30-Death panels, advanced directives, a dream, and a miracle

Death panels, advanced directives, a dream, and a miracle

by Jaxon Cohen

Part 6: The Beginning of the End

What killed my father? He couldn’t swallow properly and often coughed to clear his throat when he ate. By doing so, he aspirated – breathed atomized particles of material into his lungs. At first, it was once in a while; when it became once every few meals, I talked to his Geriatric doctor. Some swallowing problems are to be expected because saliva, muscle coordination, and attention to detail decrease as one’s days increase. He suggested it might help if Dad wasn't sprawled-out on his recliner with a dish on his tummy. Instead, he should eat at the table where he would sit upright. For a long time, logical changes like that made all the difference. About a year and a half before he died, the occasions of aspiration were no longer occasional. A sinking feeling set in. I decided to get every serious, medical book on aging at the library. There were two. One was useless. I knew all that. But Johns Hopkins’ version was invaluable. When I ran out of options, Johns Hopkins taught me about dysphasia. Severe swallowing problems are never normal, even in the elderly.

I told him if we couldn’t get it under control, we’d have to make another appointment to see his doctor for treatment. He hated doctors and hated treatment even more. Who could blame him? I mean, how many of us know what it's like to be punched in a recently sown-shut sternum? My father did and in his limbic mind, lifesaving measures are inexplicably painful. So he agreed to a strict regiment. He would get one fantastically large meal each day. It often took more than four, continuous hours to feed him, but the incidence of aspiration went from nearly every bite to almost never. The technique involved a glass of slightly fiber-thickened water, a ninety-second timer, and a food processor.

My poor father endured the same thing for the rest of his life. He never complained. In my defense, this last meal included a made-from-scratch, seventy-two hour simmered, vegetable-beef stock the color of coffee with neither sugar nor sodium, his favorite dessert, every healthy plant imaginable, and a nasty, sticky, yogurt-supplement-prescription pill slurry I insured was no more than a few spoonfuls each day. Anyone willing to say that the job of a caregiver isn't the hardest, most difficult, most (append with any number of adverbs here) known to mankind doesn't know a thing about the filthiness and despair of the human condition and the dedication it takes to deal with it every hour of every day. Entropy.

Being a caregiver presses a man’s outer limits of patience, knowledge, and fortitude. I love my father and can't imagine how hard it must be to do perform these duties when love is not the primary motivator. My father loved his religion. He wanted to live to be one-hundred, because according to his scripture, Jesus would appear to make him immortal. This was not the only idea his religion inspired I found improbable. But nonetheless, I agreed to do my best to get him to that goal. It's amazing how the simple act of taking a bite of food can become so horribly complicated. Despite the triumph of dramatically flipping the numbers, no bite felt like success. It was only when he was full and sleeping well that I smiled with relief. Of course, that’s when it started all over again.