He must have sensed my discomfort. “I know you have issues with the Church,” he said.
“Yeah, I do,” I said. “But I haven’t given up on it just yet.
I’m not done trying to figure it out.” And that much was true: I hadn’t, and I wasn’t.
“That’s all I can ask,” he said.
Lunch arrived, and I pulled up his mask and fed him his soup and yogurt one spoonful at a time.
That evening Michael and I arrived for the 8:30 visit and again we found Dad breathing comfortably through the lighter mask.
I was figuring out that the nurses switched masks when they knew family members were expected so he could talk and be heard more easily. After we left, they would switch back to the heavy ventilator mask. All the ICU nurses were caring, but one, a woman about my age named Michelle, was particularly kind and was Dad’s favorite. She seemed sincerely fond of him and always had a cheerful word. Michelle routinely let us stay past visiting
T H E L O N G E S T T R I P H O M E • 3 0 3
hours and sometimes slipped us sodas and snacks. It was just like her to think to switch masks so her patient could have more meaningful time with his children.
Dad had good color in his face and was relaxed and resting comfortably. Michael and I had a pleasant visit with him. We told him more about our trip to Lourdes and the suite it had on standby. We gave him the daily update on Mom, assuring him she missed him but otherwise was doing fine.
The ICU staff had begun timing meal deliveries to our visits because Dad was too weak to feed himself, and they were too busy to do it for him. Another bowl of pureed soup—one of the few things he could swallow with his swollen mouth—arrived and I again fed it to him by the spoonful, just as I did with my children before they were old enough to feed themselves.
“I’m helpless as a baby,” Dad apologized between bites.
“You’ve been through the wringer,” I said. “Now open up; here comes another bite.”
On the drive home that night, I told Michael I had made a decision. I would fly home that Thursday and return three days later, the day after Christmas. “Dad’s holding his own,” I said.
“He’s eating well. He’s breathing comfortably, even on the lighter mask. I can’t imagine anything changing too dramatically in the next few days.”
“It should be pretty much status quo through the holiday, I’d think,” Michael agreed.
“I’ll dash home for Christmas and be back the next day.”
That was the plan.
Chapter 34
o
Iawoke early the next morning and booked a flight home for Christmas, then called Jenny.
“Are you sure you should be leaving?” she asked.
I assured her my father was stable and in for the long haul.
“Last night he actually looked the best he has all week,” I said.
“Whichever way this goes, it’s going to be a long, slow process.”
I showered, ate a bowl of cereal, and headed to the hospital for my regular ten-to-noon shift. When I arrived, I knew right away something was wrong. The door to Dad’s room was wide open, a crash cart in the doorway. Michelle intercepted me in the hallway, her face drawn and white. “I’m so glad you’re here.
Your dad’s had a very rough morning,” she said. “Twice his blood oxygen crashed. We had the respiratory team in here. They really had to work on him to get him out of danger. It was touch and go.” The goal was to keep his blood oxygen saturation as close to 100 percent as possible. All week it had been hovering in the 90s, which was good. At an oxygen saturation level of 86 percent, alarms are triggered. On this morning, the alarms rang at
T H E L O N G E S T T R I P H O M E • 3 0 5
8 A.M. and again ninety minutes later, and both times the levels plunged, bottoming out below 70 percent even as he gasped 40
breaths per minute. Blood oxygen levels that low for more than a few minutes could result in stroke or damage to his brain and other vital organs, Michelle said.
“He’s resting now,” she said, “but this is a threshold day for your family.” I remember thinking how odd a word choice that was, threshold. It was as if she knew our family would soon be stepping through a doorway, crossing from one chapter of life into another, never to return again. “We need clear direction on what you want us to do,” she said. “If it happens again—and it will, it’s just a matter of when—we’ll need to intubate him and put him on a ventilator.” She hesitated. “If that’s what the family wants.”
She didn’t have to tell me the ramifications of being ventilated, or what the alternative meant. I looked through the doorway at Dad. The big suction mask was again clamped over his face, pushing his head back into the pillow with each forced breath.
His mouth was agape, struggling to accept each gust. His eyes were shut, his body still. There was now even more equipment surrounding him.
The respiratory therapist who had worked on him joined us.
“If we intubate him, he likely will never come off,” she said. “At this stage, it’s nearly impossible to wean them off the vent again.
You need to know that. I’ve been doing this for sixteen years, and I haven’t seen anyone in your father’s condition come off it yet.”
“I see,” I said. But I didn’t see at all. The words were pinging off the inside of my skull like pinballs. I felt blindsided by the surprise attack of information. I had arrived planning to tell him about the flight I had just booked; he was going to assure me he’d be fine until I returned. That was how our visit was supposed to go. Now all I could think was that I would not be able to feed him his lunch.
“Dr. Bober’s expecting your call,” Michelle said and she led me to the nurses’ station and dialed. The doctor confirmed every-
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thing the others had just told me. The pneumonia was winning; Dad’s lungs were shutting down. A ventilator would breathe in-definitely for him, but that was not a blessing. He could linger for months as the leukemia slowly ravaged him.
“Nature’s trying to take its course,” she said. “Pneumonia is sometimes known as ‘the merciful death’ because it takes terminal patients quickly.” The doctor knew my father’s wishes as well as I did. He had made it clear he wanted to fight with everything he had as long as any chance of meaningful recovery remained.
But if not, he wanted no heroic measures to keep him alive. In his religious paradigm, that would be defying God’s will.
“I think today is your dad’s day,” the doctor said in a voice that was so gentle and so kind I nearly began to cry. “Call your brothers and sister. I’ll meet you all there in an hour, okay?”
I did as I was told, then walked into Dad’s room and stood at his side. He appeared to be unconscious. The whir of the machine filled the room. I could see his breath fog the mask as he exhaled and disappear as another massive gust of oxygen pushed in. Michelle came in and said, “He’s been through a lot this morning.
He’s exhausted.” She shook his shoulder vigorously and spoke in a loud voice: “Mr. Grogan, can you hear me? Mr. Grogan, wake up. Do you need anything? Mr. Grogan, your son is here.”
Gradually Dad returned from his deep sleep. I touched his arm and put my lips close to his ear. “Dad, it’s John,” I said. “I’m here. I’m right here.” He didn’t open his eyes but nodded his head up and down in small, quick movements. He began to move his mouth inside the mask and was trying to lift his head and claw his hand out from beneath the blanket.
“Do you need something, Mr. Grogan?” Michelle asked in a loud voice. “Are you thirsty?” He shook his head no. “Are your lips dry?” No. “Is the mask too tight?” No. “Are you too warm?”
Finally: “Are you trying to say something?” My father’s head nodded vigorously in the affirmative, his eyes still closed. She unstrapped the mask and pulled it aside.
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“What is it,
Dad?” I asked.
“Are the kids all here?” he asked.
“It’s John, Dad. The others will be here in a few minutes.”
He lay there for a moment as if summoning from deep within the strength to speak. His eyes fluttered open momentarily, and he said, “I’m tired.” And then, each word coming out like its own sentence: “I. Don’t. Want. To. Fight. This. Anymore.”
I looked at Michelle. She nodded her head that it was okay, and I looked back at my father.
“You don’t need to fight anymore, Dad,” I said. “You gave it everything you had. You can stop. You can just relax now.” I told him what Dr. Bober had told me, that she could make sure he did not suffer. “You’ve been so brave, Dad,” I said. “So brave. You can let go now.”
Michelle replaced his mask, and he drifted back into his deep retreat. I waited in the hallway until Marijo, Tim, and Michael arrived. Their eyes were red, and I could tell they had been crying in the car on the way over. “There’s something you all need to hear,” I said and called Michelle over. “We took the mask off Dad and he said a few words. Michelle, I just want to make sure you heard what I heard.”
“He said he was tired and didn’t want to fight anymore,” she said. I was so grateful for her testimony. I did not want his last words, his final wish, to rest on my shoulders alone. “Those were his words,” she repeated, “ ‘I don’t want to fight this anymore.’ ”
By the time Dr. Bober arrived we were all in agreement that there would be no more medical intervention. Dad was ready; we had to be, too. In the ICU lounge, the doctor walked us through how the day would go. A palliative care team would take over from here, she said, and would administer adequate morphine and muscle relaxants to override his breathing impulse and elim-inate any gasping reflex as his blood oxygen levels dropped. “His lungs are so compromised,” the doctor said, “I don’t think it will take very long.”
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The four of us had agreed that Mom would want to say good-bye to her husband, but when we told Dr. Bober we planned to bring her up to his bedside for a few minutes, she looked appalled. “Don’t do that to your mother,” she pleaded. “Please, don’t.
She won’t be able to process all this. It will only traumatize her.
Let her remember him the way he was.” It was the best advice anyone could have given.
Dr. Bober said she wanted to say good-bye to the man who had been her patient and friend for twenty years. When she came out of his room a few minutes later, she was crying.
A few minutes later, a woman arrived and introduced herself as Peg Nelson. She was a nurse practitioner on the palliative care team and would be managing Dad’s last hours. I instantly liked her. She was matter-of-fact without seeming blasé, sympathetic without being maudlin. She gave us a reasoned and full explanation of what the next few hours would hold. When we were ready, she would inject Dad with the morphine and muscle relaxant, then remove his breathing mask. “He will deeply relax and slip into unconsciousness and not feel any discomfort.”
Like Dr. Bober, she said, “It should come very quickly.”
Awkwardly, we asked about the logistics of death: When should we say our good-byes? Would he be able to hear us? She said we should say what we wanted him to hear before the injections, and that he would still be semiaware for several minutes after.
I asked when all of this was going to happen. Part of me hoped she would say we could come back tomorrow. “We can start anytime,” she said. “You should eat something first. Why don’t we meet back here in an hour, after you’ve had a chance to get some lunch.” An hour. My siblings and I looked at each other. The moment was slowly sinking in. We were scheduling our father’s death like we might schedule a dentist appointment. Two-thirty would work. Right after we’d had time to grab a bite to eat.
“My God,” Marijo said and placed a hand over her mouth.
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In the cafeteria, we picked at our food. I managed to choke down half a turkey sandwich. I knew without doubt that we were making the right decision, the decision Dad wanted, the one that Dr. Bober assured us was inevitable. He would finally be free from the pain and exhaustion and debilitation of fighting this losing battle. It was the right thing. Why then did it not feel that way?
After lunch, we stopped in the hospital chapel, and I knelt in front of the miniature altar and tried to pray. “Please take him quickly,” I whispered into my hands. “Without trauma or pain.
Don’t let him be afraid. Let him go without doubting his beliefs.”
I took comfort in his certainty that eternal salvation awaited him on the other side, and that his beloved wife would join him in heaven soon enough. Before I stood up, I whispered, “Help me live my life half as well as he has lived his.”
I found Tim and Mike sitting on a bench just outside the chapel. Marijo was still inside, deep in her own moment of contemplation. “I’m going to go up and sit with Dad,” I said. “See you up there in a few minutes.”
In his room, I found him as we had left him, eyes closed, body still, the whir of the breathing machine filling the air. I rested one hand on his shoulder and the other on his wrist beneath the blanket. “Dad, it’s John,” I said, and he opened his eyes. I could see he was alert and aware, though terribly weak. He began to mumble something beneath the mask, his words lost in the whirlwind of oxygen. I hushed him.
“Dad,” I said, my voice quaking, “Jesus is going to take you home today. In just a little while, he’s going to take you.” Dad’s eyes were closed again. He moved his head up and down in short, jerky motions, and I knew he understood. Whatever I had to say, now was the time. I drew in a breath.
“Dad, you know how much I love you. I love you so much.” He began urgently working his mouth inside the mask, desperately trying to communicate something. “Don’t try to talk. It’s okay. I
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know. I know you love me, too. I know that. I know you’d say it if you could. You love me.” His head jerked up and down. “And I know you’re proud of me, Dad. I never doubted that. Don’t think I ever did.” More little head jerks. I told him not to worry about Mother; we’d take good care of her. I repeated the words he had said to me a few days earlier: “Mom’s going to be okay.” More nods.
From earlier conversations, I knew he worried that the family might crumble after he and my mother were gone, that without their glue, the four of us kids would drift apart. I assured him we would not. “We’re going to look out for each other, Dad. We’ll keep the family together.”
There was one more thing I wanted to tell him, something I had been rehearsing for the past several days even as I denied that the time was near to say them. “Dad, can you hear me?” I asked, my lips close to his ear. He nodded. I paused to steady my voice. “Dad, it has been an honor to be your son. I am so honored and so proud.” I swallowed hard, fighting to maintain composure.
“An honor.”
I glanced over my shoulder, and there was Tim in the doorway. “Okay, Dad,” I whispered. “Tim’s here now.” I ran my palm once over his sandpapery stubble, just as I liked to do when I was a little boy sitting in his lap. As then, I found the touch of it oddly soothing, at once rough and warm. One more time I told him I loved him, then kissed his temple and walked out of the room.
Chapter 35
o
When the others had each had their private good-
byes with him, we gathered in the hallway and
told Peg we were ready. The one thing we knew
Dad would want was a priest to give him final absolution. Not that any of us thought he needed it. “If this man’s not getting into heaven,” Tim said, only half joking, “then no one is.” Michael earlier had called Father Vin to ask if he would drive to the hospital from his home, more than an hour away. We thought it fitting that the priest who had married our parents and baptized all their children be there to see
the first of them off, but a blizzard was threatening to sweep in off the Great Lakes, and our uncle was afraid to be caught on the interstate. We couldn’t blame him.
He, too, was an old man now. Michelle said she would track down the hospital chaplain.
In the room, we surrounded the bed, Marijo and I on Dad’s right, Tim and Mike on his left. We each laid claim to a part of our father, a forearm or knee or shoulder, and placed our hands on
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him. Four children, eight hands. “We’re all here, Daddy,” Marijo said.
Peg was standing by with two syringes. “Are we ready?” she asked in that gentle, calm way of hers. We nodded, and she gave the injections. Almost instantly we could feel his limbs going slack beneath our hands. “We’re going to let him relax for a few minutes,” she said and looked at the clock. It was 2:50 P.M.
At just before 3:00, Peg removed the mask and flicked off the respirator. Without the rattling whir of the machine, the room went suddenly silent. It felt nearly serene. The four of us, and Peg and Michelle, too, kept our eyes fixed on the monitor that read Dad’s blood oxygen levels. They were at 96 percent when the mask came off and began slipping almost immediately: 93 . . . 89
. . . 74. As Peg had promised, our father showed no sign of discomfort or anxiety. “We love you, Dad,” the four of us said in unison.
The chaplain, a priest from Nigeria, arrived and in a clear, lilting voice administered the Last Rites, my father’s second time receiving the sacrament in as many weeks. The priest dabbed sacred oil on my father’s forehead and palms, using his thumb to smear it in the sign of a cross. “May the Lord who frees you from sin save you and raise you up,” he prayed aloud. Then, with brief condolences to us, he was gone. Marijo suggested that Dad would find comfort in hearing us say a decade of the rosary: one Our Father and ten Hail Marys followed by a short prayer I grew up knowing only as the Glory Be to the Father. None of us had a rosary, and we used our fingers to count off each Hail Mary. With my sister and Michael leading the way, Tim and I this time were able to keep up without stumbling.