Dad in Defibrillation
My 88 year-old Dad is very sleepy after our morning swim. When I swim next to him these days, I watch him underwater. Stretch, breath in, crawl, head in, bubble out, and glance over. Dad is submerged, buoyed in the fetal curl of the side-stroke. Stretch, breath in, look. The tip of his head and his nose emerge like a porpoise coming up for air and then he is held, cradled, underwater again, his mind hurtling through air on the parallel bars, skiing "like a bird," twirling my mother to win the Fox Trot competition at Trout Lake.
My Dad has a pacemaker and twenty-per-cent of his heart after nine attacks, operations, infractions, interventions. My mother died over thirty years ago but he has a cuddly second wife, eight grandchildren he loves, friends who converse and discuss, junior partners who welcome him to the office, children like me only now learning to not to burden him with our woes, and music that transports him. For the past months, he has been listening to calypso, Down the Way Where the Nights are Gay, Island in the Sun, Matilda, songs he danced to after his first heart attack when he was 57, when he could hardly make it to the Caribbean, where the nights are gay, all night, everynight, Marianne, dancing into the sea, dancing himself back to health. "I’ve accepted I can no longer ski or walk too far," he assures us, "it’s only the dancing I regret."
Two nights ago, Dad invited me into his music room/library to hear the calypso album he’d been talking about since he returned from Florida. "At sunset, I sat outside in the balmy weather with my Walkman, listening to the music, looking out at the sea." The music brought my mother back to him, and he danced with her again, live and lively in his arms. "What more could a man want." Dad carried the CD with a measured, stately walk to the excellent sound system and on the way back to his chair, the music got him. He contracted his torso and leaned into the beat, a sybaritic smile from ear to ear. He didn’t move, except rhythmically, dancing in place on the balls of his feet. And when his wife Phyllis sat down near him, he turned his dancing body to her, tongue clicking, fingers clicking, sashaying his shoulders, and swinging his butt.
Dad and I sit very still in the reception room of the swimming pool, cooling off after showering, waiting for Phyllis. Dad can hardly keep his head up.
"Very sleepy" he says.
I talk, pretending everything is normal, but notice he is fading in and out, mostly out. Sometimes he looks at me and sometimes that is too great an effort. Usually he is attentive, interested, and conversation with him is engaging and rewarding. Now he seems to be in another, more peaceful world, where little I say is relevant. I try to keep contact, chattering through fuzz. Occasionally, he rouses himself to ask a question. The answer hovers between us, words or phrases glancing off, some maybe getting through. I should say, never mind, or sing, but I don’t want to let this post swim intimacy go. He doesn’t hear what I am saying, but he doesn’t want me to worry. When I finish a complete thought and stop speaking, he surprises me with a fully-creased, extravagantly wide, beatific smile.
"I’m very sleepy too," I say. "After swimming."
But I know it isn’t the swimming. His words slur when he tries to speak, just like before he fell down on the mountain, leaning over quietly and crumpling to the ground. He looked peaceful then too.
Dad knows something is wrong and when we get home, he arranges to see the village doctor. She measures a dangerously high heartbeat and tells him to go the emergency room and see a cardiologist. Dad is admitted immediately, assigned a gurney in the corridor, and attached to drips to control his heart rate and monitors that blink his vital signs. Phyllis phones me from the hall phone near the bed and passes the phone to Dad "I have to piss in the hall," he says, "It’s something I’ve always wanted to do."
I visit the next day and see him first from the back, sitting in his stylish polyester Japanese kimono waiting to be transferred to a semi-private room upstairs. I am carrying a plastic bag with takeout couscous, tabouli, humus and some chicken. There is no place to sit. I lean against the wall, Phyllis perched on the gurney. Dad waves the light plastic hand urinal he uses to pee in the hall. "You know we used to line up and try to pee across the street on St. Urbain Street so I am getting used to doing it here. I hold the cup under my gown and look up and down the corridor like nothing is happening, meanwhile I’m pissing. Last night I was standing here holding the cup in my hand and a doctor came by, so I didn’t start, just held the cup until he passed. He walked by me, turned around, walked back, put his hand in his pocket, and dropped a quarter in."
I laugh. For a moment I believe him. And when I don’t, it’s funnier.
The next morning, I phone my brother the doctor in the States where he is working to pay off his alimony settlement. "Dad had a superficial heart attack and developed a fast heart rate," he says. "He went into heart failure. They are giving him blood thinner and medications to slow his heart rate. They are going to do a TEE, a transesophageal cardiac ultrasound, going down his throat into his heart, to see if he has any clots. If he doesn’t have any clots, then they will zap the heart into a regular rhythm. There are, of course, big risks. Dad has agreed to them. The benefits outweigh the risks. With luck we’ll get through this. And then, we should consider an internal defibrillator and the question of cauterization. But the cardiologist in Montreal is not entertaining this now."
"Thank God,’ I whisper silently and, aloud, I say, "If we could only get him home to his records, books, the streams rushing, birds returning, sunlight on the balcony looking over the valley, he’d get stronger before he has to be zapped."
"Oh, Merrily, " my brother laughs, hah, hah, you are so…." Does he say "silly," "stupid," "fey?" He wouldn’t know "fey."
"I’m thinking of the mind-body connection." I defend myself, "It’s good you know the other stuff."
"Yes, well …. hunh, ha."
I rush out and buy an organic chicken, white meat and dark, organic onions, chard, carrots, potatoes, and make a chicken soup. I get the soup to the hospital warm, on time for Dad’s supper, and am surprised by Phyllis gesturing to me as soon as I enter the lobby. She points to the cardiologist on the payphone with my doctor brother, then brings me up to date. The TEE procedure, for which Dad has fasted all day, has not worked and the zapping is postponed for now. I sidle up to the phone and hear the cardiologist alluding to the severe hemorrhaging risks of putting an 88-year-old man on Coumadin. I hear only the cardiologist’s side of the discussion of treatment options. He is considering the continuation of the heart-rate drug, with the possible addition of Coumadin to dissolve any possible clots. If my Dad takes Coumadin for five weeks, it will clear his arteries, and then they can zap him.
Dad is sleeping when I reach Room 406, his arms, head, shoulders composed tightly against the slightly raised white sheets. He hasn’t eaten all day and the test to establish if he is a possible candidate for zapping, has failed.
"He’s disappointed," Phyllis says.
Dad opens his eyes and sees me, sees my visiting daughter, sees his wife, rouses himself from his Valium slumber, drifts away, rouses himself again. "I should eat." He inches his legs through the wires, the drips, and over the gurney. I help him direct his arms into the kimono. My daughter and Phyllis talk in the hall, Phyllis sad they won’t be able to go to Florida this November because of the new medications. Dad will not have been "stable" for six months and the insurance won’t cover him. "But we’ll go in January," she punches the air with her hand.
Dad gets up to eat and I offer to push his drip stand to the chair. "No thanks," he says as he straightens up for the walk, "I hold onto it."
I lower the table, spread the food out in front of him and watch him eat. He seems to perk up like plants when you water them. I’m hugely relieved he wasn’t zapped, he’s hungry, he’s still here. I call my daughter and Phyllis. It does our hearts good to see him eat.
"How long have I been here?" Dad asks when the others have left for the evening.
"Since Monday, three nights."
"That’s not such a long time," he says, surprised.
"So much has been happening. The emergency room, the tests, the big decisions, the procedure."
"It’s like another world here."
"What do you mean."
"Other people telling me what to do. Taking me here and there."
He leans his head against the pillow behind his head and dozes off. I read the newspaper article on the new US Arctic-to-Mexico defense plan, and hope Canada opts out. Today the American’s "friendly fire" killed four Canadian servicemen in Afghanistan. Dad opens his eyes, finger in place in his unopened mystery book. "I know what will wake me up," he says, "bring me your file." He adjusts his glasses, arranges my papers on the food tray, and hunches over the numbers and schedules. For a time, everything else falls away as he wills his accountant’s skills to kick in and resurrect his professional self. Hooked to tubes, wires, drugs and graphs, pencil in hand, my Dad escapes into my income tax.
He figures out what I should do and dozes off again.
"You know, we won’t be able to go to Florida." he says when he wakes. "It’s not so bad for me because I don’t need much movement. I have the swimming, my music and books. But it’s hard on her. She needs more movement, she doesn’t like the cold."
"She says you’ll go in January."
My Dad pauses, thinking, or calculating the insurance requirements. Then he says, "Yes, I’m very optimistic about the future."
I take the stool away so Dad and the drip-stand can maneuver toward the bathroom. Passing me, Dad looks at the toilet brightly, "let’s hope." I ask him if he will be able to get into bed alone and he says, yes. We kiss good-bye. "Thank you for coming," he says.
I take the elevator and walk out into the balmy Spring air. Tomorrow, I will make prune, apricot and raisin compote. I want to get him out of there. I think he will heal better at home and I am afraid of the zapping and the Coumadin that causes hemorrhaging. My older friend died a horrific death in a cyropack, zapping, surgical quest for heroic measures. Yet Western science has kept Dad alive. He believes in doctors, norms and numbers, benefits and risks, blood tests and procedures, meds and meds, even heavy meds. And he wants to live. I fear he may accept any intervention offered. I walk to the car, hoping he’ll make it onto the gurney and that the Valium won’t make him stumble, or tumble out.
Phyllis phones the next day to say the x-rays show Dad has fluid on his lungs. He will have to stay in the hospital to be monitored with a new medication for the fluids. When I arrive with his supper, he is in a chair with a big grin on his face, free of wires and tubes. "You get used to it but it tangled me up at night." The drugs are bringing his heart-rate down and the doctors think the defibrillation will take care of itself. "The cardiologist came in with one of the rhythm boys," he says, referring to the specialist who adjusts the pacemaker, "I entertained them at the expense of my beautiful wife," he grins at Phyllis. "You know, they had to put a tube down my throat to do certain x-rays. I didn’t consider it too bad, they’d anaesthetize my throat, put a tube in, say swallow. So, I’m on the table and the doctor pushes and pushes and can’t get the tube down. He calls in a woman, she can’t get it down, calls in the supervisor. But at a certain age the collarbone and the spine enlarge and they can’t get by. ‘My wife is a health food fanatic,’ I told the doctors, ‘You had three guys trying to ram a tube down my throat but my wife feeds me things that are harder to swallow. You needed her in the operating room.’ They thought it was very funny. I think they’re not letting me out of here because I make them laugh."
He lifts the lid off the leftovers of the boiled chicken soup and vegetables I brought yesterday, "Ah, yes," he says unimpressed. As soon as he finishes eating I ask the question foremost on my mind.
"What about the Coumadin, Dad?"
"No Coumadin," he says, "I had a long talk with the doctors. It didn’t make me comfortable."
"I don’t like it. I could be working in the basement and hit my head. I already bleed easily enough with the blood thinner I’m taking, and this is …"
"Yes. I told them I have had and am having a satisfying life. I didn’t get much of an objection."
"You have so much you enjoy. Reading, discussing, the grandchildren, your music," I gush, so relieved that Dad is not going the Coumadin/zapping route. It’s his choice but I think it would have been too much. Maybe he feels that too.
"Yes. And I can swim. I don’t want to be a body-builder, just keep my body from creaking."
I feel a great sense of calm. Time unfurls, expands, levitates, without potentially-fatal chemical or surgical risk.
"And I’m not in any discomfort," Dad says, "There are things I can’t do and I have accepted this." He sounds like he is facing his health and mortality realistically, as I try, am trying to do. I conjure up his state of grace, relaxation, calm, after he fell on the mountain, his soft, sleepy face as he faded in and out at the swimming pool. It is peaceful to die naturally. I’ve seen him almost do it twice.
"Of course," Dad says, as I struggle to face letting him go. "I’ll have to build up again."
Phyllis and I bustle around preparing to leave. Two of Dad’s beloved grandchildren are expected to visit soon and stay until early evening.
"You’ll be all alone at eight o’clock." Phyllis warns.
"That’s okay," Dad smiles, looking over at his room-mate, "Me and Claude will be fine. We’ll drink the disinfectant over there and have a lovely party with the nurses."
May 7, 2002, 2500 words