Circumstances Being What They Are….

“I want to say that I am exceedingly upset about getting rescheduled a second time. Do I need to find another doctor?”

I read the message again then typed a response:

“Yes, you probably do….”

For a few seconds I stared at the blinking cursor, waiting for the guilt to overpower my hurt. Finally, I hit the backspace until the words disappeared. I closed out the note and removed it from my tasks box without responding.

I’d spent the weekend on call from my father’s hospital room and I was sleep deprived. He was in excruciating pain, choking on everything he tried to eat or drink. His blood pressure was 88/40. No urine output for almost 24 hours. He wasn’t able to maintain his oxygen levels without supplemental oxygen. And I’d STILL had to fight with the prick of an ER doctor to get him admitted Friday evening.. We’ll just send him out with some codeine cough syrup... until I divulged that I was a physician and knew what he was trying to do was wrong. Codeine cough syrup would not control his pain if 4mg of morphine could not.

Even mean, ugly, crippled people with dementia and a history of leaving the hospital against medical advice deserve compassionate medical care when they are suffering.

Over the next couple of days my father required more and more oxygen and needed my help to use the bathroom.

He stopped eating.

He stopped drinking.

Now it was Monday. I should have been seeing patients.

But I wasn’t.

Because he died...

Instead of seeing patients, I sat in front of my computer in a bare office with no windows. A box of Kleenex waited nearby, ready to catch the unexpected tears that kept sneaking out of my eyeballs. I was there to wrap up loose ends so I could take the next few days to help my mother arrange the funeral, get him buried, and get his stuff moved out of the assisted living facility.

The patients didn’t know this.

No one had any idea that I quit my job of 14 years to move back to my home town because my father’s dementia was worsening. They had no idea that he was in and out of the hospital starting the first day of my new job. At one point he had even barricaded himself in his house for over a week after my mother moved out because she feared for her safety. He would let no one in, not even me, until he finally emailed in a panic because he was hallucinating. He couldn’t remember how to place a phone call. They did not know that I removed 40 guns, some of them loaded, from his house during the subsequent hospitalization or that I helped get him into a memory care unit, that I’d filed for legal guardianship through the courts to make him stay there because he could not understand why he shouldn’t be allowed to drive or own a gun or live on his own.

Over the course of six months a once proud man lost his freedom, his dignity, and his will to live and I’d had no choice but to do it to him.

I still feel so guilty.

In truth, I was not prepared for how much losing a father messes with your head. It came as a surprise that I found myself mourning someone I spent so much of my life hating. Is it easier if you loved them? Yet, seeing someone you hate suffering as he did, trapped in a hell that was not of his choosing… it does something to soften even the hardest of hearts, I think.

It softened mine.

And then there is the guilt, even months later.

I wonder if he understands now… if he forgives me?

So here I am, less than I was in some ways and more than I was in others. I miss my blog. I miss my friends. I miss my old home, my old office with the giant picture window, and I miss my old patients. After almost a year and a half after moving I think I am finally getting past the dysphoria of recognizing bits of my past in the shadows and around the corners of this town.

Progress.

It was unquestionably the right decision making the move, and I would do it again, but it came with costs, some of which are difficult to put into words.

When people ask if I am happy with my new job, I focus on the positives. I don’t want them to know that I am second guessing myself on an almost daily basis. Here, at this place, I can make a difference in a way that I could not before. But I wonder sometimes if I am strong enough to persevere through all of the layers of bureaucracy and politics, things I really suck at, to last any length of time at this. I no longer have the protection that seniority affords and there is such a thing as caring too much. I can feel it eating me alive because I simply cannot let things go and keep my mouth shut. Not when something is clearly wrong or not fair.

Where did all of that outspoken stubbornness came from?