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30 TIMESeptember 3–10, 2018

TheView Ideas

I’M PAYING FOR A COFFEE IN BROOKLYN
when a doctor in Massachusetts calls and
asks for permission to intubate my uncle.
It’s urgent. His lung has collapsed, and
he’s lost consciousness. There’s no time to
consider what it means to put an 82-year-
old with a slew of health conditions on a ventilator. So I say
yes. On my drive to the hospital, another doctor calls to say
they need to do a bronchoscopy. I ask if it will hurt, and she
says he’s sedated. So I say yes again.
Just like that, I’ve put booming, unshakably cheerful
Uncle Bear into a system of maximum intervention because of
my own panic, not reason, not research. Later, when I look at
the statistics, the odds of recovery, or what they call a return
to baseline, are not great. There’s even a debate about whether
the very elderly should be admitted to ICUs at all because
of the cost. By 2050 there will be an estimated 19 million
Americans over 85—including me—up from 4 million in 2000.
I imagined this kind of decisionmaking would take place
in a hospital family room where doctors would lay out the
options for me and my sister Ingalisa. Turns out, those
conversations would come later, and the choices would
include undoing some of what I’d agreed to in that cofee shop.
It was late when I got to the hospital. A nurse made up a
cot for me in his room. How many times had she performed
that small kindness before? I can’t really see Bear’s face from
the cot in the dark, just the shape of the hulking, sighing
ventilator. Sometimes it looks as if it’s reaching down with its
twin air hoses to scoop him up and take him away. But mostly,
the sound is comforting. He won’t die tonight. That machine
won’t let him, for better or worse.

UNCLE BEAR REMAINEDthe family’s unalloyed optimist,
even after he lost his wife Susie. His outsize intelligence
never got in the way of his enthusiasm for almost everything,
particularly scotch. The rest of us take after Bear’s Irish father,
who when confronted with a sunny day would say, only half
in jest, “We’ll pay for this.” My favorite photo of Bear is of him
cutting a cake on my ifth birthday, cackling with a lit cigar
in his mouth. The ash looks as if it’s about a millisecond away
from dropping onto the frosting. He doesn’t notice. But me?
I look as if I’m ready to pass out with worry.
Over the next 10 days, the doctors explain the balancing
act. Fix one thing and risk something else. It’s a corporeal
Rubik’s Cube. Then there’s the ventilator. They can’t seem
to wean him of it. He’s at the cloudy intersection of living,
breathing and dying, with the irst two states not being the
same thing at all.
My sister and I gather in the nurses’ break room with
the ICU doctor and Bear’s primary-care physician, who
explains that even a young body can’t take being intubated
for too long, and the alternative is a tracheotomy and a

feeding tube, probably for life because

of his age. We all get teary at the

thought of the voluble Bear being

unable to talk or eat. “No, no, no,” we

say. “That can’t happen.”

They tell us there will be morphine to

quell the air hunger if he fails once the

tube is out. A chaplain is available. And

there’s us: the nieces; his wife’s sister,

the magniicent Wissie, who has been

propping us up for days with humor and

wine; plus the grandnieces and friends.

And the ICU doctor says gently, “You

know, you don’t hold his life in your

hands. You are not taking anything away

from him. It’s up to him.” I’m not sure

if she meant God or Bear, but it didn’t

matter. We understood.

They take the ventilator out the next

morning. Bear is sore and disoriented,

but he’s breathing on his own. Soon, he’s

cracking jokes about how he’s so thin,

he’s only 8 lb. away from a modeling

contract. He thinks he’s 62 and owns a

plane that can land on water.

Bear is untethered from reality, but

not from himself. “I hate to be an old

prognosticator, but my advice is, Don’t

give up,” he tells a young nurse. “The

boat will come back for you.” When I

show him a photo of his grandnieces, he

can’t name them but proclaims, “I love

everyone in that frame!”

Now he’s in a subacute rehabilitation

facility, emphasis on facility. And this

is where the statistics loom again.

He’s so weak and so thin. And all the

conditions that landed him in the ICU

are not better—they’re worse. This is the

baggage of a life lived with indulgence

and the kind of optimism that allows one

to ignore medical warnings. Will he have

the strength to walk again, or go home?

I think he’s wondering too. “Now

that those dying things are inished,

what’s next?” Bear asked me the other

night. “Ice cream,” I said. Of course he

adores hospital vanilla ice cream in a

Styrofoam cup.

I don’t know what’s next now that

we’ve been granted a reprieve from

the tubes and dying things. And I

really don’t know what I’ll do if I get

another call asking whether he should

be intubated. But I do know that I’m

going to stop worrying so much about

the ash before it falls. What a waste of

precious time. □

After the dying

things are done

By Susanna Schrobsdorf

Just like

that, I’ve put

booming,

unshakably

cheerful

Uncle Bear

into a system

of maximum

intervention

because

of my own

panic, not

reason, not

research

Uncle Bear

in 2015

COURTESY SUSANNA SCHROBSDORFF