A couple of weeks ago I posted about my 77 year old Dad who'd been in the
hospital for 4 weeks for pancreatitis and pneumonia and more pancreatitis
after a pretty full recovery from a brain tumor excision in January for GBM.
Sadly he was too weak to fight off multiple infections and with his wife of
46 years and three daughters present, he passed away Monday night, 4/26.

The rest of this too long post is a catharsis for me, and information for
those who might share my morbid curiosity about final endings...

Monday and Tuesday (4/19 and 20) the doctors attempted to fix his bile duct
problems, supposedly caused by stones, but there were none to be found.
They put in drains and stents and stuff and we mostly understood.
Wednesday, his labs seemed a tiny bit better, but he was weak and had an
awful lot of fluid everywhere; his hands were swollen, each breath a gurgle.
By Thursday his labwork starting heading in the wrong direction.  He had an
infection somewhere.  There were 3-4 antibiotics hanging at any one time,
plus the TPN (IV feeding since he couldn't eat because of the pancreatitis).

Friday, 4/23 his oncology doctor pulled Mom and me out of his room and said
we needed to make a decision.  Quite bluntly:  did we want him put on a vent
if needed or resuscitate him if his heart stopped?  He's weak, sick, and
surgery and radiation notwithstanding, he still has this time bomb of a
brain tumor that will come back in 3, 6, 9 months.  We weren't prepared for
this.  No decision was made (which essentially means yes, do everything to
keep him alive).

I'm not sure of the timeline after that, but he started having painful
muscle spasms in his back and legs (fluid build up? electrolyte imbalance?)
He started accepting morphine instead of turning it down.  His breathing got
worse.  Mom's favorite nurse came in with a cup of coffee for a chat.  As
much as she didn't want to, by Sunday morning, Mom decided it was time to
let him go.  They pulled the antibiotics and TPN, and added a morphine drip
to keep him comfortable.

All day Sunday and Monday, his breathing slowed.  He occasionally opened his
eyes, but I don't think he was actually "seeing".  We all spent Monday in
his room, talking to him, and to each other, barely going out, one at a
time, for food, phone calls, and short breaks.

Three to four seconds between breaths, sometimes longer.  Conversation would
stop, and we'd all look at him, then he'd breathe again.  At 8PM, all color
abruptly drained from his face.  He was gone.

The nurses were wonderful, as was the entire staff (with the possible
exception of the onc doc).  A Chaplin came to visit as well as several
nurses and aides.  Dad and Mom (and the rest of the family) had made many
friends at the hospital.

They explained what would happen next, and said we could stay as long as we
wanted, but soon we gathered up the detritus of  5 weeks and left the
building.  His nurse contacted the funeral home Mom had picked out and they
came by after we left so he didn't have to go to the morgue.

Honestly, as much as I dreaded the funeral home visit, it was not too bad.
The funeral director combined professional demeanor with warmth and cookies.
Mom and Dad wanted something fairly simple, a cremation and a short memorial
service.  My brother-in-law did a wonderful job with the service - the first
funeral I felt really WAS the "celebration of life" it's often purported to
be, more smiles than tears.  His daughter, Dad's granddaughter, sang "Stars
Below" (http://www.knology.net/~townfam/2%20Starsbelow.mov) with
considerably more grace than I could have done at her age (or even mine).
My dear husband wrote a haiku of sorts, and I'll close with that:

All too soon it seems,
You reach the end of the path
And start another.

Beth