Tuesday, October 14, 2008

Update

My father's twin passed yesterday at noon. I have not yet spoken to my father. he left a message on my machine, and I did not hear it until this morning.

Sunday, October 05, 2008

Deaths

My mother called me at work on Thursday, her voice shaky. “Your uncle Bill is in the hospital. He has had a stroke, or a hemorrhage, Nina said he was in great pain. He may not live the next few hours. Your dad is at the Symphony office. I am afraid to tell him, he’ll want to drive right down, but we won’t make it”

My parents live in Oregon, my uncle Bill a ways outside of Sacramento, California. It is about an 8 hour drive. My father will be 82 in a couple of weeks, as would his twin brother Bill.

I talked to my mom a bit. I told her to be ready to pack, but not to start until my father was home. Nina said she would call back when she knew more. She had told her daughter, but not her son, as he is dealing with his wife’s health problems at the moment.

I have seen Bill and Nina only a few times in the last 30 years. When I was a child we saw more of them and their two children, close in age to my brother and I. There was an unpleasant rivalry between our families then. The twins were not fond of each other, neither were their wives. We children, cousins, got along fine. As the years passed, my parents and Bill and Nina mellowed, becoming rather fond of each other, rivalries faded into distant past.

We had a big joint birthday party at my cousin’s house in California for the twin’s 80th birthday. A picture of them and their older sisters is in an earlier blog.

My mother calmed down on the phone. She said she knew I would be the right person to call, being always rational and calm. I think that indeed that is usually true.

I wonder. So far I not really been upset at a relative’s death. People die, life goes on. It is sad for those who are close to them. Is it that no one truly close to me has died? I have cried long over dead pets. Long ago I figured out that that was because they are my responsibility. Their death, or loss of quality of life quite dependent on my choices, my care. I have also been lucky. No one very close to me has died. What will happen when it is a good friend, or my parents? I adore them, and they are not young. Most of my adult life I have lived thousands of miles away from them, so I see them typically once in a year, on occasion twice.

My friend Lisa was dismayed when her brother died recently. He was in his early 40’s. It was an ugly situation. The situation angered her, but what dismayed her was that she did not mourn her brother the way she mourned the loss of her cat some months before.

Another friend has lost both parents to cancer in the space of three years and it hit her hard. My sister-in law lost her mother right before she married my brother a few years ago, and her father a couple of days ago. I spent some time with him last Christmas, the beautiful white Christmas in the mountains. He had good taste in wine and food and conversation. I liked him.

Yet another friend’s mother has been battling cancer for many years. The battle is not going well these days. She is having a hard time.

My uncle Bill did not want to resuscitated, did not want to be on life support, did not want a funeral or memorial. He was a man of strong opinions. As of last night he was in a coma on life-support, waiting notification of the rest of the family, and their decision. I’m not sure what I think about that. In some senses, when you are gone, or effectively gone, I suppose what is done is for the benefit of any remaining friends or relatives. On the other hand, I think it wrong to be kept physically alive for a long time, costing lots of money, only because no one has the nerve to pull the plug.

Many years ago, when I was in my 20s I worked in a medical research laboratory. I was pretty much a lab rat, doing assays to measure vasoactive mediators. I lived very close to the hospital and laboratory in New York City though, and was single with no real demands on my time (and how nice that was!) so I was the choice to be brought in, sometimes on a moments notice, to get samples from interesting cases and process them for analysis. Some of the doctors in our group were working on a disease that had been lethal, idiopathic pulmonary hypertension. We were a pediatric research lab, so our patients were primarily children. We had good luck with toddlers, staving off the disease until the child’s lungs and cardiovascular system grew and recovered. Our first patient was 2 when we started, she lived, and last I heard was doing fine.

We did not have good luck with young adults. One handsome blond track star steadily declined, became increasingly uncooperative and obstreperous during our treatments, not unexpected as our treatments weren’t working on him, and quit the experimental procedures. A beautiful, soft-spoken woman from a Carribean island was a model patient, only an occasional tear leaking from her large dark eyes over her pain and fate. They died, hearts failing from their disease. I would ask at some point and hear of their passing.

Then we had a patient who was neither a toddler nor a young adult. His name was Jose. he was our first patient who was actually local, from the neighborhood. He was about 7. He loved baseball and was a cheerful child. The doctors tried this and that and the next thing. He would hold steady for a little while, not improving but not worsening, then he would get worse. The disease was killing him. One day we had him in the cardiac cath lab yet again. I was there in a lead apron with buckets of ice and tubes for samples. I talked to Jose while yet another treatment was tried and pressures monitered. Then all the doctors left the room for a bit for a huddle over the treatment.

They came back in with grim determination. More medicines were given. They watched the monitors. Jose’s systemic blood pressure began to fall. I was given some more samples. The pressures fell further. In hushed voices the doctors fretted about possible negative results that they knew were a risk. Suddenly the medical personnel in the room went into a rush. I stood their watching, not being part of the medical team as they tried this then that to keep his systemic blood pressure from falling. The stress level in the room shot up.

“Is there anything I can do?” I asked.

“Keep him awake!” snapped a doctor.

So I talked to Jose, asked him about baseball, told him some silly jokes. Jose smiled, and talked for a bit, then in spite of my best efforts, he fell asleep. I was sent away with my samples.

An hour or two later the doctors came back to the lab, away in the research wing. I was just finishing processing the samples for later analysis.

“How’s Jose?” I asked.
The doctor looked at me with disbelief.
“He’s dead” she said, and walked out. I was left standing there, shocked.

Another doctor walked in. “I didn’t know he was dead” I said.

The second doctor looked at me, eyes hard. “Yes, he’s dead, and it was because of what we did. We knew the treatment might, if it didn’t help. I’m surprised you didn’t know. Why do you think we asked you to keep him awake? The treatment to lower his pulmonary pressure stood the risk of bottoming out his systemic pressure, and because of what we used, we would not be able to reverse it.” He did not have long to live, so we took the risk.

I went home that evening, ate, watched TV, went to bed and curled into a ball, miserable. If I had known would I have worked harder to keep him awake? Consciousness helps keep the blood pressure up a smidge. It would probably have been impossible to keep him awake, I was told. That death hurt. The others didn’t much. That one hurt because I had a small responsibility, and because I did not know.

So. Uncle Bill. He will probably be the first of his four siblings to pass. He and my father are the youngest. One of my older cousins has died after many decades of drug abuse. I was never close to him. I do wonder how my father feels. He was joking with me last night when I called. He was serious about his brother of course. I am unsure if he bottles things up, or whether he too is not feeling a lot, though surely more than I do.

I wonder about levels of feeling. What will I feel when my parents go? I wish I talked to them more. I REALLY wish that I saw them more.

I wish I knew more family history... but in a sense, why? I am single, no children, there will be no passing down. When I am gone there will not be any need to for me to have had that information. Is there truly a need to know any of the family personal past? For instructional purposes perhaps.

My mother must be thinking of my father, and of mortality, what if it was my father instead of his twin?

What if when I lose someone dear to me I am not devastated? What if my usual calmness reigns? Should I be grieving for every lost relative, grandparents, cousin, uncle? I am not an entirely unemotional person. Why are some so very shaken, and others less so?