Alive or Living?

“He’s the same,” Mary, my dad’s wife, says when I reach her on my nightly call to check in.  “He couldn’t stand up on his own.” She continued.  “It took three nurses to get him into the wheelchair,” which I could easily understand, because my dad is a big-boned 200 pounds.  “They took him down to rehab, but they couldn’t do anything with him because he kept falling asleep.”

Then Mary said that Mike, Dad’s broker, called to find out how Dad was doing. After she described his condition, Mike said that Dad had told him several years ago that if he ever got so bad he couldn’t function normally and enjoy his life, he would go into the garage, close the door, and turn on the car. “He told everyone that.”  Mary said.

Yet here he is, in a nursing home, barely responsive much of the time, and unable to make that choice.  It was Mary who, following the doctor’s advice, agreed to having a pacemaker and defibrillator put in him a month ago after he collapsed at home.  Since then she found his Living Will which, if she’d had it at the time, would have, in accordance with his wishes, prevented that procedure.

Dad spent a month in the same hospital a year ago following several strokes.  He was able to benefit enough from physical therapy to go home.  Once home, he only walked enough to get from his recliner to the kitchen table during the day for his meals and to the bathroom as needed.  He refused to consider having a bed downstairs.  Leaning heavily on the bannister, he made his way up to bed at night and downstairs in the morning.  Even though he’s fallen several times, he insisted on sleeping in the bed with Mary.

For the past few years, when his mind was clearer and he was able to read the newspaper and enjoy watching the latest Netflix movie, he would tell us when we visited that he was ready to die–even wanting to.And now, in addition to the heart attack and congestive heart failure, he’s had bleeding on the brain and multiple strokes that have him trapped in a netherworld of dementia and multiple medications.

I think about the Native Americans who would know it was time to die and walk into the woods or desert away from the tribe to do their private leave-taking. Lingering in a nursing home, drifting in and out of sleepy awareness, is a far cry from any form of self-determination. When I spoke with my brother last weekend at the end of his visit to see Dad and Mary, he said, “If he were aware, he would be horrified to see himself like this.” All the minor resentments and frustrations both my brother and I have felt toward our father over the years have evaporated into the misty sadness at seeing him in this condition.  For a man who would insist on having his way, it seems his wishes have nothing to do with what is happening to him now.

Modern medicine accomplishes wondrous cures at times, but to what end do we prolong life when no real healing can happen–when “life” is reduced to keeping the heart beating and lungs breathing regardless of whether the mind and heart are engaged in making a conscious choice to go on? I’m not suggesting that he should be intentionally “put to sleep,” as we have several cats and a dog over the years when their bodies were breaking down and in pain. But I do wonder how much of the surgical and pharmaceutical intervention has interfered with his conscious and unconscious ability to let go. My prayers for my father are that he make a peaceful, pain-free transition when it is best for him to do so.  It’s not up to me, but the sad part is that it doesn’t appear up to him, either.