The Final Hour

THE FINAL HOUR
By David N. Walker
As it appeared in Stories at the End of Life
Published by the American College of Chest Physicians © 2003

 Remembering that afternoon in the cardiac care unit always brings me a rush of mixed emotions. I hated what was happening to Dad, but I was so glad to be there.

 As I entered the room I sensed that this would be the last time I’d see this man who had always been so important in my life. The body on the CCU bed had been my father for 49 years, but for the last 18 days I wasn’t sure whether he was still really in there or not. The only evidence of life was the constant sound of the machine pumping air into his lungs, along with the lines on the heart monitor.

 Dad had always been there for me. As a young intern, he had delivered me when there wasn’t time to wait for the obstetrician. When at age two I came down with encephalitis, the old doctor in the neighborhood didn’t know what to do for me. Dad came in in his Army uniform and immediately diagnosed it, treating me with massive doses of sulfa drugs that the older doctor had barely heard of. Throughout my childhood I’d always been confident there was nothing my father couldn’t fix.

 Day after day, I’d been coming to spend time with this inert body that had been my father. As my thoughts wandered back over the years, I thought about the countless rounds of golf Dad and I had played together as I was growing up. As always, I was mystified by his attitude toward golf. He loved the game, playing it or watching the pros on TV, but despite loving for it, he’d never bothered to take even enough lessons to learn a proper basic swing. In all the years he played, it was a rare and treasured event if he broke 100.

 Maybe that was a part of our closeness. He was such a poor golfer that he took a vicarious pleasure in my game. In fact, he was always proud of me – not just my golf game. Through the years I gave him plenty of reasons to doubt me, but his pride never wavered. That reinforcement always made me feel better about myself.

 During most of my adult life, Dad and I had not been as close as either of us would have liked, partly, but not entirely, because of geographical separation. God had allowed us a second chance, however, and when I returned to Fort Worth at age 40, we became real companions.

 As I looked at Dad, artificially kept alive these last 18 days by the pumping of the apparatus which breathed for him, I was convinced he was finally about to escape the discomfort and indignity of this quasi-life. I was also glad that I was there to spend this precious time with him.

It hurt to see this vital man reduced to such a vegetative state. He had been a founder – and for 18 years a director – of the pharmaceutical manufacturer Alcon, a past president of the Texas Pediatric Society, a former Governor of the Texas-Oklahoma District of Kiwanis. He served for 12 years as a member of the Fort Worth School Board. He was responsible for causing the Denton Civic Boy Choir to move to Fort Worth and become the Texas Boys Choir; and had been a founder and one of the first teachers at Trinity Valley School, as well as a founder of the Texas Girls Choir. He should have gone out with more dignity.
I received the call and rushed to the emergency room around noon that Friday. Though in some pain, he was lucid that afternoon. When I left him in his hospital room that night, he’d been feeling reasonably good, and his mind had been normally active.

 Sometime during that night he had suffered a complete cardio-pulmonary failure. If the nurses had just been a little slower getting to his room, or the doctors not quite so quick in responding, he could have passed quietly and easily, but this was not to be.

 Maybe the doctors really thought at age 77 he would pull through and be able to resume a normal life. Maybe they had to try every heroic thing they could, just in case. I only know that when I returned to the hospital the next morning and saw him in the cardiac care unit with that horrible tube taped to his mouth, needles and wires stuck everywhere, I knew Dad was gone. They would not make him well. They would only prolong his misery – and drain Medicare of $120,000 or $130,000.

Glancing up from my thoughts, I noticed that the heart monitor indicated that his heartbeat was growing slower and weaker. I knew that I should call my fiancee and my mother and stepmother. They would all three want to be there at the end. I hesitated, treasuring this time alone with him, but I made the calls. I would still have 20 to 30 minutes before any of them arrived.

 I stood beside his bed remembering all the places he took me and the friends he introduced me to. Once, he’d taken me to St. Louis to a medical convention when I was a kid, and it was the only time I ever rode in a Pullman car. When he was on the school board he played golf regularly with a group of school principals, and he always wanted me to play with them, too. He also liked to take me to his Kiwanis meetings, where he would make sure that everyone present knew that I was his son.

 Now I was watching life literally draining from his body. Dad’s face had seemed to register stress all through these days in CCU, even though he was sedated and presumably felt nothing. Was there fear mixed with that pain? Maybe he subconsciously knew that he was going.

 “It’s okay, Dad,” I told him, leaning over his bed. “Jesus has a place for you, and He’s ready for you. All you need to do is let go.”

 Did I imagine it, or had he relaxed? His face seemed more serene. The waves on the heart monitor were becoming still shallower and longer. His heart was growing weaker.

 “I love you, Dad.” That had never been difficult for me to say, although he at times had trouble verbalizing his love. I didn’t even remember taking his hand in mine, but there it was. Had a trace of a smile flickered across his face?

My stepmother, who lived closest, was the first to arrive. Mother was next, and then Sharon, who had to drive across town from work. The waves on the monitor became weaker and weaker.

The four of us stayed with Dad for 10 or 15 minutes before the monitor became a flat, straight line. I hated the thought that I’d never see him again, but that last hour with him was something no one could ever take away — from either of us.