The Angry Baker's father is very sick. We learned last month that what was originally diagnosed as Parkinson's Disease is in fact a rare combination of both Parkinson's Disease and amyotropic lateral sclerosis, or Lou Gehrig's Disease. The ALS is progressing at the expected rate: horribly quickly, and yet too slowly.
I lost my dear father over a decade ago, and so I have been through much of what the Angry Baker is soon to experience. It isn't just my father's gone-ness that hurts. I also had to watch my father change into a different person, lose his intellectual gifts, become incontinent, and experience all the other indignities visited upon the terminally ill. Consequently, I not only lost my papa, I lost my brightest memories of him. When I dream of him now, he is irrational and sick, not the brilliant scientist who once helped me solve an important, tricky problem, nor the gifted teacher who taught me the secret of how to grade on a straight scale. As an adult living far from home, those memories were perhaps more precious to me than the man himself.
My stepmother called me in desperation (and at the behest of social workers) in the middle of a hot, hot summer. I bought a one-way ticket, and arrived at my childhood home the day after I got her call. What I found was, it seemed at the time, too horrible to bear. Papa was wheelchair bound. He was unrecognizable, because he had developed Cushing's syndrome, a side-effect of the massive amounts of steroids he was taking. He was petulant and demanding, and ran my stepmother ragged keeping up with his childish whims. He was also inhospitable and embarrassed. He didn't want me to witness his deterioration.
I can't remember now how long I was there. Was it weeks, or maybe months? My stepmother and I hid inside the house, caring for him when he was awake, turning him when he slept, doing jigsaw puzzles and watching old movies together. Friends and neighbors brought us food. Sometimes we went for a walk around the block when the hospice nurse came, but it was too hot and we were always happy to go back inside.
His hospital bed was in his bedroom, pushed close to the bed that he had shared with my stepmother. We all slept together in that room, so that I could help her change his sheets and turn him in the middle of the night. Like a little girl, I held his hand through the rails of his bed while I slept.
As the days passed, he awoke only for brief periods, and was less cogent every time he awoke. He would ask one of us to read to him, as he had lost his sight a few weeks earlier. Eventually he stopped asking. We stopped feeding him, because he couldn't swallow. Only a day later, he stopped urinating, his lungs filled with fluid that rattled when he breathed, and then early the next morning the rattling stopped. I sat on the bed and watched him for a long time.
I lost (most of) my fear of death that morning as I watched his body turn gray and cool. It was so very natural, I thought. You're born, which is an amazing event, and you die, which is another amazing event. I realized that with good care, which my father was fortunate enough to have, death can be almost beautiful: painless, dignified, and, for those of us who remain, life-affirming. I realized that Dr. Jack Kevorkian is a sick fuck, and that a good physician can help his/her patients die without murdering them. I decided that day to have a child. I realized that religion had nothing left for me. I stopped calling myself an agnostic and became a joyous, unrepentant convert to atheism. I grew up. I didn't think I could live without my papa, but I've managed okay so far.
The Angry Baker returned home yesterday from the first of many trips he will make to help his father die. My dearest love, this is probably the hardest thing you will ever do. But it is also the most wonderful, most important thing you will ever do, and I love you all the more for it.
It would be so easy for you to just stay home and let the nurses do it all. My siblings chose not to share my father's death, and so they carry their memories of him intact. You will never regret going back, even though it means you will never be able to clearly remember your father without also remembering how sick he is now. Your strength and courage, and the love on which that strength is based, take my breath away.
I know your crushing grief, and how keenly you feel your regrets. I hope that you can embrace your grief and find some beauty in your father's death.
Friday, August 25, 2006
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13 comments:
It's terrifying, but I firmly believe that it's also one of the most loving and generous acts that we can offer up to a loved one, and ultimately, to ourselves.
What a beautiful post. I can barely see to type for the tears in my eyes. My dad died almost 20 years ago. And, like your father in your dreams, he has often been ill in my dreams, in a wheelchair, which actually he was never in during his life, except in airports where he couldn't walk long distances. For much of my cognizant childhood he walked slowly, with many breaks, due to the emphysema he suffered from. Yesterday I watched a home video I hadn't seen in a decade in which he didn't yet have the emphysema. His gait is quick and natural, unlike most of my memories of him. It was a revelation, to see him that way. I was right there when my dad had a massive heart attack and the image of his deathly gray face is one that will never leave me. I too had to work hard to bring back other memories, of him alive and brilliant. But I wouldn't trade having been there for the last moments of his life. I like to think he was happy, e listening me talk about whatever silly thing I was prattling on about as he left us.
I'm more sorry than I can say that Angry Baker has to go through this. But it is something we must all live through, the death of our parents, unless we die before them. It's difficult and sometimes unbearably so. My heart goes out to him and to you.
Thanks my love. I hurt bad. But, a tad less now.
--AB
This is a beautiful post. It also scares the hell out of me, because I'm facing the same thing myself quite soon (my father has Parkinson's), and I don't think I'm going to handle it with as much bravery and grace as you express here. My sympathies to you and Angry Baker.
I lost my grandfather to Parkinson's and an uncle (not blood related to my grandfather) also has it. It's a terrible illness and ALS is horrible as well.
All my best wishes to your husband, you, and your daughter. I hope that your father in law's last days are gentle.
I am so sorry for you and for AB. I cannot imagine what a terrible experience it must be for everyone involved.
I agree that Kevorkian is a publicity hungry freak, but the fact that he's an ass doesn't make his central point wrong: there are diseases so monstrous, there is pain so bad, that a comparatively dignified death, at the time of one's own choosing, might be preferable for some.
Yes, modern pain management is a wonderful thing, and yes, doctors can often do something, through commission or omission, to bring about an end. But those doctors risk being jailed, sued, and professionally ruined thanks to the current laws. Many (perhaps most) are afraid to prescribe even the appropriate doses of many painkillers, because the fear of being lableled a scofflaw pill pusher, or worse, is very real and justified. Even the most elderly and the least hopeful of patients, in pain you and I could not imagine, have to be treated as if addiction to painkillers was a real and dangerous possibility, which legally must be avoided. Our fear as a society of drugs--all drugs--is preventing doctors from helping those the drugs were designed to help.
I wish you every ounce of strength, courage, and empathy to get you through what you, your family, and your loved ones must face. I hope there will be at least as much love and laughter in the coming months as there will be tears.
Edward - people went to Kevorkian because they were afraid. With good care, and I admit that good care might be hard to find, there is nothing to fear. There will be no pain, no humiliation, and no horror, no matter what the disease is.
I agree that our current system frightens some physicians and keeps them from prescribing pain medication at necessary doses, and occasionally performing invasive procedures instead of providing only palliative care. It would have been horrible if my father's physician had decided that he needed a feeding tube placed the day before his death. However, and I'm not an expert by any means, I think our perceptions of the frequency with which physicians are punished for writing prescriptions for pain medication are overblown. (Someone correct me if I'm wrong.)
I worked in a skilled nursing facility for a long time as an undergraduate back in the early eighties, well before the hospice concept caught on. Many of my terminal patients even then were prescribed a lovely high-dose morphine cocktail and dilautid. The purpose of the cocktail was to slip them gently from life. The drug levels were so high their breathing was suppressed. No one, not even the patients' families, expressed the opinion that the physicians were "killing" their patients with dangerously high levels of opiates.
Kevorkian is scary because, as a physician, he should have recognized that people were coming to him not because they were dying or in pain but because they were afraid and/or were not receiving adequate care. Rather than deal with their fear and refer them to physicians who could care for them, he encouraged them to take their own lives and/or murdered them. I believe he did this not because he wanted to ease their suffering (although he may believe that's why he was doing it), but because he liked to watch people die.
No real physician would presume to administer this kind of "care" to unknown strangers who already were under another physician's care.
As long as I am receiving good care, I want to stay alive. Even completely immobile and incontinent, there are books to be read: I won't be able to read all the classics before I die. When I get to the point that I don't understand what you're reading to me, then it won't matter anyway that I'm still alive. I see no reason to take my own life early. Ease my pain, and let me slip away.
Just a few links about pain management and underprescription (and the hoops the DEA makes doctors leap through to prescribe adequately). Almost all require journal access, so won't work without an institutional subscription. The first one will work for anyone, and has a news piece about the problem.
http://www.asipp.org/documents/DEA%20Statementnov2004.PDF
http://scholar.google.com/url?sa=U&q=http://www.blackwell-synergy.com/doi/abs/10.1111/j.1526-4637.2006.00189.x
http://scholar.google.com/url?sa=U&q=http://www.cato.org/pub_display.php%3Fpub_id%3D3778%26print%3DY
http://scholar.google.com/url?sa=U&q=http://www.jaoa.org/cgi/content/full/105/suppl_5/S2
Edward, we may be talking at cross purposes here. Do we both agree on the two issues? One is that physicians may be afraid to prescribe adequate dosages because of their fears of being targeted by the DEA. I agree that this is a problem, but apart from one or two splashy cases on CNN, I don't hear about the "hundreds" of physicians arrested by the DEA. I suspect that, for the most part, the physicians who are afraid to prescribe sufficiently high doses are those who do not specialize in the management of pain.
The problem with the DEA is that the pain specialists put themselves on the radar by prescribing lots of narcotics. But how many times has the DEA targeted an innocent physician? I have no doubt that they have, but to say that there is a real problem I'd like to know the numbers. I can't find any apart from vague references to "hundreds over the years," and how many of those hundreds really were behaving unlawfully?
The other issue is the role that Kevorkian plays in assisted suicide. I found an old 'zine article (http://www.ragged-edge-mag.com/archive/p9story.htm) that explains my point of view fairly well. The problem was not that Kevorkian helped people kill themselves, it was the fact that he could not acknowledge that the reason that they wanted to die was irrational fear. And his willingness to insert himself into an established doctor-patient relationship to serve his own ends.
What a moving post. I'm sorry to hear that Angry Baker's father's ill.
I was fortunate to lose my own father quickly, painlessly, and without warning, so my memories of him at his best are intact and not overwhelmed by less happy memories.
Thank you all so much for your sentiments. I can't visit this post too often because it's too beautiful and I can't function very effectively at work crying. Thanks again.
--angry baker
My father has Parkinson's. I am planning to go see him this weekend because of this post. I've been afraid of seeing his decline. Angry Prof has shown me my visits aren't about me or for me. They're for my dad. Thank you.
Gorgeous post which should be republished far and wide.
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