A good death

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Working in an emergency department changes the way you see the world. My nine months working in CUH ED taught me compassion and gratitude in equal measure, but it mainly taught me that my dad’s old adage of ‘your health is your wealth’ is tragically accurate.

After the first few months working there I realised my dad was an incredibly healthy man for his age – but I also realised that that could change in the blink of an eye. I saw older people full of life, suddenly laid low by a fall or a broken bone – there are no simple injuries at that stage in life. It meant decreasing independence and less freedom to do things like go on holidays. So I started badgering my dad to go on a holiday, telling him he needed to seize the day while his health was good.

In May he went to Lanzarote, and spent a week eating steak, swimming in the sea every day and walking a few miles to and from the beach. When he came home, he told me he had bought a tablet in one of those electronics shops the tour reps warn you about. I could tell he didn’t quite know what he had bought, or even why he had bought it. But the worst part was what he had paid – 1,000 euro for something worth about 50. He had been all over the world, and was a streetwise traveller, but had been ripped off in spectacular fashion on a sun holiday to an island he had been to dozens of times. That was the first sign that something was wrong. Soon his speech was affected, and he became quiet as he realised he was struggling to form coherent sentences. A trip to the doctor turned into a trip to hospital, where scans revealed lesions on his brain and tumours migrating from his lung to his ribs. It was the beginning of the end.

As your parents get older, you think about their passing more. I had always assumed dad would go in the blink of an eye, via a stroke, cardiac episode or falling into a lawnmower (he has a big sloped lawn). He had always claimed his family went quickly down through the generations. But his older sister died last year after a prolonged and cruel battle with cancer – so not everyone got such a clean exit. Her battle haunted him after his own diagnosis, how she wasted away to almost nothing, how her love of life disappeared as chemo ravaged her. But he knew that chemo meant more time on earth, so he opted to go for it. But by the time it came to deciding on whether to press ahead with treatment, he was too sick, weak and confused. They decided against it. As we left CUH the cancer care nurse told us he could stop taking the vitamin B injections. There was no need to be healthy anymore. We were in our last days as a family.

I had dropped everything – my wife, my kids, my job – to move in with dad. My family were due to move in, but we soon realised that he was too sick to be around us – with four children our family makes slightly more noise than a thermonuclear detonation – so we decided to wait. We knew it wouldn’t be long. The medics and carers all thought I was pessimistic when I said I would be surprised if he made September and that there was no way he would make October. But they hadn’t seen him in full health – they didn’t know the transformation, the toll it was taking on him, the shock of sudden illness after a life of almost perfect health. He was crumbling.

My time with him settled into a simple routine – I’d cook and clean, he would potter about from room to room, often becoming confused by simple things, or agitated by others. The steroids used to control the inflammation on his brain caused sleeplessness, restlessness and made a difficult situation even harder for him to process. They also exacerbated the shake in his hand, meaning he couldn’t write a letter, or even drink a cup of tea properly. Technology, never his strong point, became a complete vexation. One day the phone was ringing; I could hear him answering it, but it kept ringing. When I went downstairs to investigate, there he was, shouting ‘hello? hello?’ into the Sky remote. He became completely confused by mobile phones, portable landlines, TV remotes and even the electric shaver I got him for Father’s Day, a gift inspired by his inability to use a razor with the shakes in his hand.

He used to joke about being sent off to Dignitas if he started to go ‘gaga’, and here he was, struggling with the basics. He hated it – hated the dulling of his mind, the confusion. But he carried on and even tried to be optimistic about the cancer, telling me that he really thought he was going to beat it. I told him it was good to have a positive outlook. He also claimed his GP told him he had a year to live, and started telling people this fact, usually while I stood behind him shaking my head at them. Because they needed to know that he didn’t have long left – don’t put off calling up, we won’t be there long; don’t talk loosely about meeting up at Christmas, because he won’t see Halloween.

Living with him wasn’t all sweetness and light and Wonder Years-style dewey-eyed anecdotes about love and life; a lot of the time he simply wrecked my head. But that is one of the defining features of family – do they wreck your head? Yes they do. Are you still going to stay in touch with them? Of course, yeah. The inescapable irritation of the people who know you better than anyone. But for the most part dad and I got on fine, especially given that we hadn’t lived together for 20 years or more.

Having this time together meant we were able to talk about what he wanted when he was gone – specifically his funeral. He told me he wanted the cheapest coffin money could buy, one of those wicker ones if possible, or maybe a cardboard one. He also said there wasn’t to be any meal after, sandwiches at best. His reasoning for this was to save me money, but I joked that I was going to have a viking funeral on Garryvoe beach, complete with roasted venison and fireworks display. He was unfailingly generous to me throughout my life, but was frugal when it came to himself. All he had he gave to me – the least I could do was bury him in something that resembled wood. We laughed about all this stuff – what else could we do? As Voltaire said, life is a shipwreck – but we must not forget to sing in the liferafts. So we laughed when we could, and waited for the end.

Soon the cancer ate deeper into his ribs, and the pain got worse. At this stage we were in the care of the Marymount Hospice palliative homecare team, who decided that ten days respite in the hospice might help with pain management. Or at least, that was how it was pitched to dad. But I felt he wasn’t going to be coming home. He hated the idea – he wanted to stay at home, and – if possible – die here. But his medical needs were growing steadily, and my terrible lasagne and nightly pints were not going to ease the pain of a rib being ruined by disease.

At this stage, I was burned out. I had spent three months trying to be the strong one, ditching my wife and kids to care for my dad, feeling more and more like a stranger to them. It was like going through a separation, except without the Ukrainian girlfriend and Ed Hardy pyjamas. But this was my cross to bear alone – there was no one else who could or should have to do it. When my sister was sick, my parents cared for her; when my mother was dying from brain cancer, my dad cared for her to the bitter end; now it was just me left to be there for him. I’m lucky I was able to – if my career had been more stellar, if I lived farther away, if I had stayed the angry young man I used to be, I possibly wouldn’t have been able to do any of it. But I did, and I am proud to have done it.

Once he went into Marymount, he started to quietly accept that he wasn’t going to beat the cancer, or live a year, or see Christmas. In the space of three days he went downhill fast. His mobility decreased, mental functions slowed, and – perhaps most tellingly – his appetite decreased. This was remarkable because he always had a huge appetite, and also because the food in the hospice was great; in fact, most things in the hospice are great, including the Wi-Fi.

Cork people have this intense feeling for Marymount, because almost everyone has been touched by their work at some stage. When I worked in the Evening Echo we used to run a Christmas charity appeal, setting a target of about 70,000. One year we chose the Simon Community and we raised about 50,000. The year we chose Marymount we brought in 260,000, and people were still coming into the office in June the next year with bags of coins they wanted to donate. Marymount is how the whole health system should be – a place of peace, dignity, and incredible care. My dad’s time there was short, but memorable – one day I was there when the drinks trolley came round. He had a G&T as we sat in the corridor outside his room. You could hear the mood change along the halls as patients had a drink – the murmur of voices grew louder, there was more laughter, and for a while the future was forgotten.

Towards the end of his ten days of respite, he really began to wane. He asked for his friends to visit, and I called family and told them to bring forward their trips down. He had a gang of pals who used to meet in Midleton every morning after Mass and share a big pot of tea and all the gossip they could muster. They came to see him on the final Saturday; five of them  – all with various ailments – shuffled into the room. He opened his eyes, shook their hands, closed his eyes, and never woke again. They said their goodbyes, and a prayer, and left.

Dad’s breathing in those final 24 hours was ragged with mucous and secretions from the tumours. The nursing staff checked on him every 40 minutes or so, adjusting his medication and moving him in the bed so he would be comfortable. They made up a cot bed for me on the floor next to him, and I stayed the night. Convinced I would wake to find him gone, I was surprised to sleep soundly and then awake to the same ragged breathing. But in the morning as I lay there wondering what to do for breakfast, something changed – the ragged, rattling gurgles changed to quiet little gasps. Nine years ago I held my mum’s hand as she died, and listened to the same change in her breathing. I got out of the bed and sat on the chair next to his bed. The gasps got quieter. I sat on the bed and held him. More and more space opened between the gasps, as though he had stopped taking in air altogether and his body was just going through the motions. This was it – 85 years of life was about end. I put my head on his chest and let the grief devour me. He stopped breathing and that was it, he was gone. My safety net, my panic room – my one phonecall from a police cell, the person who would always catch me when I fall. This was the end of everything; all his years of life on earth, the incredible things seen and done, all now lost, like Roy Batty’s tears in rain.

I spent a good five minutes sobbing, drooling, snuffling and croaking incoherently. I knew that once I pressed the call button, the nurse would come and the great gears of mourning would clank into action – suddenly it would be death notices and coffin catalogues, prayers of the faithful and funeral suits. So he and I had those last few minutes, and no more. The nurse came and called it at 8:11.

Clonakilty in west Cork used to be home to a notoriously awful workhouse. When travellers would meet along the road and ask where they were headed, if the destination was Clonakilty, the reply would be ‘Clonakilty? God Help Us’. To my dad’s age-group, it is still known as Clonakilty-God-Help-Us. I used to say it to older patients in the emergency department when they were checking in, as it was a handy way of saying you had family links to the place. I’d meet people who went to school with my dad or one of his siblings, as Clon was a small place and everyone knew everyone else. But there weren’t many of that generation left, and those who were often ended up in emergency departments talking to me.

Clon always seemed like another world. I spent my holidays down there, nearly drowning in Inchydoney, getting nipped by lobsters in Ring, listening to my dad’s zany stories about the place: The WWII warplane coming down in the marsh outside the town, and the monkey mascot being buried behind the hotel, the airmen’s Lucky Strikes being passed around by the altar boys after one of them nicked a carton from his father, the local garda. Dad used to talk about the glory days of Clon GAA, usually cursing Nemo Rangers in the same breath, as he saw them as some sort of GAA Boko Haram, stealing away west Cork’s sporting talent with the promise of the (relatively) bright lights of Cork city.

After school he joined the bank and worked all over Ireland and had stories that ranged from the terrifying (from the North usually) to the ridiculous (everywhere else). He told me a while back that he thought money was a grubby commodity to be dealing in. I asked what he would do if he could have his time over again. He said ‘I’d like to own a pub’, before cheerfully adding, ‘but I’d probably be dead and broke’.

He was assistant manager of the BOI in Midleton, and I’ve met a few people over the years who told me they would wait until the manager was on holidays before they would go to my dad and get their loans and mortgages. It wasn’t that he was some feckless Anglo Irish style banker – he did the math, but he always wanted to give people a chance. He saw the best in people. He saw the best in me: He was ridiculously proud of everything I did. He kept a collection of cuttings from articles I had published, photocopying them and sending them on to relatives – even the one about getting a vasectomy. He believed in me to a level that was almost frightening – his faith in me was unshakeable.

A while back I wrote a piece about him and whiskey, and it ended up in this month’s Irish Tatler Man. I had hoped to show it to him, as the first piece I had published by the Irish Examiner was also about him and about whiskey. By the time I got a copy, he was gone.

He had 85 years of good health. He had his losses, and endured the tragedy of losing a child, and then losing his wife, but generally he had a good life. He loved us, and we loved him in return. He was a big part of our lives, a fact acknowledged by us naming our youngest child Daniel (although with four kids we had basically just run out of names). I joked with him in the days before he died that I was glad we had finally got around to naming one of our kids after him, but felt bad that it was the worst behaved one. Dad assured me he wouldn’t always be like that. Maybe he was thinking of me – a mess for half my life, and a slow recovery thereafter. Here’s hoping.

I feel sad, but I know that this is as good as it gets – someday I will face the same fate, and I hope my kids are as happy as I am in life, or that they love me like I loved him. Loss is the high price of love just as death is the high price of life. I’ve seen sad deaths in my work, the bodies unclaimed for a week. To be able to stand on the altar at a funeral and say ‘I love you and I miss you’ is a wonderful thing. Why would I want him to hang around? He hated being sick, and he had to go at some point – what sort of son would I be if I had tried to keep him here, to watch him wither and die just so I could put off the inevitable?

I’m still at the stage where the phone rings and I think ‘oh that’ll be dad’ or ‘is that him at the door’. Eventually I will accept he is gone. Life will go on. I return to work in a couple of weeks, not to the emergency department sadly, as I had to be replaced once I took leave. In the meantime I’m sifting through his life, reading his love letters to mum, finding photos of him with women whose names I will never know, trying to pull together all the loose strands of his time on earth so I have something to tell my kids about who he was. The best I can do to honour his memory is try to be a good dad and a good husband, because I only became a good son at the very end.

Dad loved the beach – all those childhood summers on Inchydoney left their mark on him. Even after mum died he still went south for sun holidays on his own, coming back with a camera full of images like the one above – blurry landscapes with nobody in them, save the odd thumb. Any time we would go to the Canaries together, he would invariably head off to the beach for the day, and lie there like an iguana. When I think of him now, it is like that – on a beach somewhere, with poorly applied suncream, ill fitting trunks and a faded Munster Rugby towel, dozing in the heat.

Dad left this world as he lived – gently, peacefully and with dignity. It was a good death. I miss him, I love him, and I am happy. 

2 thoughts on “A good death

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