I know that my father is very sick because his room is cluttered with machines that click, hum, and beep.
On Thursday, my father and I spent a good day discussing family, politics, and the Lewis and Clark expedition. Our conversation was interrupted frequently – by the nurse who routinely measured his blood pressure and by the respiratory therapist who administered periodic breathing treatments – but it was a satisfying conversation. Talking is what dad and I do best. Its is how we relate to one another. I’ve been chatting with him at least once a day by telephone for years. We discuss life, politics, history, anything really.
Our conversation was very much like hundreds we have shared in the past despite our surroundings. His finger was hooked up to an oxygen monitor, his arm a drug infusion pump, and he wore a small oxygen mask connected to a spigot on the wall by a length of clear surgical tubing. The infusion pump delivered medicine to him via a PICC line, a port that runs from his arm directly to his heart. His oxygen mask is light and does not prevent him from speaking clearly. It is surprising how little the hospital intruded into the intimacy of a private conversation between father and son.
Dad’s voice is strong. His wit and humor are intact. He is dad. As we talk about the “undaunted courage” of Meriwether Lewis and William Clark. Dad greatly admires these men and considers them American heroes. But it is the man in the hospital bed who I admire. I marvel at the courage with which he faces his illness. Dad’s ability to be himself gave me strength. I was aware of the irony that I was taking comfort from him not the other way around. Even at 41 years old, even in the ICU, I look to dad for reassurance. I was not disappointed. In typical Cravens fashion, Dad had a plan. We brainstormed what he will need for his return home from the hospital. He predicts that he will be too weak to walk unaided and reasons that he will need ramps, rails, a wheel chair at home. He tells me how to build the ramp, what equipment we can jury-rig (dad could build a lunar lander with a little bailing wire and an old lawn mower motor) and what will need to be purchased. Dad is still in charge. There is much hope in the room. There is talk of his coming home. I believe that it will happen and soon.
His condition suddenly worsened that evening. He coded that night. Though he was resuscitated by means of CPR and a defibrillator, he revived to very different circumstances. Now he was surrounded by three infusion pumps, each one delivering three or four different drugs, a ventilator, and two monitors. The vent delivers life-sustaining oxygen by means of a tube inserted through the esophagus into the lungs. The tube is so uncomfortable that a patient receiving mechanical ventilation must be sedated. One of the infusion pumps carefully titrates a mixture of fentanyl and propofol into his superior vena cava in order to maintain him in a constant state of conscious sedation – i.e. he will respond if roused by touch or voice but otherwise will float just below consciousness. The sedation means that I cannot speak to him. The tube means that he cannot speak to me, though he sometimes tries. Dad can’t talk to me. This fact is impossible to bear, a glimpse into the inevitable.
An ICU doctor is deeply distrustful of the patient’s body. This makes sense because, after all, the patient would not be in intensive care unless his body was failing. The sicker the patient, the more trust the doctor places in technology and the less in the flesh. Dad’s doctors do not trust his failing body. The infusion pumps impose an artificial sleep. The ventilator breathes for him, carefully calibrating and recording each breath. His heart is watched suspiciously like a wayward child. It is left to beat on its own for now but a machine stands ready to take this task over if necessary.
My experience of dad is now completely mediated by the potent medicine that sustains him. The only way to connect with him is to hold his hand, and even that is made difficult by straps and tubes. I try to memorize everything about the hand and the tactile experience of holding it because it is the only bit of dad left. If I lose him, the hand will be my last memory of dad. His hand is warm because his heart still beats. It is thick, meaty still even though the rest of him has atrophied. Dad used to be six feet, two inches tall. Always a source of pride for both him and me. He told me recently that he is barely six feet now due to the collapse of his spine. Though he is seventy-five, his hand is still rough and callused by work. They are hands that chop and carry wood. They labored his entire adult life to provide home and safety to his children. They protect, reassure, and caress.