A story about 2 siblings & the choice they must make when their father is critically ill. |
Monday morning started off like most days for David. He was lying in bed, dreaming of something he wouldnât remember ten minutes from now when an annoying buzzing filled the air. He groaned and slapped at the alarm clock on his nightstand. After a few misses, the buzzing stopped. He rolled over and squinted at the noisy machine. Six oâclockâfar too early to be up. He could hear rain falling outside. Great, he thought. Itâs raining, dark, and Monday. For a brief moment, David thought about going back to sleep and skiving off work today. After enjoying that sentiment for a few minutes he threw off the covers and rolled out of bed. He heard a mewling sound coming from the pile of blankets on the bed. He must have covered up his cat, Perkins. Perkins was a little thing, just over a year old. He was white and fuzzy with a long gray tail and gray patches over his eyes and ears. One thing he didnât like was to be covered up by anything. David pulled the covers off of Perkins and he leapt off the bed and ran down the hall, sounding like a herd of elephants on the hardwood floor. It always amazed David how loud a four-pound cat could be when running. David knelt by his DVD collection, trying to decide what movie to watch. He had so many; it was starting to become a very difficult decision. His eyes scanned the titles: "Pale Rider," "What Dreams May Come," "The Sixth Sense," "Patch Adams," "Beetlejuice," "Four Weddings and Funeral," "The Greatest Story Ever Told," faster and faster until they all blurred together. He finally settled on a comedy, "Defending Your Life," when his phone rang. He stood up, arching his back and wincing as it popped in several places. Padding over to the phone, he grumbled to himself, annoyed at the interruption. He waited for it to ring again before picking it up. âHello?â He ran his hand through his unkempt hair. âDavid? Itâs Sue.â Sue was Davidâs sister. âOh. Hi, Sue. Whatâs up?â âI need you at the hospital. Dadâs condition just got worse.â Sueâs voice quavered. David swore silently to himself. âOK, Iâll be there in about twenty minutes.â Stifling a sob, Sue said, âHurry, David. Itâs bad.â âOK. Just hang in there, Sue. Iâm coming. OK?â She croaked out, âOK.â âSee you in a few minutes, OK? Bye.â He hung up the phone and leaned against the wall. Crap, he thought. I donât need this right now. David was still a young man; he was only 33. He still had a full head of thick, brown hair, but was starting to develop what he referred to as a âbeer belly.â Still, he was considered attractive by a lot of women. At least, heâd never had any trouble getting dates. His sister Sue was a few years younger. Together they had weathered the storm that was their fatherâs health of late. He had been in and out of the hospital at least a dozen times over the past two years. David was having a difficult time keeping track of all his fatherâs maladies. So far there was congestive heart failure, gall stones, kidney stones, a hernia, arthritis, and a recurring urinary tract infection. There were a few conditions David couldnât remember the names of, like the poor circulation in his fatherâs extremities that made it difficult for him to walk and he was pretty sure his father was starting to suffer from some dementia. This last visit to the hospital was for a âsimpleâ operation to fix the hernia. That was yesterday. He was supposed to be out of recovery and just a few days from being released today. Obviously, it wasnât as simple as the doctors made it out to be. Sometimes David hated doctors and hospitals. He pulled on a fresh shirt and grabbed his cell phone before heading out the door. His cat, Perkins sat watching him. âBe good, you little shit,â David said to Perkins as he went out the door. Traffic was light as David drove to the hospital. Normally, heâd be exceeding the speed limit by a good margin, but he was getting really sick of visiting it. Deep down in the dark recesses of his brain, he felt a little guilty about driving so slow when for all he knew, his father could be on his deathbed. But, theyâd had a lot of little scares over the last couple of years, and he was getting a little cynical about the whole thing. He was very thankful that he and Sue had managed to talk their father into getting Living Will and a Health Care Directive about ten months ago. At least now, if something bad did happen, there would be very few questions about what should be done. It was hell getting their father to talk to them about it though. David understood that death was far down on the list of his fatherâs favorite subjects, especially after their Mom died in 2001, but as litigious as the country was now, and with all the bureaucraticâor as his father called it, bureaucrapticâred tape you ran into dealing with hospitals and insurance companies, it was better to have everything written down in advance. Sue cried a lot the day of that conversation. Their father kept asking why they were so eager for him to die. He didnât have a lot of money, but he had a lot of insurance and he assured them that theyâd get it all, so they just had to have patience; eventually heâd kick the bucket and theyâd be very well off. He said that there was no way in hell heâd ever go to an assisted living facility or a nursing home because he had the kids to take care of him. He just couldnât understand that Sue had her own family to take care of now and couldnât just abandon them to take care of him, though she would readily do that. David kept telling him that though he was indeed his son, he was not qualified to provide the level of care that his father would need, should things get that bad. Their father could be a stubborn old bastard at times. The digitally reproduced sounds of Magnum, P.I., brought David out of his contemplations; someone was calling him on his cell phone. He dug it out as he took the exit for the hospital. Unknown. He decided to ignore it; he wasnât in the mood to talk to someone with an unlisted number just now. If it was important, they could leave him a message. Sue stood when David entered the hospital room. Her eyes were red-rimmed and the makeup had run from her tears. She was about three inches shorter than David and was wearing a pink and blue skirt and sweater combo that would have been cute anywhere but in a hospital. Her auburn hair was tied back in a ponytail. She came over to him and hugged him tight. âDavid, Iâm so glad youâre here.â âWhatâs going on? How bad is it?â He looked over at his father. The ICU was even worse than regular hospital rooms. There were wires and tubes all over his father; he looked like some sort of cyborg. A machine was breathing for him. âHe had a stroke in recovery. They ran some tests, but havenât been able to tell me anything yet.â Sue collapsed back in the chair. It looked like she had made it her home for the last few days. Knowing her, she probably had. âCrap. Shit. Dammit. Whereâs the doctor?â David looked around for his fatherâs chart, as though he could understand it with one semester of college biology under his belt. âThey said he was on his way up.â She blew her nose on one of the hospital tissues. It made her look even worse. David always felt those cheap tissues were one step away from fine grit sandpaper. David leaned back against the wall and stared at the myriad of machines surrounding his fatherâs bed. Their clicks, whirrs, and beeps began to drown out all the other sounds, with the quiet sobs of his sister underscoring the whole cacophonous symphony. So engrossed was he, that he gave a start when the doctor walked into the room. âGood afternoon, I am Doctor Goswami.â He offered his hand to David. He was a dark skinned man from India. Though, he had an accent, he was very easy to understand and had a pleasant voice. His hair was cut short and he had a wide nose. David could see a suit underneath his white lab coat. The pockets of his lab coat bulged and David could see the ear pieces of his stethoscope poking out of one of them. David shook the doctorâs hand firmly. âDavid Cavanaugh, Iâm his son.â Dr. Goswami nodded. âWhatâs the situation, Doctor?â âThe hernia operation went remarkably well. Everything seemed fine until your father suffered several strokes in recovery this morning. We were able to treat him for those immediately, but I ordered an MRI on him.â âAnd? What did that show?â David looked to his father, then back to Dr. Goswami. Sue was sitting straight up again, looking intently at their father. âThere is the possibility of brain damage. The strokes were quite severe.â Dr. Goswami said. âI donât mean to be rude, Doctor, but donât sugar-coat it for me. Be brutally honest. Is he a vegetable now?â David started to dread the answer, even as he asked the question. âI canât say. What I can tell you is this: he is incapable of breathing on his own. In 90% of cases similar to your fatherâs, the patient never recovers consciousness.â His pager cut him off. He glanced down at it. âExcuse me for a moment.â Dr. Goswami stepped out of the room. David turned to his sister, âDammit, I thought Dad had a DNR in his will?â A DNR was a Do Not Resuscitate order, given by a patient who doesnât want heroic measures taken to prolong their life should they die. Sue looked up at him, âHe does, but they havenât had to resuscitate him yet, David. He was still on the respirator from the surgery when he had the stroke.â David walked over to the window. The room didnât have much of a view. All he could see was the machinery on top of another wing of the hospital. Dr. Goswami came back into the room. âIâm terribly sorry. Do you have any other questions?â David looked to his sister. She shook her head. He looked back at Dr. Goswami. âNo, Doctor. Thank you, youâve been very informative.â Dr. Goswami handed his business card to David. âCall me anytime if you have any other concerns, OK? Thank you. Bye-bye.â He offered a smile and left the room. David knelt by Sueâs chair, âWhereâs Steve?â Steve was Sueâs husband. âHeâs in London on business. I talked to him. He offered to come home, but thereâs nothing he really can do. He and Dad were never close anyway. I didnât want him to risk screwing up the deal.â âHeâs a good guy. I donât know why Dad didnât like him.â He blew out a breath and stood back up, looking over to his father. âYouâre Dadâs agent, arenât you, David?â Sue asked. âAccording the Health Care Directive?â David looked at his sister, âYeah, so?â âDo you know what that means?â David scrunched up his brow, unsure of what Sue was getting at. âNo. What?â âIt means that if it comes down to a decision of whether or not to keep Dad on life support, you have to make that decision.â David sat there. Heâd heard what his sister said, but his brain was having difficulty processing it. He knew that decision would be his to make, but it never occurred to him that heâd actually have to make it someday. âDavid?â âDavid?â Sue asked again. âShit.â David was not at his most articulate right now. âAre you OK?â David sighed, âYes. I just donât know what to say right now. I feel like Iâm the guy who catches cannonballs with his stomach.â He walked over to the bed and looked down at his father, lying there tubes and wiring going into and coming out of nearly every orifice on his body. He was struck by how helpless his father looked. It almost seemed as though he were already dead. The next day, David called off work. They didnât hassle him too much, and he knew heâd be useless at work today. The only thing heâd accomplished since getting home from the hospital was check his voice mail. The unknown caller had actually left a message, which surprised him. It was Janet, one of his sisterâs co-workers. Theyâd met at a company picnic about a year ago. Sueâs husband didnât want to go, so she dragged her brother along instead. Janet had seemed nice. She was a little short, with classic Mediterranean features. But she dressed nice and had a personality that made it difficult to be grumpy around her. Her message was short and to the point: Hi David, itâs Janet. Remember me? We met a year ago at the company picnic and then again at the mall a few weeks ago. I got your number from Sue, I hope you donât mind. Anyway, I was just wondering if you wanted to grab a bite to eat, or catch a movie. If youâre busy, donât worry about it, it was just a thought. Give me a call if you think about it, 587-9487. Ok, bye. He hadnât called her back yet. He really didnât plan on it. He just wasnât in the mood right now. He hardly slept the night before and he knew he would be next to useless at work while he was worrying about his father. Oh yes, he worried, though he would never admit it to anyone. For years, heâd cultivated the image of being a rock upon which others could rely, but inside he could feel himself getting older as each day passed with his fatherâs mortality hanging over his head. So he just lay there in bed, thinking about his father while Perkins slept on his chest. Sue thought having a pet would make David mellower. Plus, Sue loved cats and thought everyone should have one. The sun peeked in through the partially-drawn curtains. Dust sparkled in the sunbeam as David wondered what time it was. He had barely moved a muscle in hours and considered getting up, showering and heading back to the hospital. He was so tired, though. He hadnât slept a wink last night. Every time he fell asleep, he kept dreaming about being surrounded by writhing snakes. Once of them would crawl down his throat and when he would snatch it out, he would be unable to breathe. The phone rang, startling Perkins. He dug his claws in and leapt off of Davidâs chest. David winced and picked up the phone. âHello.â He noticed how groggy he sounded, even though heâd been awake for hours. âItâs Sue.â âOh, hi Sue. Did you go home?â David sat up in bed and ran his fingers through his hair. It felt particularly oily today. âYeah. The nurses finally convinced me sleeping in my own bed would be better for me. They promised to call if anything changed with Dad.â âDid they call?â David asked. âNo. Iâve been worried about you, though.â She sounded concerned. âWhy?â âWhat are you going to do about Dad?â âI donât have a clue. Do you think we should pull the plug?â David said, wishing Sue hadnât brought this subject up. Sue replied, âI donât know, David. What if he gets better?â âBeats me. Thatâs that damn hard part. If he can recover, and we pull it, he could die. If he doesnât recover and we donât pull it, heâs a vegetable. Maybe heâll linger for weeks after we pull the plug and still die.â David wracked his brain for a segue to a new topic. âStop. Just stop. Youâre talking about our father.â That did the trick, though not quite the way David wanted. âOK, OK. Are you going to the hospital today?â âOf course. Are you?â Sue said. âI donât want to.â David tried to think of a reason why he couldnât go and came up blank. âBut heâs our father!â Sue sounded like she did when she was scolding her husband. âI know, Sue. I didnât say I wasnât going. I said I didnât want to. I hate that place.â David threw the covers off and got out of bed. He started to walk towards the bathroom, dragging the phone off of his nightstand. The handset yanked out of his hand and clattered on the hardwood floor. âGoddammit!â He shouted. He already wanted a do-over on this day. He could hear his sister talking into the phone. âDavid? David? Are you OK? What happened?â He plopped down on the floor and picked up the phone. He shook his head, âSorry about that. I walked away from the bed and forgot that I wasnât on the cordless.â âOh.â Sue sounded worried, but was obviously trying to stifle a laugh. âLook, Iâm going to take a shower, then Iâll head over to the hospital?â The floor was cold on Davidâs butt, but he sat there punishing himself for being stupid enough to try to walk across the room on a corded phone. Times like this made him glad to live alone because he felt like the worldâs biggest dork. âOK, Iâm heading that way as soon as I get off the phone with you.â âFine. Iâll see you soon, then. Bye,â David said, sighing. âBye, David.â There was a click then a buzz. David sat there listening to it for a minute. He hung up the phone and placed it back on the nightstand. It was going to be a long day. David was just finishing up his shower when he could hear something very faintly. He turned off the water and listened. It was his cell phone. He decided to ignore it. Whoever it was could wait until he got the unpleasantness at the hospital over with. When he arrived at the hospital, David saw a well-dressed woman leave his fatherâs room. She was wearing a grey business suit and was carrying an attachĂ© case. Her hair was pulled up in a tight bun at the back of her head. She smiled as she passed by him and he wondered if she was wearing a Chanel suit. A voice in his head said how would you know if it was Chanel? You never heard of a Chanel suit until you saw one on "The Simpsons." He walked into his fatherâs room. Sue was already there, standing at the side of the bed, looking down at their father. âHey, Sue,â David said quietly. âHi.â She looked up and David and sighed. âIt gets better and better everyday.â He frowned. âWhat do you mean? Who was that who was just in here?â âSheâs one of the hospital patient advocate people or something like that. Sheâs the bearer of bad news.â âWhat news? Theyâre kicking him out or something?â David looked back at the doorway. âNot exactly. She just wanted to be sure that we were aware that Medicare wonât cover this type of long-term care for Dad indefinitely. She couldnât give me exact figures yet, but says that once Medicare runs out, weâll have to foot the bill ourselves.â Sue closed her eyes and turned away from David. âBoy, you werenât kidding. That sucks. What the hell do we pay taxes for, anyway?â David asked. Sue didnât answer. She gripped the rails of the bed tightly. He put his arm around her and hugged her close. They stayed like that for nearly ten minutes before Sue finally decided to sit down. She looked much older than her thirty years with no makeup. Worry lines creased her face and her eyes were red. David thought she looked like she hadnât slept at all last night, which was probably not far from the truth. He went outside for some fresh air. The antiseptic smell of hospital rooms always bothered him, and today was worse than normal it seemed. He just had to get out of there for a minute, the person in the room next to his father was moaning very loudly and David was sorely tempted to go and throttle that person. Once outside, he remembered the phone call that came while he was in the shower. He dialed up his voicemail. Hi David, itâs Janet again. God, Iâm so sorry about your father. Sue told me about it. If thereâs anything I can do, just let me know, OK? Give me a call if you need someone to talk to, or if you just want to get away for a minute. Anything, OK? That goes for Sue, too. Let her know, OK? Well, ummâŠbye. Call me if you need anything.â David shook his head and deleted the voice mail. His sister had some awfully nice friends. His friends all seemed to be a bunch of beer-swilling slackers. He would bet that if he called them and cancelled plans because his Dad was on his deathbed, theyâd bitch about it. He looked up as a lifeline helicopter roared overhead towards the hospitalâs helipad. He wondered if the people in the helicopter had Living Wills. Had they signed DNRs? What would I want? He wondered. Would I want to be kept alive on a machine if there was very little hope of recovery? Does Dad even know whatâs going on? Or did he go to sleep before the operation and just never wake up? He took a deep breath and headed back inside. A week later, David and Sue were eating lunch in the hospital cafeteria. Theyâd both started being able to sleep again, but their father showed no improvement. Dr. Goswami said it was highly unlikely their father would ever regain consciousness, and if he did, he would not be cognizant; the brain damage was quite extensive. He wouldnât know who he was or where he was. He wouldnât recognize his children. He wouldnât be able to feed himself or go to the bathroom. He would most likely never breathe on his own again. Therefore, he would never eat solid food again. David wondered if it was just him, but the hospital cafeteriaâs food tasted like ashes. âSue, Iâve been thinking about something.â âWhat?â She ate her food mechanically, not really looking at David. âIâm not sure I can sign the order, Sue.â âYou mean taking him off life support?â She ate another spoonful of pudding. âI just donât know what to do, Sue. I donât think I can kill Dad like that.â Sue said nothing. She took Davidâs hand. David fought to maintain his composure. The truth was, heâd been thinking about it all week, and it was tearing him apart. He thought it would be a no-brainer: if his father would be a drooling vegetable, pull the plug and be done with it. If there was a good chance heâd recover, give it time and let the old man have a few more years. But now that the time had come, David felt like a helpless infant. I feel like one, he thought, but Dad is one. NoâŠnot an infant. An infant will grow, develop. Dad canât do that anymore. Heâs just helpless. âJust helplessâŠthereâs no hope,â David whispered. âWhat?â Sue asked. He thought back to the day when they finally got their father to do the living will. When he finally warmed to the subject he was very adamant about not wanting to be burden on anyone, despite what he said earlier about wanting David to care for him. He was a proud man, and couldnât stand the thought have having to have his every need cared for by someone else. It was one thing when you could do for yourself and someone waited on you, but to be forced to rely on someone because you could no longer control your basic functions, well, that was an indignity David and Sueâs father could do without. âSue?â âYes, David?â Sue looked at him. âIâm going to do it. Iâm pulling the plug.â Sue withdrew her hand from his. âYou want him to die?â She looked at him like she did when her husband was trying to pull a fast one. He shut his eyes. âNo, of course not. But itâs not about what I want. Itâs about whatâs best for him. Iâm going to have them remove the life support. Heâs a vege, Sue. He wouldnât want to live like that.â âYou better be damn sure, David. Heâs not dead.â David could feel eyes on him. He noticed a couple hospital staff had sat down at the next table and were looking at them. He ignored them. âDad left this decision to me when he made me his agent. Iâve been thinking about this all week.â David rubbed his forehead. âLook, I want him back too, but everything he was is gone, Sue.â âHe might recover.â She said in a small voice. âDr. Goswami says itâs highly unlikely. I probably have a better chance of winning the Powerball than Dad has of bouncing back from this,â David said. He shoved his tray aside and took his sisterâs hand. âBreathing on a machineâŠpissing down a tube. Not eating. Not knowing where you are, who you areâŠwhat you are. Itâs not living, Sue. Dadâs not alive anymore. He just exists. Thatâs it. Thatâs not living. He wouldnât want this.â Sue shook her head. âYou canât kill Dad.â âDammit, the stroke killed him! If he wasnât on the respirator when it happened, we wouldnât be having this conversation.â He squeezed her hand. Sue pulled away again. âSo thatâs it. You can just discard him, just like that?â âIâm not discarding him. Think, dammit. Remember that day he signed the living will? He doesnât want to be a burden. He doesnât want to be a vegetable.â âIâm not ready to lose him, David.â Sue grabbed a napkin and wiped her eyes. âIâm not either, but thatâs not really our choice, now, is it?â He hated getting stern with his sister, but if heâd learned one thing over the past 33 years, it was that if someone didnât stay grounded, then no one in the whole family would make a decision. âDad left this choice to me. I hate having to make this decision. Believe me, it sucks. I canât sleep, I can barely eat. But I think this is what Dad would want.â Sue looked at him, âYou think? Youâre going to take Dad off life support because of what you think, huh? I want you to know that what youâre doing is right.â She pointed at David. âYou canât take this back, David. If you do this, thereâs no going back. We have to live with this decision for the rest of our lives. What if he can recover? What if, David?â David took a deep breath and let it out slowly. âIâmâŠIâm not going to play grab-ass with the supernatural, Sue. The âWhat Ifâ game really sucks right now. IâŠIâŠI donât know that Dad wonât recover. Thereâre no absolutes in medicine. No...no one can be sure of anything,â David said, trying to keep himself calm. âWell you better be damn sure about this.â Sue said. Davidâs lip trembled. He saw his sisterâs expression soften a bit. âThey say he canât breathe on his own, Sue. I say we pull the plug and find out. Dadâs a fighter. If heâs going to recover, now is as good a time as any. The longer he stays on that damn machine, the greater chance he has of getting pneumonia, or some other complication. If we do it now, and he recoversâŠthen great. If he doesnâtâŠwellâŠat least the suffering will be over. We canât live like this forever, Sue,â David said as he took his sisterâs hand again. âThink about it. If you were in a vegetative state, never to regain consciousness, never to eat again, laugh again, cry againâŠ.never to see your children again and know who they areâŠwouldnât you want someone to love you enough to end it?â Tears trickled down Sueâs cheeks. Her lips quivered. âFine. Itâs your decision, David.â Once all the paperwork was done and everything was triple-checked and checked again, David and Sue stood in their fatherâs hospital room as the staff made preparations to turn off the life support. It was a little more complicated than the phrase âpull the plugâ would make it seem. Sue held on to David tightly. He glanced up at the clock at the nurses and doctors did their work. The respirator was off now. The clock ticked so slowly. Their father didnât breathe again. He flatlined. They pronounced his death at 2:37 P.M., Monday, August 7th, 2006. Sue cried over the body for twenty minutes before she allowed herself to be led away. David held her, but gave himself the luxury of letting tears fall freely. He kept his composure though, like he always had. When he got back out to his car, he just sat there for fifteen minutes. Life would be different now. Theyâd always had their father. Now, he was gone. Magnum, P.I. came over his cell phone again, startling him. He looked down at the display. Unknown. This time, he answered it. âHello? Oh, hi Janet.â |