When Our Feelings Take Us by Surprise

Last week I wrote in my post that suddenly the exchanges between my father and I had become incoherent and illogical.

This observation turned out to be a foreshadowing of sorts as towards the end of this past week, my brother and I learned the reason why.

My father is dying.

Several days in the beginning of last week my brother, Daniel called him and he had not answered the phone. Daniel entered his apartment to find my father collapsed on the bathroom floor unable to get up. I left work early mid-week to take him to the emergency room. I took him down from his apartment to my car in a wheelchair Daniel had rented but when it came time for him to transfer himself from the wheelchair to the front seat of my car, he didn’t have the strength and fell to the curb. I was unable to get him up, he was unable to get himself up and I had to call the paramedics.

When I arrived at the hospital and made my way to the ER, an IV was already inserted, he was on oxygen and an EKG was being run. I asked the ER secretary to have the doctor come out to the waiting room to talk to me when he or she knew something.

“You mean you’re not staying with him?” She raised her eyebrows as she cocked her head towards his bed. “No,” I replied curtly and headed out the door.

I spent an hour in the waiting room trying to ignore a reality show blasting from the television and eavesdropping on an entire family of siblings whose mother was in the ER. They weren’t talking to each other; they were each on their cell phones. It was a cacophony of human voices, each as different as their appearance. It was too much and I left in search of the cafeteria to get a cup of coffee. The quiet of the corridor was a welcome contrast and I walked slowly.

When I returned I went back into the ER and I found Dr. Street in my father’s room. “He definitely needs to be admitted,” she told me. “His bloodwork is all off and he’s dehydrated. Does he live alone?”

I ran down the events of the last several days and a brief history; his alcoholism, his smoking and his physical and emotional decline, including his severe depression.

She asked me to stay until the admitting team arrived. “Your father is not the most cooperative patient,” she gently remarked.

The admitting doctor asked me if my father had a living will. "No," I told him.

The doctor urged me to ask him if he wanted life-saving measures taken if something should happen.

"Here? Now?" I couldn't fathom.

"Yes."

I tentatively approached his bedside. "Dad. Listen to me. If something serious should happen, something that should put your life in danger, do you want the doctors to try to save you?"

My father closed his eyes and shook his head. "No," he whispered and he made a feeble slashing motion with his hand. "Nothing."

"Okay Dad."

Daniel went to the hospital the next day to talk to the doctors. He called me at work. “They want to amputate his leg.” I was standing at my desk and my knees gave way. I fell into my chair with a thump.

His foot was gangrenous and his kidneys were failing. If they didn’t amputate to try to restore the blood flow, sepsis would set in, the infection would enter his bloodstream and multi-organ failure would ensue. Death would be in a matter of weeks.

“What do you think?” Daniel asked me.

I thought for a moment. “I honestly can’t see him going through an amputation. He said he doesn't want any life saving measures taken. Does this count as one? "

I took a deep breath. I couldn't believe what I was saying. I felt as though I was condemning my father to death,

"He couldn’t care for himself before much less having to worry about going through a major surgery. He’s going take care of himself following that? He’s going to go through rehab, or spend the rest of his life in a wheelchair in a nursing home when he hates being around people?” I was speaking fast now as the nightmarish scenarios for my father came to mind.

“I think you’re right.” Daniel conceded.

“Is he competent enough, lucid enough to understand what is going on?”

“He goes in and out.”

“Try to catch him and see if he can understand,” I urged him.

Daniel called me back several hours later. “He doesn’t want the amputation,”

“Dad understood?”

“Yeah, he seemed to. The doctor was in the room and she appeared to be satisfied.”

“Now what?”

“There’s a meeting tomorrow morning with the social workers and the doctors. I told them we’d both be there.”

The family situations that endure with my patients are as varied as the topography of this country. For some of them, both parents have passed at varied points in their live; for others one parent may still be living and they may be involved in the caretaking.

For other younger patients both parents may still be living; they may or may not be living at home and still under the auspices of their parents or, they may be out of the house and trying to support themselves.

These scenarios are only a few of many that are possible; each patient has his or her own which is distinct to them. Each one has lived their particular life and has had their unique relationships.

People go through various stages of relationships with their parents as they grow from children to adults, from dependency to the attempt to support oneself. There are moments of peacefulness, moments of upheaval and times of compromise.

Many of my patients come to my office having never talked about their relationship with their parents before, whether their mother or their father is dead or alive. Amazing utterances and declarations are made in my office; sounds and expressions are heard as patients dig and remember, laugh and sob.

What do I do? I listen, I tell them that it's okay and I encourage them to keep going. I reassure and I look them in their eyes and tell them that they are not going crazy. Feelings about parents, especially feelings that tend to be perceived as unloving or uncaring, may have been buried for years. Because we are supposed to love our parents and be grateful to them, even adult children are capable of concealing their true feelings from themselves. Years go by and emotions take root underground; the greater the number of years, the deeper the roots and the more difficult they are to dig out.

The only option for my father is palliative care where he can be made as comfortable as possible so he does not suffer as the infection invades his body.

Daniel and I are waiting to see if the hospice near our respective homes will accept him.

A sense of profound sadness has engulfed me which I didn’t expect to feel. I am very anxious as we wait for an answer for if he does not get a bed I don’t know what we are going to do.

I am coping with the anxiety by cleaning, by attacking the miniscule particles of dirt in my apartment. I spoke to my therapist and she suggested perhaps I am trying to clean up my father.

I can clean up the outside until he shines, but the inside — what makes a person a person — a heart, a hug, a nod of approval, a smile has been stripped raw. Perhaps they were never there in the first place.