9.3 Daddy Care: End Game Deepens

By Janet Grace Riehl

Date line: Evergreen Heights, the Big Brown House, January 30^th and 31st 2012

Photo: Pop. Erwin A. Thompson. (photo by Janet Grace Riehl)

The story so far:  I’m part of a three-person family care team that works to keep my father at home with dignity and independence. Pop lives in the house where he grew up, raised his children, nursed his wife for five years before her death, and now plays out the end game of his life. We each have our jobs. My brother focuses on business. I do my younger daughter thing. My niece lives next door to the Big Brown House and tracks all things medical. Pop’s doctor is only a phone call or a text away. He is prone to Heart Thingies—more accurately known as “atrial fibrillations” or “A-fibs” for short.  “Thus, the background,” as my father would say.

Monday, January 30th

The phone rings. I throw off my warm covers and lunge to answer it. Who on earth calls at this time in the morning?  “Have his vitals changed?” I recognize the voices of my father’s doctor and then my niece Diane as they consult over the phone. I rush downstairs to my father’s bedroom. My niece turns her head from the phone. “Give me five minutes.” I retreat upstairs, splash my face with cold water, and pull on some clothes before my niece arrives with the update.

“He’s been in A-fib since 2 a.m. He called us at 5. His vitals are low. Dr. Miller wanted to talk to him directly, so she called the house. It’s a hard way for you to wake up.”

I trot downstairs.  Pop looks up from his bed. “I’m still here. We’ll make it.”

“That’s what we like to hear.” I touch my forehead to his and inhale deeply. The smell comforts me.

I text my brother. “Daddy in A-fib since 2. Now back to sleep. Everyone is doing their part. I slept until Dr. Miller called the home phone to talk to daddy.”

“Call me when you can.” I do. He comes down from the Upper Brown Cottage.

Thus begins a day of watching and waiting. The A-fib continues, and continues, and continues. Afternoon finds Pop sacked out in his chair. My niece—an expert on the mortgage lending crisis—hunches over her laptop. Her makeshift desk is his desk. Our long dining room table is piled high with his projects: historical clippings, photos in binders awaiting commentary, a novel-in-progress, and whittled critters in all stages of completion.

I poke my head in from the kitchen where I’m making ginger cookies. “How’s it going?”

“His pulse is still rapid and erratic.”

Since his big heart thingy on New Year’s Eve Day, the A-fibs just keep a comin’. For the past four years they’ve usually lasted 6 to 9 hours, now they go on and on. Amazingly he snaps back, but each time his heart gets weaker.

“I need to go on some errands, but I can sit with him when I get back,” I say.

When I do, Pop’s pulse is slower and more regular. He eats a bit and then takes his medicine. It’s not quite over, but the crisis has passed. My niece goes home.

Tuesday, January 31^st

“How are you?”

“Not too good. I can’t get a reading on my blood pressure or my pulse.” He keeps a blood pressure rig by his bed and records the readings every half hour. If he can’t get a reading, then he’s definitely in A-fib.

I cradle his wrist to feel for his pulse.  My nursing skills are pretty limited. I can fluff a pillow and fetch a meal, but I’m not too good at this pulse-taking. Even I, though, can feel his heart’s wild beats.

“We’d better call Diane.”

She’s good at this stuff. When she comes, she grabs our clock with the second hand and counts as well as she can with a heart that’s racing to the finish line. Not good. She steps out to contact Dr. Miller, and then comes back to take his temperature. It’s 92 degrees. Finally we get a blood pressure reading. Not too good, as Pop said. Low temperature. Low blood pressure. Back to Dr. Miller.

“His systems are shutting down. He may have 24 hours. Keep him as comfortable as possible.”

We keep a little pill handy that lowers the heart rate, but, sadly, it also lowers the blood pressure. That’s the tight rope we walk in calibrating the medication. Should he take it?

“Yes,” says Dr. Miller.

Later I visit Pop as he lies in bed. “I’m cold.” He’s shaking under the covers, but in no pain. “This isn’t moving in a good direction,” he says. “It’s not following the usual cycle. This thing is just going on and on. We’re in a new phase.”  That’s the curse of a clear mind. He knows. But, he doesn’t know all. We’re not about to march in to tell him he has 24 hours to live, right?

These prognostications of his imminent demise have been in play for the last five years. It’s not just the doctor thinking out loud. It’s us. It’s him. “Janet, I don’t think I’ll make it to spring,” he told me the fall of 2007. But he did. And time and time again he’s made it beyond his due date. As Mark Twain said, “Reports of death have been greatly exaggerated.” But this time? It seems ever more real that the end could be in sight.

There’s no hospice here. No professional caregivers. Not a blink of a thought about trekking to the hospital. Just us. Just Daddy. Just whatever is going to happen. But, if he were to die today, it would be a dream death. The family members who live on top of our hill are all here. We’re on our best behavior. I’m strong and steady. Daddy is charming. It’s a day of tender and funny moments. A day of reconciliation.

While my niece and I love each other, it’s not an easy relationship. We’re not easy people. None of us in the family are, really. But, after she and I discuss how this all might go down, she starts toward the door to head out for a walk. Her nerves are stretched tight. She’s on the medical front line. Then, she turns.

“I want you to know that I see you reaching out to me. Time and again, even when I rebuff you. Even when it doesn’t connect with me. It’s like a marriage vow. You don’t give up. You’re constant in your effort. I appreciate that.”

Constancy isn’t my strong point, though god knows I try. I’ve taken it as my watchword for the year. My hand flies to my heart in surprised fullness. To be seen—even when my wish to make it work falls on its face. I tear up a little.

“Thank you. I can’t tell you how much that means to me.” We hug lightly and she slips out the door.

Even though we don’t tell my father directly that we fear his time is nigh, the steady stream of visitors throughout the day must give him a clue. My brother and his wife, my niece and her husband, their girls, and me.

“My, I have a lot of people coming to see me today,” he jokes.

And, I’m around to greet them. Daddy likes it when I’m a good hostess. Diane’s husband drops by on his way to a job.

“Is he awake?”

“No, but that’s not a big deal.” He’s been sleeping lightly most of the day. I go in first.

“Daddy, wake up,” I whisper. “You’ve got a visitor.” Then, back to the kitchen where I’m cooking bacon in the oven.

My niece comes back to work on her laptop. In the afternoon my niece’s children come home one by one from school. Her youngest shows up first; she sets up shop across from her mother. Even math homework must go on.

“Would you like a snack?” She looks askance at her mother who nods “yes.” We peer into the refrigerator reviewing her choices.

“Would you like something sweet or something nutritious?”

“What about both?”

We settle on lemon pudding, and she goes back to work on her math. She’s wearing a blue fleece jacket. When she goes to see Daddy, he says “Oh, it’s my little blue bird come to greet me.”

Later my older great niece comes by on her way home. She sets down her book bag, and goes in to greet him.

“I love you, Papa.”

“I’m glad you do. That’ll help me get through it. Have you watered your farm today?”

Her farm is several flats of different kinds of grain that look like grass. It’s her experiment for her science project. She’s fascinated by erosion. This is one of her days to water it; she scoots down to the basement.

When she comes up, I walk with her to the porch. Much to my surprise she comes to hug me. I hold her for a long time while she cries. “We’re gonna make it through,” I tell her, echoing the words I’ve heard my father say so many times.

Then I rejoin my niece and her daughter. Diane and I speak softly about Pop’s condition. It’s a bit hard for my great niece to concentrate on her homework. She looks up, concern shadowing her young face.

“Would you like a hug?” her mother asks. And she comes for a cuddle.

I draw a straight chair close by. “Come on over here. And, none of those wimpy hugs.” I draw her to my lap where she puts her head on my shoulder. We rock.

My brother and his wife come to visit throughout the day. We eat supper together. I’ve made a seafood gumbo that goes down pretty good. Pop’s better now, and asks for his favorite supper: bacon with little tomatoes.

He’s pulled out once again. How, I don’t know. None of us do. “Who knows but God?” as the lorry slogans in Ghana proclaim.

On a Masterpiece Theater program I first heard the term “end game.”  Though “end game” comes from chess, in that context “end game” referred to the end of a lineage—the end of a way of life for the landed gentry. It works here, too. Pop is the family patriarch. When he goes, a generation passes and with it a way of life. He’s trained us up well, and we carry his line, each in our own way.  But, there’ll never be another him, that’s for damn sure.

Only a few pieces are left on the chess board. The king stands alone facing the dark knights of old age and death.

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