And now he's gone

My father has died. It was, as these things go, relatively quick and gentle; he went into a hospital on a Wednesday to seek treatment for COVID-related difficulty with eating/keeping food down, developed trouble breathing while he was in the emergency room, and coded out while they were trying to intubate him. They got his heart started again, and put him on some meds to keep him unconscious (critical when you have a tube down you throat and a respirator forcing your lungs to work) and try to dissolve the blood clot (COVID, again) that were causing the issues with his breathing. My brother and I waited up until he was placed in a room in the Intensive Care Unit, while my brother's wife drove Dad's wife back to their house. 

I pause here to observe that Dad was, technically, a DNR. He'd said for years that he didn't want to end up on a feeding tube, and he didn't want people working to try to keep him alive if there wasn't a reasonable chance that he'd wake back up with his faculties intact. However, at this point it looked like we had a pretty good shot at that kind of outcome. 

By Thursday, that was looking a lot less certain. Despite some truly excellent medical professionals, the drugs were damaging his veins and doing horrible things to his liver, and dehydration was damaging his kidneys. 

I took off early from work and went down to help Dad's Wife look over some medical paperwork that they wanted her to sign. This was when we found that the nutritionist wanted to start putting food in through the feeding tube; it was also when we got a better impression of the way his health was teetering. The doctors were patching holes as quickly as they could, but sooner or later the dam was going to give way. 

So we called it. My brother and his wife came down to join us. My wife had just flown back in from a family event (her sister's retirement) and the first she heard of all this was when I called her on her way back from the airport and asked her to detour to the hospital instead. 

The five of us talked it through, and concluded -- pretty much unanimously -- that the best thing to do was to keep him off the feeding tube, get Third Brother up to visit from Austin first thing in the morning (he didn't feel that he could safely drive up, having heard the news, and if his wife was going to drive then they needed to prepare their girls for the trip), and notify everybody that this was happening.

We also figured out how to adjust the music, so we could turn off the pop that was playing. My dad was not a horrible music snob, but I really didn't think he'd want to leave this world to the tunes of Katy Perry. Instead, Beautiful Wife brought in a bluetooth speaker and used her phone to play hammered dulcimer music for him on Saturday. Third Brother and his family came up -- we really need to find happier reasons to see them -- which was, I believe, critically important for his mental health. Other folks were farther afield, including some who were actually out of the country, but we gave anybody who wanted it a chance to say goodby via Facetime -- with the understanding that Dad wouldn't really be able to react them, of course.

About one o'clock on Saturday afternoon, after talking with the ICU doctor about likely outcomes and what Dad would have wanted, we told them to cease care. They turned off the respirator, extubated him, and switched from the cocktail of medications to a gradually-increasing dosage of morphine, to keep him unconscious and pain-free. 

I don't remember when we left on Saturday. 

We came back on Sunday, and this time we played folk music. We could track how his vitals were slowing down, but the man had constitution of a musk ox and it wasn't until 10:45 p.m. that he finally drifted off. Like, I watched his blood pressure get down to 14/14 and he was still going -- but we all knew at that point it wouldn't be long. His wife curled up beside him on the bed, until his breathing finally jerked and stopped, and the nurse came in and called it. 

So that was how my dad died. Next time, I'll tell you how he lived.