Danna’s Spine

Well, at least the sex was pretty good, thought Danna.  Not rock-em/sock-em, but it left a smile on my face.

She didn’t say anything, though.  Her brother Rayan was in the middle of another tirade on her loose morals, weak will, and overall lack of respect for herself.  This time, the occasion was her weekend away with his (married) work buddy, Jack.  How could she let herself do that, he asked again.

Danna knew there was no point in responding.  This was not the Punjabi in him speaking.  He was as relentlessly Canadian as she was.  This was just an older brother expressing concern for his sister.  It was not the first time, and it would not be the last.  At twenty-five, she had learned both the independence of adulthood, and the wisdom of shutting up when that was necessary.

Shutting up was currently necessary.  Rayan (pronounced “Rain”, as far from the Sanskrit pronunciation as his parents could get) was going to say his piece.  Even if his low opinion of her could hurt sometimes, she knew he really loved her, and just wanted her to be happy.

And, he was not entirely wrong.  I mean, what kind of idiot has a few drinks too many, then agrees that a weekend in a low cost motel is somehow romantic?  With an almost forty-year-old guy who spent most of the weekend on the phone with his wife, lying about where he was.

Danna didn’t even really care about Jack.  That wasn’t the point at all.  She was lonely.  A little horny too, perhaps, but mostly just lonely.   And Jack was available.   Available-ish, anyway.  Everything doesn’t need to be complicated.

“I can’t imagine what Dad would say if I told him,” Rayan was saying.  That got her attention.

“Why on earth would you tell him?” she said.  “What kind of brother does that?”

“Oh, I wouldn’t,” he replied.  “I’m just saying…”

“Well don’t.  Enough already.  I get it.  I was a slut this weekend.  I shouldn’t do that.  Next time I feel the urge, I’ll find another solution.”  She didn’t really mean that completely, but he was at least half right.  That was enough for her to capitulate.

He knew how to get to her, that’s for sure.  And, even if it was entirely out of love and caring, she came away feeling down, thinking a little less of herself.

As she often did in these situations.

*   *    *    *    *

Two days later, at the office, Danna found herself in exactly the same frame of mind, but for a different reason.

On her desk was a massive pile of reports, probably more than a hundred of them.  Hard copies – who uses hard copies these days?  The flash drive on the top of the pile seemed like an afterthought.

Her mission, should she choose to accept it, was to cross-reference the key conclusions in those reports based on individual issue, chronology, source, geography, and result.  She would be preparing, she was told, a “synthesis report” for upper management.

For this she stood third in her MBA graduating class?

Danna knew why this was on her desk.  If anyone else in the Finance Department had been given this task, even one of the other two women in the department, they would have screamed bloody murder.  In fact, the women would have been the first and loudest objectors, because, as Danna often said, they had more balls than the men.  All the men.  Combined.

Not Danna.  One thing you could be sure about Danna is that she wouldn’t complain.  Whatever she had to do, she would lower her head and trudge forward, getting the job done and done right.  You could count on Danna.

This report was tedious, a long, thankless task that any moron could do.  It would take days, maybe weeks.  She didn’t want to do it.  She didn’t really even have to do it.  She knew that.  She could have resisted, and given her performance in her job she probably would have succeeded.

But “Danna the doormat”, as her brother might say, wasn’t like that.

So here she was, staring at a pile of crappy work, knowing that she only had it because she had no self-respect, and refused to stand up for herself.

And I don’t even get “pretty good” sex out of it, she thought.

She was still feeling sorry for herself (another sign of weakness, she knew), when she was interrupted by Beethoven’s Third Symphony, her cell ring from her brother.

He was breathless.  “Dad’s in the hospital.  Something happened at home, maybe he fell, I don’t know.  Nobody is telling me anything.  You should probably get down here.”  Then he hung up.

*   *    *    *    *

Rayan hated hospitals, but they didn’t really bother Danna.  Hospitals are a place to go to feel better.  How could that be bad?  Rayan was more affected, maybe because he was a little older than her when their Mom died.  He remembered the hospital more vividly, and to him hospitals were more of a place to die.

After she found Rayan, waiting inside the Emergency area, she started to get a sense of the seriousness of the situation.  Rayan was thoroughly agitated and angry.

“They won’t let us see him,” he said without preamble.  “Fucking doctors.  Fucking, fucking doctors.  I hate doctors.”

One of the advantages of being weak, thought Danna, is that you are also slower to anger.  Shit happens.  You accept it, and deal with it.  Rayan was more emotional about things.  Stronger, but sometimes a bit volatile.

“Just sit down and fill me in, OK?”  Reluctantly, he moved over to the corner of the room, and they sat together.

“I’m not actually sure I know anything,” he said.  “They called me from Emergency because he had my business card in his pocket, and from the name I guess they realized we’re related.  I got here in no more than fifteen minutes, tops, but by that time he was already in surgery.  They forced me to sign some stuff, then went away.  I keep asking the nurses, but they say that the doctors will tell us more when they’re out of surgery.”

“Do you have the stuff you signed?”

“No, they took it all.”

“OK, well then first thing to do is get that stuff, and maybe that will also give us more information.”  She stood up and went to the nurse’s station.

“My father, Steve Mandeer, is in emergency surgery right now.  My brother, who’s sitting over there, signed some papers about that.  Can we please have a copy.”

The nurse gave her a look.  “We’re a little busy right now.  Ask later.”  She turned away, not really that busy.

Danna, weak Danna, knew a brush-off when she heard one.  “No, actually, I think if we’ve signed some papers, you need to give us a copy.  It’s probably right in your hospital procedures manual.  There’s a copier right over there.  I’ll wait while you copy them”  She smiled.

While the nurse was copying the four pages, Danna went on.  “Do you have an idea how long the surgery is likely to be?”

“What?  Are you in a hurry?”  The nurse was pissed off.

“No.  It’s just… that’s our Dad.  We don’t know anything about why he’s here, or what kind of surgery they’re doing.  It’s a little scary for us, you know, and we would certainly appreciate it if we could get even a little information.  We lost our Mom in this very hospital.”

That did the trick.  Nurses have a tough job, and it’s not surprising that sometimes it makes them a bit cranky, but mostly they are nurses because they care.

“Well, I’m not supposed to give out any information.  That’s for the doctors.  However, what I can tell you is that the doctor doing the surgery is one of the top neurosurgeons in the country.  When your Dad came in, he was unconscious, and the preliminary diagnosis was a some kind of bleeding near the brain.  The surgery is to relieve the pressure and stabilize him, so that they can figure out what to do next.  Honestly, it might take a while.  Cranial surgery has to be done very carefully.”

She stopped, apparently realizing that she had already said too much.  “The doctors will give you a report when they’re done.  It could be a few hours, though.”  She handed Danna the copied documents, gave a sympathetic smile, and turned away.

*   *    *    *    *

By the time the doctors were able to talk to them, they already knew a lot more.  Vangie, their Dad’s housekeeper, had been looking for them at the hospital, and when she found them she filled in more details.

When Vangie arrived at their Dad’s house at 9:30, as she had twice a week for the last fifteen years, she found him on the kitchen floor, unconscious.  She tried to wake him up, then called 911.  Maybe it was the panic in her voice, but the ambulance was there in just a couple of minutes, and they had him to the hospital ten minutes later.  Still unconscious.

She said when she found him, there was no blood or anything, so she thought he hadn’t injured himself falling, but maybe something else.  She thought stroke, or heart attack.   Their Dad was a fit 57-year-old, but he did take medication for high blood pressure, and his job as the Director of Operations for a trucking company was very high stress.

Vangie said she wasn’t allowed to ride in the ambulance, but she gathered some clothes and the rest of his medications and drove to the hospital.  They wouldn’t tell her anything, didn’t even ask her to provide information.  She was nobody to them, she said.  When she said she would call the patient’s kids, they told her not to bother.  They would look after that.

Vangie, not one to be shy, kept hounding them to do something for another ten minutes, until a new doctor came in and there was a sudden flurry of activity.  When she spoke to a nurse a couple of minutes later, she was told the patient was in emergency surgery, and his son was on the way to the hospital.  The implication was that her services were no longer required this particular morning.

Danna, meanwhile, had been looking at the documents her brother had signed.  The admission form was pretty innocuous, repeating some of Vangie’s story about finding him on the floor, and the rush to the hospital.  This had apparently all come from the paramedics, who had also filled in the information about medications that they had seen in the house.  The other main document was the consent to surgery, which stressed the very high risk of any neurosurgery, and absolved the hospital, the doctors, and everyone else within earshot of any responsibility.

What mostly caught her eye was the tick mark beside “loss of cognitive functions” on the list of risks.  There was a star, handwritten beside it.  Rayan told her the doctor who got him to sign the forms specifically pointed that out to him, and starred it for emphasis.

The waiting seemed endless.  Once they had the story, from the papers and from Vangie, what was there to do?  Just wait.  You couldn’t really read, or work, or look at your phone.  Who could concentrate?  Things were happening, but you were totally helpless.

It was almost dinner time when the two doctors came out to talk to them.  Although there was a younger one and an older one, it was the younger one who did all the talking.  Was he the “star neurosurgeon”?

“Your father has been taken to intensive care.  We had to open up his head and drain some fluid, so it looks like there was some kind of ruptured blood vessel.  It is likely there was an aneurysm, which is a weakness in the wall of blood vessel.  We think it may have burst, producing what’s called a subarachnoid haemorrhage.  However, we can’t really tell for sure at this point.  The area was pretty badly affected, so our main goal was to get him stable.  We did that, and he is out of immediate danger.  Once his tissues calm down from the surgery, we’ll run a CT scan, and maybe an MRI, tomorrow morning to learn more.”

Rayan had questions.  “Do you know what caused this?   Is there any permanent damage?  He’s a very healthy man, that has to count for something.”

“It can and it does,” replied the doctor.  “We don’t know for sure what triggered this, nor how long he had been alone before he was found.  But clearly, if he hadn’t been so healthy he might not have survived it at all.  It will be a few days, at the very least, before we are able to determine both the cause, and the medium and longer term impacts.  I won’t lie to you, though.  This was a very very serious event.  He will be in intensive care for a while, and he is still very much at risk.”

While Rayan tried to get more information, without success, Danna had the incongruous thought that they had a doctor who spoke in paragraphs.

After a few more minutes, the doctors told them they should go home and get some sleep, because nothing was going to happen before the next day.  Imagine, as if they were going to leave their Dad alone in the hospital, and simply go about their business.  Really?

*   *    *    *    *

It turned out that they had to work out shifts at the hospital, Danna, Rayan, and Rayan’s girlfriend.  Most of the time they couldn’t do anything.  They could see him through the window in intensive care, but he was still in a coma, with no signs of change.  The doctors didn’t want anyone in the room who wasn’t scrubbed.

Danna appreciated her crappy synthesis report.  She loaded everything on her laptop, and spent hours at the hospital working on the report.  It was at least as boring and stupid as she expected, but in a perverse way its colossal tedium was therapeutic.  And there was nothing else to do at the hospital.  It was just waiting, waiting, and then more waiting.  Danna hated waiting.

And there was no change.  Day after day, hooked up to ventilators and IVs and monitors, her Dad just lay there, his skin seeming to turn grayer and grayer with each passing day.  The monitors kept beeping and blipping regularly, but her Dad – her full-of-life, face-the-world-head-on-and-win Dad – looked more and more like meat on a slab, going bad from exposure to the air.

Every day they took her Dad away for more tests.  Every day the older doctor made a brief report.  It was always the same.  Their Dad was stabilized, the tests were showing that he was out of serious danger, but there was no improvement.  Brain function remained limited.  They were still working on it.  They hadn’t given up.

After a little more than a week, the doctors announced that they were moving her Dad out of intensive care.  They called Danna and Rayan in for a more detailed report and discussion.  This time the younger doctor was back, and he again did the talking.

“We now know that your father suffered a ruptured artery in his neck, and his brain was starved for oxygen and under pressure for an extended period of time.  We don’t know how long, but it was certainly several minutes, and probably longer.  The brain is strong and resilient, but it needs oxygen.  Without it, systems start to shut down.  If it lasts long enough, the shutdown becomes permanent.  In this case, your father has lost considerable brain function.  There is only a very small chance he will regain that function back, at least not fully.”

Rayan took charge.  “What are the practical effects of his loss of brain function?  Will he regain consciousness?  Will he be able to walk, talk, look after himself?”

“There is some chance he will regain consciousness.  Right now his body has generated a coma because that helps the healing process.  His body is focusing all of its attention on healing, nothing else.  As his physical condition improves, his body will be ready to…wake up again.”

“And then?”

“Well, right now we don’t know, of course.  However, generally in situations like this the speech function is affected for a long time, or permanently, and it will certainly be a long time before your Dad is ambulatory, if ever.  Whether he will ever be able to look after himself again?  Honestly, that is highly unlikely.  You should be realistic in your expectations.”

Rayan was stunned, and looked it.  He was prepared for death, or a long recovery.  You could see on his face that “neither” was not something he’d contemplated.

The doctor went on.  “I need to turn to the hard part of this discussion.  There is a very real risk that your father will never have any quality of life again.  That is – I want to be very clear to you – that is a high probability.  It is too early to make any decisions now, but you should find out if your father left any instructions – a living will, a power of attorney, medical care instructions, or anything that expresses his wishes in this kind of situation.”

Danna knew what that meant.  “You are telling us that, at some point soon, we may be asked to decide whether to pull the plug.”

It was clear Rayan was still catching up.  “What do you mean, pull the plug?  What do you mean?”

The doctor stepped in.  “As I said, it is far too early to talk about this.  I just want you to start thinking about it, and see if your father left instructions.  I don’t call it pulling the plug.  That’s harsh.  At some point, though, someone has to make a realistic assessment of your father’s quality of life, and determine whether he would be happier if his life were allowed to end naturally.”

There was an awkward silence.  Danna understood.  Rayan did too, but he couldn’t really comprehend what it meant.

Danna spoke.  “Thank you, doctor.  We’ll take some time to think about that.  It is an important decision, and not an easy one.”

The doctor looked like he wanted to say more, but he didn’t.  Abruptly, he stood up and left, as if knowing he had been dismissed.

Danna turned to Rayan.  “We do have to think about this, but not emotionally.  This is about Dad.  Let’s be smart.”

“There is nothing smart about this, Danna.  The doctor wants us to kill our father.  How could you even consider it?

“I’m not considering anything.  Not yet.  You’re going to go to the house and look through Dad’s papers.  I’m going to call his lawyer.  We’ll find out if he said anything about this kind of situation.  Then we’ll talk about it.”

“I’m not talking about anything.  I don’t have a mother.  I will damned sure not agree to pull the plug on my father.”  He was on his feet, almost shouting.

“Just go look in the house, Rayan.”

The next day, the conversation was different.

Rayan had found a package of documents – a will, power of attorney, list of assets, and other things – that included a memorandum about medical care.  That document appointed Danna and Rayan to make joint medical decisions about their Dad if he couldn’t make them himself.  Under the heading “Heroic Measures”, it said:

“In the event that I am gravely ill, with no reasonable prospects for enjoying my life in the future, I rely on your good judgment, but I do not want you to feel obligated to use “heroic measures” to keep me alive.  I do not embrace death, but I want you to know that, if I were to become a burden on you, that would make me more unhappy than anything else I can imagine.  You have your lives ahead of you.  Live them.” 

Danna confirmed that the original of that document was in the lawyer’s office, and he said it was current.

“He wants us to pull the plug,” said Rayan.

“That’s not what I read here,” Danna replied.  “What I read is that he wants us to understand what is important to him, but it’s up to us to decide.  He is treating us as adults, showing us respect.  We have to decide.”

“I think this is pretty clear, Danna.”

“It’s not as clear to me as it is to you, and I’m not going to decide anything today.  This needs more thought.  Dad’s relying on our good judgment.  I’m going to make sure he has that good judgment.”

Rayan gave an impassioned speech about respecting their Dad’s wishes, but Danna was having none of it.  After an hour, Rayan gave up, saying “We’ll talk about this again tomorrow.  We have to do what is right here.”

When Rayan left, Danna went to her Dad’s room and looked through the door.  He was still lying there, gray and inert.  No quality of life, for sure.  What to do?

*   *    *    *    *

They must have gone back and forth a dozen times as the days went on, sometimes reacting to more news about his condition, sometimes just beating the same issue again and again.  Mostly, Rayan was ready to pull the plug, and Danna wasn’t.  They didn’t argue.  But they didn’t agree.

At one point, Rayan got a little frustrated.  “What are you waiting for?  You won’t say yes, you won’t say no.  You just wait.  What for?”

Danna didn’t know, but she did know that she couldn’t come to the decision Rayan thought was right.

Then everything changed.  Rayan and Danna were both there, just sitting quietly in their Dad’s room, when he opened his eyes.

Nothing else changed.  The machines were still beeping and blipping.  The IV was still attached to his arm.  His body didn’t move.  But for Danna, her heart was suddenly beating faster.

“Look, Rayan,” she said.  “He’s awake.  He’s awake.”

They both stared, not knowing what to do.  Danna pushed the button for the nurses, but they were already at the door.  They knew from the machines’ output that something had happened.

“I’ll call the doctor,” said one.  The other moved over to the bed, checking the IV insertion, shining a light in his eyes, initiating a blood pressure test.  They were calm, as if this was all planned.

“Is there something we should be doing?” said Danna.

“No, you should probably just wait outside for a few minutes.  When the doctor comes, we’ll probably do some tests, and then come talk to you.”

As they sat outside, Danna spoke.  “Maybe this is what I was waiting for.  Maybe I wanted to know what was going to happen, and I hope now we will.”

It just made the waiting more difficult, though, because more waiting was all they got.  For three days, the hospital did one test after another.  Her Dad’s eyes remained open, and he seemed to be looking around.  But he didn’t move, and he didn’t speak.  It was not clear that he even realized they were there.

Eventually, there was another meeting with the doctors.  It was like a re-run, but with more of an edge.  The executive summary?  Their Dad was conscious, but his brain function was still very limited.  There was no real sign of improvement, and his prognosis was not good.

“Your father has suffered permanent damage to his brain.  While his eyes are open, it’s unlikely that he is processing anything he sees.  He is not making any attempts to communicate, even though clearly his motor functions – the physical side of them, at least – are fine if his brain were able to send the right signals.”

Rayan had lots of questions.  “Is he feeling any pain?”

“There’s no indication that he is in pain.  Usually the body will respond with physical signs if there is pain, even if the brain is not functioning properly.  We’ve found nothing to suggest that he’s in any pain.”

“But what we see as consciousness is…not really that at all?”

“I think that’s a good way to look at it.  His eyes are open, but to all intents and purposes he is still in a coma, and doesn’t really perceive the world around him.”

“How do you know that?” Danna interrupted.

“Well, we don’t really know that for sure.  We can do some brain function tests, and they show that there is a very low level of activity in the brain.  We have also tested responsiveness to stimuli, and there are low response levels.  Loss of brain function is an area in which there have been great strides in the last decade or so, so we know a lot more than we did in the past.  Still, the honest answer is that a lot of what goes on in the brain remains a mystery.  We continue to be surprised by sudden recoveries, for example.  Maybe only one in a thousand in cases as serious as this, but they do still happen.”

“So we should be patient?  Wait and see?”

“I can’t tell you what to do.  All I can tell you is that the odds of any recovery at all are very low.  Even then, the possibility that your father will ever live the kind of life he had before is, well, almost zero.  I don’t want you to get your hopes up.”

“Does he have to stay in the hospital?”

“He should, but the real answer is no he doesn’t.  As long as he can continue on the ventilator and other life support equipment, he can stay at home.  But, don’t be too rash in thinking that’s a good idea.  It is much more difficult than you think, and he will need constant care.”

Danna wanted to ask more questions, but she already knew the answers.  She sat quietly, and eventually the doctors left.

They both knew it was time to make a decision.  Rayan spoke first.

“I think the decision is clear.  I can tell you, Danna, it makes me want to puke just thinking about it, but you know that’s what we have to do.”

Danna’s tone was hard.  “No, Rayan, that’s not what we’re going to do.  Dad is not dead.  There is a chance he can recover.  We have to give him that chance.  At least, I have to give him that chance.”

“Really, Danna, you have to be practical.  Who is going to look after him?  How will we make his house into a hospital?  And what about money?  We’re not rich.  We can’t afford round-the-clock care for him at home.  We’d have to sell the house, and then where would he live?  And for what?”

Suddenly, it was no longer just a discussion.  It had become a conflict, a confrontation between brother and sister.  They were on opposite sides, and something had to give.  They both knew what happens next.

But it didn’t.  Danna would not agree.  “I will become his caregiver.  While we’ve been waiting over these weeks, I’ve done some research.  You don’t have to be a nurse.  You have to learn some things, and you have to know who to call in an emergency.  I can do that.”

“And your job?”

“What about my job?   I’ll quit my job.  My job will be caring for Dad.  I’ll find out all the best therapies, and I’ll work with him to give him the best chance possible.  You’ll help, too.  I know you will.”

She stood up.  “You’re right, Rayan.  The answer is clear…very clear.  The answer is that we have to give him a chance.”

Rayan stood up too, as if to challenge her eye to eye.  He didn’t.  His shoulders slumped forward, and he hugged his sister.  “OK, Danna, that’s what we’ll do.”

*   *    *    *    *

The logistics almost beat them.  Setting up a room in her Dad’s house that was the equivalent of a hospital room was much more complicated than they thought.  Rental of the equipment was very expensive, and things like re-wiring, and changing the home insurance, and arranging emergency backup assistance, and getting visiting nurses, and supply of drugs and nutrients, all took time and energy.

At the same time, they were negotiating with their Dad’s employer and the insurance company, who initially didn’t want to pay for anything at all.  Eventually, a package of long term disability and pension was approved, and the insurance company covered some of the costs of the medical equipment and support.  Meanwhile, Danna gave notice on her apartment, and even sold her car and most of her furniture.

While they were trying to arrange everything, Danna insisted on spending most days at the hospital.  Her employer didn’t want her to leave, and was willing to let her work remotely for as long as she needed.  She didn’t really have time to do any work, though.  The arrangements were all-consuming.

It took almost three more weeks, but finally everything was ready.  An ambulance took her Dad from hospital to home, and set him up in his own bedroom, hooked up to new machines.  The doctor showed up before they were finished, inspected everything, and gave her an initial supply of prescription medications for the IV.  He also gave her some brief instructions, but then, twenty minutes after he arrived, he was gone.

Danna stood in the room, alone with her Dad.  She did indeed have a new job.

*   *    *    *    *

It is really quite amazing, thought Danna months later, how even the most unusual things can become normal.  She had gone from being a completely untrained, maybe even unsuitable, caregiver, struggling to manage each day’s tasks, to handling her daily routine without hesitation.

It was very hard.

It wasn’t just the mind-numbing boredom of no change, no change, no change.  She was dealing with that by constant, expanding research into therapies and methods of improving patients with severe brain damage.  Quickly she realized that she was not going to continue to do reports for her employer.  They were great, and all, but she had more important things to do.  She was honest with them.  She couldn’t work anymore.  That lifeline was severed.

No, it wasn’t boredom that was hard.  It was the physical work.  Caring for a bedridden patient, it turns out, is intensely physical.  She learned the techniques to make it possible, but whatever she tried, her back was still hurting pretty well all the time.  Her arms were becoming muscular, but she still used a medicated patch for the soreness.  Every day, at least once, she would get a headache so bad she had to withdraw to a dark room for an hour.

The fact that the lifeless body was her Dad made it even worse.  The initial shock of intimate contact with her once-energetic Dad wore off, but it was still difficult to accept.  Every time she applied lotion to prevent bedsores, she couldn’t help but remember her Dad as a stronger, younger, man.  Someone who was still alive.

She settled into a routine, which she insisted had to include at least a couple of hours of stimulative therapies each day.  There were dozens to try.  Flashing lights when his eyes were open.  Music, reading books (and audio books when she wanted a change).  Physical movement – the legs, the arms, the head.  Photos of people he knew.  Every day there was something more to do.  She alternated them to see if that would work.  Then she tried the same thing ten days in a row.

She learned about the RLA scale of cognitive functioning.  She hoped that her Dad was in Level II (of ten).  In her heart, she thought maybe he was really in Level I, the lowest and least functioning level.  Sometimes called a PVS, or “persistent vegetative state”.

And she kept a log of everything she did, and all of his responses, however slight.

Sometimes, though, she thought she might be imagining some of the responses.

Rayan came over most days, usually for an hour or two.  At the beginning, he was very supportive, upbeat almost.  After a while, though, he was quieter, as if coming over was depressing him.

One day, six months into it, she raised the subject of his feelings.  He wasn’t going to.  She had to.

“It’s hard for you to see him like this every day, isn’t it.  I know, I’m probably immune to it because I’m here all the time, but when you come over it’s like he brings your life down by his condition, right?  Even if you’re having a good day, then you’re reminded of this reality.”

Rayan almost laughed.  “You’ve got my feelings all wrong.  I’ve accepted that my Dad will probably never be in my life, ever again.  I remember what he was, more than the person in that bed.  What is hard for me is watching what this is doing to you.  Watching you put your life on hold…  I know, I know.  I accept that it’s the right thing to do.  I just hate to see the toll it’s taking on you.”

She was taken aback.  “I’m OK, Rayan, really.  This isn’t hurting me.  I never had a chance to do anything like this for Dad.  Or anyone else, in fact.  This is a good thing.  As long as there’s hope, even the tiniest bit of hope, this is good what is happening here.”

“You can put on a happy face if you want, Danna.  I know how hard this is for you.  I wish I could do more, even, but that doesn’t really solve the problem.  Even if we were both doing this full-time, it would still be hard.”

“Fair point, but I’m not complaining.  I’m doing something worthwhile.”

She stopped.  “You know, I’ve also had a lot of time to think.  My brain, after all, is still working 100%.”  Suddenly she laughed and turned toward the bed.  “Sorry, Dad.”

“Look, we’ve had to live without a mother for more than twenty years.  Most of our lives.  Now, really, we have to learn to live without our Dad.  I see there is no progress.  I’m not an idiot.  And, I know it’s not for lack of trying, God knows.  Even though he’s still alive, I have to be honest.  He’s pretty well gone from our lives.”

“Yes,” he responded.  “I guess we both know that.  And a life without both of our parents is inevitable, I guess.  Most kids end up there, although usually when they’re a lot older.  I just thought there were going to be things in my life I could share with at least one of my parents.  Getting married, having kids, maybe starting a business. I don’t know…getting divorced, maybe.  Winning a lottery.  Becoming president.”

“Our family is shrinking, Rayan.  It was four of us when I will little.  Then it was three of us for most of our lives.  Soon it will be only two of us.  Maybe it is two already, really.  But then we’ll have our own families, and our family of two will grow again.”

They both wanted to say more, but they had nothing more to say.

*   *    *    *    *

It was during the Christmas holidays.  Of course, I don’t have holidays any more, thought Danna, but it is still a time of year for family.  And reflection on your life.

It was night time.  She was alone in the living room, reading a book, but not really.  One light was on beside her, but the rest of the room was dark.  She could hear the machines beeping, and if she looked to the side she could see her Dad through the door to his room.

This was her life, and it was fine.  She was OK, handling everything well.  Her back didn’t even hurt any more.

But it was time for Dad to go.  He had been reacting to some stimuli, but not in a good way.  His legs were sometimes jerking from reflex actions, even without any stimuli.  The fight against the bedsores was not always successful, and Danna didn’t really think either the antibiotic or the pain-killing ointments were fully effective.  She felt that he was sometimes in pain.  It was only intuition, maybe, but still.

It was time.

She called Rayan to come over the next day.  They talked about it.  He wasn’t happy, but he didn’t object.  “I trust your judgment on this, Danna,” he told her.

It was not a dramatic event.  The doctor and the nurse both came, and Danna and Rayan stood by the side of the bed.  Her Dad was asleep.  They signed some forms, then turned off the machines.  The sounds stopped.  Her Dad took two breaths, as if by reflex, and then stopped.  There was no movement.

She didn’t cry.  She looked at Rayan.  He wasn’t crying either.

*   *    *    *    *

A few days later, at the funeral, there were a few tears from both of them, but their hearts were not wrenched apart.  Both were surprised at how many people came to pay their respects, and how few of them they knew.  It was almost a social occasion.

After the ceremony, they stood side by side, just the two of them, a little distance from the grave.  For a few seconds, they were both silent, lost in their thoughts.

“I don’t know how you do it sometimes, Danna.”

“What do you mean?”  This was out of the blue.  She looked up and waited for him to explain.

Rayan had his head down, now speaking very softly.  “When I said pull the plug, you said no, and stuck to it.  You quit your job.  You put the burden of caring for Dad entirely on your shoulders.  I don’t know how you knew, but you were right to do that.  So much courage.  I couldn’t have done that, but you made the right decision, for Dad and for us.  We had to try.  You knew that.  I didn’t.  And you carried it through.  Did everything.  For Dad, but also for me and for you.  How did you do that?  I don’t know.”

She was stunned, but stayed silent.

“Then, when it was really time to let him go – when the time had actually come – you had the strength to make that call.  You knew when to make the decision, even when I didn’t, and you were able to make it.  Or maybe I knew, but I wasn’t tough enough to decide.  You were.  What would our family have done without your strength?”

But as the mourners slowly drifted away from the gravesite, all Danna could think about is that now she didn’t have a mother or a father.  All she had was Rayan.

Goodbye Dad, she thought.

–   Jay Shepherd, July 7, 2016

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About Jay Shepherd

Jay Shepherd is a Toronto lawyer and writer. This site includes a series on energy issues, plus some random non-fiction on matters of interest. More important, it includes the Lives series, which bridge the gap between fiction and non-fiction, and now some short stories. Fiction is where I'm going, but not everything you want to say fits one form. I am not spending any time actively marketing what I write, but by all means feel free to share if you think others would enjoy reading this stuff.
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