|Death in the Family.
||[Aug. 1st, 2006|06:00 am]
Early Monday morning, I received a phone call from my aunt.
She asked me, voice slightly cracking, to wake my mother, and she asked me to come with her to the hospital.
My aunt briefly explained that she had called 911 for an ambulance to rush my grandfather to the hospital.
I told her that we'd be there as soon as possible. I went and gently woke my mother, letting her know that grandpa was back in the hospital. She took a few minutes to ready herself, and we drove to the hospital. It was approximately 3 AM.
I told my mom that I'd be right into the emergency room after I finished a smoke. She walked in ahead of me.
The next thing I hear and see is my mother, running out of the emergency doors, wailing, "Oh, no, he's deeead! He's dead, oh God, noooo . . . "
My grandfather, on July 31st, who was to turn 90 later this August, died of heart failure.
With emergencies, I'm alert, and I'm focused.
The little things, however, kill me.
As I'm holding my mother, I noticed two nurses on their smoke break, eyes wide, watching us. As we walked in, I was overcome by a wave of anger and contempt. Had they never seen a person's emotions over someone's death?
"STOP FUCKING STARING," I shouted at them, as I escorted my mother back through the doors.
We met my aunt. My mother and aunt, tears streaming, consoled themselves. We went to a room with chairs and a couch, and I stood outside as a doctor entered the room and told, in brief, that he died on arrival from the heart failure. More anger swelled in me, as I couldn't fathom at that point how it could have been his heart.
"So, you guys had him all summer, and nobody noticed that something was wrong with his heart?" I bellowed from behind the doctor, who was crouched in front of my mother and aunt.
He shifted to the side, and he turned his head to me. He offered some statement, but I gave him no quarter. "All summer, he spent in the hospital, and it's his heart." I could hear my mother plead for me to calm down, but I was incensed. Grandfather's death had not shaken me. The details, many of which I lacked, did.
The doctor, who turned around and stood to face me, offered another statement, but no chance was offered. "No. FUCK YOU."
About this time, a security guard showed up, reminding me of the emergency room and the need for quiet. "NO! I don't care! FUCK YOU." I brushed off his outstretched hand, doctor staring, mother and aunt staring, mother pleading, security guard standing his ground, making no further effort, and I swung myself around and made my way out to the emergency doors. Unspoken, I grew angry at the result of all the help that grandpa received, only to have not recovered. "This place is a DEATHTRAP," I shouted, and I exited the hospital.
Outside, the summer heat and humidity boiled, even in the late hours of the night.
I could not cease my anger.
You see, I expected my grandfather to make a full recovery.
Early in the summer, at the beginning of June, my grandfather began to have trouble with his urination. One afternoon, at his home, he became very weak. His hands shook, and he almost passed out. He managed to call my house, in a shaky voice, asking my mother and I come quickly to his house to take him to the hospital. We took him into this hospital's emergency room, where we waited for hours in a room as the skeleton crews that evening ran preliminary tests. He had a urinary infection so potent that the liquid in his catheter bag was blood red. The infection, we found out, had spread to his bloodstream. He didn't get a room until after midnight.
In the next days, doctors also noticed that he had developed a fungal infection in his throat, possibly from a steroid inhaler. My grandfather had mild emphysema, and he had some trouble breathing for these last few months. He had been taking the inhaler along with other medication. His general practitioner misdiagnosed him with bronchitis during the previous week.
He spent most of June in recovery from the infections. During this time, he began to have pronounced trouble with breathing.
The doctors were able to stabilize his condition, and he was sent home. He spent the next handful of days at home with help from my mother, aunt, and uncle, who stayed with him in turns, as they had done for him in the hospital. He continued to have problems with shortness of breath. One attack, rather severe, sent him in a panic. His heart raced, and he was rather weak, and he just could not breathe, and my aunt, who was there with him, called 911.
He spent the rest of that month and most of July in this hospital, and by this time, his body had weakened from spending so many days in bed. I'd estimate from the first hospital stay that grandpa was half of the strength he'd been before the infections. During the second stay, his strength shrunk to one-quarter. He was having trouble getting in and out of bed. A physical therapist got him on a minor regimen, if only to walk up and down the hospital's hallway.
Random attacks of shortness of breath provided multiple setbacks during these last two months. At one point, during his second stay, grandpa had an attack as severe as what landed him in the hospital the 2nd time, and they rushed him down to intensive care, where he stayed for a few days until they stabilized him enough to get back to the regular unit.
Grandpa tried his best, and he fought to stay above complete fatigue and indefinite hospitalization.
Despite his frailty, I did, however, notice that his mind and will were rather sharp despite the decline of his body. I believed that he'd make it through the 2nd hospitalization. He'd made it through countless hospital stays in the past.
With every moment I had with him over these last couple months, I told him that he looked like his health was improving. This wasn't false encouragement, you see, because he had many uneventful hours and sometimes days between his attacks. When I visited him, he tended to be in positive spirits, and he usually was doing well enough to elicit such encouragement.
I made the mistake of not questioning or rationalizing how the compound of his illness could put a terrible strain on his 89 year old heart. He did have high blood pressure. It wasn't until much later that I found out that grandpa, over the last days of his life, showed arrhythmia. His heart rhythm began to beat abnormally, and his heart would race with increased frequency, and the arrhythmia probably progressed into ventricular fibrillation.
What that means is, in his last days, his heart wasn't behaving too well, and with any breathing attack, any complication at all, it could cause him to suffer sudden cardiac arrest. The doctors had told his children that his condition was frail enough to where this could happen. In his last days, grandpa's heart became a time bomb that none of us, including my grandfather, really wanted to address.
The goal was to get him home, and that happened last Wednesday. He was in good spirits, but he was extremely weak, and he didn't talk much. I spent one day this weekend with him, and he didn't say more than a handful of words as I conversed with mom. Over this last weekend, grandpa's breathing problems flared. This kept him up each night into the late hours.
All I saw as I steamed outside by myself that night was a medical outfit that had kept him the entire summer, barely getting him stable, only to release him before he could regain enough of his strength.
Many times he had to wait for medication from perpetually short-staffed nurses. Doctors visited him infrequently at all hours. He was woken from sleep many times by the shuffling of patients, and he was shuffled from room to room. He had hundreds of different nurses, and there were many doctors. Because he had so many people on so many shifts for so long taking care of him, his charts and information progressed into the size of a major metropolitan phone book. At one point during his stay, he was scheduled for a colonoscopy, and the staff didn't prepare him correctly. They botched the colonoscopy, and the doctor, in a rush, didn't stick around to deliver the bad news. The nurses had to tell us that they screwed up and put my grandfather through a procedure, painful enough for him, for zero result. When he needed help in and out of bed, he'd wait for a while after paging someone before anyone attended him. On my last night in the hospital with him, he paged the nurses for help into bed. He waited for over a half hour before a nurse arrived. He claimed to me that this was par for the course.
As I sat outside, I viewed a big fancy building with a bunch of people who call themselves doctors and nurses who provided little help when help was needed. In sum, my grandfather's hospital care was mediocre.
Mom made numerous attempts outside to find me to plead with me to return. My mother needed me to be present. Many things were about to happen, including the visitation of the body. Somehow, I calmed myself down just enough to agree to re-enter the emergency ward.
Around this time, many things happened. Most were not pleasant.
My grandfather was Catholic, and he'd had Last Rites/Extreme Unction last fall, during a time when he'd had complications for a previous infection.
Last Rites is one of multiple sacraments, of which, in brief, are necessary blessings for Catholics on the way to salvation. Last Rites is kind of ambiguous at this point in the church's history. In earlier years, it could be performed before or after death, but most people with their first serious illness receive this sacrament. Once you receive it, it's generally considered as a covered base.
Yet, for death, it's still very common in Catholic practice to have a final blessing on the deceased from a priest.
The hospital had no Catholic priest on call. Apparently, 4 AM on a Monday morning isn't a popular time for religion.
Many churches, synagogues, mosques, and temples have a priest, rabbi, or someone of order who are available in an emergency through a pager. Many hospitals have someone of order who is stationed to serve the hospital.
A religious attendant on staff, a chaplain, tried calling his parish. My grandfather's parish is filled with ancient priests. Unfortunately, it was way past bedtime for all the old priests. It was not a surprise to realize that the church also had no one on call for the night hours.
The chaplain was not Catholic, so he was rather unfamiliar with the urge for this final blessing. In my opinion, this guy was a total failure. He had trouble with his speech, and he was not confident, and as a result, he didn't appear experienced, even competent, with his regular duties.
In the middle of this confusion, a nurse appeared. He needed to speak with the family, notably my mother, who was the head of this family, about documents and information regarding my grandfather's death.
My mother, unfortunately, who was tired from lack of sleep, had already expended much energy, and she wasn't fully prepared for him. He plodded through with the briefest offering of rather superficial sympathy, and he continued. At one point, he offered, which he assured was standard, information about The Gift of Life and the possibility of donation from my grandfather. My mother, still quite upset over grandpa's death, let alone any decisions to be made, thoroughly rejected. She would not accept the brochure packet from him, but he insisted that he leave it with someone, so my aunt took it from him.
The Gift of Life is a nice and worthwhile organization, but the nurse could have held off from his duty until a later moment when the confusion had settled. Noting his lack of giving a shit, I voiced my displeasure, interjecting a comment about a general lack of desire to use parts from an 89-year-old.
Around this point, another confusion brewed over whether my grandfather was to have an autopsy. He essentially died outside of the hospital, and the Wayne County medical examiner's decision was pending.
In the middle of all of this, my uncle appeared at some point. He made it to the hospital later than expected from the other side of town because of a major freeway shutdown stemming from a terrible accident.
We couldn't get a hold of a priest, but we had tried paging a second parish.
At some point, the decision was made to view my grandfather's body.
We had essentially held off on the viewing of the body until my uncle arrived. The chaplain escorted us down the hall of the ward to the room where they kept him. My mother, aunt, uncle, and I entered through the doors into his room.
My mother, in my arms, became rather upset at the sight of my grandfather's corpse on the table.
The staff ceased handling him after he was pronounced dead. This was to wait, as part of procedure, until the medical examiner made a decision, but we didn't know that to be the reason why they left him like they did. He lay there, on the table, with a tube in his mouth. A couple of blood stains were through a white sheet that was over him. His mouth was agape, and his eyes were partially open.
The chaplain made his own awkward attempt of consolation, and he was letting the situation get out of hand.
"You better get your shit together, pal," I ordered the chaplain.
The chaplain mustered some common prayers, and he offered up what he could from his text, and we said our goodbyes.
I knew and observed there was nothing left of him.
I suppose in cases where the body is grotesque, which was the case of one of my aunts, this situation can be infinitely more traumatic. I had done this once before with my grandmother, who was my grandfather's wife, back in the late 1990s, around the time I was 20. She died, like grandpa, en route to this hospital, also from massive heart failure. They laid her on a table just like the one grandpa had been laid. She had a tube in her mouth, and her mouth was agape, and her eyes were still open, just like grandpa.
Grandma's death was sudden, just like grandfather's, but the onset and days leading up to death, the inkling of danger, well, it was the span of days instead of a couple months. My grandma had been relatively fine up until pains intensified over a week, and she was to have a checkup by a doctor the next week. Nobody realized that her situation was as serious as it progressed. She suffered her heart failure before the appointment. Death literally rushed up on her.
Her death was the first that I'd experienced of the immediate family and relatives.
My other grandmother, on my dad's side, she had the longest regression into death, over a span of years with Alzheimer's, which ended her in 2003. Her slow demise was one filled mostly with utter struggle for my father, who took the lead with his brother and sisters for her care. Over her last months, visiting her was pointless because she was completely incoherent.
Her husband, my other grandfather, died before I was born.
I hadn't expected grandpa to die, but the length of time spent in the hospital and the multiple emergencies allowed me to have the notion of danger with his health. I was focused for this moment of reckoning, despite my anger and all of the events.
Each took turns to say individual goodbyes. When it was my turn, I was calm and ready.
"I love you, grandpa. I'm going to miss you." I touched his head, and it was not yet cool. He still had some warmth to him, and his skin was soft to the touch. I caressed his forehead, and I reached and felt for his arm, which was crossed over his chest under the sheet. I caressed his arm and hand.
We calmly made our way out of the room. We waited for the examiner's decision.
Around this time, the doctor who was present earlier, during my tirade, made a second attempt to talk to the family.
I had been outside, collecting my thoughts, trying to whittle down my anger over the events. I realized that I had acted rather selfishly over the course of the night, and while my anger was genuine, people like the doctor and the security guard did not need my wrath. My anger, however, was legitimate, but for sake of my own professionalism, I decided to afford apology at next opportunity.
When I re-entered the ward, I made my way back to a room where the family was located.
There was the doctor, once more, talking to the family.
This second attempt went better. He had collected his own words, and he explained some of the details that I had lacked when I blew up on him in the middle of the initial chaos. I noticed that he'd made this effort one of quality, and he was rather receptive to the group, even with my presence.
At some point during this time, I voiced my extended words of apology to my mother, relatives, and the doctor.
I don't remember what I said, but I remember my mother's remark of pride with me over the quality of my words.
To be honest, I'm writing this particular sentence at 5:04 AM on August 1st, which is about 24 hours after I made the apology. I've tried to recall the events as they happened with as much accuracy as possible. My memory of specifics over the times and events of that evening are fading.
I do remember asking the doctor a battery of questions which I had needed answers. He told me more about the details about his heart. I gleaned from his conversation that he was the doctor present for the treatment of him in the emergency room. They worked for 20 minutes to revive him before he was pronounced dead. The details of how they realized that there was no chance to revive him, well, I don't fully understand, but he offered it, and at the time, it sounded very plausible.
To be sure, almost like a cop, I bluntly asked him whether or not he was offering us all of this information about my grandfather as part of a shineboxing of my family. He looked me in the eye, and he assured me that he was genuine. I ended up shaking his hand, along with the other members of the family, as he made his way out the door.
Around this time, a priest arrived.
His parish had forwarded the call to their voice mail to his pager. He was at the hospital within a half hour, and he greeted us and offered his condolence. We could now do a proper blessing of my grandfather. Around this same time, the examiner had cleared my grandfather. He needed no autopsy.
We went back with him into grandpa's room. This time, the staff had cleaned up the room. Someone had removed the tube from his mouth.
Once more, we stood over him. The priest conducted prayers, and he spoke in brief after the ritual.
The priest was a middle aged man, and he'd performed this service multiple times for many others. He held a genuine care and sympathy that was absent from most of the rest of the hospital staff, especially the nurse who offered the Gift of Life. The priest possessed the clarity, confidence, and organization that the chaplain, in comparison, utterly lacked.
We had another chance to say goodbye to grandpa. "I'm going to miss you, grandpa," I said, and I kissed him on the forehead, as the others had kissed him this time. "Go be with grandma."
After the second round of goodbyes, the priest and our family left the room.
We had to make a trip back to my grandfather's house to help my aunt collect her things. She was to have stayed overnight with grandpa.
We proceeded to shut down most of the stuff in the house. I went upstairs to turn off a fan, which I found near my grandfather's room.
He hadn't slept in his bed for many weeks, but I could feel the familiarity of the house and his room, and in his room, I uttered, "I'm sorry, grandpa."
The sorry, really, was for myself.
Writing this helped ease my anger, which has now been replaced with some sadness.
At this point, I'm having regret over promises and future events to not be fulfilled.
I always wanted to get my grandfather to record some audio or write down some information about his life. I really wanted to do this in his last months, but I couldn't because of the trouble that he had with shortness of breath. I couldn't very well stick a recorder on him or ask him to write down words at length in a pad. He wasn't one to type, and he had no computer.
My grandfather was the one who paved the way for my interest in sports. He followed baseball, golf, hockey, basketball, and american football.
We spent many hours where he'd tell me about history. I'd listen to him as he recalled, in a giant blend, events he'd witnessed, sporting history, lessons from life, and history of his own life.
I've already forgotten much of the content of our talks, and I never wrote down the details.
He really enjoyed the resurgence of the Detroit Tigers. This was the one thing that he followed with great interest during the summer. I regret that he won't be able to see the conclusion of the season, in the flesh. I looked forward to talking about the upcoming NBA season. In the last couple years, he'd listen at length to my wealth of knowledge. I was one of his personal reporters.
I regret that I never quit smoking for him. He begged me on multiple occasions to quit, especially after he was diagnosed with emphysema.
I was hoping that grandpa would be present, still in the flesh, at the time of my wedding.
He was one of the few people in this world who believed in me.
I have much to do in the next days. Most of the extended family may not yet know about his death. I have reached only one friend, Jim, over the phone, and I've yet to contact other friends. I need to get a proper dark suit for the visitation and funeral, as most of such suits that I've owned do not fit, as they are from my childhood. I need a haircut.
His funeral will be Saturday.