My father passed away in his sleep,in hospital, on Friday, February 19, 2010 at 2:30am after suffering a cardiac failure. Despite partially successful resuscitation attempts 3 times, he succumbed.
Although he had been acutely seriously ill since December, and hospitalized since January 13, this was a shock, in that he was doing very well, and it was planned that he would be going to the rehabilitation ward to prepare him for coming home. He was to be transferred there as soon as later the same day as his death.
Our family takes comfort in the fact that he did not consciously suffer, that he had excellent in-hospital care, and appropriate resuscitation measures were taken, then stopped when futile. The doctor on call was compassionate and had excellent interpersonal as well as technical skills, and my father did not die alone but surrounded by truly compassionate professional caregivers, if not family.
February 15, 2010 was Family Day in Canada, a rather new holiday, but one which we all spent with my father in his hospital room. He was in good spirits and very much enjoyed seeing us all together, especially his 10 year old grandson, my nephew, whom he helped raise, and with whom he shares a middle name, Paul.
Saint Paul is the patron saint of the parish my father attended faithfully in the last few years. He took great spiritual strength and comfort from returning to regular mass attendance, now one of the senior members of this new congregation, when once he was the altar boy for the old cathedral dedicated to Saint Mary which was across the street from his childhood home.
He died in a hospital founded by the nursing sisters of Saint Joseph--in the newest wing, across the street from where he was born in the same hospital’s historic maternity home, literally an old mansion. It was the hospital where he always felt safest and best cared for. After he died, a priest came to his bedside to pray for him, something he would have wanted.
In keeping with his own Catholic faith, and good character, I am confident he now walks with God, in the company of his grandparents, parents, brother, and extended family, protected by all these Saints, while we who loved him so dearly protect his memory and his legacy on earth--the one thing he cared about most of all, his family.
My Dad and I shared a love of athletics, travel, international cuisines, and classical music. We were once opera buddies, and concert and ballet buddies. He was knowledgeable without being pedantic, and preferred Tchaikovsky for a stirring musical experience. We were hoping for another trip to Italy together.
My father was always proud of his family’s accomplishments, and spent a career putting other people through university: his older brother, my mother, and my sister and I, for more degrees than he initially planned. At one point he had 3 of us in university, in graduate or professional schools: my sister in the Faculty of Education, her then husband in the Faculty of Engineering, and me in the Faculty of Medicine.
He never complained, though he did once say in frustration “I want to retire eventually!”, then caught himself and asked if I needed money for books and instruments. He was also the man behind the camera for the graduation pictures, the chauffeur, the mover, the builder, and the one who bravely let his daughter travel on scholarship to a variety of “scary places”--at least ones scary according to the news. At the nadir of my medical school experience he was the rock I leaned on. Unaccustomed to this being necessary, he still stepped up and was my support and strength as long as I needed it.
He was often the man behind the women, and a feminist before it was popular. He always encouraged us to excel at our chosen professions, to behave with integrity, and to remain lady-like while doing so. Although he was an outstanding athlete, and I had glimpses growing up of what an excellent father he would have been to sons, he never once gave any impression of having wished for sons over daughters, or being dissatisfied with his girls.
The last 10 years have been filled with the joy of a grandson who has lived with my father, mother, and sister since birth. A traditional father, in that he was the breadwinner, and the “outside man” when it came to household chores, my father was also good at helping out in the kitchen and with cleaning, as he was raised by a working mother. However, his willingness and availability to take on baby care only came with grand-fatherhood. It was both surprising and hilarious to have him arrive home from a coffee with his buddies, with all sorts of grandfatherly advice on diaper rash solutions--less surprising and hilarious than watching him change a diaper though.
My nephew shares his left-handedness, athleticism, height, and good-nature. When he skates it is like watching a boyhood version of my father. When he jumps to fix something in the house, or help out with something, it is always as the young boy modeling himself on my father. He now says often, “Now I’m the only boy”, and worried about who will clean the filters because, “I don’t know how to do that; well I watched grandpa, but I am not sure”. He volunteered that he can do the barbecuing, and accompanied us to the grocery store, remembering to get buns because Grandpa was the one who always did that.
My father took pride in a job well done, was meticulous, and was rigorous about safety. My nephew does things like use a saw for a school project exactly the way my father taught him--carefully, safely, and precisely. The tool room was their room, and now will be his. The same is true of the garden shed and the garage, male domains they shared in taking care of the family home.
It saddens me that my nephew will go through adolescence and adulthood without my father’s wise counsel, but heartens me that at least statistically he is above the age range for the type of “early loss” that is a more profound psychological negative. It also encourages me that he will have so many good memories and such positive modeling from my father on how to be an excellent man, professional, citizen, friend, and most of all, a family man. Then again, we are all, regardless of age, feeling this loss acutely, and each in our own way.
Though I have complained, and made jokes, about being the GP, ER doc, family shrink, nurse, night nurse, nurse’s aid, and chief cook and bottle washer for my Dad during the month I was home with him before he went to hospital, it has been an honour and a privilege to have him allow me to do so. He has always been far too independent before, so that even needed medical advice had to be given covertly--a word to sister or mother, or a surreptitious comment to a nurse or a doctor when he was in hospital previously.
I am glad that I was able to rearrange my life to stay on past the holidays, and to be with him and the rest of my family. I am proud that he turned to me for care when he fell and could not get up, had a major nosebleed and had to go to hospital, fell again and split his forehead open, went through follow-up visits to the ER and his GP, and then admission to hospital and a 1 month stay. I was able to visit almost daily, by car with my mom, or solo on the train. This gave us now even more precious time together.
I regret that he placed such great faith in a GP who seems to have decided that he was not worth more effort, and allowed his medical status to decline, particularly in the last 6-8 months, when simple measures would have greatly improved his health and well-being (iron pills, a consultation, decreasing his Coumadin dose, adequate pain relief for his arthritis, adequate medication for Parkinson’s), and prevented complications that further strained his system, and resulted in further cardiac damage.
In contrast, the professionals at his “home hospital”, who met him for the first time, were more actively concerned, more encouraging, and did a splendid job of recognizing that he had many easily treated conditions. They unfailingly believed he was worth the time, effort, and taxpayers’ expense. They were compassionate without being condescending.
The male nurse who saved him one night with hours of fearless cardiac care, unintimidated by blood results and monitored numbers, a mechanical mitral valve, profuse GI bleeding, or a newbie intern, took great pride in his accomplishment, joy in a social visit when my father came back to the ward from the ICU, and seemed to know and appreciate him as a person, and his family as well. More so than the GP of decades.
I am trying hard to forget her cavalier attitude in allowing his hemoglobin to drop from a normal 120 to below 100, below 90, below 80 which made him weak, unable to eat, and despondent; or his INR to rise from a normal 2.5 to 4.5, 6.0, 9.0, without telling him to go immediately to hospital (at 4.5-6.0) until he started bleeding to death at 12. I half-wish I didn’t know about her direct advice NOT to get a transfusion when his hemoglobin was 67 (transfuse at 70-75), or her failure to call at all when he had a hemoglobin of 69; and wish I hadn’t heard her say later to my mother, “Well they would only give him one unit anyway” (actually 3 that time; and more later).
I am sorry he yelled at me every time I mentioned her name, but happy I backed off enough so that he died thinking she did genuinely care about him and had helped him professionally. He believed she had saved him by re-starting medication he had been started on in hospital, and needed, but was discharged without (due to bureaucracy) in 2005; and I didn’t tell him how much work I did to make sure he got it, including letting the GP’s nurse insult me for identifying myself as “his daughter, and a doctor” in an effort to make sure my concern was taken seriously (no one had called back for the previous 2 "daughter" messages). He believed the same nurse cared enough to get him an emergency appointment this past December 22 with the on call doctor, and didn’t know that she only did so after my sister called her again when she failed to answer a message, and bullied her into it.
The day he fell asleep and died, he was in a lot of abdominal pain, during the afternoon, and early evening, but had a visit with my mother and myself, asked about my nephew, and then had a brief phone conversation with my sister, and another one with me later on. His last words to me at 8:38pm were “I feel terrible… stop calling, you are waking up the whole…city”. Not profound, but then he was in pain, thought he would see me the next afternoon, and was concerned about others in his semi-private room. His words were also typical him--to the point, straight shooter, and conscious of others. He later received adequate pain medication and fell asleep with relative ease.
When the doctor called at 2am to tell us about the first cardiac arrest, I am glad I took the phone call, and helped prepare the others, then stayed on the phone until the doctor said, “If it were my dad, I would come to hospital”. We woke my nephew who began to cry; somehow he knew, even though we at first only said, “Grandpa is very sick”, and then my sister insisted that he had to come and “Say goodbye”. We arrived 10 minutes after he died, but he had not been conscious.
Perhaps it was best, though sad, to see him lying as if asleep, and to say our final words to his spirit. I stroked his hand and his brow, and even forgot about the now healed place where I had repaired the gash with steri-strips. His brow, though wrinkled, was at peace, and his lovely grey hair soft. Odd to stroke one’s father as one does a child, yet comforting.
The lilacs are in honour of the ones he planted: first as a young and vigorous newlywed, in the garden of my parents' first house, the one he built by hand, including mixing and pouring the concrete foundation, because my mother loved lilacs; the next were planted, through the hard and heavy clay, when he was weakened by arthritis and Parkinson’s, in their final home and garden, because he still loved my mother so very much.
He too was, and is, much loved, and will be forever missed.
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