I remember the day we went to the oncologist with my father. The doctor came in said hello, and before he finished sitting down, he had delivered the bombshell, "you have less than 6 months to live." I remember being so angry at him, and me the meek person I am, let him have it. I proceeded to tell him, and without expletives, that he is the sorriest physician there was and would ever be, me the new nurse who started his practice less than six months ago. We waited while they copied my fathers records.
My father just beat a run with colon cancer just two years prior. He had a colon resection and they did not do chemo afterword's because the doctor's "THOUGHT" they got it all. My dad's attitude now was "**** em" look what these smart ass doctor's know." Little did I know this was the beginning of a most surreal journey.
Now my dad was a self made and educated man. As a child he grew up in the depression in New York. He had a ninth grade education. I remember him telling me that he got expelled from school because he got into a fight with his principal. He was a tough guy. His favorite sayings to me was "never take any crap from anybody because once you do you will take it your whole life." Although that was his main premise for life he became a very successful businessman. He had a life that few could match.
Let's just say my relationship with him was hot and cold. He always talked yatta, yatta, yatta. He loved people, I remember being embarrassed many times by his social charisma. We disagreed about everything. I used to joke with him "are you sure I'm your son." We would both laugh because I was adopted.
I had told him from the beginning "dad you have had a life many only read about. Let it run it's course, it is the quality of your life not the quantity that matters." This drove him nuts. Anyway he had called in many of his markers and he was treated with experimental meds, the whole nine yards. It was almost three years since he was diagnosed with terminal Lung cancer, which spread from his colon. My dad was doing pretty good. He had been on the experimental drugs with none of the usual side effects. I took care of him just like I was taught to in school. He was my patient. I was the teacher. Little did I realize that he was going to teach me.
Then he got the word. The PO meds he was on weren't working any more so he had to start conventional chemo treatments. During the time he started the what he called "the hail Mary pass" He spent his days playing tennis and spending time with me. My dad and I were becoming friends.
I was at home on a thursday. My father called and he was in a state... I had never seen him act this way, Hell I only remember seeing him cry once, when his mother died when I was eight. When I get to his house he's frantic, pacing the floor, grabbing his head and chest, he sits me down and doesn't say a word. He tried several times to talk but the words didn't come out. I thought he was having another TIA. Finally he was able to speak and what he told me shook me to my core. He told me he was going to die very soon. Have you ever had a patient tell you that" I'm going to die tonight" and of course you think yeah whatever, by the end of your shift THEY WERE GONE. Well this is what hit me... and as if looking through a hazy pane of glass I could see my dad realizing for the first time that he was going to die.
The surreal part was we were arriving at the same realization, at the very same time. I knew all the Kubler -Ross stuff and all the intellectual mumbo-jumbo but, emotionally for the first time we let it in, the finality of death. Both of us sat there for what seemed forever. He suddenly stood up, rearranged his clothes, looked at me and said "I don't want to kept alive on machines unless YOU FEEL this is only temporary." He had started giving me exact specifications as to what he wanted and didn't want. After his directions were finished we just sat after that not really talking. I was realizing that after all the years of fighting with him it took cancer for us to finally respect one another and became very close friends.
The next day he was back to his same old self talk, talk, talk, except now he was reminiscing, as if he was double checking his life. He in his 73 years never said I am sorry, not to me or anybody that I can remember. That day we went for a walk and guess what he apologized, it didn't matter to me for what... I knew at that very moment he would be leaving me soon. When we got back his wife,my stepmother, said to me," is your dad OK? he has been acting very strange the last few days."
It was Saturday night around 9pm when I got the call at work from a policeman informing me that my dad "went down " at a restaurant and that they were taking him to the hospital. I remember just staring at the code cart directly in front of me. I slowly walked out of work and drove to the hospital. When I came in the ER doors I could here the defibrillator charging. I also heard a very familiar voice, it was my Paramedic friend from nursing school. As soon as she saw me she started crying and kept saying I'm Sorry, I'm sorry. She had held her arm up and dropped the EKG paper of how many times they had shocked him in the field. We walked and hugged and she took me back to see my dad.
I was almost elated when I saw who the doctor was who was running my dad's code, as if It was my only last moment of delusion left to keep me sane. The Nurse in the room was phenomenal. I couldn't believe what she was doing and how much of it, yet she was completely calm except she needed another eight hands. You could smell the burnt skin. My dad woke up after being shocked over 75 times. He looked at me. He couldn't talk because of the ET tube. I picked up his hand and asked him if he wanted to fight a little longer he nodded yes, I told him I remembered what we talked about, as if reading his mind, He closed his eyes and that was the last time I had any further communication with him at all. The doctor got him stable enough to take to CCU.
My stepmother said to me "I hope he doesn't die tonight because it is your sisters birthday." I tried talking to my stepmother about making him a DNR after he coded a couple more times but all she could say to me was "I can't make that decision, I don't want him to suffer, but You are going to have to make it. Of course it being my sisters birthday i can't get a hold of her. During the next couple of hours I had signed the DNR papers still hoping to get in touch with my sister. It was early Sunday morning when i spoke with my sister. It would be some time before she got here, so we just waited.
Well my dad had other plans as if to remind me that enough is enough he started to code, and the nurses that were taking care of him were on break, my step mom comes out and tells me their putting pads on him again. As I am walking into the unit I hear the defibrillator charging. I popped my cork. Well let's just say that the hospital staff will at that hospital will not make that mistake again. I had gotten my step mom and withdrew everything. Even as a nurse I knew all the right words and lingo to help somebody else in that position but for me I was numb. The enormous weight of helping my dad die with dignity and following his wishes was crushing my soul. I was tormented, of course it didn't help when my sister arrived and yelled at me "you killed my father." So much drama.
It wasn't until almost six months later when the doctor in the ER saw me and asked "how are you holding up." That was it, out of know where I was crying like a baby. That poor doc was just standing there and I could see he was like Oh **** what did I do. For the first time since his death I allowed myself to grieve. I didn't know why then. Then it hit me, something my dad said to me in his dissertation of directions. The day he told me he was going to die very soon. He told me "don't blame yourself for anything, what you are going to do for me is the hardest thing you will ever have to do but at the same time the greatest act of love there is."
My fathers greatest lesson to me has helped me more as a nurse than anything i have learned or will ever learn in caring for patients. His love for people made him sensitive towards their needs. It gave him a great insight into them as an individual. We as nurses today live our work lives in a state of constant flux. Just when you think there could not possibly be another piece of paper to fill out there is. Just when you think you have enough meetings to go to and enough committees to be apart of there is more. The reason there is more is that we take care of people. Yeah there are some real pieces of work out there, but they are people. My patient, my father taught me that I as Nurse I am going to help people die, and to do that with dignity and compassion. If my dad didn't take me on that journey with him I don't think I would still be a nurse.
I feel honored to have been apart of so many people's final journey. Each and every time I learn something. Yeah we have to do our jobs effectively and objectively, and take care of all the litigious issues, but alas we are taking care of people. Thanks dad for helping me to a more sensitive and caring nurse. Thanks for helping me to see the individual needs of a patient on a daily basis, and most importantly Thank you for teaching me how to deal with and help others deal with the final journey. I miss you dad.