To My "Dad" Ralph

This roller coaster ride started on February 27th.

As I was leaving the office, I checked my cell phone for messages. Shelley left a message, “Daddy is not doing well. I am going to the hospital.”

Her tone of voice told me a lot. This is not good. You were admitted a few days before, due to a bladder infection and dehydration. I have been checking your blood test. There was no infection in the blood.

What could it be?

When I reached the hospital lobby, I got a call from your attending physician. He told me briefly what was happening.

Finally, I reached your hospital room. There you were, gasping for your air, using every abdominal muscle that you can recruit. It was not a very good sign.

The working diagnosis was aspiration. You were ready to be transferred to the skilled nursing facility to recover that day. Your breathing suddenly changed.

DNR ( Do Not Resuscitate ) or Full Code? Your attending physician kept bringing up that question. Just a few days ago, Shelley and I asked you the hard question, “How can we modify the help that you get at home so that you do not get dehydrated and get admitted to the hospital again?”

We took care of that question, but we did not anticipate this new one.

The plan was to transfer to Intensive Care. Your attending physician made that decision. I agreed. I was not sure if you could make it through the night.

The next day, Shelley’s voice in the phone was jubilant. “Daddy’s doing much better. He is just like the Energizer Bunny who keeps bouncing back!”

Your son Bob came from Ohio that day. I did some research and prepared some of your lab reports to share with him. The conference by the elevator was good. I was able to explain your medical condition to him. I felt that with more information and understanding, he was able to accept your state of health.

So, three of us were in front of you when I asked, “The hospital team has been asking me about you code status. What should I tell them?” I proceeded and explained the difference between DNR and Full Code.

To our surprise, you had a very clear idea of what you want. It would be DNR. The discussion ended right there.

Tuesday, March 3rd. You were transferred to the skilled nursing facility. Somewhere along the line, hospice care was brought up. I did not know the details of that discussion.

Wednesday, March 4th. You were in heart failure. They also found out that you had a heart attack.

Again, another tough question, “Hospice or back to the hospital?”

All along, I have been switching hats. At times, I was the physician explaining your medical status to Bob and Shelley. At times, I was your son, your adopted son in Albuquerque. At times, I was your friend, someone who talks to you about Tiger Woods and the golf swing.

Ben, your nephew and a doctor too, helped us make the decision. They gave you some diuretics. You felt better. They transferred you to the hospital.

I learned something that day. I learned that I had already changed from a physician, to a friend, to a family member. I could not make an objective decision anymore.

Thursday, March 5th. You were burning with fever. You kidney numbers were creeping up. You were struggling with your breathing again. This time, the x-ray of your chest showed pneumonia. When I left your bedside that night, I was not sure if I will see you again. I did say good night. I was not sure if you heard it.

Friday, March 6th. Like the Energizer Bunny, you bounced back again. It seems that you were just going to kept going, and going, and going. I did not know what was worse, this roller coaster emotional ride between hope and fear, or the roller coaster at New York’s stock exchange.

Saturday, March 7th. I was driving down the Pacific Coastal Highway with my wife, Angela, after her audition for the Songfest at Pepperdine University when Shelley called. She said that the decision was made to put you on hospice. She said that you were comfortable with that decision. The infection was overwhelming and the kidneys were failing.

Monday, March 9th. Shelley called in the morning. You passed away peacefully that morning. She said that you did not have any wrinkles on your face. I was happy to hear that. I felt sorry that I did not have a chance to say goodbye, one more time. Where did the Energizer Bunny go?

As I write this newsletter, I have your picture which Shelley gave me yesterday next to my computer. The place was Concord Golf Club in New York. The caption says, “Staff Outing July 28, 1994. It showed you on the white tee box swinging the golf club.

We had our golf outings too in the last few years. You were not able to make a full swing, but I would not make a bet against your short game. You could still chip and putt.

Talking about putting, Shelley gave me your putter last night. I will bring it to the golf course and play with it this year. I know that there will not be any more golf outings with you in person. With that putter in hand, I know that you will guide every putt and we will drain those testy putts together.

Lastly, I am happy to report that I completed my first 5K run. 38 minutes and 51 seconds. It is not a bad record for an old novice like me. I am sure you could beat that time when you were my age.

I will do the Duke City Marathon this October. I will print a tee shirt that says, “This is for Ralph!” Run with me, we will celebrate together at the finish line!


written April 2009