It's two o'clock in the morning, and my grandfather is in the hospital on life support. He's been here for almost two weeks now, but tonight the situation is looking particularly grim. For hours, I've been watching the machines next to his head, black screens with bright green text, loud beeping and whirring. Every few minutes, a blood pressure cuff inflates and deflates. More beeping ensues. I know that soon, the nurse will come in and ask me to leave. I'm not even supposed to be here, since visiting hours were over at 8:30 p.m. But I couldn't sleep, and it's all the same to him now. I'm sure it's all one long blur of constant medication and dreamless sleep, the nurses all know that any forced breath could be his last, and so they allow this.
I'm supposed to be in my hotel room, next to the room that my parents rented for themselves and my other grandfather. Him, my family calls "Big PaPa" (pronounced "paw-paw") and he is my mother's father. The grandfather in the bed in front of me is just PaPa (pronounced "paw-paw", as well), and is my dad's father. I couldn't sleep, all I could do was toss and turn and I was keeping my niece awake. So I got up and dressed quietly, asking her to keep an eye on my kids. She nodded her understanding, and went back to sleep. I locked the door behind me.
My dad's father has never been one for storytelling, until lately. It's as though he knew that his time for relaying information was almost up. He knew that he wasn't going to be able to tell about the pranks he played on board the submarines in the navy (in WWII) if he didn't tell them now. And I should have known then that something was wrong. When someone who is always taciturn begins to tell stories, listen, dammit!
How can I be thinking about submarines now? Stories? Please. The doctor says we should "make our peace" with his death. What is that supposed to mean, anyway? I have never understood why people will tell you that you should be happy that people you love are dying. And I never will make peace with it. But I can look at this head-on. Most of my family members cannot come into this room. They can't face PaPa at all. Or when they do come in, they stand with their backs to the wall, as far away as possible from him and the situation, and stare at him. They speak in whispers, and talk about his "coloring". Not me. I want him to know that I am here. I know, I just know, that he's aware of us. And I want him to get some sort of comfort from my presence.
So, here I stand, in the middle of the night, holding his hand. It is strangely warm. If you have never noticed, elderly people's hands are very seldom warm. I think it has something to do with poor circulation. But since he is on life support, he has artificial circulation, and it is evidently much more effective. I tell him that I love him. I remind him that his great-grandchildren are here, and that they all want to see him, but have not been allowed into the room, due to restrictions by the hospital. And then, slowly, I feel his thumb start to rub the side of my hand.
I'm not sure when it happens, if it is a voluntary response. He has been moving a lot in his drug-induced stupor, and most of the time his movements have only been to pull out the IV's and oxygen masks, which has led the nursing staff to restrain his arms for his own safety. But this is the first sign he has shown that he knows that I am here. I ask him very quietly if he needs something, if he is comfortable. I tell him again that I love him. And that's when I notice it. Tears are running out of his tightly shut eyes. I call for the nurse. His heart rate has shot up, and a nurse comes running in, the sounds of the beeping machinery breaking the silence of the ICU ward like sirens in a library. Through this, he is still slowly rubbing my hand with his thumb, a very calming gesture, a feeling almost like that of slowly rubbing a baby's back to put it to sleep. His grip on my hand has become tighter, as well.
I begin to think that the staff is about to ask me to leave, but they never say anything about it. They just work around me. Pushing buttons to silence various machines, asking PaPa questions in loud voices. ("Mr. Carlin--are you feeling any pain?") I don't know how they expect him to answer. He has tubes in his throat. And his eyes are still closed. But he is clearly conscious. I wipe away his tears with a tissue I have in my pocket, first warning him that I am going to touch his face. When I move my hand away, his head follows it. So I place the hand that isn't being held in a death grip on his cheek, and gently stroke the stubble there.
The nurse tells me that they will have to sedate him. She says that the life support machine requires a certain amount of cooperation from the patient, and that he is "fighting" it. She then asks me if I would remain here until he becomes calm again, holding his hand, and talking to him. But when he hears the word "sedate", he becomes instantly agitated. He begins to moan quietly, and to try to toss in his bed. This, clearly, is not what he wants. I feel so terrible. What if these are his last moments? And we are trying to rob his consciousness from him? How can we justify this? But I know that I have to do as she asks. And I know that as far as my family is concerned, I am not even supposed to be here.
I lean closer to him, laying my head on his arm. I whisper to him, quietly. "It's okay, PaPa. I'm here. I won't go anywhere, I promise. I'll stay here until you fall asleep. I will hold your hand. I will tell you happy family gossip about the babies that you love. It will all be all right. And I love you. We all love you. And that love is going to make it okay. I promise." I try very hard not to cry. I don't want him to feel anything but love from me. Sadness is not what he needs. I want to give him strength. I used to have so much. If I can just find it in me. Somewhere. And, miraculously, I do.
About 20 minutes have passed, and his hand is starting to go limp. The sedative is finally working. When his hand drops out of mine, I cover it up with the thin hospital blankets, and back slowly from the room. The nurse sees me, and heads back in to lower the lights, and do nurse-type things. She calls out to me, "Ma'am?" I turn back. "Yes?" "Look. I think he wants to tell you goodbye."
I turn to look, and there he is, eyes closed, gently waving. I start to come back. I say, "I'm sorry, PaPa. I thought you were asleep. I'll stay." He motions me away. And waves goodbye again. He is ready to fall asleep. And then his breathing becomes slow and regular. I know now that it is going to be okay. I walk from the ward, and out into the hot, humid parking lot. I drive slowly back to the hotel, park and make my way back to my room. I let myself in, and slide back into bed. I fall immediately into a deep, dreamless sleep.
Update: PaPa is doing much better, is out of the hospital, and in a Rehab clinic. He will be returning home in less than a week. He suffers now from a great deal of memory loss and dementia due to lack of oxygen to the brain during his bouts with pneumonia and congestive heart failure, but appears to be greatly on the mend. -
12/24/2003 at just before 9pm this evening, PaPa died in his sleep.