, ranting about the bad weather that had caused her to miss her connection in Atlanta. Tossing her overnight bag onto the floor, she marched over to my father and stared at him for a moment as if waiting for him to greet her. She was looking at him so intently that I half expected him to open his eyes and comply. When he didn’t respond, Lauren took a step back and her face contorted. But she didn’t burst into tears, as I thought she would. She got angry.
“How could this happen?” she asked the doctor, berating him as if he were the one who’d caused the stroke. “I just talked to him the other day!”
“There’s often no warning until it’s too late,” the doctor said, his voice preternaturally calm and clinical.
“Someone should’ve warned us this could happen,” she cried. “We could have taken steps to prevent it. Aren’t there medications he could have taken? Things he could have done?”
I tried to calm Lauren down, but she shook me off, firing off more questions at the doctor and listening bitterly to his responses. For the next few minutes, I stood silent as she cross-examined him, asking about his training, bringing up information she’d read online, mentioning ideas her doctor friends had shared. To each of her questions, the doctor gave cool, measured responses, and Lauren’s fury quickly spent itself. She suddenly looked lost and exhausted. I reached out to her again, and this time she didn’t shake me off but sagged heavily against me.
“Now that you’re both here,” the doctor said, “we need to discuss whether you wish to put in a feeding tube.”
“A feeding tube?” Lauren asked, blanching.
“Isn’t that really invasive?” I asked.
“It’s a medical intervention, yes. Your father’s on a ventilator and can’t chew or swallow. A feeding tube is the best way for him to receive nourishment, especially since we have no idea when or if he’ll regain consciousness.”
“Is the tube permanent?” I asked.
“In your father’s case, it may be, since we don’t know if he will ever regain the ability to eat.”
“And what are the risks?”
“Some patients can aspirate or develop infections.”
Lauren roughly cleared her throat. “What’s the alternative?” she asked.
“We focus on making your father as comfortable as possible. Give him fluids, but that’s all.”
“You mean hospice?” she said, her voice wobbling.
“Yes. We move the patient to hospice care in such cases.”
Lauren shook her head. “There has to be more we could do. He’s still so young—he’s not even eighty!”
“Dad wouldn’t want a feeding tube,” I said, putting my hand on Lauren’s arm. “You know him. He hates being forced to do anything he doesn’t want to do.”
“He doesn’t know any better, though,” Lauren said.
I shook my head. “He’d never want to be this way.”
“He could still wake up—right?” Lauren asked, turning to the doctor.
“He could, but we’d have no idea when. It could be tomorrow, or it could be twenty years from now. And he’ll likely have a substantially reduced quality of life.”
“ ‘Substantially reduced’—what does that mean?”
“He may be paralyzed. He may have impaired cognition, memory loss, difficulty speaking.”
My mouth felt heavy and dry. “If we forgo the feeding tube, how long until he . . . until he dies?” I asked. Even as I said the words, I couldn’t believe they were coming out of my mouth.
“It could take a few days or he could linger for a few weeks.”
A few days or a few weeks. Lauren and I sat there in stunned silence, contemplating my father’s death sentence. He’d always been so vigorous, carrying us around easily when we were kids, one under each arm. I remembered how he’d climb the roof after heavy rains to check for leaks, or how he’d mow the lawn under the hot sun, or how he’d moved us single-handedly from place to place, using only a hand dolly and his brute strength to move everything from our refrigerator to our sofa. When he talked, it always sounded like he was barking out commands, and Lauren and I learned to warn people that even when it sounded like he was yelling, he wasn’t really yelling. Now, though, it was hard to believe that the silent, fragile figure under the white hospital sheet was really my father. When had he gotten so old? Until then, the thought of his death had always seemed strangely abstract, but this—this was final.
“How long do we have to decide?” Lauren finally asked, looking tearfully at the doctor.
“You have some time. It’s a difficult decision, I know. We want to be here, not just for your father but also for you and your family.”
“Lauren?” I asked tentatively. She was sitting with her hands clenched in her lap, her forehead furrowed.
“Do you need a few minutes?” the doctor said. “I can step out.”
“It’s OK,” Lauren said, her voice distant and strained. “Anne’s right. Dad wouldn’t want this. He’d want to go on his own terms.”
“Are you sure?” I asked her. “We don’t have to make the decision right now.”
“I’m sure,” Lauren said. As I reached out to touch her, she crumpled into herself. I held her tightly, rocking her back and forth, my shirt turning damp with her tears.
For the next ten days, Lauren and I took turns sitting beside my father’s bed, reading to him or playing music while he slept, leaving only to grab a shower and a change of clothes. I dabbed Vaseline on his dry lips and massaged his hands with lotion, little gestures of affection he never would have tolerated had he been conscious. Lauren brought her kids over for a final visit, the three boys standing solemnly over their grandfather’s body, Tate trying to tickle my father’s calloused feet and wondering why there was no response. “Stop it, buddy,” Brett said, but his voice was halfhearted. He gathered his youngest son to his side and hugged him tightly. After they left, Lauren placed a picture of the boys by my father’s bedside, along with Archer’s Student of the Month certificate and a small vase of daisies. We spent the night at the hospice facility, sleeping on roll-away cots that had been placed beside my father’s bed, waking every couple of hours when a nurse came in to take his vital signs and check to see that he wasn’t in pain.
Lauren never lost hope that my father might revive, waving me over excitedly whenever he grunted unexpectedly or spontaneously moved a limb. “What does it mean?” she kept asking. “Is it a sign?” When he made no further noise or movement, she’d inevitably looked disappointed and would sit with her hands folded across her chest, as if giving him the silent treatment for his recalcitrance. True to form, my father clung to life until the very end, even as his breath grew increasingly labored and drawn out. In those final hours, the waiting was both endless and terribly brief. When he finally slipped away early on a Sunday morning, Lauren and I were both seated beside him, each holding one of his hands. It reminded me of the Emily Dickinson poem—he seemed about to mention something, then forgot; consented, and was dead. We sat there stunned. Was he really gone?
A nurse came in to confirm, and only then did Lauren and I burst into tears.