This Knife Ain’t Sharp Enough

My Dad is back in the hospital. His remaining penis is like a bloated poorly-cooked pork sausage.

I am reminded of a neighbour beyond the pickets whose favourite children’s party game was called pork sausage. The children would be in a line. No smiling, laughing, giggling allowed. He would go along the line and point and grope you on the body or the face and in a heavy Welsh accent say, What’s that there? And your answer had to be pork sausage but you weren’t allowed to laugh. Laugh and you were out. I was good at this game. It seemed the saying of pork sausage was hilarious to most small children. And when coupled with a big bellied man pointing and fondling your ear lobe, and asking you what it was, and having to say it was something it wasn’t, something as ridiculous as pork sausage, it was very nearly impossible. But I could do it every time. He could pinch my nose, my ears, grapple with a roll of tummy, fiddle my fingers and I could say it straight-faced. Pork sausage, Mr Elliot. Till I was the last kid standing. Grim-faced. Thinking, not funny Mr Elliot.

Winning this game did not endear you to adults. They wanted to see kids giggling uncontrollably. They loved to tickle you till tears were welling in your eyes. A kid that didn’t find pork sausage funny was a kid with no sense of humour.

This is what we are here for; to exam the pork sausage and decide its fate. No giggles. Not funny. The nursing home GP thinks an area of tumour recurrence can be seen near the urethral opening and he has organised Dad to go back to the private hospital to be seen by the surgeon who did the partial penectomy in the first place.

The ambulance is transporting him. I meet them at the doctor’s rooms but there has been a mix up. He is to be admitted and the consultant will see him on the ward when he has finished his appointments.

In the ward they have him down for 2pm. We have nine. But they find him a room. No 13. I sit talking to him but he has his head turned away and is not answering me. I go to the other side of the bed and then he realises it is me.

Oh Nicole, what a surprise. I explain he is in the hospital to have his penis looked at. Because it is sore isn’t it Dad? That’s why we are doing this.

He starts out just a little old man, a little confused. After six hours he no longer knows what he is, where he is and he’s as mad as a cut snake.

A nurse comes in and wants to take a peek downstairs. He is saying no more no more but she manages a look and with her ultrasound measures his bladder volume. It has 138mls in it and he has wet his pad in his pants. Reluctantly I call it a nappy.

He has bitten his lip or his tongue in the transport and has some blood in his mouth. I ask him about it but he doesn’t seem aware of it. I get him a choc milk and he drinks it with a straw.

He starts talking about leaving and all the things he must do to leave. He will need a bus on the highway. But where is he going to? What is his home address?

He is trying to swing his legs out of the bed and attempting to sit up. He is easy to push back down. And when I do he has to start his effort all over again. It weakens and tires him.

I wait till he is nearly up then down I push him. I think he probably doesn’t know I have done this to him half a dozen times. Each time I stop him getting up he is surprised I have stopped him.

When he is nearly upright I stop him again and he says, Oh no oh no. Exasperated. He leans back down in the bed. You have to stay Dad to see the doctor. Over and over again I say it.

I am driving myself nuts.

Oh I love you darling, but I have to go. I have so much to do at home.

He asks me why. Why must we stay for the doctor? I have him booked next week and he gives me a wink. That’s the way the cookie crumbles.

I have a lot to do at home. The dogs and cats need to be fed.

No time for yakkity yak.

He says I am trying to hoodwink him. He says the nurse is part of the secret service. Everyone is keeping stuff from him. Like information. Like addresses and where he is.

They move his bed from room 13 down the corridor close to the nurses’ station and he falls asleep. He has his glasses on. When I tried to take them off he objected. You want to hoodwink me. You know I can’t go without my glasses. Why have you taken my socks and shoes off? I can’t go without my socks.

When he wakes up he is gripping the side bar of the bed like he thinks he is moving or falling.

Dad. Dad you’re okay. I try and peel his fingers from the side bar. But he is hanging on.

No, he says. He has woken up different. More stubborn. Ready to fight.

He has woken up in another world. He starts talking about straw. You need to move the straw. Give me the pliers. You have to dig it there. When I try and move his fingers he gets  snarly with me.

Okay okay. But you don’t look comfortable.

Don’t take stuff without asking.

I can recognise the consultant’s voice outside. He’s on the ward. I feel relief to know Dad will be seen soon. He is slipping into further delusion and the longer it takes the harder it will be. I hear the consultant talking to nurses and then his voice fades as he heads into another room.

I poke my head out. Only nurses. A plate of cream cupcakes on their bench top.

I tell a nurse I am worried that I won’t see the urologist. Paranoia catching. Don’t let him skip us.

No no your Dad’s on the list.

The consultant’s voice wafts in and out of ear shot.

Dad is talking gibberish. Ellen on the TV.

The urologist enters the room smiling. He has beautiful teeth and a polished head.

Righto Alex. Do you remember me? I am your doctor who did your surgery. The nursing home wants me to have a look. They’re a bit worried about it. Despite Dad’s demented state the urologist talks to him like he is compose mentis.

I wonder why he bothers. Perhaps it is for my benefit. Maybe he thinks something might get through. When I tell him about the past month and how I am struggling with it all, he tells me how when his grandmother was dying he would gets calls from his mother all the time telling him today would be the day and how badly the grandmother was faring. In the end he said to his mother don’t call me till she’s dead. By the time she finally died he had done all his grieving, it was simply a relief. I think he is trying to empathise with me. But I am like his mother. I am the one who is doing it. I can’t say don’t tell me for there is no one else to do this.

Gloves snap on. He tries to move him in the bed; to get him to let go of the rails. But Dad is resistant and starts telling him to get off him.

You don’t ask, you just do.

Dad is shouting and the doctor pulls back. But Dad keeps on shouting. Swinging fists on skinny arms.

We might give him something to settle him before we look or else it’ll come to blows.

Two haloperidol, he tells the nurse.

I’ll be back. Gloves snap off.

Dad tells the nurse to go to. He is pointing at the door. Get out. Get out. You have no manners. Ask. You should ask.

Dad you need to take the tablets. She is proffering them close to his tongue and I am fearful she will get bitten. It’s feeling very veterinary. I am thinking of chemical restraint, muzzles. When faced with an aggressive dog we get the owner to help. Like the nurse is using me. Do you think you can get him to take them? I am like the client who stands back and drops the lead when the dog begins to growl. I don’t think I can do it, I say. But it is my dog. I am required to try.

When the owner gives up in the vet clinic the dog is put in a cage and the pole needle is used. As the dog is cornered the needle advances on it through the bars and a quick hard jab to the thigh muscles is attempted. Hopefully the needle doesn’t snap off. Hopefully the whole dose gets got. Victory is a dog that can’t curl its lip, can barely lift its head.

I suggest a needle for my Dad. The nurse thinks this might be just as hard. We persist with the little white tablets. Dad put your tongue out.

Don’t touch my nose, he shouts.

I try and give him the tablet so he can put it in his mouth himself. Perhaps it is control he wants. Trying to get him to take them from my fingers he is uncoordinated and we are not getting anywhere. Our fingers are like polar opposites on a magnet and he can’t take the tablet from me.

She gets a mini tub of ice-cream and I put the tablet in a teaspoon of vanilla. Here you go Dad. We get them down.

It has taken 30 minutes.

He is not very sedated when the doctor comes back. He is just as angry. He starts swearing. Fucking hell.

The nurse tells me not to worry. He’s not responsible. He’s not your Dad when he’s like this. Her being nice to me, tips me over and I am crying.

I am trying not to cry in front of Dad thinking this might upset him more but it doesn’t seems to effect him. He is oblivious of my noisy nose blows into paper towel. He has forgotten about me, who I am even. Why are you staring at me? he says.

The doctor tries to get him to pull down his pants but he can’t do it.

Okay Alex lift your bottom. Nothing. So in the end he yanks them. I am placating. Its Okay Dad.

You’re cruel to an old man.

Yes Dad I know.

He’s not that strong. You hold his wrists, can you? the doctor says to me. I am the client who digs in. Who says yes I can hold him, my writhing rabid dog, while you trim his nails.

Okay. I will. I grip them. They are thin. I push them down so the doctor can get a look. Dad is swearing and cursing me.

Get off me. Get off me. You brute.

The doctor is pawing down there.

He might as well be sawing it off for all the screaming Dad is doing. Is it really that sore I wonder? Is it just being restrained? Some dogs (think Cavalier King Charles Spaniel ) start to panic before a thing is done to them, screaming before anyone has touched them even. Is this Dad?

It’s thrombosed and woody but its not recurrence, the urologist says. I suspect the issue the staff is having is getting to it to clean him. But I don’t think there is benefit in doing more surgery. It might end up with a worse non-healing area. We could do some radiation for the pain. But he is still urinating. Actually if he stopped urinating it would be quick. It’s a good way to go. A potassium spike stops the heart.

We are talking about him across his woody penis while he rants and shouts. The urologist is pulling his nappy back up and we are telling him its over but he is still shouting abuse at us.

I want to hear the doctor Dad. Shh shh.

I think what we need to do is talk to the nursing home about what they see as the difficulties in managing the area. We can give him more pain relief but I think surgery is ill advised and he isn’t a good candidate. And he can’t have more clexane after the subdural bleed. We’re limited in what we can do.

I ask about a suprapubic catheter.

Hmm not necessary while he is urinating.

I just don’t want him to be in pain, I say. I don’t want him to have more intervention if it is likely to be bad for him. Tears are welling up again. I’ll be guided by you, I say. I am thinking what I want is for someone to take the responsibility out of my hands.

In my head I am thinking how crazy it is that we are talking about a urethral blockage causing a spike in blood potassium as a good way to go. Now we are imagining scenarios that are quick and painless. I think I know a quick and painless way – it’s called euthanasia and I do it to animals on a regular basis.

People don’t want to see their animals suffer and at the end of their lives they decide the time to bring them to the vet clinic. I give them a sedation that sinks their head to the table. They probably feel like they are floating. Then I clip a foreleg and put a tourniquet around the elbow. A vessel stands up. I slide the needle into the vein and a rush of blood comes into the hub, mixing with the green pentobarbitone, the red turns blue-black. I unclamp the rubber band and tell the owner I am going to inject now and they might sense their beloved pet slipping away. I inject slowly, as slowly as I can. By the time the ten mls is into the animal all breathing has stopped and the heart has slowed down. I change syringes for the next ten mls. By the end of this syringe the heart will have stopped. I say Nice and Peaceful like saying it will make it so and place a hand on the dog’s head or on the client’s hand if it is nearby. I check the heart. It is never beating but I take a minute to listen. Then I tell them their pet has passed away. Then they cry.

But my old Dad must hope for a quick and painless death some time in the future. We still don’t know how it’ll be. But this hospital business is not helping him.

We have been here six hours and the decision is made to do nothing. He can go home tomorrow. Endone might be a good thing. He’ll be more sedated.

The nurse brings me a cup of weak, luke-warm tea the colour of a muddy puddle. She had no teaspoon so she brings me a knife for which to stir. I am stirring my tea with a knife and Dad is asking me why I am staring at him.

I am thinking of how to kill you Dad, but this knife ain’t sharp enough.

 

 

 

 

About Nicole Lobry de Bruyn

Born in the psychedelic sixties to hard working and conservative parents my sister and I grew up in sleepy suburban Perth, Western Australia. We played by the river, the beach and in the bushland of the cementary. I loved a chocolate Dachshund enough to make me want to become a veterinarian. I did. I became paralysed from the waist down when car hit tree. But not running, walking, standing or kneeling didn't prevent me being a vet. I am still a vet but would prefer to write and read and read and write about walking and not walking, feeling and not feeling, knowing and not knowing. So this is what happens when you enter thechookhouse.
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One Response to This Knife Ain’t Sharp Enough

  1. Joelle says:

    This is so sad Nicole! I couldn’t read it all, I am reminded of what I am going to have to face when I go and see my mum soon….
    The end of living is so unfair..

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