Monday, April 24, 2023

Wasps and Doves

There's English Ivy growing on the front of my home, and I was cutting it back this morning.  Not killing it, which I probably should, given that it's aggressive and invasive and all, but I can't quite bring myself to eradicate it down to the roots.  I love the look of it, our windows poking out of hobbit hole greenery, the hard brick frontage of our rambler softened and organic with photosynthesizing leaves.  Having made that fools choice, I am resigned to knocking it back two or three times during the growing season.  

So I was up on a ladder, my battery powered hedgetrimmer clattering away in my hands, when I startled a dove.  I've startled other ivy dwelling critters while cutting it back before, most notably a fierce tribe of yellowjackets a few years back.  That encounter left me stung a half dozen times, as the merciless little devils chased me around the yard.  I retaliated, of course, finding their subterranean lair the next day and nuking it from orbit.  Yellowjackets are intrinsicly warlike monsterlings, neither trifling nor to be tolerated.

The dove had waited, frozen, until I was right on top of her, then exploded away from her nest in a whistling flurry of wings.  I startled, of course, and pulled back from the nest.

There, on the ground just a few meters away, the dove did all she could to draw my attention.  She fluttered feebly on the sidewalk path, feigning injury.  Look, look at me, I'm so weak, you can kill me instead, come catch and eat me, she was saying, putting herself in peril that her brood might be saved.  It's an instinctive behavior, just part of being a dove, and it's as much a part of her as stinging murderous aggression is part of yellowjacket nature.

Being of a species prone to sentiment when we're not blindly destroying everything around us, I was touched by the gentleness of it.

No attack, no making of war, nothing but an effort to distract this pink hairless primate and his clattering blade machine away from her precious eggs.

"Oh, dear heart," I muttered, smiling.  "It's gonna be fine.  Your babies will be fine."

Which they were, as I took more care in the trimming.

Friday, April 21, 2023

Bad Theology

Dad's still in the hospital, nearly a week in.

The diarrhea meant he was severely dehydrated, which would be a problem in a healthy human person.  But he's not a healthy human person, not by a long shot.  For the last year, we've been leaning heavily on his kidneys.  As his congestive heart failure has advanced, it's become harder and harder for him to clear fluids from his body.  The ticker sputters along, and the water builds up.  Dad would fill up like a vessel, first the feet and legs swelling, then the breathing starting to rasp and wheeze as fluid fills his lungs and the interstitial spaces in his chest cavity.  Thanks to modern phamacopeia, we can knock that back with furosemide, a heavy duty diuretic.  First forty milligrams, then eighty, then maxed out at one sixty a day.  Then we added metalozone, tiny little blue pills that are a serious pain in the ass to split, a drug whose sole purpose is to amplify furosemide, squeezing every last drop of fluid out of his body.

All of that to keep him from drowning in his own body, because death by slow suffocation is just the very worst, like being waterboarded by a relentless torturer over months.

To do that, we needed his kidneys, and all of a sudden they weren't really working.  He was, or so the various and sundry tests indicated, deep into kidney failure.  I visualized two dessicated kidney beans, suddenly hard and lifeless.

The IV fluids helped a bit, and he started eating, and we thought, OK, this is getting better.  

But on day three of the hospitalization, he woke in agony.  He could no longer move his arms and legs, or sit up without excruciating, unmanageable pain.  Mom and I arrived to find him crying out, unable to move, unable to do anything at all besides suffer.  Nurses scurried about, and the attending physician arrived.

Dad was sure he was dying, deep in the throes of mortal agony.  "Take me now," he cried.  "I just want this to end."

"What did I do wrong to deserve this," he moaned.  "I'm being punished for something."

"That's bad theology, Dad," I replied, which...given that Dad's a preacher's kid and all...managed to get through to him.  He nodded.  "Yes.  OK."

Through all of it, he was certain of death, certain that these were the final moments of physical life.

And then the doctor said, "You've got gout."  "What?" Dad whispered.  "Gout.  You're having a severe flareup of gout, because your kidneys aren't processing uric acid."  "Gout?"  "Yes."

Suddenly, Dad was calmer.  Still in pain, but calmer.  "Rich man's disease, eh?  Didn't think I was that well off."  And he smiled a little bit.

In the zigs and zags of late modern aging, it's never what you expect.

Back to the Hospital We Go

Dad's been hospitalized for the last week, but not for the congestive heart failure that's been consuming him over the last year.  He's grown more and more frail, as one system after another succumbs to the endless march of senescence.

Our concern had been the wounds that were opening up on his feet, pressure wounds that would not heal as his cardiovascular system struggled to get oxygen and nutrients to his extremities.  Two weeks ago, that was my primary concern and the focus of my attention in his care, as the specter of sepsis and gangrene hovered in the shadows.

But then he started complaining of "the runs."  That was mentioned after a couple of days, and I was immediately on alert.  "Oh, it's not great,  but it seems to be getting better," he'd say.  His weight began to slide, as mom noted his appetite declining.  He started sleeping more, as fatigue overwhelmed him.  I was concerned about a gastrointestinal infection, and dehydration, and spent much of an evening waiting for the poop to come, helping him repeatedly to the toilet, where he squatted diligently.  "Wait, here it comes.  Nope, just a fart," he'd laugh.  His bowels seemed empty, so I'd given up and was on my way home when mom called to triumphantly announce that they'd succeeded in my absence.  "We have poop," she crowed.  I sighed, and turned around.

So at slightly after ten that night, I was methodically spooning rank, ashen liquid excrement into a small plastic vial, which I delivered to a 24 hour lab.  The results came back negative.  No infection in the stool.  

That didn't matter, because two days later, he wasn't better, nor had he been able to consume the protein drinks I'd gotten for him.  I contacted his doctor, and she was blunt in the way I appreciate in medical professionals.  

Take him to the emergency room.  Do it now.  Sure, it was Saturday, and sure, a six hour stay in the ER isn't exactly optimal when you've still got final sermon editing to do, but that just goes with the territory.  This is a season of late nights and a deep body weariness that even strong coffee can't quite dispel.

What sort of parent wouldn't stay up with a sick child?  I remember being a little boy with a stomach bug, remember puking into buckets and whimpering piteously as mom and dad sat with me in my illness.   What sort of child wouldn't do the same in return?

Monday, April 17, 2023

A Season for Caregiving

The Easter season has passed, and I've not been writing.  I'm not all that motivated to write, because beyond my church work, all of my energies are wrapped up in managing Dad's care.  I interface with his doctors.  I get him to appointments.  I'm the point person for his home care providers.  I manage invoicing to his long term care insurer.  And most importantly, I'm there, physically, as part of the team that prepares him food and helps clean him and dress him and tend to his various failing systems.

There is no bandwidth for writing, just as there wasn't bandwidth for writing back when the boys were tiny tikes.  I'm just too tired, most of the time.

"You're suffering from provider exhaustion," Rache suggested to me the other night, as I returned home having dropped off a stool sample at a lab.  Ten o'clock, and I'm dropping off a vial of ashen diarrhea in a near empty medical facility.  Was I tired?  Of course.

But it's not the sort of fatigue that rests so heavy on the souls of those who find themselves alone and caring for an aged loved one.  I am remarkably privileged, after all.  Dad has competent doctors and remarkably generous health care.  He has financial resources enough that we can have eight hours a day of home aide support.  And there's that long term health care insurance, which may get around to helping once the endless hoops and barriers hidden away in the fine print are overcome.  

It's every day, but it's not every moment of my time.  I have time to exercise, time to read and relax, time for my garden and for my church work.  But I don't have the mindspace to write manuscripts.  Not really, this writing notwithstanding.

And that's just fine.  

There's a peculiar theme in our culture, one that insists it is not fine.  We must be ourselves!  We must be free to do what our heart desires!  Caring for an aging parent is not something to which we aspire.  It is onerous, an impediment to our careers and our creative endeavors.  It's a little dismal, the sort of life suffered by a hopeless, loveless Victorian spinster, living alone in a shadowy mansion with their mad invalid mother.

I recently read the novel DINOSAUR by Lydia Miller, in which there was a minor subplot involving a socially awkward character trapped at home caring for his mom.  He couldn't get out, couldn't find love and meaning, because, well, he was stuck dealing with mom.  His blossoming as a supporting character comes when he finally finds his joy by putting mom in a care home.  Finally!  Free!  Free of mom!  Yay. 

Our grandparents and parents are, when they reach a certain age, mostly seen in those terms.  They become an inconvenience.  A thing that must be gotten out of the way so we can be our true selves, so that we can live our best life now, so that we can work and work and work and work.

But this isn't life, not as it is meant to be.

Life comes in seasons, and this season of my life is best spent being there for my parents.  Sure, my vocation is important.  Sure, I miss the creative outflow that writing provides.  But I've written.  I've done that.  This is what is mindful now, what is essential now, what builds relationship now.  

It's not about me being me.  It's about me being a child, about me recognizing that my duty to support my parents as they age is as vital as "parenting" my children when they were young.