Tuesday, December 09, 2008

The Heart, the Hospital, and the Family


It was becoming all too common, this type of trip to the hospital. Congestive heart failure, a call to the ambulance, and a quick trip to emerg, followed by a move to ICU, and then PCU. Maybe he would spend a couple of days there, and maybe he’d spend a week; it depended on how serious the failure had been. Occasionally, it wouldn’t just be congestive heart failure, it would be an actual heart attack. He usually couldn’t tell the difference, unless it was a major heart attack. They’d run their tests at the hospital, and let him know.

This time it was different. It was a heart attack, a major one, and the doctors told his wife that she should prepare for the worst. There wasn’t anything else they could do for him, medically speaking, except make him comfortable. It was news she had been dreading for too long; for the past year he’d been into the hospital about once a month, and she knew that it had to be a matter of time before his last trip to the hospital. She steeled herself, and then called the kids, being honest with them but careful to hide any of her own feelings about the matter. (Which were confused anyway.)

The kids—one in Toronto, three hours away, and one in Ottawa, eight hours away—immediately cleared their affairs, and began the trip home. And meanwhile she sat with him, as she’d done many times before, feeding him water and ice chips, and being there for him. He may or may not have realized that she was there, in his drugged state, but that didn’t matter. She was there.

The son was the first to arrive, in the early afternoon. He and his wife made their way to the ICU, and went in to sit with them. There wasn’t anything they could do but sit; the job of feeding him ice chips and water was already taken, and he wasn’t able to do much talking. Not that he was communicative at the best of times. They just sat with him, and tried not to think of it as watching him die. His son wondered about the state of his soul; was he ready? If not, it might be too late.

Early in the evening the three of them left for a quick supper, and then returned to continue their vigil. News was a scarce commodity; doctors were loathe to give it and were never present anyway; the nurse practitioners were more willing to give news, but they were hardly ever present either. When news did filter down to the family, it was difficult to know which news was important, which was accurate, and which was simply opinion.

Later in the evening the daughter arrived with her boyfriend (who went to the house, to give the family their privacy). The son and his wife left the room, so as not to crowd it, and the daughter took her turn sitting with him. The family was spread between his room, a waiting room, and the house, but they were all thinking the same thing: “I wish there was something I could do.”

Nobody knew what would happen, but everyone feared that it would happen soon. Most prepared to stay throughout the night, but his wife knew better. They couldn’t do anything for him at the hospital, so it would be better to go home and get some sleep. Around midnight she passed this advice on to them, they took it, and they left. She stayed behind, however, to be with him through the night, and continue to feed him ice chips and water.


The kids woke up the next morning to see a note from their mother on the kitchen counter. She’d come home for a few hours of sleep, but would they please wake her at 10? They didn’t have to, however, as she woke up herself, shortly before they were supposed to do so. Once everyone had showered and had some breakfast—and once they’d made a quick run to Tim Horton’s—they set off for the hospital.

Thursday was much the same as Wednesday afternoon had been. News rarely came from the medical staff, and when it did, it was bleak. They spent the day at the hospital, except for a brief trip to a restaurant for an early supper.

As the day progressed, he seemed to do better, to get stronger, to become more coherent. But nobody let their hopes get too high; the phrase that kept sticking in the mind was “there’s nothing else we can do for him, except make him comfortable.”


Friday started much like Thursday had. The family woke up, got ready, and went to the hospital. But things changed a little on Friday afternoon: his doctor called, and said that he wasn’t going to give up hope. Although the hospitals in Canada weren’t able to do anything, maybe the hospital in Detroit could? They have medical technology there that we don’t yet have in Canada—such as an artificial heart, that can be used during a long operation—and maybe that technology could be used to give him hope?

He would start the paperwork, and start talking to the people in Detroit about a bypass. The family accepted this news with cautious optimism, reluctant to give up on their pessimism, after it had become such a part of their lives. And anyway, there was time to think about it, before a decision would have to be made. Nothing would happen before Monday, at the earliest, since there was all the paperwork that had to be filled out.

His doctor had already sent x-rays and other materials to the doctors in Detroit, and the doctors in Detroit were beginning the paperwork. He’d go to Detroit, they’d examine him, and they’d talk about next steps. It was beginning to look like he might be in an ambulance as early as Saturday, but they had changed their minds now, and maybe it would be an angioplasty instead of a bypass.

Again, the family left the hospital for a quick, early supper. In the middle of supper, his wife got a call on her cell phone, from his doctor: The American doctors were still working on it; at this point, they were calling all of the Canadian hospitals, to confirm that there was nothing they could do. (OHIP would pay for an operation in the States, if it’s something that no Canadian hospital could do. But if a Canadian hospital could do something, then of course he’d be sent there, instead.) Since the family had already been through this with the hospital in London, they knew that there was nothing they could do, so this was just a formality.

Then they returned back to the hospital, they were surprised to find that he had had visitors. (Visitors who had brought some very nice chocolates.) But they were absolutely floored to hear that the plan had changed again; he was no longer going to be sent to Detroit, he was going to be sent to London, and he was going to be sent tonight. And in fact the ambulance would be there any minute, and they needed to get him packed. London didn’t have an artificial heart, but London had specialists, and London had a CCU, so he’d be in good hands in London.

The kids cleared out, his wife made sure he was packed, and then his wife and daughter got in the car, to head for London, to meet the ambulance there. Unfortunately, it turned out that “any minute now” was wishful thinking. It was hours before the ambulance picked him up in Chatham, so his wife and daughter waited in the waiting room in London for a long time.


The family all met up near London, at a relative’s house. His wife reported that things were promising. The doctors in London were very annoyed that they hadn’t been consulted, when he made previous trips to the hospital. Of course they could do something for him! The options currently on the table were now an angioplasty, a triple bypass, or maybe even a transplant.

And so he stayed in London. There was nothing else the kids could do, so they left to go back home, and await further news.

Who knows how long the saga will continue—but it probably won’t be posted about here. At least not in this level of detail.