The Long Goodbye
Mike Fair
Two weeks ago my dad was still at home talking and eating and doing most things for himself. Now he was in the hospital, and we were being forced to think about things that heretofore had been merely philosophical.
It’s hard to be sure when we noticed that Daddy was having trouble remembering things. He was still working his fulltime job when he was 72. Then we got calls from friends at the plant—they were concerned about Daddy’s forgetfulness. Consequently we encouraged him to retire, using his age as the justification.
At age 75 his sister had succumbed to this disease that Nancy Reagan calls the “long good-bye.” So we judiciously avoided using the term Alzheimer’s, trying to spare either our feelings or his.
If one is otherwise healthy, there are drugs that help stem the progression of the disease. Other drugs in the testing stages also hold promise. However, after many years of smoking cigarettes, Daddy’s general health was not good, which ruled him out as a candidate for any experimental therapies. He had finally quit smoking, but emphysema was now a fulltime partner, reducing his breathing capabilities dramatically.
As a family we waited and watched the progression of the memory loss. The drama was turned up a notch when I saw him driving one day and followed him to see where he was going. He was about three miles from home and had gotten lost. We never did convince him that he could no longer drive, so we hid the keys. Later we had his license revoked. Frankly, we should have taken this action much sooner. A physician advising us three years earlier had said by all means to stop him from driving: “One day he won’t come home.” We were fortunate in that regard because I saw him on the day he reached his driving milestone.
My mother took the verbal abuse that often accompanies the long good-bye. The anger Dad experienced is common to the disease. He was convinced that he was as capable as ever. It took my mother a very long time to reach a perspective that allowed her to receive the verbal abuse without taking it too personally.
In fundamental ways my dad was a great and good man. He loved our family to a fault and lived the life publicly and privately of a Christian man. Throughout much of his life he worked two jobs just to stay ahead of the financial requirements of supporting a family of five. When my sisters and I married and had children of our own, Dad was a doting grandfather.
Now Dad was in a hospital bed, this time for three-anda- half consecutive weeks, and his options were becoming fewer and fewer. Pneumonia had caused the diseased lungs and heart nearly to kill him; he was rescued from the edge of death by the good work of an EMS squad. When they entered the house that morning at 6:00 a.m. they asked if there were a Do Not Resuscitate (DNR) statement.
It should be noted that DNR is an individual circumstance— families do not love their dads any less because they choose DNR. As a family, we had talked about the policy and decided that Daddy should be resuscitated if possible and to evaluate this circumstance over time.
After a week in a nursing home, Daddy went back to the hospital. One morning my sister, mother, and I were by Dad’s bed talking about his condition. He was sleeping 18-plus hours a day, had a peg in his stomach for feeding, a pic in his arm for IVs, and needed his diaper changed often because of an intestinal disorder. He did not talk audibly any longer, and when he was awake he stared into that other world of forgotten faces and forgotten places.
All of us took some consolation when he smiled at us, but none of us had a clue as to what he was thinking. My sister said that we were going to have to make some hard decisions. Intervening to shorten the dying process was anathema to my thinking, and I believed my sister’s conversation was headed in that direction. I did not want to consider that maybe it was time for us to place a DNR form over our father’s bed.
As a Christian, I believe the Bible, which says that the human heart, mine included, is desperately wicked. Our wills and actions are so depraved that God Himself in the Person of Jesus Christ had to pay our sin penalty on the cross. It was that morning when I asked the question, “Why don’t you just get a gun and shoot him?” In that moment I demonstrated the essence of my being and how I would act all the time if it were not for the Lord’s governance. I apologized to my mother and my sister. My sister did not love my dad any less because she did not want to see his death occur more gradually.
Today in America we have a dilemma: we have the ability to extend life for years for people who may not care to spend years in a hospital or nursing home bed not knowing who or where they are. A “living will”—in which a family member leaves clear instructions regarding prolonging his life—has relieved some of the burden for the families when the Lord allows such circumstances to occur.
We faced many questions as children of a man who did not leave instructions. What is the right thing to do? How do we advise our mother? Do we remove the feeding tube and allow him to drift off into eternity? Do we keep him sedated so that the discomfort of intubations and tube feeding are of no consequence? Do we just keep doing this until his heart simply stops beating? We finally realized that not resuscitating Daddy at the end was not in conflict with Biblical teaching in terms of what is right.
I am learning that not taking heroic measures and the steps to euthanasia outlined by the Hemlock Society are not inextricably linked. I have also learned that life issues are more complicated than any trite clichés might indicate.
Was Hitler right when he suggested that there is such an idea as those who are unworthy of life? I am sure he was wrong as we think of abortion-on-demand and euthanasia. Yet tough questions remain.
If heroic measures are taken to sustain the life of a young person—and they should be—why should not heroic measure be taken to sustain and prolong the life of the elderly? Is age the measure of worth? Is an arbitrary definition of the quality of life the final arbiter for who lives and who dies?
How about the one in the bed who has no one standing by except the attending medical personnel? Are they to make the decision to “pull the plug”? Is “wantedness” and the relative costs of these procedures the measure that is used to determine who dies?
The Bible says to be absent from the body is to be present with the Lord. However, Christians do not rush off to end it all when faced with sure death. We must approach dying in such a way as not to embrace the enemy, but neither should we damage the name of the Lord in an all-out scramble to avoid the inevitable.
God created and creates life. Genesis 2:7 says that God breathed into man the breath of life. The taking of a human life should be God-ordained as well. Biblical principles apply in these circumstances, but they can only be discovered through diligent study of God’s Word, meditation on these principles, and wisdom from God.
The Lord graciously took Daddy home two days after the family met for prayer and gave him over as completely as we knew how to the keeping of the Lord. Daddy died a peaceful death with his family gathered around his bed. With the argument about tube feeding raging in corridors around the country, Dad’s body simply refused to accept any nutrition. It was important that we try to give him palliative care, and we did. None of us wanted to prolong our father’s suffering; in fact, we asked for and he received morphine to neutralize any pain his body might have incurred during suction or feeding times. It was even more important that we do right because our dad was God’s child.
Now part of my dad’s legacy is the time and the events that he gave us to help examine these important issues about life as it comes to an end. We are praying with other Christians to find a solution to these issues and to find relief from dementia-related diseases. Dementia robs posterity of the insights of our elders. I am grateful to the legion of scientists who are doing God’s work to unravel the maze that creates the “long good-bye.”
Mike Fair is a long-time member of the South Carolina state legislature, currently serving as a State Senator.
(Originally published in FrontLine • July/August 2001. Click here to subscribe to the magazine.)