Active Dying ~ John Picard

 

It wasn’t supposed to be this way.  When Jenny imagined her father’s death, she’d always pictured Rob standing next to her, ready with a hug and a comforting word, and her sister and brother-in-law close by offering additional support.  At the appropriate moment, they would all take turns saying goodbye, telling the dying man how much he’d meant to them, how much he was loved.  That done, they’d witness his peaceful and dignified exit from the world, his eyes slowly closing, his head lolling on the pillow.  Instead, she was alone with a nurse she didn’t know and it was all she could do not to run out of the room again.

She’d returned both times embarrassed in front of the RN with the unusual name.  Stout and fiftyish, Verda was a person of few words who, whenever she entered the room, stood in the corner with her arms crossed, saying little and rarely if ever smiling.  Not that there was anything to smile about, but whenever Jenny asked a question Verda answered in a clipped, no-nonsense manner that was off-putting as well as doing little to assuage Jenny’s feeling that her family was being judged.  Rob had been telling her for all of the twenty years they’d been married that she cared too much what other people thought.  Nevertheless, Jenny had explained the situation to Verda in some detail, made it absolutely clear what the circumstances were.  Even so, she couldn’t help worrying how it looked, her father all but abandoned in his last moments.

Now, his body trembling, his eyes open, he took a deep, raspy breath, held it for several seconds, then loudly and forcibly exhaled.  He did this again and again, the time between breaths longer than when Jenny arrived six hours ago, and they’d get longer still, Verda had told her, the closer he got to the end.  He had just taken a breath, Jenny counting the seconds to herself–three, four, five–when he cried out,

“Help me!  Please!  Oh, please help!”

Tears filled Jenny’s eyes.  This was the worst part of it, her father’s desperate pleas to some invisible and unnamed person or thing, and in a voice she scarcely recognized.

He sucked in another breath, held it for seven, eight, nine seconds, exhaled with a whooshing sound, drew another breath and shouted, “Somebody help me!  Somebody please help me!”

Jenny stood and strode out of the room.

Her call went directly to voice mail.  She tried again with the same result.  She knew Rob was at work and he tended to turn off his cell when it got busy, and he didn’t like to tie up the office phone, but this was an emergency.  The young assistant Rob had recently hired picked up.

Mr. Franklin, he told her, was not there at the moment.  Could he take a message?

“Could you tell Mr. Franklin his wife called?  And that she wants him to call her back on his cell phone?”

“Yes, ma’am.”

“And could you tell him it’s urgent?”

“I surely can.”

“Do you know where he is?”

“He’s over at the garage with the police.”

“The police?”

“Yes, ma’am.  One of drivers got held up.”

“Oh my.  Well, please tell him I called.”

“Yes, ma’am.  Have a nice day.”

Jenny hated being alone, and she’d never felt more alone than she did now, sitting in the hospital’s first floor lobby, surrounded by people she didn’t know.  Except when work interfered, she and Rob did everything together: vacations, of course, but also walks, church (she wouldn’t go without him), doctor’s appointments, errands.  Her attitude was old-fashioned, she knew, but so was Rob’s.  He liked feeling that he was taking care of her, and he appreciated a wife who deferred to her husband on certain key matters, so it was extremely frustrating–and just plain wrong–that when she’d never needed him more, Rob, who’d been unable to take off work on such short notice, was over a thousand miles away.

As for Karen and Ken, they’d left for their long-overdue vacation on Friday, when her father had been fine.  Since then, Jenny had been driving her sister’s car twice a day to their father’s apartment at Lawndale, the assisted living facility in South Miami.  Relatively fine.  Her father had been in decline since his wife died last winter: eating little, refusing to get out of bed, wasting away.  Her once indomitable father had given up; he felt he no longer had anything to live for, a viewpoint Jenny tried not to take too personally.

On the contrary, she’d made sure to be upbeat and positive when she visited him at Lawndale, putting on her cheeriest face and doing her best to rouse him from his stupor.  Her father was a keen observer of current events and Jenny had always come ready with at least two late-breaking news items to discuss in hopes of stimulating his interest.  They rarely did.  It had been particularly discouraging–and no better indicator of his state of mind–that when she’d mentioned to him the latest outrage by the Clintons all she got in response was a grunt.  The next day she received a call from Lawndale telling her that he’d been moved to the critical care unit in St. Joseph’s Hospital.

He’d been languishing ever since, but last night he’d taken a turn for the worse, the doctor telling her he wasn’t expected to live more than forty-eight hours.  Her father, he explained, had begun what was known as “active dying.”

Jenny found Karen’s number on her contact list.  Her sister was already seriously stressed because she was half way across the country and probably wouldn’t make it back before their father passed.  But Jenny needed to talk to someone besides doctors and nurses and though she had been praying non-stop what she really wanted was to feel she wasn’t going through all this alone.  Times like this made her wish she had more friends.  There was Christine, whom she’d known since first grade and who lived with her husband and three children only ten minutes from her and Rob’s condo, but their relationship consisted almost solely of meeting three or four times a year for lunch at Village Tavern and even though she thought of Christine as her best friend calling her out of the blue at such a moment was unthinkable.

Karen picked up on the second ring.  Jenny could tell immediately from her sister’s tone–somber at first, then faintly exasperated–that she hadn’t expected to hear from Jenny until she had something major to report.

“Who’s with him now?” Karen said.

“The nurse,” Jenny said.  “There’s a nurse with him.  Have you left yet?  Are you on the road?”

“Ken’s packing up the RV now.”  There was sigh and then, “I should have known this would happen.”

“It’s not your fault.  You two deserved–”

“The moment we decide to get away, the very moment…It’s too perfect.”

It had been twelve years since Karen convinced their parents to move to Florida, arguing that the warm climate was only one way in which that state was hospitable to seniors.  Except for college, Jenny had always lived in the same city as her parents.  Her acquiescing to her sister’s logic hadn’t prevented her from missing her mother and father, and she’d looked forward year-round to her and Rob’s Miami vacation.  It was after her mother’s Alzheimer’s became acute and her parents had to enter assisted living that Jenny, as fearful as she was of traveling by herself (Rob didn’t get as much vacation time as Jenny did at the library), began flying down whenever Karen and Ken were feeling overwhelmed.  Karen thought Jenny’s fears out of proportion and told her so–she was too dependent on Rob, she needed to do more things for herself, be more adventurous–and Jenny, despite having been deprived of her mother and father in their golden years, felt guilty every time Karen complained about the difficulty of caring for their elderly parents.

“I’m just sorry you had to drive all that way,” Jenny said.  “And now you have to come back.  Did Ken get his elk?”

“No.”

“He must be disappointed.”

“That’s putting it mildly.”

“Maybe you can drive back…later.”

“There’s only one week left of elk season.  Five days to be exact.”

“I’m sorry.”

After Karen’s and Ken’s retirement, they’d purchased a Winnebago for the express purpose of doing things they’d put off while they were working.  But there came a point when they didn’t feel they could leave town without a family member to make sure the Lawndale people were taking proper care of their parents as well as being a buffer between the nurses and their father, a gruff and an impatient man in the best of circumstances.  Karen had called Jenny two weeks ago, appealing for a respite.  It had been six months since their mother died, six months of dealing with their father’s deteriorating health and bad temper and they really, really needed a break, Karen had said.  Next month was September, she’d gone on, elk season in Colorado.  It would mean the world to Ken–who had been so understanding during both of their parents’s illnesses, so forbearing–if she would fly down and stay for an extended period–a week, perhaps; ten days would be even better.

What could she say?  Her bossy sister hadn’t foreseen how their parents’ inevitable decay would disrupt her day-to-day-life, upset her retirement plans, frustrate her husband.  Jenny resented that Karen, in the unspoken competition for their parents’ love and attention, had lured them to Florida, stolen them away, but she tried not to dwell on it.  She didn’t want to be petty.  She only had one sister, one sibling.  Still, it added to her sense of unfairness that Karen, who’d had the last good years with her parents, was being spared the last gruesome hours.

“It’s horrible,” Jenny said.

“What is?”

“Daddy.  What he’s going through.  I feel so sorry for him, but all I can do is watch.  I feel so helpless.”

“I know.  I was there when Ken’s mother died.”

“Did she suffer in the end?”

“She died in her sleep.  She went quietly.”

“That’s what I’m saying.  Daddy isn’t going quietly.  He isn’t going quietly at all.  He’s fighting it.  Well, his body is.  The nurse said–”

“Don’t forget the perishables.”

“What?”

“I’m talking to Ken.  Put them in a plastic bag.  Not that one, the other one.  That one has a hole in it.  The nurse said what?”

“The nurse said he could go on like this for hours.”

“Go on like what?”

“Fighting it.”

“This nurse, do you like her?”

“Not really.”

“When Ken’s mother was dying, the nurses were useless.  Worse than useless.”

“She’s not useless.  She’s just kind of–I don’t know–rude.”

“Two days before Ken’s mother died, she rang and rang for a nurse.  One never came.  Ken was furious.  He threatened to sue the hospital.  You know Ken.  It didn’t make any difference, though.  The day she died the nurses disappeared.  Vanished.  Every last one of them.  They knew Ken’s mother was dying and they didn’t want anything to do with her.”

“That’s terrible.  This nurse, she told me the last of the senses to go was hearing.  So I’ve been talking to him when he’s quiet.  But that’s happening less and less.  And he’s doing–”

“Did you check the freezer?  Check the freezer.  Go on.”

“He’s doing this horrible breathing thing.  Karen, it’s awful.”

“I’m sure.”

“And I can’t get Rob on the phone and I have no one else to talk to…”

“Why can’t you get Rob on the phone?”

“He turns it off at work, his cell.”

“Then why does he bother taking it?  Why does he bother taking it if he’s not going to use it?”

“He uses it, just not all the time.”

“Isn’t it on vibrate?  Can’t you leave a voice message?”

“I did, but he keeps it in his coat pocket and when he doesn’t have his coat on he can’t, you know, feel it.  But what he’s saying is even worse.”

“What who’s saying?”

“Daddy.  He’s shouting things.”

“Well, that’s nothing new.”

“I can’t stand it.  I had to leave the room.  I should be there now but honestly I don’t know if I can go back.”

There was a long silence.  “Karen?”

“Ken just dropped a jar of mayonnaise on the floor.  You’ll need a sponge.  Paper towels aren’t going to do it.  Can we talk later?  This cabin has a three o’clock check-out and it’s almost that now.  Keep me posted.”

“I will.”

“That’s Karen for you,” Rob said.  “That’s Karen all over.  She’s been wishing your parents would die for years.  When it finally happens, she gets you to do the dirty work.”

“That’s not true.”  From where she sat, Jenny could see the hospital entrance, enormous peace lilies on either side of the automatic doors.  Patients in wheelchairs were waiting on the sidewalk for their rides.  An ambulance was parked at the curb.  “Karen couldn’t have predicted this,” she added, taking Karen’s side despite her own misgivings.

“I don’t know,” Rob said.  “Karen has a sixth sense about these things.”

“I don’t want to talk about it.”  It was a source of recurring sadness for Jenny that her family–her little family–didn’t always get along: Ken was even bossier than her sister; Karen didn’t think Rob–who hadn’t completed college and didn’t always control his temper–was a worthy husband; their father agreed with Karen; Rob thought Karen exploited Jenny’s good nature to her own ends.  Only Jenny and–when she’d been alive–her dear, sweet mother succeeded in keeping above fray.

“Did Ken get his elk?” Rob asked.

“No.”

“Oh God!  Oh Jesus!  Ken didn’t get to blow a fucking hole in some defenseless animal.  The world’s coming to an end.”

“Stop yelling.  I can hear you perfectly well.”  Jenny knew from long experience that her husband was not at his best in a crisis.  He panicked.  He became unreasonable.  Until he worked the emotion out of his system he said wild and hurtful things.  He’d started the conversation with a rant about the driver who’d been robbed at gunpoint and how that was bound to cost him–Rob–his job.  Until that was addressed, she knew, he wasn’t going to be any use to her.  “They’re not going to fire you, Rob.  It wasn’t your fault the truck was held up.”

“It occurred on my watch.  That makes me responsible.  I’m the one in fucking charge.”

He also cursed a lot when he was upset, which he knew she didn’t like.  “Are the police still there?”

“Would I be talking to you if they were?”

“What did they say?”

“What did they say?  They said the company was out beaucoup bucks in valuable merchandize and they had absolutely no suspects.”

“Will you please stop yelling.  Where are you?  Can anyone hear you?”

“I’m fine.  Just dandy.”

“Doesn’t insurance cover that?  Doesn’t insurance cover robberies and–”

“Of course insurance covers it.  That’s not the point.  The point is–”

“Will you please…You’re not going to lose your job.  You can’t be fired for events beyond your control.”

“Oh yeah?  It just so happens events beyond your control is the number one reason people are fired around here.  Remember Rich?  Rich got fired because one of his drivers crashed into a tree.  Rich got fired because of events beyond his control.”

“That’s because Rich knew the driver was drinking on the job and didn’t do anything about it.  That’s not the same thing.”

“I hope you’re not too attached to your evenings and weekends.  Because you’re going to need to get a second job.  Someone has to support this family.  Someone has to be the breadwinner.”

She began to cry.

“Don’t,” Rob said.  “Stop.  I’m sorry.”

“It’s just so hard.”  She got a tissue out of her purse and wiped her eyes.  “I wish you were here.”

“I wish I was too, but you know how they are about time off around here.  So how is he?  How’s your father doing?”

“Rob, he’s dying.”

“He’s been doing that.”

“No.  They say it’s only a matter of time.”

“How often have we heard that one before?”

“We’ve never heard that one.  We’ve never heard that one before.”

“The doctors have been telling you for months he was at death’s door.”

“This is different.  He’s in a coma, Rob.  My father’s in a coma.”  She could hear the pleading in her voice, both for understanding and for sympathy–for her father, not for her.  Rob had always been afraid of her father.  Unlike Ken, who was older than Rob and had been a successful business man, Rob had never stood up to her father.  Ever since Rob bragged to him about a pay raise and her father, who felt he had nothing to brag about, told him it was too bad he’d dropped out of college to become a dispatcher for a trucking company, Rob had watched what he said around his father-in-law.

“What kind of coma?” Rob said.

“What kind?  I don’t know.  Are there kinds?”

“Of course.  Coma is a very broad term.  There’s comas from stroke, comas from head injuries, comas from–”

“This is a coma from dying.  This is the coma you get just before you die.”

“You don’t know that.”

“His skin is changing color.  He can hardly breath.  He’s saying terrible things.”

“Wait a minute.  He’s talking?”

“Not talking.  It’s more like–”

“But he’s speaking?  He’s saying things?”

“Yes.”

“Well then, it’s not a coma.  People don’t say things when they’re in a coma.”

“All right.  It’s not a coma.  I don’t know.  It’s called active dying.”

“What is?”

“When someone is about to die.  But even if I didn’t know that, believe me, you can tell when someone is–”

“Hold it.  You’re not in the room with him?”

“Would I be talking like this if I were in the room with him?”

“Then where are you?”

She told him.

“If he could die any minute why aren’t you with him?”

“Because I can’t stand watching him suffer.  And I’m not sure I can go back.”

“Then don’t.  He doesn’t know what’s going on anyway.  He’s totally out of it.  What difference does it make if you’re there or not?”

“I don’t want him to die alone.  No one should die alone.”

“He doesn’t know he’s alone.  And you don’t know for sure he’s dying.”

I do too know.  Why are you being so difficult?”

“I’m not being difficult.  I just want to spare you any unnecessary suffering.  Why don’t you let someone know where you are and they can get you if the worst happens.  Make it easy on yourself.  Look, I need to get off.  I have to call our insurance guy.  Are you going to be all right?”

“Yes.”

“You sure?”

“Yes.”

“You really think they won’t fire me?”

“Rob.”

“Okay okay.  Love you.”

“Love you too.”

In the gift shop Jenny perused the magazine rack, the rows of candy bars, the glass case full of cut flowers and potted plants.  She didn’t know what she was doing there.  She was incapable of reading or eating and her father was way beyond receiving gifts.  The woman behind the register asked if she needed help.  Jenny, blushing, told her “No thank you” and a minute later walked out.

There was an even longer wait than usual for the notoriously slow elevators, which didn’t make it any easier, tempting her to return to the lobby.  And when an up elevator finally did come and the crowd surged, she had the quite reasonable excuse of waiting for the next one instead.  But afraid of not getting on that elevator either, of losing her nerve, she became part of the throng cramming into the car.

The moment she stepped out onto the third floor, she began listening for her father.  Drawing closer to his room and hearing nothing, she envisioned a sheet pulled over his face or, worse, an empty bed.  But when she entered the room she found two doctors examining her still living, still breathing father.  The younger one told Jenny they were continuing to do all they could to make him comfortable.  The doctors were doing “their rounds,” she understood, making scheduled visits to their many patients, but where her father was concerned their job was almost done.

After the doctors left it was just her and her father in the room.  She pulled her chair closer and clasped his hand with its purplish blotches and pale blue fingernails.  He offered no pressure in return.  His breathing was labored but not as extreme as before.  His mouth was slack.  His partially opened eyes stared vacantly at the ceiling.

She’d already told him goodbye and how much she loved him and what a good father he was.  She’d explained why no one else could be there and how much they regretted that.  She’d recounted memorable moments from the family history, including her own with him: his helping her with her math homework, sharing with her his life-long love of maps, making his homemade peach ice cream for her birthday.  She’d recalled the afternoon she arrived at the DMV and discovered him standing in line for her.  Recently retired, he’d remembered her telling him that she’d have to use her lunch hour that Tuesday to get her license renewed and, to reduce her wait in what was always a long line, he’d gotten there an hour before she did.  She could have told this story again, could have repeated everything she’d already said, but as the only male in a household of chattering women her father was someone who didn’t like to be told anything twice or at too great a length.

She noticed his head was slipping off the pillow.  Standing, she reached across the bed.

“I’ll do that,” said the nurse, appearing from nowhere and putting herself between Jenny and her father.  Verda raised his head and slid the pillow back under, then dabbed his lips with a sponge.  As if her ministrations upset a delicate internal equilibrium, her father’s body began to quiver and shake, his head rolling from side to side.  The terrible breathing started again, long, gasping intakes of air he would hold for what seemed like forever until, with a shuddering release, he exhaled and drew another ragged breath.

Each time Jenny prayed it would be his last.  The intervals between breaths grew even longer, as if he were pretending to be dead, or trying it out.  Her father suddenly shouted,

“Help!  Please!  Somebody help me!”

Jenny squeezed her eyes shut.  Her tears overflowed, trickling over her face.

“Please!  Won’t somebody help me!”  His body shook, his head rolled.  “Somebody please help me!  For God’s sake!  Somebody help me!”

It was too much.  Jenny reached down for her purse.  She was rising when she felt a weight on her shoulder.  She saw Verda’s hand resting there.  Responding to the light pressure, she lowered herself back into her chair.

Just then her father took a slow, raspy breath.  He held it for at least half a minute.  His next breath lasted twice as long.  He had yet to exhale when he made a gurgling noise and his body went limp.

Jenny waited, watching and listening.  She looked up at the nurse.

Verda nodded, then stepped over to the bed.  She closed the dead man’s eyes, propped his head in the middle of the pillow, moved strands of hair from his forehead.  “I’ll get the doctor,” she said.

The next hour passed in a flurry of duties and details.  She spoke to the doctor.  She signed the death certificate.  She called Rob, who didn’t answer and she left a message.  She called her sister who only wanted to talk about the funeral.  She called Morgan and Sons and arranged to have her father’s body moved while setting up an appointment the day after tomorrow (when Karen and Ken would return) to look at caskets.  She did all this while dealing with her grief and her weariness.  But there was relief too.  Her father’s suffering was over; he was in a better place.  At some point she started looking around for Verda who hadn’t returned after going for the doctor.  On her way out, she passed by the nurse’s station and inquired about her but no one there knew where she was.

Jenny was walking down the crowded corridor, wondering if she should have left a note at the nurses’ station, when she spotted Verda coming toward her.  Jenny stepped around a young man in a nightgown hooked up to an IV.  Verda had a brisk, strutting walk, her short arms swinging close to her sides, her head erect.  Jenny walked up to her.

“I wanted to thank you for what you did back there.”

Verda nodded, unsmiling.

“If you hadn’t stopped me….I would have never forgiven myself if I hadn’t been in the room when…”

“You were very brave,” Verda said.

“No.  No, I couldn’t even–”

“Yes,” the nurse said, cutting her off.  “You were.”  Without further comment Verda walked around her.  Jenny watched her disappear through the double doors into the adjoining wing.  Continuing on herself, she decided to take the stairwell rather than bother with the elevators.

As soon as she got in the car she let herself go.  Her hands on the wheel, her head lowered, she wept.  She was still crying when her phone rang.  In no condition to talk, she didn’t even bother taking it out of her purse, though it did remind her that she needed to pull herself together.  She didn’t want to start hyperventilating, which happened sometimes when she couldn’t stop crying, usually after something Rob said to her.  She took out a wad of tissues and dabbed at her face and eyes.  She brushed her hair in the rearview mirror.  As she was driving out of the parking lot, she thought about the one thing guaranteed to make her feel better.

After merging onto the interstate she remembered her call, but she didn’t want to go digging in her purse while she was driving, and she was pretty sure Florida had a law against driving and talking on cell phones.

Arriving at Karen’s house, she went to the guest bathroom where she ran water for her bath, kicked off her shoes, dropped her clothes on the floor.  Lowering herself into the tub, she stretched out and tilted her head back.  She could just hear her phone ringing over the sound of the running water.  She could have gotten it, she supposed, could have jumped up and run into the living room.  But she probably wouldn’t get there before it stopped and, besides, she didn’t want to drip water all over Karen’s carpets.  She’d answer it the next time it rang for sure.  She’d get it no matter what.