As he lay dying, a life barely sustained by oxygen coming out of a very noisy respirator, I interjected my voice loudly as I stood in the door way of his room,
“Daddy this is Uzma!”
The first time that I needed to do that. Never in his 87 years, had I needed to introduce myself to the man who introduced me to the world in all its amazing ways.
Ironical that I needed to, on the last day of his life.
I was unable to elicit a movement, a gesture, nor a smile. I had seen him just two days ago and he had told me” Come back soon okay?” and I had nodded in affirmation. He was up in his room and I chronically tired by chemotherapy did not feel like going up the flight of stairs and said “Bye, I will” not knowing that I had passed up on a last good bye hug with my father, a hug that he actually was able to understand.
A disruptive respiratory sound of accumulated mucus was clearly audible from his throat, the liquid spinning in a chaotic fashion in a pipe totally stuck, neither allowed to go lower or be coughed up. It took a little while to get adapted to that sound, accept it and embrace it as part of the impending death. The harsh word that gutted me is called “death rattle” in medicine. That sound was indeed the death rattle.
We play with rattle as babies and then as-near death adults. Somehow a rattle ever present, ever distracting, in arrival and departure land.
The hospice nurse used tiny lollipop like spongers to keep his mouth wet and periodically his lips would pucker around-it.
He had largely stopped swallowing but my mom in her desire to feed him his favorite food, kept bring up a bowl of her hope in form of strawberry ice cream. She remained interested in extending his life even though that morning arrangements for funeral and grave were being made.
A strange mismatch of acceptance and denial often plays out in deaths. Even when we can hear it and see it, we choose not to.
I was also torn. The physician in me knew before hoping on a train from Chicago to Milwaukee, that I am going to visit a dying man. But as soon as I entered the room a daughter’s tears flooded her eyes. I regrouped myself to assess the seriousness of this juncture in his life. The rattle often lasts no more than24/48 hours. I had packed clothes for a day. I positioned myself right next to him in his own bed in which he laid comfortably albeit some respiratory distress. I suspect the rattle was harder to hear for my mom and me than for him.
Given my own stage four metastatic breast Cancer, I have read plenty articles on death, dying and the transition.
Keenly aware that hearing is maintained till the last I used this chance to tell something’s and express my love for him. I played some of his favorite qawwali (devotional) music and would see his toes move. I can no longer hear those songs now without balling.
I asked him for a selfie and I got an awkward facial movement that could be considered the best smile from a dying man or so I decided to believe.
His eyes had started to look muddied; hospice nurse explained it as an imminent sign. I stuck even closer to him. It was the last few hours to cuddle with Dad and I wasn’t letting those go. His grip on my hand remained firm till the end even as his grip was loosening over life, I stroked his hair and he passed away with more hair than I currently have. My own image of death has always been dying bald, without eyebrows and lashes, I felt happy that he had been spared the indignity.
He used to sleep with a comb at his bedside and if woken up, comb again and then fall asleep. He never looked shabby.
He also had very sharp hearing, much like mine.
In the middle of the night was me putting water to boil for tea as I used to wake up at two am to do my med school studying.
He would gently call me from the bedroom with one eye open and ask “are you making tea?” That question incorporated the assumption that he gets a cup too.
He would drink that cup and then immediately fall asleep.
I would envy his sleep which remained terrific until he got on steroids for his lung disease.
He was an-early sleeper and-early riser and I suspect it was a significant factor in his mental sharpness up until some delirium set in his last days.
Today he was dozing in and out under the effect of morphine. He was quiet without the stories of British India, his math skills and how attending-class was optional for a student like him. His current mobility was restricted to an electric chair that helped him negotiate two floors and a fun ride a nana’s house for my kids.
I was somewhat convinced that he had been accepting his fate from now on.
At 87, I have often wondered what he saw and accepted and what he vehemently denied. He underwent two migrations, one that was bloody and rife with fears and the second one requiring consciously giving up what he migrated for the first time.
I stood there trying to figure out what to accept and what to deny.
Sometimes hearing oneself aloud clarifies psychological issues faster than spelling acceptance.
Many patients moved forward not because I offered them golden nuggets of insight but it was their own voice that changed things within.
I readily accepted that he was waiting for me to pass on to be with me my big brother could not make it in time.
I felt Dad gave me special gift of his last moment like the 2 am-tea cups he-and I used to share.
He very tactfully avoided my Cancer for the last five years and every to me convinced me that the scan would be normal.
It mattered for him to say this aloud to make it believable, I would fall a little into his denial hope trap with him.
Then scan results would come and he would reset expectations to the future scan.
I had suspected that internally he knew that I was terminal and he had decided that he would go before me and when I got diagnosed with metastatic disease in my liver and bones, that is when I saw his decline.
I saw him more desperate, vague and more in denial during my illness. But with time, he was more in denial as he deteriorated.
When I got Cancer, it took me a while to loudly here my own voice saying “I have Cancer” I thought it was the hardest thing to say.
Little did I realize that saying “my daddy passed away” is so much more gut wrenching and real with no ability to be in denial it as death is so irreversible and even opiates cannot take away that pain.
I am currently trying to work past the denial that I will never see him ever again, call him when I want, or visit.
Have him see his grand kids
grow up and possible say the (fateha) prayers only daughter.
He denied that this possibility and left.
You won the death race and dodged your daughter’s funeral.
You collected happy memories in your blanket and coffin. I hope they offered you the same ease when your breath was leaving your chest forever and I woefully wishing for a similar peaceful death with loving family in my own bed and blanket.
You were teaching me as were leaving us.
You are no more around me but, within me, in me, my choices, my desires, my current and my future.
My genes often dictate things you passed onto me.
May be this father’s day I celebrate your legacy within me, and may be this metastatic daughter with cancer should celebrate her life which came from yours.