Poor old man. These are the words that flash into my mind when I walk into the ward this afternoon.
Poor old one legged grandad, draped in his crisp white sheets, mouth open, tongue cracked and dry. Up his left nostril is a tube that will provide all nutrition from now on, above his bed is a new green sign announcing NBM.
Within the tube I see greenish liquid floating in and out his body like the tide.
Morphine is his friend. Morphine could be a much better friend but we discover this evening that “his family” and indeed himself have said they would like “full active care” meaning that he will have to endure a considerable amount of pain as various obstacles and setbacks present themselves.
My sisters and I flutter like angry sparrows. Who was the “family” who said they wanted full active care? It wasn’t me. It wasn’t me. It must have been dad and grandad, that first night when the doctor said his leg should be amputated.
But we realize that the only person who would know what that actually means, minimum pain killers, intrusive procedures in response to the litany of organ failings, would be youngest sister K, the nurse.
Grandad’s eyes flutter open and shut. The whites are still yellowish but the centres are clear pale blue.
Last night I dreamt that I was trapped in a room and my big toes were bitten off and I tried to run through a shopping centre with blood splashing underfoot.
He said he wanted to be alive for his birthday which is in a few days. I don’t think he will be. Or maybe he will but he will wish he wasn’t.
My dad is six hours away. He is driving back to Newcastle as I type.
I ask them to correct the name on the whiteboard above his bed. They have James written there, they call him James and indeed James is his official name.
But the name he prefers is Pat. And finally I ask them to correct the name and they do.
“Pat” It is like a suggested action for comfort.
There are three other patients in the room and I realize this afternoon that they are all amputees. Except for one man who sits, fully dressed, on the bed with his knees drawn up to his chin. I think he is saying goodbye to his legs. Nobody else in the room seems to get visitors but one lady is surrounded with loads of flowers.
They are talking about ventilators. Pat’s chest is wheezy. But if he has a ventilator that will be curtains. Curtains with a ventilator.
I stand and stroke my grandad’s hair just like I stroke my toddler’s hair when I am trying to get him to sleep, just like my mother used to stroke my hair when I was a little girl, just like I stroked her hair when she was dying.
Yesterday when my sister T left the hospital after seeing him, her last look at two legged granddad, a man walking on the footpath in front of her collapsed and died. He was talking on the mobile phone and he dropped like a stone and my sister grabbed at him and shouted DUDE DUDE WAKE UP. I think this was the surfer in her talking and then the Chinese medicine masters student with a recent first aid certificate took over and she thumped away at his chest while another woman did mouth to mouth until one of the passing ambos came and took over. It was full on, she said as I gaped at her story. But in some ways it helped me to take my mind off things.
He has said that he doesn’t believe in any sort of life after death, does not believe he will be reunited with my dead grandma, does not even think his essence will be dispersed Harry Bliss style and he will float up and up, spreading thinner and wider, until he is absorbed by the trees around him. This is a shame because just outside his window is a veritable forest of beautiful tall roughbarked eucalypts and anyone of these would make a pleasant receptacle for one’s soul.
This evening it is made clear to me that my granddad will die.
The doctor tells me that she doesn’t think he will leave the hospital. She tells me that she told him the same thing when he was deciding whether to have the operation or not. He could succumb to the infection and just be kept comfortable on painkillers or have the operation to remove the source of infection. At the time I thought, well what would I choose, of course I would choose a shot at life, one legged though it may be. But now I learn that he will die anyway. He was always going to die anyway, there are too many things wrong with him. And so why did he have to have his leg cut off my sisters and I ask each other tearfully. He is in such terrible pain, why can’t he just be comfortable?
Because he made a choice, our youngest sister, K says. And we have to respect that. As a family we can override his choice but we have to understand that it’s what we will be doing.
But he didn’t realize…
But he thought it would do him some good…
But he’s in so much pain….
But it is his choice.
Then just as we think maybe he will drift off in a hazy sea of friendly morphine K tells us that if he does, they will administer Narcan to revive him and that will negate every trace of opiate in his system and so he will be hit with the full force of his post op pain and it will be like being hit by a bus. Worst case scenario, she adds hastily as T starts to sob and say we have to ring the hospital and tell them he has to be comfortable, we want him to be comfortable…this is just inhumane.
But his choice…
And so now we wait for our father, now three hours away, and we see how Pat is tomorrow. And as a family try and make a decision for a poor old man, a poor old grumpy man, rude and cantankerous, stubborn and abrasive. But loved.