He and I spent days poring over questions like “If I am unconscious, in a coma or in a persistent vegetative state and there is little or no chance of recovery ... I would [want/not want] to have life-sustaining treatments.” That one was easy for both of us.
But other questions were more perplexing: Would he want to have regular life-sustaining treatments like, say, dialysis if he were mentally competent but unable to communicate? It would depend. Many of the questions remained in the limbo of “it would depend.”
He was excited about dying. He talked about it constantly. He formally enlisted an old friend to be his “advance-care agent” and put her on his list of emergency contacts. In the end, though, he didn’t need her services.
He was hospitalized four times in his last month of his life. His lungs kept filling with fluid, making it hard for him to breathe. He wasn’t expected to survive the third hospitalization, so I flew out to have a chance to see him before he died. When I arrived, at midnight, he was awake and pleased to see me. “I pulled my plug!” he announced excitedly, holding up his arm, with its new DNR wristband, in an air punch of victory. But after he had signed the DNR, he allowed doctors to remove fluid from his chest once again—which revived him.
I spent five days at his bedside, during which time he told me that he had had a wonderful marriage, and a wonderful life. This seemed like good news, since he had been depressed during much of the past year.
One day he greeted me by telling me cheerfully, “I’m wearing women’s pants!” (They weren’t really women’s pants, but sweatpants with an elastic waistband, a style he identified with my mother.)
When his nurse asked him how he was, he told her, “I’m a loser. I’m an engineer, and my whole career I’ve been fighting the natural forces that eventually destroy all things: wind, fire, water, air, heat, cold. And now I’m fighting disease, and I’m losing.”
When Other called him and asked him how he was, my father said delightedly, “I’m wearing diapers!”
Everything about the process of leaving the living world fascinated him—and made him seem more alive than ever. It was as though he had been bored by the tedium and stress of a life that had devolved into paying bills and preparing his taxes. But dying—now that was interesting!
Shortly after he was discharged and I left him to fly home, he was hospitalized again. This time he was resolute. He demanded to be sent home. “I can’t live like this,” he told me on the phone. By the time my brother and sister-in-law arrived, he had yanked out his chest drain. They took him home to the apartment he shared with my mother and their home aide, and within 24 hours he was gone.
Before he died, he underwent a process called “terminal agitation,” thrashing and trying to throw himself out of the hospital bed that the hospice service had set up in the living room. It took all my brother’s strength to subdue him. At one point, my brother and sister-in-law called me and asked me to try to talk to him on the phone to see if I could calm him down. “Dad,” I said. “Everything is o.k. You don’t need to worry about anything. The bills are paid, and we’ll take care of Mom.” Those were the last words I spoke to him.
They tell me that he seemed calmer after that. He continued to mutter unintelligibly, occasionally breaking into coherence. He told my sister-in-law, “You have given me a great gift” (apparently alluding to her help in arranging for him to die at home rather than in the hospital). He shouted out at one point: “I’m going … to Death!” And at 8 in the morning, he uttered his old familiar catchphrase, “Take care, and have fun!”
I struggle to remember anything from my childhood about my father. But images of his old age and dying are vivid—and infinitely touching.