The Process of Dying

 I have been struggling with the emotions of watching my Father die.  I have spent a lot of time with him recently, late at night, sitting next to his hospital bed.  And I have wanted to write about the experience, but I have not been able to bring myself to do it, until now.

I started this blog last year as a means to liberate from my head some of the thoughts I have about politics and current events and to spend some of my writing energy on something other than the asset purchase agreements and credit facility documents that occupy most of my time in my life as a lawyer.  I have posted links to this blog on my Facebook page, and I have been surprised, and honored, that some of my friends have taken the time to read what I have to say.  But other than a brief entry about my daughter, I have not spent too much effort writing about my personal life.

I don't know when this photograph of my Father was taken, but I would guess it was sometime in the late 1950's or early 1960's, somewhere near our home in Berea, Kentucky, where I was born, the third and final son, in 1962.  I can remember my Father vividly when he was young and I was a child, which may explain in part why seeing him now is so hard.  The man lying on the hospital bed, struggling through the last days of this life, is but a shadow of my Father.  His face is pinched and drawn.  His hands, which I remember from my childhood as big and strong and perpetually covered with the bruises and scars of his life as a working man, are now shriveled and purple and shaking.  He can no longer speak beyond some barely perceptible mumbles that cannot be interpreted.  He holds his hands to his head as if to contain the evil forces that dwell inside his skull:  the Alzheimer's Disease that started his decline, and the cancerous tumor that has pushed him toward his death.

Both my Father and Mother were born into poverty that is hard for me to fathom.  Dad was the youngest of eight children growing up on a hardscabble farm at the back of beyond in Kentucky.  Dad finished all of the schooling that was available to him at home, and then he moved to live in Berea with one of his sisters and her husband while he attended high school.  After graduation, he volunteered for the Army and served at the tail end of World War II in the Pacific.  Thanks to the GI Bill, he was able to attend Berea College, where he met my Mother, who had found her way to Berea because it offered a way for poor students to work their way through school.  They married in 1952 and lived in Berea until two years after I was born, when they moved near Mom's family in Lewisburg.  Dad worked for his father-in-law in the construction business until my Grandfather died, and then Dad took over the business.  He carried it along for the remainder of his working life.

Even after Dad retired and sold his business some twenty years ago, he remained active.  He worked in his garden in the Summer, planting and nurturing half-runner beans and Summer squash and tomato plants by the dozen.  When harvest time would come, he would sit with my Mother on the front porch stringing and breaking up green beans so she could can them.  When Mom and Dad would visit me in Charleston, Dad helped me with countless home improvement projects, including climbing a ladder 25 feet into the air to help me install storm windows on the back side of my Carroll Road home.  He volunteered his time with the Lion's Club to work the ticket booth at high school football games and to sell Christmas trees on the coldest days of late November and December in Lewisburg.  He was the man who was counted on by a stream of little old widow ladies who needed to have jobs done around their homes or rides to doctor appointments.  He drove children from Greenbrier County to Lexington, Kentucky, to the Shrine Hospital, where they could receive free treatment for any number of orthopedic problems.

But more than anything else, my Father loved and cared for my Mother and for his three sons.  As his dementia slowly robbed him of his cognition, he could always be comforted simply by having his family gathered around him.  He might not say anything--my Father was never a man to waste words--but he was happy just knowing that all of us were close by and safe.

I have come back to this post after a couple of days away.  I was not able to finish it the first time around, so I am going to give it another go now.  I am in Dad's hospital room on Friday night, April 2, and he is slipping away.  His breaths come slowly, three or four at a time, separated by a long period of apnea, where he does not breathe at all.  He receives morphine every two hours for pain, but I have no idea what he is feeling.  He has worn sores onto the pressure points of his knees and ankles and hips from lying in bed now, uninterrupted, for almost six days.  Those sores must hurt terribly.  I recall my own time in the hospital when I had heart surgery and how sore I felt from lying in bed so long.  But I was able to reposition myself, and I was able to walk in less than 48 hours.  Dad will never walk again.

I have experienced the death of many family members and friends with whom I was close.  I can remember attending the funeral of my Grandfather, Walter Lewis, when I was six.  He died at about this same time of year, on April 15, 1968.  And I have attended a steady flow of funerals since then.  But I have never been present when someone passed away.  I have never so closely observed the process of dying.

Three weeks ago, my Father's prospects appeared so different to me.  He suffered from Alzheimer's Disease, having been diagnosed with it over a year ago.  He had a lot of trouble with his short-term memory, and he experienced what his health care providers call "sundowner's syndrome", the worsening of his symptoms as each day drew to a close.  In the mornings, though, he was almost his same old self.  He would get up and make breakfast, one of his favorite things to do.  He would read the newspaper and sort the mail and watch news shows on television.  I knew he was deteriorating, and I knew that some hard times would come to our family, but I had no idea how soon.

Since Christmas, Dad had lost a lot of weight.  His appetite, always strong, diminished.  He had less energy.  But I was able to set those things aside.  I chose to see him as he had always been.  But then, on Wednesday, March 17, he had a seizure while still in bed in the morning.  I was not present, but my Mother and my brother Don both describe the scene with horror.  He was taken to the hospital by ambulance and admitted to ICU.   Only then, after a CT scan of his head, did we learn of the cancerous tumor that had taken hold of him.  It had not been there six months ago when a previous scan had been done, and in that short span of time, it had grown to the point that it was compressing his brain, thus causing the seizure.  He spent the next six days in ICU before being discharged from the hospital.  I spent the week of March 22-26 in Charleston, and I returned to Lewisburg to be with him on Friday.  On Saturday morning, he was feeling well enough to go out to breakfast with family at Bob Evans in Lewisburg.  He ate like his old self:  a three-egg omelette and biscuits with gravy.  It was the last meal of any consequence that he would eat.

I spent a sleepless weekend with him, staying up all night to run to my Mother's aid when Dad would try to get out of bed, completely unaware of his surroundings.  I returned to Charleston late on Sunday night, but less than four hours after I left, Dad was back at the hospital.  He had gotten out of bed unnoticed by Mom or his caregiver, and he had walked all the way to the basement steps before he was stopped.  He was completely disoriented and barely able to speak.  They called the ambulance to take him to the hospital.  On Tuesday morning, March 30, while I was at the office, I received the call that Dad had taken yet another turn for the worse.  His hospice nurse saw signs that he did not have long.  And indeed here we are, on Friday night, and the signs are clearer than ever.

My Dad lived honorably. He loved my Mother with all his heart.  He worked hard, and he provided for his family.  He served others.  He was a thankful recipient of God's grace.  He was my model for how I should live my own life.  I know I fall far short, but I also know that he never saw it that way.  As with my brothers and his grandchildren, he was proud of me beyond measure.  I love him so much.  I will miss him more than I can say.