Wednesday, June 25, 2008
Oh What a Ride! (Update 2)
“You know, when I was nineteen, Grandpa took me on a roller coaster… Up, down, up, down. Oh, what a ride! I always wanted to go again. You know, it was just so interesting to me that a ride could make me so frightened, so scared, so sick, so excited, and so thrilled all together! Some didn't like it. They went on the merry-go-round. That just goes around. Nothing. I like the roller coaster. You get more out of it.” – Grandma (from the 1989 film, ‘Parenthood’)
I slept terribly last night. I woke up at 8am, which was 6am on my internal clock. Immediately my mind was absorbed in the nervous anticipation of what the day would hold. The idea of seeing my dad for the first time, on his back and incoherent in the ICU of a VA hospital was not settling easily on my mind.
I was expecting the worst. Over the last six weeks, my father had spent less than twenty-four collective hours not sedated into a fog. Breathing tubes made speaking or any other verbal communication impossible. Being heavily sedated seems like the only logical way to be.
The warranted press that VA hospitals have been given in this country had prepared me for almost anything from the hospital facility itself. As we drove up I was pleasantly surprised by the outer appearance of the building. It is a red brick building that fits nicely in the company of the adgacent Children’s Hospital and the Oklahoma University Medical Center. As we walked through the parking lot and into the entry, veterans milled about. On the sidewalk outside the main entrance a Vietnam-era amputee sat in a wheelchair with a friend smoking a cigarette together.
On the main floor, on the way to the elevator, we passed a line and lobby-full of veterans waiting on bulging lines for prescriptions to be filled. I was struck by how so many of these guys fit the Vietnam vet stereotype – ponytail, tattoos and baseball caps labeled with unit and squadron.
As pleasant as the facility truly seemed to be in comparison to disgraceful places like Walter Reed Hospital and others, it was clear that the system and its broken processes continue to fail these men (mostly) who gave nearly everything in the service of their country in our first meaningless, worthless, pitiful and criminal war. As companies like Haliburton and Blackwater and their pathetic boards grow rich wading in the blood of dead and wounded young men and women, boys and girls; we sent them home to stand in lines that last hours for pills to manage pain caused by injuries acquired in "defense of their country". Writer, Jean-Paul Sartre said, “when the rich wage war, it's the poor who die.” The ones who don’t die are left a sorry fate back home. Sorry! I swore I wouldn’t do that!
Upstairs as I approached the room my heart raced. I wondered how he would look. We had to put on a coverall and surgical gloves before entering the room. As I dressed, I gazed in and could see that my dad’s eyes were open. They seemed to be fluttering, and he fidgeted in his bed. He laid leaning to his left side, away from the door, so he did not see me enter his room. I walked to the opposite side of the bed so that he could see me clearly. He looked up at me and his eyes widened. They were huge and powder white. The look he gave me was something akin to. “who the hell are you?!” Clearly he did not recognize me. Then, after about ten seconds, the image of me made its way through the fog and haze of the lingering medication and sedative. Suddenly the look on his face melted into a mix of excitement and emotional joy. This look was one of, “thank God! My son is finally here!”
I held his left hand and talked to him. I struggled with what to say. “Howya, doin?” just didn’t seem appropriate or even mildly funny. He began to try to speak to me. The mass of tubes and hoses in his mouth eliminates any possibility of audible communication. Yet he struggled to communicate something to me that he clearly felt was paramount. His eyes accentuated his point, but didn’t help at all in establishing what that point was. I feel certain that whatever he was trying to say to me, it started with, “listen to me! Please…” What is next is the mystery. Is it, “get these tubes out of my throat and let me die with some dignity!” or “don’t leave me! Don’t let me die!”
His doctor took my aunt and me into a conference room and spent about thirty minutes answering all of the questions I have had in queue for all of the last six weeks. He explained in careful and respectful detail, diagramming the chemistry and physiology on a dry erase board.
The bottom line and his dilemma is drawing my father into the discussion of what his short term fate will be. There has been little progress in the time that he has been in the hospital, and any at all has been followed by multiple significant steps back. The doctor wants to know what my father wants. He wants him in on this cruel and enormous decision. He wants to hear it with his own ears, or at least through our ears – his children, brother, sister, nieces and nephews.
My dad has indicated in writing that he does not want to be kept alive by a ventilator. This seems like clear and concise direction. Acting on such instructions with no audible voice to go with it and eyes as alive as mine is a confusing and intimidating dichotomy. His confirmation – any confirmation is all I desire right now.
My aunt said that she had not seen him as alert as he was this morning. He remained wide-eyed for the entire time that we were with him. As we left, we assured him that we would be back later in the day.
As we walked back into his room this evening, just after six thirty, his doctor stopped us and told us that my father had just been violently agitated again and seemed to be attempting to pull the tubes out of his arms and throat. This has been his pattern when he has come out of his sedated periods. The question remains and only frames itself differently; is he saying to “get these tubes out of me so I can die”, or is he saying, “this stuff is hurting me!”?
As a result of his tirade, the new wave of anti-anxiety medication they had started were ratcheted up to “industrial levels”. The man I saw when I walked back into the room was the man I expected to see this morning before I was so pleasnantly surprised. The only word that came to mind, no matter how I tried to rephrase it in my mind was, vacant. His eyes were open, but very little was there. Whatever was there this morning was now sealed tight behind a metal door of medication.
Before he left us to go on his last rounds of the day, the doctor stepped to me and said, “you know, the more I think about where we are and how things are, I just don’t think he’s going to be able to play a part in this decision.” This was the clarity I had been asking for, just not the answer I was hoping for.
Which version of my dad will we get on Thursday? Family reinforcements arrive in the afternoon. After just one day, I’ll need it. While I love roller coasters, this is not the type I enjoy.
I slept terribly last night. I woke up at 8am, which was 6am on my internal clock. Immediately my mind was absorbed in the nervous anticipation of what the day would hold. The idea of seeing my dad for the first time, on his back and incoherent in the ICU of a VA hospital was not settling easily on my mind.
I was expecting the worst. Over the last six weeks, my father had spent less than twenty-four collective hours not sedated into a fog. Breathing tubes made speaking or any other verbal communication impossible. Being heavily sedated seems like the only logical way to be.
The warranted press that VA hospitals have been given in this country had prepared me for almost anything from the hospital facility itself. As we drove up I was pleasantly surprised by the outer appearance of the building. It is a red brick building that fits nicely in the company of the adgacent Children’s Hospital and the Oklahoma University Medical Center. As we walked through the parking lot and into the entry, veterans milled about. On the sidewalk outside the main entrance a Vietnam-era amputee sat in a wheelchair with a friend smoking a cigarette together.
On the main floor, on the way to the elevator, we passed a line and lobby-full of veterans waiting on bulging lines for prescriptions to be filled. I was struck by how so many of these guys fit the Vietnam vet stereotype – ponytail, tattoos and baseball caps labeled with unit and squadron.
As pleasant as the facility truly seemed to be in comparison to disgraceful places like Walter Reed Hospital and others, it was clear that the system and its broken processes continue to fail these men (mostly) who gave nearly everything in the service of their country in our first meaningless, worthless, pitiful and criminal war. As companies like Haliburton and Blackwater and their pathetic boards grow rich wading in the blood of dead and wounded young men and women, boys and girls; we sent them home to stand in lines that last hours for pills to manage pain caused by injuries acquired in "defense of their country". Writer, Jean-Paul Sartre said, “when the rich wage war, it's the poor who die.” The ones who don’t die are left a sorry fate back home. Sorry! I swore I wouldn’t do that!
Upstairs as I approached the room my heart raced. I wondered how he would look. We had to put on a coverall and surgical gloves before entering the room. As I dressed, I gazed in and could see that my dad’s eyes were open. They seemed to be fluttering, and he fidgeted in his bed. He laid leaning to his left side, away from the door, so he did not see me enter his room. I walked to the opposite side of the bed so that he could see me clearly. He looked up at me and his eyes widened. They were huge and powder white. The look he gave me was something akin to. “who the hell are you?!” Clearly he did not recognize me. Then, after about ten seconds, the image of me made its way through the fog and haze of the lingering medication and sedative. Suddenly the look on his face melted into a mix of excitement and emotional joy. This look was one of, “thank God! My son is finally here!”
I held his left hand and talked to him. I struggled with what to say. “Howya, doin?” just didn’t seem appropriate or even mildly funny. He began to try to speak to me. The mass of tubes and hoses in his mouth eliminates any possibility of audible communication. Yet he struggled to communicate something to me that he clearly felt was paramount. His eyes accentuated his point, but didn’t help at all in establishing what that point was. I feel certain that whatever he was trying to say to me, it started with, “listen to me! Please…” What is next is the mystery. Is it, “get these tubes out of my throat and let me die with some dignity!” or “don’t leave me! Don’t let me die!”
His doctor took my aunt and me into a conference room and spent about thirty minutes answering all of the questions I have had in queue for all of the last six weeks. He explained in careful and respectful detail, diagramming the chemistry and physiology on a dry erase board.
The bottom line and his dilemma is drawing my father into the discussion of what his short term fate will be. There has been little progress in the time that he has been in the hospital, and any at all has been followed by multiple significant steps back. The doctor wants to know what my father wants. He wants him in on this cruel and enormous decision. He wants to hear it with his own ears, or at least through our ears – his children, brother, sister, nieces and nephews.
My dad has indicated in writing that he does not want to be kept alive by a ventilator. This seems like clear and concise direction. Acting on such instructions with no audible voice to go with it and eyes as alive as mine is a confusing and intimidating dichotomy. His confirmation – any confirmation is all I desire right now.
My aunt said that she had not seen him as alert as he was this morning. He remained wide-eyed for the entire time that we were with him. As we left, we assured him that we would be back later in the day.
As we walked back into his room this evening, just after six thirty, his doctor stopped us and told us that my father had just been violently agitated again and seemed to be attempting to pull the tubes out of his arms and throat. This has been his pattern when he has come out of his sedated periods. The question remains and only frames itself differently; is he saying to “get these tubes out of me so I can die”, or is he saying, “this stuff is hurting me!”?
As a result of his tirade, the new wave of anti-anxiety medication they had started were ratcheted up to “industrial levels”. The man I saw when I walked back into the room was the man I expected to see this morning before I was so pleasnantly surprised. The only word that came to mind, no matter how I tried to rephrase it in my mind was, vacant. His eyes were open, but very little was there. Whatever was there this morning was now sealed tight behind a metal door of medication.
Before he left us to go on his last rounds of the day, the doctor stepped to me and said, “you know, the more I think about where we are and how things are, I just don’t think he’s going to be able to play a part in this decision.” This was the clarity I had been asking for, just not the answer I was hoping for.
Which version of my dad will we get on Thursday? Family reinforcements arrive in the afternoon. After just one day, I’ll need it. While I love roller coasters, this is not the type I enjoy.
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