I'm spending the night in the hospital, though it's not me who's ill. My father-in-law, now 92 years old, is in respiratory distress. We've all taken turns sitting with him. He's very much aware, and tears spring from Daniel's eyes when he perceives being left alone. His three children, my wife included, have rotated bedside duty for two days. I've volunteered to spend the night here so everyone else can get a solid night's sleep.
First, let me say that I am that rare person who has never had a complaint about his in-laws. My wife's parents, Helen (now 10 years gone) and Daniel, have been better parents to me than my own ever were. Of corse I loved my parents, and I'm sure they loved me. I was fifty when my father died, and I never once heard him say that he loved me, though in some hidden place within himself, he must have loved me. Helen and Daniel had no problems expressing their feelings toward those they loved; my wife and I each got a hug and a “love you” each time we parted after a visit. Coming from a restrained family, it took a few years before I was comfortable with the demonstrative ways of my wife's parents.
Daniel was a farmer, and even at 92 he has thick, strong hands. Though his eyes are beginning to fail him, turning cloudy, and his knobby, arthritic joints slow his pace, Daniel's mind remains crisp and his soul kind. Not many live to his age, fewer with wits intact. Some elderly people use their age as an excuse to say whatever they want, whenever they want. Daniel seems to recognize that even though he has attained the age of a crotchety old man, no one really wants to be around a grumpy curmudgeon.
The rhythmic sighs of the ventilator affect me like a strange lullaby. Daniel is resting with the white hospital sheet pulled to his armpits, his veined arms on top of the sheet like fallen branches atop snow. I think that perhaps the next time he stirs I should tell him how important he is to me. But the mechanical lungs are whispering to me "hush, hush, hush," and I can't seem to come up with meaningful words for what might be our last visit together. I think Daniel knows he won't pull through this illness. What are the right words when you're waiting for someone to die?
The third shift nurse walks in to check on the menagerie of snake-like tubes that spring from Daniel's body. "Would you like a pillow, sir? Maybe you could get some rest while he's sleeping." I accept her offer with gratitude, and arrange two chairs into a makeshift bed. Soon the dreams start streaming, though perhaps more memory than dream. I have flashes of Helen and Daniel, here in this same hospital, welcoming their first grandchild into the world, noses and hands pressed up against nursery glass for their first glimpse; Daniel sawing wood for one of the many household projects where I'd gotten in over my head and called him in for assistance; Helen in the kitchen helping my wife make Christmas dinner; Daniel quietly walking away from the auction of the farm equipment it had taken him a lifetime to accumulate.
Daniel turns in his bed, and I'm startled awake. In a flash, I see Helen standing in the corner, looking over Daniel, waiting. Just that quickly, she is gone. I peer over at Daniel, eyes open and tear filled. Had I awakened to the specter of Helen with no independent confirmation, I would have dismissed it as the remnant of a dream. Daniel, though, has seen her as well, even though he cannot tell me because of the tube down his throat. I lay my hand on top of his.
"Someone's waiting for you, Pops. Did you see her?" I move from the chair against the wall to the chair facing Daniel's head. He nods his head up and down in affirmation, finally allowing the accumulating tears to escape the boundaries of his eyes. Though his ventilator keeps perfect time, Daniel's heart monitor jumps to allegro. "Do you think you're ready?" Again, he nods in agreement.
"You know, Pops, before you go, I just want to thank you and Helen for making me a part of your family. You've done a lot for me, and I love you both." I haven't cried in years, but I find myself grabbing for my handkerchief. Daniel begins frantically waving his hand in the air, hand gripped as if holding an invisible pencil. I reach for the tray and pull off the pen and paper. I wrap his right hand around the pen and place the small pad of paper in his left hand, holding it steady so that he can write. Daniel lifts his penned hand to paper with a palsy I've not seen in him before. I hope I'll be able to read his writing.
After much strain and effort, his hands fall to the bed causing a tidal wave of air to puff up his bed sheet. I take the paper from his left hand and draw the message to my face. In jagged script, it reads: "Love you as my son. Tell my kids I love them. Ready for nurse." Tearing his message from the pad of paper and placing the slip of paper in my pocket, I rise and bend over Daniel, kissing him on the forehead. Daniel might be ready for this, but I don't know that I'm ready. I sit back down, waiting for the words to come.
"Okay, Pops." Time seems suspended, and I'm not sure how long I sit before I press the 'call nurse' button and return my hand to grasp Daniel's.
The nurse enters in a tizzy, saying "What's got you worked up, Mr. Flanagan? Your heart is racing."
"He's decided he's ready to pass. I think he wants the ventilator removed," I respond, keeping my eyes locked on Daniel's eyes.
The nurse stops adjusting a variety of tubes and knobs and leans in to address Daniel. "Is that what you want, Mr. Flanagan? Do you want your vent taken out?"
Daniel pulls at the apparatus covering his face.
"Give me a minute, sir. I'll get this removed as painlessly as possible." The nurse looks at me and tilts her head toward the door, motioning me to speak with her out of Daniel's ear shot. I follow her to the doorway. She runs her hand across her forehead, as if to massage away a headache. "There's no living will, is there?"
"No, but he clearly is aware and is directing you to remove his breathing support," I tell her.
"Look, without a doctor, I can't remove the ventilator. However, if he's getting some backup of fluid into the airway, I may need to remove the ventilator hose to replace it with fresh one. I might not be able to re-attach it if he refuses to allow me. Are you following? So you've been hearing a little gurgling with his respiration, right?"
It took me a few seconds to digest what the nurse was hinting at. It didn't matter to me the reason the vent was removed. Daniel was ready and Helen was waiting. "Right, yes. Gurgling."
"Yes, I believe I heard it too. While I go get another nurse to help me, you should discuss what's going to happen with Mr. Flanagan. If he doesn't want me to put the vent hose back in, he's going to need to refuse me. Understood?" The nurse leaves the room, looking back at me over her shoulder.
I return to Daniel's bed side, again grasping his hand. "The nurse is getting some help. Look, Pops, the nurse needs to act as if she's taking out the ventilator hose in order to replace it, okay? If you want to go now and not wait for the doctor to get involved, you need to refuse to let the nurse re-attach the vent hose, okay?" He nods one final time, squeezing my hand in his farmer's grip.
We sit, listening to the noises of the hospital with its beeps and voices. I debate layering my own words over the meaningless hum of the hospital, but there's nothing I can say that Daniel doesn't already know. The heart monitor returns to keeping time with respirator. He is ready, I am ready, and Helen is ready. Now, all we do is wait.