Time for Dad to die

Ilove my 90-year-old father, and I wish he would die. In August, he told me, “I just want to live long enough to vote.” On Oct. 20, just past midnight, he turned off CNN in his house in Massachusetts, started up to bed and had a massive hemorrhagic stroke. Had he had the stroke in the chair, my stepmother would have assumed he was sleeping, and without medical attention, he probably would have died by morning. The thumps he made falling down the stairs woke my sister and my stepmother, and saved his life.

But what kind of life? Since that morning, he has been in a deep sleep, rousing rarely and unpredictably and only enough to say a word or two. He’s paralyzed on his right side. His eyes are closed, and the nurses, the doctors and his family cannot wake him. The rehab doctor literally knocks on his chest and shouts “Wake up, Arthur!” and he does not respond. He is not in a coma, he is not in pain, he is breathing on his own, his heart is strong, but he has basically checked out. The doctor said it’s not uncommon to be lethargic after a stroke, although my father’s response is unusually severe. The scans of his brain show that the bleeding and swelling have stopped, but he is not getting better. A feeding tube is keeping him alive.

Over the last three years, my father suffered a series of strokes that left him functional but frustrated. He could no longer drive. He could walk, but not well enough to take the dog out or go anywhere alone. A longtime lover of word games, he found that the words and the jokes were suddenly out of reach. My three sisters and I hated to watch him struggle, trying to find the noun, the pun or the name that he knew was there but just could not say. He told my brother-in-law he wanted to kill himself. He was not joking.

And now this. He is in a good hospital with the latest advances available. He has insurance for as long as he needs skilled nursing, “acute care.” His doctor is compassionate and honest. In a best-case scenario, the doctor said, the swelling in Dad’s brain would recede, he would become more alert, he would regularly respond to us in one or two words. He will never again walk; most likely he will never get out of bed. Eventually, if another stroke does not end my father’s life, his organs will begin to shut down, or he will get pneumonia or another infection that he cannot survive.

Meanwhile, he is still in there. When my aunt and uncle came to see him, he opened his eyes at the sound of his sister’s voice. She chattered and he seemed to be listening. She said she would be back in a couple of weeks and asked if he would still be there. “Probably,” he answered with a shrug. It was a joke of a kind. The minute she left, he retreated into sleep. No response to his daughters or his wife or his doctors since. I’d like to think it’s just because we bore him, but he won’t wake up even for the young intern talking politics.

Now the hospital wants to move him. It is not a long-term care facility, and he does not need acute care. He needs what they call sub-acute care, daily maintenance and monitoring, some rehab therapy to keep blood circulating. We have begun the depressing, complicated process of looking for a home. The nicest place we found is $10,000 a month once his insurance and Medicaid run out. We have no idea how long he’ll be there. My stepmother would have to sell the income property whose rent supports them. Then she would have to figure out another way to live.

The entire family knows he would hate being stuck in bed barely able to communicate. He has an advance medical directive that states he wants no extraordinary measures -- no ventilator, no CPR, no paddles to jump-start his heart -- and definitively no artificial means of support. We knew what he wanted when my stepmother consented to the surgery for his feeding tube. She said she couldn’t deal with “that” then.

My father is an atheist. He believes that when we die, we are dead, period, the end. My stepmother is a non-practicing Christian. We four daughters were brought up without organized religion, believing in Santa Claus and the Easter Bunny but not eternal life and resurrection. We have no authority to tell us what to do. The Vatican recently ruled in the case of Eluana Englaro, comatose for 16 years, whose father has wanted to remove her feeding tube. The Pontifical Council said “to stop giving food and drink to Eluana is tantamount to committing murder.”

But if only God has the right to give and take life, then by feeding my father, aren’t we playing God already? Dad would have been dead years ago without medical intervention. If we remove the intervention, then we truly let God decide -- as well as following my father’s instructions. The right-to-die groups say talk about everything with your loved ones before a crisis occurs and put your choices in writing. My father did that, but we are the ones left to decide.

Food and water seem basic, not “extraordinary measures” by any definition. People with various ailments live their lives with feeding tubes. And he does occasionally respond. When I, his daughter who lives farthest away, arrived at the hospital, he opened his eyes and said, “You’re here.” He knew me. He knew where he was. Who can blame him for wanting to sleep through most of it until ... until whatever happens next.

My husband thinks we have not respected my father’s wishes and that we are failing him by keeping him alive. One of my sisters agrees. She thinks Dad will be too miserable even if he recovers enough to sit up in bed, watch his beloved CNN and see that his children and grandchildren are around him. She says it is not a life he would want.

I know she’s right, and I also know that the independent, vigorous life he wants has been gone a long time. Still, two months ago he was laughing at our president -- although he couldn’t remember his name and called him simply “that joker.” He was able to hold his newest grandchild. He had moments of joy. The question becomes: “How many moments are enough to justify a life?”

The day before I returned to Los Angeles, I was alone with Dad. He never opened his eyes or even moved the entire day. I talked to him, read to him, held his good hand and stroked his great bald head. No response. The sun went down and the room took on that eerie hospital glow. I leaned over and whispered to my father that it was OK to stop fighting. I told him we all loved him and we would never forget him. I said it was time to die. It was not easy, and I cried.

The next morning on my way to the airport, I stopped by the hospital. The nurse said that earlier Dad had opened his eyes, looked right at her and said, “Good morning.” He was asleep again as I kissed him goodbye. I don’t want to be the one to remove the feeding tube, but I am not sorry I said what I did. It is time for him to go.

Diana Wagman is the author of the novels “Skin Deep,” “Spontaneous” and “Bump.”