Wednesday, March 9, 2011

Call in the Calvary

One year ago, on a sunny but cold morning not unlike this one today, I received a call from my father's hospice care nurse, Ed.

It was time.

Dad had taken in very little to eat or drink for days. He was emaciated. He was dehydrated.

It was time for my father to make the final move of the bitter endgame that had been going on so long it was hard to recognize he was finally there.  Until he so clearly was.

His pain could no longer be well managed by his in-home hospice care team.

He was suffering.

He had wanted to die at home, but had become so un-moored in time and space, he no longer know he was home when he was there.

The comfort of easement from pain trumped the comfort of his own unrecognized bed.

And so we made plans to bring him to Calvary Hospital.  A lovely, caring hospice center in a godforsaken corner of the Bronx.  They specialized in cancer patients, but were known to take the frail elderly, dying of other causes, too, if asked properly.  And Ed, of course, had connections.

When I got the call, Ed didn't know if a bed would be available right away, but as I rushed through my morning routine to hurry to my father's side, I got a second call from Ed: yes, there's a bed, and yes, they're coming for my Dad today.

I was told it would take a few hours for the transfer ambulance to arrive, but they pulled up to the door of my parent's senior residence precisely as I was approaching the building.  We rode the elevator up together, they: on the job, jovial; me: grim, ground flat, pasting a thin smile on my face to greet my mother without sending her into tears.

It was decided that my mother and their lovely, loyal aide, Mina would ride to Calvary with my father, while I would stay behind and make phone calls, arrangements; meet them about an hour later.

They hurried out, and soon I was busy on the phone canceling his in-home aides, alerting my siblings, arranging pick-ups and drop offs and all sorts of childcare for my kids for what I knew was going to be a very long day.

Also, my least favorite call, alerting the funeral home that it was likely to be sooner rather than later, checking in to see that things were still as I had left them in December, when I had first contacted them, when we had been told to prepare for his immediate departure.

Mina called to let me know they had arrived, that all was OK.

I completed my tasks, sat for a few moments, shell-shocked, in the suddenly too quiet and still apartment.  A cranky meow reminded me of my last obligation here: leave food out and a light on for Willie.  He wove himself about my ankles as I poured him fresh water, told him his “Daddy” was gone.

I hailed a cab on the street. Actually I hailed three or four before I found one who hadn't begged off, whose eyes didn't go wide with terror when I explained we were traveling to the Bronx and I had no idea exactly where we were going, knowledge of only a street address and a general neighborhood name to steer us.

We drove through grim, gray, blighted streets; past sagging houses whose children tumbled out to play on concrete playgrounds washed in visible car exhaust.  I had thought I was too numb to feel any sadder, but that did it.

I arrived, found Dad's room with Mom sitting by his side holding his hand.

He was grimacing, agitated, seemed to be in pain. We notified the nursing staff and mere moments later a morphine shot mercifully appeared. His face softend, his body relaxed once again into sleep.

I looked around the small, spare, clean room, noticed a shopping bag on the window sill, clearly come from home. "What's that?" I asked my mother, hoping it might be items she had packed to keep herself comfortable and occupied while waiting with my father.

Her unexpected answer: "Oh, that's some clothing I brought along for your Dad.  He'll need something to come home in." I must have looked perplexed because she added "Remember? He was only wearing underwear when they brought him in here."

Mina comes up beside me, whispers that she had tried to dissuade Mom from bringing this bag, but Mom had insisted.

I sigh.  I take my mother's hand, stroke it.  Look down.  Look up.  Bite my lip.

As gently as I can, I remind her: "Mom. He's not coming home from here."

"He's not?" she asks, her voice quavering; confusion, doubt, veiling her eyes.

I understand. The many other times my father has gone into the hospital, gotten fixed up, he has always come home.

"It's not that kind of hospital" I try to explain. "This is a hospice. Here they will make his final days as easy and pain free as possible."

"Really?" My mother asks, all teary. "This is the end?" her voice crackling, sadness swamping her anew.

This is the tragedy of my mother's terrible memory.  While it has provided her the welcome relief from having to live day-to-day as we do, with the knowledge of Dad's immanent demise hanging over her head, it makes it constantly heart wrenching for us, who must over and over and over again inform her, as if for the first time, that his life is soon drawing to a close.

On the other hand, it does occasionally provide some comic relief.  When my sister Lois called to discuss her travel plans for Friday, she asked to speak to Mom, too.  I didn't listen in on their conversation, let my mind wander.

Afterward, Mom asked me: "Where are we? What is this place called? Lois asked and I couldn't remember... I told her it had something to do with horses."

It took me a moment to figure out the exact disconnect, and then I laughed.  "No mom, you're thinking of the cavalry.  This place is called Calvary."  She laughed. 

I didn't add that it is named for Jesus's suffering, the location of his crucifixion.  Better for her think of rescue by a charge of horses, instead. 

In a bit, Mina brought my mother to the cafeteria to get something to eat, to give her a break, and I was alone with my father for a little while.

I watched him sleep.  He woke for a moment, I stroked his gaunt cheek.  He fell back asleep.

And then?

God help me, I pulled out my phone and I took some photos of him, there.

I knew they would be sad, awful, ghastly; not how he would want to be remembered.

But I also knew they were an important document, a testament to his great strength of will that I should not forget.

I knew that exactly how he looked at the end would fade, and that somehow I needed it to not disappear completely; that I would need to remember, and that my father the photographer, the documentation, would understand this impulse, and approve.

So I took a few quick photos, the last of my father.  At the very bitter end of his very long sweet life.

For those who do not want to see the ending?  For those of you want to remember him as the proud, strong, handsome man he was until nearly the end?  Look immediately below, then do not scroll down further.

Here is a lovely photo of my Dad, taken on my Mother's birthday in September, 2009, on one of his last good days:

Dad, September 2, 2009

And now, if you are willing to bear witness to my father's gruesome ending, keep scrolling down to find this: a set of photos taken in my father's hospice room, three days before he died.

They are not lovely.
He is emaciated.

There are scabbed bruises on his forehead and nose from the last time he had tried to get out of bed at home, tried to stand, long after it was possible.  He had banged his head on the protective bed-rail.  Hard. 

He barely looks alive.

But still I need to share this.

I need to show you, who wish to look, the father I last saw, held, kissed goodbye, one more last time, this one year ago.

These photos were taken on my phone, the only camera I had handy.

They are blurry and of odd color, the blue light from the window, the yellowed incandescence of his room lamp blending in the middle over his face, adding a further edge of the surreal.

But no, this was all too real:

Dad, March 10, 2010

It was hard to leave him, late that night, but I had to go home, rest, gather strength for the coming day.

My mother stayed. She was by his side, as ever.

I came back the next day.

And then, the day after that?

He was gone.

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