Jasper and the Yellow Burley

Good Friday means there are no cars on the road. The pool is closed today like it is on Christmas day. There is no music blasting from aqua aerobics. No drone of leaf blowers across the cement. No whistles from the coach punishing the squads. Our neighbourhood is at its quietest. Someone will probably bake Nigella’s Norwegian Buns and invite the others around. Yeasty, buttery, sugary cinnamon buns. No ordinary Baker’s Delight Hot Cross Buns around here.

People go away for Easter, if they can, and this year the holiday is longer than most with ANZAC day thrown in. Families leave the city with car roof racks piled with surfboards, bikes clinging to bumpers, eskies full. This is when the weather changes in the West. Marshmallow clouds hold promise. It will rain, we hope.

Jasper has a new football. It is a yellow Burley. A Rover. For nine to eleven year olds. Snug in his mitts. Made in India,  Jasper tells me. He is surprised. Isn’t India a poor country? You’d think they would be wealthy from all the footballs. Pumped hard it stings the tops of his foot as he bombs it as far as he can.

We can’t go anywhere. On watch for frailty. My dad has had a suprapubic catheter put in. This means his bladder will drain into a bag, by-passing his urethra which is becoming narrowed and invaded by the cancer in his penis. Like a rocky gorge its insides have become craggy, spiky; a place of pain.

We wait for him to come back to the nursing home in an ambulance. We can hear him coming down the corridor. His familiar chant to any staff required to move him; No more No more.

But we do more. Always. Pushing and prodding.

He is slid over from the gurney to the bed. Not until there are no hands on him and he is in the bed does he settle.

The catheter means the staff will need to fuss less around the painful penis.There will be less changing of pads and beds, less sensation to urinate and no urine stinging its way through the diseased urethra. Now the urine is bloody, but this is supposed to be temporary.

But the RN on duty looks dubious as to the difference it might make to his pain. Still very painful, she says.

Can we leave him alone now, I wonder. Can we finally stop all the intervention? There is talk of radiation. The urologist thinks it might ease the pain. But it will not cure the cancer. It has gone beyond that. No one thinks they can do anything more but alleviate pain. But pain still exists. He is still irritable, asking to be left alone.  But then again can’t be left alone because he can do nothing for himself. His hands are like claws, grabbing at rails. Hanging on. The skin of his face is suctioned to his skull. His skin is yellowing, but stubble continues to grow. Like stubborn weeds his eyebrows sprout in mad directions off his brow.

Jasper wants to go and kick the Burley. The nursing home smells. Daisy Jones has lost her room again. We take her to room number seventeen, remind her again, that this is her room. How much do I need to pay for it? she asks. She shuffles in a wheelchair using her feet to propell herself, one arm across her chest, useless from a stroke. Her eyes begin to fill with tears as we talk to her. I don’t know where I am , she says. Walking through the dining room, on our way out, the oldies all look at the boy with the yellow ball spinning on his hand. He bounces it and catches it, because he can.

 

 

 

 

 

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.

 

 

 

 

At My Father’s Bedside

While I wait at my father’s bedside I read Cormac McCarthy’s first book, The Orchard Keeper, published in 1965, the year after I was born.  It is a bit of a vigil. There is something peaceful about watching the shadows change as the day progresses.  A yellowish glow tints the scene as the day goes on. All the while in the background the wind whooshes and whirs about the building. We are on the seventh floor of the hospital, up under the roof, and there is a view of sail boats on the Swan, like folded paper napkins. Another woman waits and watches too. She has the title  of PSA but I don’t know what it stands for. Her job is to sit and watch the demented, the wanderers, the ones who might decide to get out of bed and fall. She reads a thick book but she is close to finishing. I can tell it’s a romance from its cover; a damsel in the arms of an officer. The thin waisted beauty leans back but he traps her in his strong arms, moves his rock jaw close to her cheek.

My father is asleep. He has had a subdural bleed. Sandwiched between skull and brain there is blood. Now we wait. They check his eyes for light responses, lifting his lids like raising the morning blinds. He sleeps on.

Over pages the character from McCarthy’s book, Sylder, is in a physical fight for his life with a man he has given a lift to. It is 1933. They are fighting by the stationary Ford car on a dirt road. The man has struck the first blow, striking him with the car jack. The killing takes pages. One paragraph I read over;

“He was jerking at the man’s head but the man had both hands over it and seemed lost in speculation upon the pebbles on the road. Sylder let his hand relax and wander through the folds of the neck until they arrived at the throat. The man took that for a few minutes, then suddenly twisted sideways, spat in Sylder’s face, and tried to wrench himself free. Sylder rolled with him and had him then flat backward in the road and astride him, still the one arm swinging from his broken shoulder like a rope. He crept forward and placed one leg behind the man’s head, elevating it slightly, looking like some hulking nurse administering to the wounded. He pushed the head back into the crook of his leg, straightened his arm, and bore down upon the man’s neck with all his weight and strength. The boneless looking face twitched a few times but other than that showed no change of expression, only the same rubbery look of fear, speechless and uncomprehending, which Sylder felt was not his doing either but the everyday look of the man. And the jaw kept coming down not on any detectable hinges but like a mass of offal, some obscene waste matter congealing and collapsing in slow folds over the web of his hand. It occurred to him then that the man was trying to bite him and this struck him as somehow so ludicrous that a snort of laughter wheezed in his nose. Finally the man’s hands came up to rest on his arm, the puffy fingers trailing over his own hand and wrist reminding him of baby possums he had seen once, blind and pink.”

But still the man is not dead. He takes another page to finally succumb to the brutal force of Sylder. Finally extinguished the man relaxed “his hand and the fingers contracted, shriveling into a tight claw, like a killed spider.”

How hard he fights to hang onto life. How hard is it to die? Even old Dad seems to struggle on inwardly. Inside is he at war, dueling in hand to hand combat to hang on and not die? To emerge the victor.

The vivid richness of McCarthy gets me thinking about murder. I imagine bringing the pillow down, like in so many movies. I think of Francis. So many teenage tears shed watching Jessica Lang turn vegetable. Maybe the guard is here to protect Dad from me and what I might do faced with the diagnosis just given; “he might be starting to pass away.”

Lying in his hospital bed the nurse comes to clean his teeth, no matter that he is sleeping, or at least mimics it. No matter that clean teeth no longer seem a priority.  She asks him to open his mouth and he obeys. He has three teeth that she cleans with a bicarb swab rotating it around his mouth. When he’s had enough he bites down on it and attempts to draw it away from her. I think of a dog at tug of way. Ok you’ve had enough of that I see, she says. Give it up. The toothless gums hold the brush and then he lets go. He has won this fight. She retreats.

He sleeps on.

Jasper and Goong Goong on Dying

When Jasper was about seven years old and his Goong Goong was already in his eighties we sat talking of death and dying. Jasper said the worst way to go would be wart failure. He qualifies the statement – you know covered in warts. He talks about this because he has one wart. A plantar wart. And it has bothered him.  Slowly it is going away, dabbed daily with some liquid. Jasper says the best way to die is as an old person – not sick or anything, just plain old. Goong Goong then talks about an old woman we all knew called Mary Nunn who died at the age of ninety when she was sitting in an armchair in her own flat holding some-one’s baby. A party went on around her and then someone realised she had passed away. Goong Goong says – that’s how he would like to go – holding Jasper’s baby.