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Monday, July 25, 2011

A WEEK IN HOSPICE

It was the last Tuesday in April when Barb and myself went to pick up my Uncle Dan for our usual standing dinner date at Sharp's in Brookside.  He was in a good mood and seemed to be feeling pretty well.  He had cancer of the lungs that had spread to mainly his spine, and a few other places.  He had survived through decades with AIDS and was still beating it, but the cancer was too strong.

He ate well that night and seemed to enjoy himself.  He was laughing at jokes and at slips of the tongue that people would make while telling a story.  He was tired though.  The cancer had a habit of doing that.  He carried around a little canister of oxygen in case he needed it and I don't recall him using it that night.  We went home a little early and got him to lay down on his hospital bed that he kept in the living room on the first floor.  He no longer had the strength to climb up and down stairs.

We had a rotating system of people who would come and spend the night with him in case he needed anything.  This was Martha's turn to spend the night and so Barb and I left for home.  Over the previous few weeks I had not slept very well at all.  I would go to bed and worry about how Dan was doing.  I knew that any day could be his last with us.  On this night I slept fairly well.  He had been in good spirits and had eaten and was not complaining too much about the pain he was enduring.  The pain was always there, but he reserved his complaints for when it was really bad.

The next morning I received a phone call from my wife.  Brian had spent a long night with Dan.  Dan was in a very irritable mood and was in great pain.  He had not slept all night and had kept Brian jumping all night to do things that he thought might help his pain.  Now he was having trouble talking and did not seem himself at all.  He was refusing any medical help.  As so many times before, I left the office immediately and went over to Dan's house.  Dan lived only about ten minutes from the office but I feel like it took me over a half hour to get there that morning.

When I got there Brian was sitting in a chair and Dan was laying in his bed.  I sat and tried to talk to him.  One thing about Dan was that you didn't tell him what to do when it came to things that involved him.  You asked.  So I asked him if I could call Dr. Lee and see what she said.  I had to ask several times before he okayed the call.  Dr. Lee advised us to get the hospice nurse there.  When she arrived Dan was in great pain and was not expressing himself very well.  I imagine the pain was so bad that he could not handle it.  I had given him some morphine tablets but they were having little effect.  Between the hospice nurse, my mother and myself we decided to transfer him to the hospice facility where he could get enough medication to ease the pain.

The ambulance arrived and I rode in it with Dan trying to calm him down on the ride over.  Everytime we hit a bump he would groan loudly.  I began to ready myself for the fact that this may be the last ride he would take in this life.

He was admitted into the hospice and immediately hooked up to a morphine pump.  It was not long before he went into what I can only describe as a totally aware coma.  His eyes were open and he would respond with those eyes when you talked to him but he couldn't move nor could he talk.  He would be in this state for the next week.

He would gasp for air with every breath.  His lips were getting dry so we spent a lot of time wetting them down with ice chips.  Family and friends would come and see him and you could tell that he was aware by looking at his eyes.  It was the only form of communication that he had.  On a regular schedule the hospice nurses would come in and check on his morphine and his blood pressure.  He was slowly dying.  All I could or can hope is that he wasn't in too much pain during this process.

I had promised Dan that I would be there with him until the end and so I determined that I would.  I had no idea how many days it would be but I didn't think it would be long.  My mom and dad spent a lot of time there going home to rest when they needed to.  Barb would go home and then come by after work.  My little brother spent a lot of time there with Dan.  My sister and my Aunt from Alabama came up for the weekend to visit with Dan.  This whole time Dan did not sleep.  His eyes remained opened every day and every night.

I asked one of the hospice nurses in the middle of the night one night if he even knew I was there.  She answered very firmly and positive that yes, he knew we were there.  He knew he wasn't alone.  She would later make me a little origami bird as a present to try to cheer me up.  It worked.  Soon my uncle from St; Louis returned home and my sister and aunt went back to Alabama.  They had to leave because duties from home needed their attention.  They were going to come back in short order to spend more time with Dan.

Hospice has a network of volunteers who bring in donuts and sandwiches and soups for families to have while they sit in hospice with their loved ones.  This is a great thing that they do.  If it were not for these volunteers We would have to be leaving all the time to get food.  The work of these volunteers should a level of caring that is hard to find these days.  And their actions took an extra load off of our minds because we did not need to worry about that part of staying in hospice with Dan.

The next Tuesday night, My cousin Susie brought Barb and I dinner from Sharp's since we weren't able to make it to the weekly foodfest.  It was so nice of her to do so.  It kind of put a little normalcy back into everyday life even if we were eating outside Dan's room.

Dan had never heard me play the piano and always wanted to.  Earlier that week I had sat at the piano in the main room of the hospice and played their piano for a little bit.  When I finally had some alone time with Dan, I told him I had played the piano for him and that people liked it.  His eyes widened a little bit and sparkled.  I think it was his way of saying thanks you.

After Susie left that Tuesday night there were my mother, my brother, Barb and myself left with Dan.  My little brother went home to shower and take a little nap and would be back later that night.  I fell asleep on the couch in Dan's room.

I awoke to Barb shaking me and saying it was time.  I got up and for the first time saw Dan with his eyes more or less closed.  His breathing was hardly noticeable.  The nurse kept a stethoscope to Dans chest waiting to see when his heart went silent.  Finally, a little after two in the morning, she said that he was gone.  A few minutes after that my little brother arrived.  He took care of mom while I went to walk outside and think things over.  I had a lot to do.  I had promised Dan I would email all of his classmates and friends informing them of his death.  As I walked up to the front nurses station I noticed the young nurse holding her head in her hands and crying.  I asked her if she was okay and she tearfully said that she had just gotten word that her mother had died.  I felt so sorry for her.  She pulled herself together and asked me how things were going with me.  I told her Dan had just died and she did what she was suppose to do.  She offered her sympathy.  This girl who had just heard about her mother but she had to set that aside to do her job.  It takes a strong person to be a hospice nurse.

I walked outside to find it raining very softly.  Dan had wanted to die when it was raining and God had granted his wish it seemed.  After walking around the parking lot a bit I went back inside to Dan's room to see him one last time.  I was heart broken.  I took comfort though in feeling that he died with his family there for a whole week surrounding him with love.  I took comfort in believing that he died pain free thanks to the nurses of hospice..  I took comfort in knowing that he was ready to go.  We had discussed it several times over the previous three or four weeks.

Now I had to pull myself together and do the chores I had promised him I would do when he died.  Barb drove me over to his house so I could begin to carry on after the end.

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