I’m sitting in one of the most uncomfortable chairs ever made by mankind. Hospital furniture is unforgiving at best and hell on spines, backs, arms, legs, every possible bone in the body that comes in contact with them.
“It is a dark and stormy night,…” actually it is. There’s a tornado watch out for our area until 3a and it’s only 1148p. The big stuff has already rolled through with just some lingering showers still remaining in the line, at least what I see on the radar on my phone.
Room 624 is a rather noisy place. About 3 feet to my left is my wife, trying but failing at sleeping on a roll-away bed and her mother is next to her in another. The nurses up here brought them in here last night when they stayed in here to keep an eye on the room’s patient.
6 feet in front of me lies my father-in-law, all of 73 years young. He’s got a PICC line in his left arm. Hooked up to that is a maintenance line of .9NS, a PCA pump with morphine running TKO @ 2mg / hr and 1 mg boluses q 10 min. He’s on 15 lpm via a partial non-rebreather mask and hooked up to an oxygen “oximiser” which is basically a high pressure / high flow humidified oxygen device. He’s got that hooked to a nasal cannula at 30 lpm. The noise of the high flow oxygen is almost deafening but it’s doing its job.
Pulmonary fibrosis is sapping the life out of Bill, my father-in-law; one of the best men I’ve ever known, ever will know, and an all around fantastic father, papaw, and man. Hard working, educated, sentimental, sensitive, no bullshit kinda guy he is; always has been and still is today. Even with all this he still has a wicked sense of humor.
He was diagnosed with PF about 8 months ago and began using oxygen at home PRN. Then it went to constant use @ 2 lpm, then 4, then 6. A week ago he developed pneumonia which sapped things quicker. The docs told us he had 3 – 6 months to live. After the pneumonia kicked in and really began whipping his ass the docs told us it was down to a couple weeks, if that. The digression in status continued rather quickly from there and still does.
But what this is about, other than the background history, is what I’ve seen, what we’ve seen in the last two days. I can’t explain it, it defies logic, it’s almost miraculous. I don’t think dad will ever go home from here and twice in the last two days I, we thought it was the end. He’s still here and let me tell you about it.
Dad’s a recovering alcoholic and scotch was his drink of choice. Hasn’t had the stuff in a decade since he’d stopped. Went to AA and treatment and got dry. Best move he ever made. He’s slowly been making requests for things and getting affairs tidied up since he accepted the end is near. Three days ago he said he’d like to have a shot of Johnnie Walker, the “best stuff they make.” He’d never had it and I knew it was JW Blue. I’d seen it in duty free shops all around the world. Damned expensive so I never bought any.
I called around to at least 14 area liquor stores and none had it. Went to another half dozen and the same. So I went to work yesterday morning and made a couple calls to find a bottle somewhere, anywhere, regardless of cost. He was worth it and I’d travel if I had to. He’d paid his dues and it was his wish to have that one last luxury of life and I was making damned sure he got it. I made the call to the fourth place in Indianapolis and I asked the clerk if he had a bottle of it. “I have one bottle and that’s it.” My eyes lit up and my hands grabbed for a pen to write down directions. I told the man to guard it with his life, pull it off the shelf, hide it somewhere that nobody else could see it; this was the last request of a dying man who so richly deserved this taste of excellence.
I left work and hurried down the road to get it. It was only 10a and the clerk seemed more happy than I was to sell it to me since I told him what it was for. I paid for it, snuggled it safely in the crook of my arm like a newborn baby, smiled from ear to ear, and hurried to my truck to deliver the fantastic present.
Throughout the day Bill had been declining in status. Sats were in the low to mid 70s, pulse in the 110 – 120 range, doing a lot of belly breathing and moaning, and had us all wondering how long he could work so hard to get his next breath.
I left that afternoon to go pick up our kids to bring them to see papaw. I went to the barn to do some work and forgot my cell phone in the kitchen. #2 went to the house and came running back to the barn carrying my phone. “Daddy, someone’s been calling you. Your phone’s been going crazy!” I saw 12 missed calls, 9 text messages, and 7 voice mails in the last 15 minutes. My wife was frantic, telling me he was about gone, taking his last breaths, and he was asking where I was, that he wanted to see me, “my son,” and his wife. I grabbed the kids and rushed to the hospital in my truck.
I was met by a friend of my wife who’s also a nurse. She met me at the elevator with tears streaming down both cheeks, the corners of her mouth turned downward in a sad frown, and she said, “The end’s almost here. Hurry up and get in there.” I left our kids with her and walked inside. The minister was there as was Bill’s wife, me, my wife, my sister-in-law, and Bill’s brother-in-law. We said a nice prayer, all told him we loved him and that everything would be all right. We were all teary eyed and some crying, knowing the end was in sight. “It’s all right to go. Everything will be fine. Don’t worry about mom, we’ll take care of her. We’ve got everything under control so there’s no need to worry. Rest and relax and go if you want. We love you, we all love you.”
I looked around and said, “I think it’s time we do this before it’s too late.” I walked to the other side of the room to the closet where I’d hidden my smuggled bottle of Johnnie Walker Blue Label and put it on the counter. I pulled out a couple shot glasses I grabbed form home and poured 4 shots out. I gave one a shot glass to Bill, one daughter, his brother-in-law, and one for me. We made a toast to family and love and downed our shot. Damn, that was some smooth stuff; worth every penny. I’m not a scotch drinker but that stuff was wonderful! Dad's response? "Man! That's goooooood" with a wide smile and twinkling eyes.
Now for the good part.
In about 30 – 45 minutes after that shot Bill was talking normally. Even though he was still wearing a non-rebreather he wasn’t gasping for air. His pulse dropped to below 100. His sats climbed in to the mid 90s. He was visibly relaxed and breathing wonderfully. I grabbed the ears off of the RT and he was clear. No wheezes, no congestion / rales / crackles, nothing. We were talking like normal. We began talking about family, old times, work, making jokes and laughing; it was comical. We had gone from doom and gloom to laughing and cracking up. The scene reminded me of the movie “Awakenings” when the patients “come back to life” from their frozen Parkinsonian states. It was a miracle! It was neat as hell. It was something that I couldn’t explain. This 180 degree turnaround could only be attributed to a shot of scotch! For the next 4 hours it was like this. Simply fantastic; unexplainable but fantastic. Wow! Even the minister commented that he “now believed in the power of Johnnie Walker Blue Label.” We all cracked up on that one, even dad.
After about 4 hours things began going south again. I likened it to patients I’ve had before who had a fantastic turnaround for a short time before the end crash. Seen it happen before and I thought this was that too.
Through the night things steadily got worse. During the next day things continued downhill to the point of putting on the high pressure oxygen and adding a PCA pump. He was working hard, harder than before. Coughing came more frequent with blood tinged sputum. He was tired. He said he was and we all knew it. It couldn’t be much longer.
I went home to get our kids again and bring them up. When I got here I was met by my brother-in-law who brought in Bill’s other two grandkids. We all went up to the room and the boo hoos began again. It was a repeat but worse of yesterday afternoon. We all said a big prayer and were hugging, crying, and saying our “goodbyes” all over again. I looked at my brother-in-law who knew the story of the day before’s events and said, “Let’s do another round and call it ‘the Final Shot Round 2.’ “ He smiled and agreed. All of the immediate close family was present. All the grandkids and relatives who were close and tight knit gathered around the bed. I poured 7 shots, enough for every adult present. We said another toast as I asked dad to offer it. He passed that honor to me. “Family” was all I could muster out between sobs and caught breaths. Dad finished it with “love and togetherness always.” We all clinked our shot glasses and plastic cups and downed our Blue Label again.
And it happened again. In about 30 minutes the breathing eased, the sats skyrocketed to 98, 99, 100%, the coughing ceased. The speaking was easy but slightly labored. But the conversation came again. The jokes, the stories, the laughs, anything and everything. Twice in two days. Another day, another brief miracle of a couple hours to spend with this fantastic man just talking and living as normal, even if we were in a hospital room. The kids were eating popsicles courtesy of a floor tech, we sat and talked and joked as the kids played. Dad even removed his NRB so he could talk easier and hear better as we all talked, seemingly at once. It was fantastic. The emotional roller coaster had made another stop in his room yet again.
So now it’s after midnight and he’s lying on his right side, moaning with each breath. The belly breathing has resumed again, the PCA pump still running in its medication. The RT just gave him a nebulizer treatment, shortly before his nurse gave him some haldol to relax him so he could sleep a little. He’s struggling for each breath. I know he’s worn out and tired. He’s worked harder in the last couple months than he has all of his life. This damned disease is sucking the life out of Bill, the man who has to be the best father-in-law a person could ever ask for. A friend, a mentor, a papaw, a gentleman, protector, and just all around fantastic person to everyone he met.
But we all got to see not one but two huge rallies. Unexplainable by any means. I’ve seen it once but never expected twice. I still can’t figure it out and I don’t want to try. I just want to remember these two “awakenings” as they happened. The love, laughter, conversation we all had for those 3 or 4 hour windows was truly fantastic. I still shake my head and smile about it.
We’ll try it again later today if we get the chance. If not I’ve already decided to take the rest of the bottle and do a toast graveside with all of us who witnessed those rallies. It’ll be a fitting tribute to this man, this terrific man, father, and friend to us all. The bottle will go with him, one way or another. It’s his bottle, not mine.
But for now life is again quickly fading away in room 624. I’ll miss you Bill, dad, pal. At least not just me but everyone got to smile and talk with you these last two afternoons like nothing was wrong. It was terrific. It was fantastic. It was a miracle that happened not once but twice. I know the end is near but those extra precious moments we had were just, how to say it and give it justice, were awesome. I’ll always smile when I think about it.
My eyes are welling up as I finish this as he struggles 6 feet from me to breathe. But I’m also smiling knowing what I know, seeing what we all saw, and enjoying those last moments. Take a break. You’ve earned it. You deserve it. Rest and relax. I’ll miss you dad, thank you for everything. I love you.
Love,
Your son-in-law
Simply... beautiful.
ReplyDeleteCondolences to you and the entire family.