While You Were Out
Watching My Father Die
While my father was dying I wrote an essay about how he was going to live. It was about the ICU, and the tubes and machines, and the white cotton mittens to keep him from pulling out his IVs or scratching himself in delirium. It was about how traumas in the ICU are all the same, but the tragedies are meaningfully different. But my dad didn’t live, and the essay is now an anachronism.
My father was supposed to die of bladder cancer but first he died of sepsis. Had he survived the massive infection brewing in his gut and lungs, the cancer would have killed him quickly. Bladder cancer at Stage IV is aggressive, said the doctor. My father was oldish, frail, and a poor patient: “He’s not participating in his own recovery.” The doctor also said that.
While in the hospital, during the conscious moments he had, my father would sometimes plead for death. Over and over like a mantra: let me die, let me die, let me die, please, I want to die. He would also cry out for help — a plaintive, painful utterance that was less a word and more an instinct. It stood in sharp contrast to the man I knew who would only ask for help when he needed to move something heavy or have you hold down a thing while he drilled, or cut, or sanded.
“Please, I want to die.” A few days after surgeons removed my father’s cancer-riddled bladder, his colon ruptured and flooded his abdomen with fecal matter, causing a massive infection that required emergency surgery. My mother and I had come to the hospital that morning in good spirits — the first surgery had gone remarkably well and he seemed to be doing OK. I’d even gotten him to eat some syrupy pears and a few spoonfuls of Lipton noodle soup, his favorite. But as we walked down the hall to his recovery room, we heard him crying out for help in a terrified wail. I bolted for a nurse.
After four tense hours in surgery, my father was transferred to ICU and was just starting to regain consciousness. My mother and I sat on a long padded bench near the window. Outside, a 12th-floor view of East Dallas. The weather chilly but sunny. I adjusted the blinds to let in more light.
“Please, let me die.” He waved one of his mittened hands a few inches above the covers, like he was paddling in a shallow pool. Thus beckoned, I put my face very close to his face — whiskered now, ashy, his mouth a mumble — and cautiously rested my hand on his arm, fearful of all the tubes and needles. “You don’t really want to die, do you?” I’m crying but not crying. I don’t want him to know how scared I am. Or that I think he is right about the dying.
My father shook his head. No, no. I don’t want to die. He patted my hand with his mitten. A clear plastic bandage on his forearm kept an IV needle in place. There were little swells of blood under it. Another line fed into his neck, called a PIC line, and pumped a slurry of nutrients directly into his vein.
I left the room to hunt for a vending machine. While I was gone, he asked my mother to bring a gun to the hospital so that he could kill himself. A true Texan, Dad had guns stashed around the house, loaded and chambered. I found them after — a Glock in the nightstand, a vintage .38 Police Special in the garage where he worked on his art, a Remington single-barrel shotgun in the guest bedroom (that at least wasn’t loaded). He was ready for anything but I doubt he ever considered that someday he’d most want to shoot himself.
My mother: “I love you, but I’m certainly not going to jail for you.”
That night my mom let me sleep in their bed. I took my father’s side, my head on my father’s pillows. Suddenly I couldn’t breathe and I could feel my face getting hot, the panic mounting. I was choking. My mother leapt out of bed and rushed to my side, tilted me forward in case I threw up. The words came uncontrollably: I don’t want him to die I don’t want him to die I don’t want him to die I don’t want him to and she just kept saying, over and over, I know it honey, honey I know it. There is something about grief that puts language on urgent repeat.
Cancer gutted my father. Literally. I imagined the empty space inside where organs should be but were no longer. His stomach sunken and deflated. My father was a impressive man: 6’ 3”, handsome, strong, slim. Never exercised a day in his life. Smoked and drank like it was going out of style. Wore smart blue suits with brown belts. Kept his shoes polished and always — always — carried a crisp white handkerchief. My mother swears that she fell in love with him the moment she opened her front door and saw him standing there, 41 years ago, in his blue suit and white collared shirt and tie: “all the other men coming after me just looked like bums compared to your father.” It was their first date.
I’ve never fully understood the metaphors of war we attach to cancer, the way we personify it as an enemy, as if it targets us specifically and in such a way as to cause maximum anguish. My father, the most stubborn, combative man I have ever known, didn’t die a warrior. He wanted to live. And then he didn’t. Drugged, intubated, operated on: at a certain point his life was out of his hands, and it would never return. He knew this.
Susan Sontag, in Illness as Metaphor, writes that “nothing is more punitive than to give a disease a meaning.” Cancer, ascribed malicious intent, inflicts a horror beyond the physical. Your body rises up against you. I know that my father felt betrayed. He had regrets, weirdly specific and petty: he would never drive a fast car again, would never again wear smart suits, or be young, or flirt with pretty girls. He told me all this one evening when he was still at home. We had family over for drinks but dad couldn’t get out of bed, so he was curled up in the bedroom in the dark. I went in to see him, and I sat in the middle of the bed and stroked his forehead. He was crying because leaving work one afternoon he’d seen them — the handsome young men with their fast cars and their pretty girlfriends. And he knew, he knew.
When my father pleaded and begged to die, no one balked. It seemed fair, given the pain he endured, that death might be desirable. No one tried to feed him antidepressants. No chaplains or counselors were brought in to convince my father that it would be better if he stayed positive and tried to live. There seemed to be a point, however unspoken, when fighting was both optional and futile.
They’d cut out his bladder and his colon and punched two gaping holes into his abdomen, turned his bowels inside out, glued two plastic bags to his sides of his stomach. One for urine, the other for shit. I sat with the nurse to learn how to care for the stoma — the hole in the gut — and how to wipe the mucous from it and apply the adhesive, ensure a good seal so that it wouldn’t leak. Some fucking idiot cheerfully informed my father that, even with these bags attached, he’d still be able to play golf.
I think that idiot was me.
We waited five months before having a memorial service. Right after dad died, my mother couldn’t even comprehend of doing anything but simply trying to survive, and then there was the work of having my father cremated, the will, the bank accounts, the forms and signatures and the mounting panic of a life lived suddenly alone. We put dad’s urn on his bedside table and placed the gilded rose he bought my mom for Mother’s Day atop it.
My brother Davis was late to the service and nearly missed his turn to speak. He scrambled into the chapel with his dog, Lucy, clutched tight to his chest. Lucy is a French bulldog and she wears one of those brightly colored small-dog harnesses and because my brother loves her so much her little white paws rarely touch the ground. She is a perpetual bundle in his arms. Davis scrambled to the front, dropped Lucy into the lap of a family member, and rushed to the lectern with a fist of crumpled notes. But everyone in the chapel, including the priest, was busy staring at the dog.
He was also late to my father’s death. I called a half dozen times from the hospital, texted another half dozen: you need to be here now. Davis phoned back, annoyed. “Is dad dying or dead or what? Look, I’m in a cab.” By the time he arrived at the hospital our father had been gone for over an hour. I’d already had the nurses remove the IVs and the PIC lines. They cleaned his body while my mother and I stood behind a screen, hands over our mouths because to make any sound during the process felt sacrilegious. You could hear the nurses grunt as they shifted my father’s body around to change the sheets.
When Davis finally showed he seemed to be physically startled out of his own skin by the silence of my father’s body. He backed rapidly out of the room — arms and legs pinwheeling like in a comic strip — and disappeared into the hospital hallways. I wasn’t sure he’d return.
But he was definitely there for the memorial service. While Davis stood muttering an incoherent eulogy, Lucy squirmed and snorted in our cousin’s lap, second pew from the front. You couldn’t ignore it. My mother and I squeezed hands to keep from laughing out loud.
My father is just a bunch of powdery ashes in a brass box, but if he had a body, it certainly would’ve rolled over.
My eulogy was short and off-the-cuff. I’d tried to write something down on my flight to Dallas but found I could not. Instead I drank a fair bit and wrote a letter to a woman I’d just started casually seeing and who I’d stop seeing within days of returning to Baltimore because, honestly, who is any fucking good at dating right after a funeral?
On the plane my handwriting skipped around the page and I knew I’d have to redo it when we landed. A line from Steinbeck’s East of Eden repeated in my head — something Samuel Hamilton says about how “a man’s mind can’t stay in time, the way his body does.” I took it to mean that while the body is fragile, and stuck in the here and now, the mind can and does take flight. Sam Hamilton was a bit of a wacky genius. My father, too. I noted that.
I stood at the front of the chapel next to my father in his brass box and said the quote. Explained it. Cried in front of two dozen business men and golfers I’d never met. My family in the first two rows. I paused for breath. “I love him. And I miss him so much.”
The morning of the day that he did die, I came to the hospital by myself to give mom a break. Dad was awake, groggy. He had been shivering the night before but now he seemed ok. I leaned in and told him that I’d given mom the morning off and it was just going to be me. “She’s pretty exhausted, dad.” I put my face very close to his. He nodded and said “that’s good.” The tubes in his mouth and nose made speaking difficult, when even possible. When I looked up a flood of nurses and doctors were piling in.
A massive infection in the left lung. “He’s struggling really hard to breath,” the doctor said. “It’s not sustainable.” Bloody material was filling his abdomen and creeping throughout his system. The plastic tube coming out of my father’s mouth was tinted a dark brown-red.
It’s a bit of a blur. The doctor asking me if they could intubate. My answer. The phone call to my mother. Standing with her in the hallway, holding her by the shoulders. “If we give them permission and he survives, the cancer will kill him,” I said. “It’ll be awful. Maybe worse than this.” We shared a look and my mother agreed — just a brief, defeated dip of the chin. Because she knew that no matter what we did or did not do, he would still be dead.
A thing I learned: if you have a pacemaker installed, when you die the nurses must hold a magnet over your chest to turn it off so that your dead heart does not keep on going and going like a demon Energizer Bunny. The magnet looks like a round fridge magnet you’d tuck birthday cards under, but larger.
My mother and I didn’t know this and we weren’t paying attention. We’d been waiting for my father to die for six hours and, let’s be honest, there is only so much agonizing ‘witnessing’ you can do. Instead, we were chatting and drinking Cokes on the window bench. I glanced up at dad. He looked… different. He’d been unconscious all day and on morphine so that he could rest comfortably while his body gradually failed, and I was used to the sight of his jaw hanging slack, the tongue resting towards the back of his mouth, the extreme stillness of a body that is nearly but not quite gone. But this time was different. He’d been there. Now he was not.
We rushed to his side and my mother’s voice took on a sharp pitch: “Is he gone? Is he gone? Is he gone?” Her words on repeat. The monitors showed a heartbeat and breathing — two or three breaths a minute, but the heart faster — and yet my father was clearly just a body now, the pinkness in his skin fading. I called for a nurse, horrified that my father might have died while I was looking out a window and eating a bag of chips.
“Is he gone? Is he gone?” My mother held his hand and kissed his cheek over and over. The nurse pulled the magnet out of her pocket and placed it over my father’s heart. We all stared at the monitor. There was a delay, and so for a few excruciating seconds the screen showed my father as still breathing and with a beating heart even though he was clearly not. Another nurse had entered the room and she stood with her hand on my mother’s shoulder, crying with her. They called it: 5:36 p.m., November 11, 2017, as the last blush of sun set on another chilly Dallas night.
Correction: Three typos resolved May 10.