Friday, December 08, 2006

COMFORT CARE WTF

The title says it all. Here is what I've got:

My father is in incredible pain.
His stomach has an infection.
His head hurts.
His left side is frozen.
He makes about 3 or 4 controlled movements. There are a lot of spasms.
He mumbles a lot.
He groans pretty much constantly.
The doctors say that even though there is no leukemia in his system, it is inevitable that it is coming back, so there is no "remission" definition for him.
His beard is sparse. His hair has fallen out...and then it hasn't.
The man grimaces.

So we had a big meeting with Dr. Oh yesterday. The bottom line isn't the bottom line with these fucking doctors. I want to be angry with them but I get it. They keep on telling us that they can do something about his pain. They can make him comfortable. They will do this, but we have to sign off on the DNR (do not resucitate).

What is being said is this: My father can have a level of pain medication. If he has more than they are willing to give, his lungs will collapse and he will be put on a ventillator.

If we sign off saying that we will NOT put him on the ventillator, then they will give him the pain medication he needs to assuage his agony. In essence, we give them the right to give him a lethal amount of medication.

If we don't sign off on this thing, then my father fights his way through his current existence. This is a grim sight to absorb.

If we sign off, he will have about 2 days of comfort before he sails on.

If we don't sign off, there is a small chance that he could actually negotiate his way out of the maze of pain and suffering and be conscious and human again. I strongly doubt that his mind will be back though...and that was some sort of mind.

If we sign off, he drifts off to sleep. The focus will be what these cynical-ass doctors call "comfort care". The shift will be away from his symptoms and more on making him comfortable. Yesterday, Dr.Oh gave the concession that they would still keep on treating his issues, but there would be more pain reliever in his system.

If we don't sign off, and he goes on a ventilaor, he will never get off of the bitch. Apparently, a youngster should only be on a ventilator for a minimal amount of time or the lungs atrophy and forget how to breathe on their own. Patients on a ventilator have to be rendered basically unconscious in order to make sure that they don't wake up and pull the tubes out of their mouths.

If we sign off, his pain will end on the micro and the macro.

If we don't sign off, th pain continues...and in all honesty, I don't see his situation improving.

THAT IS THE VACILLATION ON THE BLADE.

So what is driving these doctors? Where is the truth here? No one is using words like "euthanize" so WTF?

It has to be money. It is always money at the bottom of the pile. I remember when I realized that I had to get out of teaching. It was when I realized that students get saturday school for cutting class so that the school can get the state money back that they lost for the absence...not for discipline. It was when I realized that suspension of more than a day was something that wasn't given out because the school LOSES MONEY every day a student isn't in class. When I realized that shit, I realized I was in the wrong profession; specifically if they are professing to care about kids. They don't give a rip about the kids. It is the money.

So, with these doctors, I am trying to chase the money trail down. Of course they won't tell me, but it has to be a financial bottom line here. They took their Hypocratric oaths to take care of people, but somewhere along the way, it is compromised. The compromise is probably being pushed by a kingpin in the system whom I have not even seen yet. You know when you go to a used car dealership and the salesguy goes to talk to a manager that you never see? That kinda shit.

So what is the money issue? Is the insurance running out? I know that they are worried about him being bedridden for a ridiculous amount of time. Maybe that is it, they have given up hope, and they want to employ their efforts elsewhere. I have to know what the TRUTH is underneath this thing.

They can keep him alive by following through with the status quo...indefinitely it seems. So why the give-up? I don't get it. Why the push for the give-up? There is a triple-beam assessment somewhere in this whole thing and some motherfucker has said that we need to slash our losses and get the hell out of Stanford.

I don't get it. I don't get how the money is working. I don't get how their minds are working. I don't get how much time my father has. I don't get any of it. I am blinded by my old man's pain I suppose. I can't rise above the blast radius that I am in. These doctors have perspective. They have a level of insight and vision that I don't have and unfortunately, I don't comprehend it either.

I guess "comfort" truly is synonomous with "pulling the plug".

Am I supposed to have the balls to vote that my father only should have 2 days to live? This guy brought me into this world and now I have to make this kind of decision?

Yes, I want him to have no pain.

Yes I want him to live.

No one can show me the future, and I have to make calculated guesses on all of this stuff.

My father, tough bastard that he is, is only in his 60s.

I am at a loss here. I have no idea where I should stand. I love the man, and I don't want to have him killed. But I don't want him in pain. I don' want him to suffer and suffer only to lose.

Suppose we put him through all of this agony and then he dies any damn way?

It is on my head that he suffered for the last of his life.
It is on my head that he was euthanized (let's cut the shit and call it what it is).

I have the word HOPE tattooed across my stomach. It was some of the worst pain that I have ever experienced. Yet I am just about out of hope on this one.

The best case is that he bounces back. He becomes a man again. he looks me in the eye. He gives the gentle smile, and he says something completely unpredictable like old times. Am I going to ever have that again?

Had I known that the day I checked him into the cancer ward...that it was to be my last full day with him, would I have been so flippant? Would I have given more of myself to him? Would I have interacted harder? Did he want that kind of interaction? Did I fail him on that day? Was he disappointed in me because my marriage has gone to shit? Did he still think that I was a hard person to deal with? Did I fail him as a son? Did I fail him as a man? What could I have done better? All I ever wanted to do was please him somehow...impress the guy. I don't think I will ever get that chance again. Yeah, we cleared our shit up as far as our all out hatred for one another, but now what?

Years ago, when we were driving back from Texas (Granny's funeral) the whole car was asleep, and it was just he and I. He told me that he was proud of me. He told me that I was shaping into a decent man. I think he meant it.

However, when I broke down and cried with him a few months ago and told him that I couldn't salvage my marriage and I didn't know what to do, he told me to man up. He told me to get back in there and make the shit work. For the kids. Make it work for the kids, he said. I countered him and told him that I couldn't, that I was dealing with a situation that I couldn't think my way out of. That it was a loss. He told me that he loved me and that he understood...and that no matter what I did, I was still his son. That last conversation fucks with me.

So I was dropping him off at the hospital that day, and there was so much shit in the air. So much of my shit, and so much of his shit...and we were trivializing and talking about pop culture as we always did. I wish I had known. I wish that I had known that was it. Maybe I would have reached harder. Maybe I would have scraped at that scab of a conversation that we'd had a few weeks before and hunted for some closure.

Comfort care, wtf. I want the old man back. I want him to suck up some sort of life power and get up and walk again. I want the man back. I'm not done with him yet.

Sorry. This one was a little raw.