My father died last Monday. In a couple of hours, it will have been one week since he took his last breath, having done battle against a metastasized melanoma since October. The doctor at Calvary Hospital in the Bronx, a hospice facility, called the time: 2:30 AM. “He’s looking at you” she said. It was a sweet thing to say, though even at that moment I thought that it was rather quaint to suggest he might’ve been looking at me as he died. He WAS faced in the direction that I was sitting most of the evening, on his right side, first in a chair right next to his bed, and then at the end, half sleeping, half dreaming, in a recliner chair a little bit further away, still on his right side. Still, I presume that it is merely a reflex that turned his head from one side to the other.
Not a week earlier, Dad and his wife met with the oncologist at NYU and got the bad news: the immunotherapy treatments that he had gotten monthly between October and January had not impacted the course of the disease. For a couple of weeks prior to this, he’d been experiencing increasing pain and other symptoms, but continued to hold out hope that these were byproducts of the treatments, side effects that would ease with time. In fact, it was the progression of the disease that was causing such difficulty. Up until that point, my father continued to do virtually everything that he did before getting the diagnosis. He undoubtedly tolerated a great deal of pain before he finally acknowledged it out loud. “I have a very high tolerance for pain. You know that if I’m telling you it has me laid up in bed, it’s getting bad.” There was no doubt in my mind that if my father was lying in bed in the middle of the afternoon, something was terribly wrong. Still, we all held out hope that the PET scan would reveal that the tumors had shrunken, and that dad had been given some extra time.
From the moment he was told that the treatment had not helped, and that there were truly no other options besides those that would bring him physical comfort, he began the last phases of dying. Just that same week he was driving with his wife down to the city for his appointments, making phone calls to deal with various business matters. “I’ll drive us” he told his wife, she offering to do so but seeing no need to intervene, as he was still capable. But after the news was digested, he began to not only be given care for his pain, he began his rapid decline. Within two days of hospice support at home, his needs became so great that he was moved to Calvary Hospice House, where he received excellent care. The call from my brother came on Saturday evening: his mom told him that we need to get on a plane and get up there right away. And so we did, he arriving from Colorado on a redeye flight, I making my way up to the Bronx from North Carolina on Sunday morning. Dad had previously expressed the desire to keep visitors limited to his most inner circle. His wife, three of his four children who could be present, his brother, and two of his former NYPD colleagues, one of whom he maintained a strong 42 year friendship, long past and beyond the scope of the job.
I have had some personal experience with hospice and the dying process, and so it was not a surprise to me that once he saw the last person he needed to see, he was almost finished with his process. I also know that there are as many ways of leaving as there are individuals. I was so preoccupied with being present, in the moment, with my dad, that he surprised me at the end.
I had indicated to his wife that I wished to spend the night at hospice with dad. I knew that his youngest son had stayed there with him the previous night. I was concerned that perhaps his son would want to stay with him again and would prefer that I not be there. I needn’t have worried, for his son was exhausted and welcomed the support. I was relieved, because I really needed to be there. I knew this was as much for me as it was for my dad. At about 10 PM, I sat in the recliner chair and promptly fell asleep. Having had about 2 hours sleep the night before, I was exhausted. At 11:30 I awoke, and alternated between sitting and holding my dad’s hand, pacing the room, and drinking the little juice cups the nurse had given me for the evening. Earlier in the day when dad was still somewhat aware of his surroundings, I acted on a suggestion made by a friend, and took a picture of my hand on his with my camera phone. Now as I sat watching and listening to him breathe, I took one of just my own arm, palm up and open. Finally, at about a quarter to two, I decided I should try to get a little rest. I held his hand once more, and kissed it, and stroked his hair. I climbed back into the recliner chair, a little further away from the bed. I fell into a fitful state for about half an hour, dozing and then glancing over at dad, whose breathing was full of crackly sounds. He looked very relaxed, no signs of distress, so I did not worry. I fell into a deeper sleep, and I began to dream that I was in a struggle with someone or something that had a grip on my wrists, on my hands. I did not feel that I was in danger, only that there was a struggle ensuing. I was in that half dream state, you know when you know you’re dreaming but you can’t get yourself out of it? I remember thinking that someone would come and help me. As I fought off the force that had a grip on me, I started to scream. I thought I was screaming so loudly that it was coming out and into the room and that someone would hear me and come to my assistance. I screamed long and loud and yelled let go! Just let go! As I shook myself awake, the door to the room opened, the light was turned on, and a nurse and aides walked into the room. One of them came to me and softly said: we need to call the doctor. He has stopped breathing. I jumped up, fumbling around for my eyeglasses, and said oh my god I just dreamed there was a struggle and I couldn’t get free of it! I looked at my dad, his eyes closed, mouth slightly ajar, but his face looked so peaceful. He had stayed on all the while I was holding his hand. As soon as I moved away, and fell into sleep, he let go. I doubt he was waiting in the sense we usually mean, but there was a sense of closure, like he was just going to hang around until I could let go. And then he let go, too.