Time Sep

(Jeff_L) #1
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
Free download pdf