Tomorrow will be 14 years since my father died but I remember the events as if it just happened. How my brother asked me not to come to the hospital because my youngest son had a cold, how I got a call from my mother saying my Dad was fine, just needed an abdominal ultrasound for pain, how some doctor called at midnight saying she couldn't reach anyone else and that my father wouldn't make it through the night. How my brother, who lived in New Jersey in those days had just gotten back to his apartment, how he said he would get back in his Jeep to pick up my mother and me. How on the ride to the hospital, I read my father's living will under the overhead lamp of the car bumping along, having forgotten if my mother was unable to take him off life support, I was designated.

My father was in the ICU and had coded at least twice that they recorded despite a DNR. We were ushered into a tiny family waiting room. A doctor dashed in to say, "You should come say your goodbyes." Before she even finished that short sentence, a nurse poked her head in to say he was coding again. The doctor left briefly then returned to explain his condition. I interrupted her and asked if there was any brain activity, something my father was very clear about in his living will. She said no. My mother was silent, pale, and said nothing. My brother was also stunned as they had just been with my Dad hours before. The doctor guided us to where my father was, his broad chest moving up and down, his lips turning blue despite oxygen.

I had seen my father look much worse after chemo and several surgeries but I knew immediately he was dead, that they had kept the ventilator on so we could say goodbye, perhaps a small mercy. That plus the coding and visible resuscitation attempts made me mad then and later. We were left alone. My brother hung back against a wall. I put one arm around my mother's small shoulders and asked if she wanted to pray or say something. Typically not one at a loss for words, she said nothing. "Mom, you were married over 50 years and had quite a life with Dad. It's okay to cry." She still said nothing. Inching her closer, she touched his left hand, murmuring, "He's still warm." With difficulty I said,"Mom, it's the machine. Dad's gone. Can't you feel it?" I said a few things aloud on her behalf, then the three of us said The Lord's Prayer in unison, after I elbowed my brother.

The doctor came back, as if following some unseen script. Taking us into a dim hallway, she and another doctor asked what we wanted them to do. Since my mother was obviously in emotional if not actual shock, I told them to turn off the machines then signed some consent paper. They asked if we wanted an autopsy. We all said no but months later I learned one was done. Primary cause of death: neuroendocrine stage four cancer, metastatic. Heart failure and sepsis were also listed. He lived five years longer than his doctors expected. Looking back, it was enough time for him to say his goodbyes.

Causes of death: which does your doctor treat?