A LOSS DURING COVID-19

by Fran Lyons

I learned about Dad’s fall on a Monday afternoon in August, two days after his eighty-seventh birthday. The doorbell security camera shows Dad shuffle across the wet grass with Gracie, his smaller dog while his neighbor walked the other dog. No cane in his hand, no walker, and no one escorting him. The video cuts out as he nears the neighbor’s driveway. I’m both frustrated and relieved that it stopped because then we’d know exactly what happened.

On Monday, August 10, 2020, a derecho passed through northern Illinois. A derecho is a widespread, long-lasting wind storm with multiple fast-moving squall lines. There were fifteen tornadoes in northern Illinois that day, and the town of Harvard, where Dad lived, experienced sustained winds over seventy-five miles per hour. The skies were dark, and tornado sirens kept sounding to ensure residents remained in their homes.

Dad was alone, but had Stella and Gracie to keep him company, although they were likely spooked from the storms as most dogs are. The house had a full basement, but he was too unsteady to use the stairs to take shelter.

During a lull in the storm, the neighbor rang Dad’s doorbell and suggested that he bring both Gracie and Stella to their house to relax in the finished basement. Considering the terrifying weather, I think Dad felt scared and vulnerable, and jumped at the chance to be in his best friend’s company. He may have even been concerned about protecting himself and wanted someone to take care of him. The whys don’t matter. Dad went because he wanted to be with his friends.

A few minutes after that gut-wrenching security video stopped, my sister Leanne received a frantic phone call at work from the neighbhor. He said that Dad had fallen and was taken by ambulance to the hospital.  Leanne called our sister Lori, and both left for the medical center.

Lori raced to the hospital so fast that she passed the ambulance carrying Dad. Leanne arrived later, but was blocked from access. Only one family member could sit with him in the emergency room due to COVID-19 restrictions. Lori stayed with him because she was Dad’s ‘medical person,’ having worked in hospitals for over thirty years. She calmed his thrashing and ranting until they admitted him to a private room. It was then that they turned her away, stating that overnight visitors were prohibited and that in standard rooms, visits were limited to one person per day, for two hours.

Hospitals scared the bejeezus out of Dad. He hated being alone and surrounded by strangers, even though their sole purpose was to save his life. After previous hospital stays, he’d had nightmares involving a shadow figure entering his bedroom. Lori and Leanne solved that problem by insisting that they stay the night with him. Now, the COVID-19 rules separated our injured elderly father from the reassuring comfort of his daughters.

As she left the hospital, Lori called to inform me that Dad’s prognosis was good. He was alert and cursing a blue streak at the nurses because they fussed over him. In other words, he was perfectly normal. I decided then to fly in and help him out for a few weeks.

I didn’t talk to my sisters again that night and left for Phoenix Sky Harbor airport at five a.m. the following morning. At Departures, I said goodbye to my husband, Michael and our kids, Nicky and Mia.

The schools hadn’t opened for in-person instruction due to COVID, and the kids were learning remotely. Although technically they could attend classes from Dad’s house, Michael and I decided to leave them home. I’d brought them in 2019, after Dad’s stroke, thinking their presence would encourage him in some way or take his mind off his troubles. Dad adored the kids but was frustrated and depressed and generally treated everyone like crap. The kids sat six feet away from him on the living room couch, but he barely acknowledged their presence. I understood why, but the kids didn’t and wanted to go home.

Another factor that played into our decision to leave the kids in Arizona was the rioting in Chicago. Amid the Coronavirus lockdown came horrific police brutality against a black man named George Floyd, ultimately causing his death. When the white officers weren’t charged, demonstrations for Black Lives Matter began, not only in the United States but around the world. I’d say that the only positive thing that came out of Coronavirus is the togetherness each of us shared with our fellow shut-ins. George Floyd’s death brought the systemic suppression of black people and other people of color into a spotlight so bright that the world noticed. The Black Lives Matter demonstrations were peaceful and organized; however, infiltrators and looters began moving from city to city, starting riots and destroying property. The media showed looters using U-Hauls to drive from store to store. At that time, Chicago was a city on the brink of disaster. Demonstrators blocked major expressways, and infiltrators rioted and destroyed property.

According to Leanne, even Harvard experienced violence in their downtown area, and Dad house was close to the city’s business center.

Nicky and Mia’s health and safety were top of mind, and leaving them home was the best decision. At this time, I can’t imagine how traumatic the next few weeks would have been had they accompanied me.

I kissed Michael and stepped out of the car. As he drove away, I blew Mia and Nicky kisses, gave air-hugs, and then walked through the sliding doors.

Thankful that the airport had a mandatory mask rule, I strode through the terminal to security. As I eyed the masked travelers, some anchoring the mask on their chin and others just beneath their nose, I worried that I’d bring him something much worse than a bump on the head, but it was too late to turn back.

At five a.m., the airport was just waking from its overnight hibernation. No one walked ahead of me as I made my way past closed shops and restaurants. I took my time browsing the only open souvenir shop. After my second go-round, I bought a bottle of water and a granola bar and headed to the gate to await the flight. The walkway was more crowded by then, but I noted that everyone wore masks and diligently created at least some distance between them and passers-by. However, once seated at the gate, masks came off, and social distancing didn’t exist. It’s like their seat was ‘home’ to them, and they could do what they wanted.

I settled into an end seat and placed my bags on the adjoining chair. The next ninety minutes were spent reading Stephen King’s The Stand. The book is basically a fictional handbook for this deadly super-spreader virus, complete with an arch-villain who will stop at nothing to have control over the remaining population. As I read, I wondered how King’s book would have changed if the fictional president had mandated masks and self-isolation. I figure it would have been a much quicker and less dramatic read.

Of course, the flight was fully booked. I chose a window seat, so my aisle-mates wouldn’t need to crawl over me to use the restroom and then touch everything around me with their filthy hands when they were done. I don’t sleep or use the facilities when on a plane. I don’t sleep since I woke once to everyone around me laughing because I was snoring. I don’t use the restroom because it’s a porta-potty with running water. I don’t chitchat, and yes, I like to look out the window, and no, I will not lower the shade. If you want the shade down, stop shooting me dirty looks and buy the window seat next time.

All in all, the flight went well. The passengers kept their masks on, and while they still rushed the aisle when the plane came to a stop, they waited patiently while each row cleared ahead of them. At least, I assume they were calm; I was in row eight and didn’t really care how the people behind me felt. I just wanted to get to my Dad.

I arrived at his house at 4:25 p.m. to my sisters waiting outside. I brought my carry-on bag into the house, but when I sat on the floor with the dogs for a proper furry greeting, Lori said, “Fran, I’m sorry to do this since you just walked in the door, but we have to go to the hospital to see Dad and talk to the doctors. They’re expecting us by five, so we have to leave right now.”

Tired and confused, I replied, “They have rules. We can’t all see Dad at the same time.”

Lori said, “We didn’t find out until your plane was in flight…” She sighed, her face pinched in a frown. “We have to make a decision for Dad. He was fine last night but took a turn for the worse today.”

My head spinning with questions, we got into the car and began the thirty-minute drive to the hospital. During the ride, Lori explained that minor bleeding inside the brain had worsened, and Dad was no longer responsive. “We can keep him on the ventilator, and they can attempt surgery, but they believe that the damage to the brain will mean he’ll be in a nursing home and need constant care.”

That idea devastated me. Dad in a nursing home, unable to care for himself at all? I choked back tears and said, “Dad would hate that. We can’t do that to him.”

Leanne, who hadn’t spoken much during the ride, replied, “The alternative is to take him off of the ventilator.”

I was overwhelmed by this dark conversation about Dad. I could only say, “I came to help him recover.”

“We know he wouldn’t like a nursing home,” said Lori. “If the bleeding wasn’t inside the brain, it would have been easier for the doctors to perform surgery. If the bleeding inside had slowed down…” She paused, sighed, and said with finality, “He’s not going to get better.”

At the time, I was shocked by her calmness and matter-of-fact tone, but realized later that by that time, they’d had twelve hours to come to terms with Dad’s condition. “What do you want to do?” I asked.

“We talked about it, and we think he should be taken off the ventilator. There’s a chance that the surgery wouldn’t work, and if it does, we don’t know if Dad will be Dad afterward. Since the doctor said that Dad will require nursing home care, we know that his life wouldn’t be a good one. But we won’t do it if you don’t agree, so we’ll talk more after we see Dad.”

Lori’s answer was the one I expected but didn’t want to hear.

We arrived at the hospital’s Emergency Room entrance and waited for approval since multiple visitors weren’t allowed. Lori explained to the receptionist, “We should be pre-approved. We’re here to talk to the doctor about moving our father to palliative care.”

The receptionist tilted her head to the side and put her hand on her chest. “I’m so sorry. Let me get you some visitor badges.”

At that point, I had no idea what palliative care was, but upon seeing her response, I knew it wasn’t good.

After slapping ‘visitor’ stickers on our shirts, we headed to Dad’s room. The ten-minute walk was surreal, to say the least. We strode through a maze of empty hallways until we reached the massive three-story white marble lobby. Our footsteps and voices echoed in the eerie silence of what should have been an area bustling with activity. We didn’t see another person during our entire stroll to Dad’s room until we reached the nurses’ station on his floor.

Upon checking in, we walked into Dad’s room. He was agitated, thrashing his arms and kicking his legs like a child in the throes of a silent tantrum. The last time I’d seen him was on our video call when he’d laughed at the kids’ jokes and talked about Stella and Gracie. It was heartbreaking for me to know that his blue eyes would never open and crinkle in the corners with a smile. I’d never again hear his raspy voice call me ‘Francie’ (no one else is allowed to call me that).

His arms were confined in restraints, but somehow he’d managed to free his fingers, which were flexing and moving as if to grab something floating in the air. I grabbed his right hand and held tight, and Leanne did the same with his left. We said hello, which seemed to calm him somewhat, but his legs continued to kick. For several minutes, we took turns talking to him, chatting about nonsense, just wanting him to hear our voices.

Then the doctor arrived, along with a swarm of interns and nurses. This doctor was the one on shift, but not the neurologist who cared for Dad the day before.

I despised this doctor from the moment he opened his mouth. Maybe it’s a side-effect of their profession, but he spoke about Dad as if he were a pet we were putting down instead of our beloved father.

I told him that Dad seemed to respond to our voices and definitely calmed when we held his hand.

He snorted and shook his head. In a dismissive tone, he said, “He can’t hear you.”

I looked him in the eye and said, “There is nothing wrong with his ears. Why do you say he can’t hear us?”

The doctor tapped his own forehead and said, “Because his brain”…tap-tap-tap…”is bleeding.” He explained that when Dad’s stroke hit in 2019, a portion of his brain tissue had been damaged. Then, when his head hit the concrete the previous day, the already-damaged portion was sheared, causing the brain to separate and shift. Overnight, it moved back into place, so they’d been hopeful when the admitting neurologist saw that the bleeding had slowed. However, throughout the current day, it had worsened.

The doctor’s condescending attitude still rankled, so I asked, “How does internal bleeding affect his ears?” I wanted Dad to hear my voice and know that I was with him, that I hadn’t blown this off for a ‘later visit’ due to COVID, as I had several times during the pandemic.

The doctor ignored my question, so Lori and I walked to Dad’s bedside. He had begun flailing his arms when the medical staff entered the room (not that he could hear them or anything). We each grabbed a hand, and Dad immediately quieted.

Lori said, “He knows we’re here. He calmed down when we grabbed his hands.”

I was gratified to see a couple of the interns eye the physician. Without missing a beat, the doctor said, “That’s a reflex action. Doesn’t mean a thing.”

I don’t know if he was afraid we’d decide on the surgery and nursing home solution or that he was just an insensitive prick, but in a matter of ten minutes, he told us that Dad couldn’t hear us say we love him, and our touch meant nothing.

Lori – bless her good-natured heart – rose above the physician’s attitude and confirmed that we didn’t want the surgery. The decision made and official documents signed, Dad was then transferred to their palliative care ward, so their end-of-life team could watch over him. We were able to stay in his room, so I assume Coronavirus rules only cover hospital wards where there’s a chance the patient may recover.

We sat in the visitor’s waiting room until they moved Dad to his new room and removed the ventilator. When we were given clearance to come in, I was filled with mixed emotions about the missing breathing aid. It meant goodbye forever, but it also meant release for Dad who was probably screaming for help inside the prison that was his injured brain.

A nurse arrived to check on Dad.  Her smock was wrinkled and stained, and the dark circles under her eyes emphasized her exhaustion. After she checked his breathing and heart rate, she smoothed the blankets and patted his hand.

“Is this your Dad?” At our affirmation, she said, “It’s nice that you all can stay with him.”

Leanne commented, “In his other room, only one person was allowed a two-hour visit, so we’re glad, too.”

The nurse’s lips tightened and her chin quivered a little as she held back tears. She concentrated on tucking and smoothing blankets that didn’t need it. “I’ve sat with COVID patients and held their hand in their last moments because their family wasn’t allowed. It’s awful because, in the patient’s view, they’re dying alone,” she murmured. Tears welled in her eyes as she offered a sad smile. “I’m sorry for crying. It’s just that we really can’t take much more of this.” She patted Dad’s leg and added, “This is the end of my shift. Kevin is your nurse for the night, and he’ll be in soon. I’m very sorry about your dad.” With a small wave, she left the room.

At that moment, I realized that Coronavirus made healthcare workers both heroes and villains. Until Dad was in the hospital, I empathized with health care workers who sat with dying patients while their families waited at home or in the hospital parking lot for news. I still feel strongly that they are the heroes of this pandemic. However, until I heard that nurse talk of her heartache, I’d been angry that our father had been denied access to his children when he needed it most. After all, he didn’t have Coronavirus, and we certainly didn’t, so why should we have to play by those rules? The nurse’s outburst made me check my internal selfish-bitch voice, and understand that COVID-19 rules keep everyone safe. The hospital has to protect the people within.

After settling in, we asked Kevin to request Last Rites but were devastated to learn that due to COVID-19 restrictions, Pastoral Services only worked days. We prayed over Dad, hoping it was good enough. Honestly, I’m a believer that God understands that no one is perfect, so unless a person commits a heinous act, St. Peter’s going to wave them through. There are staunch Catholics that probably had to pick themselves off the floor after reading that. Still, when a good man like my father is denied Last Rites only because he died after business hours, he should get an automatic pass.

Lori went home to get some sleep, leaving Leanne and I to watch over Dad.  We weren’t concerned, since the doctor thought we might be with him for up to forty-eight hours.

We got some coffee and were chatting about who tweeted what and how disgusted we were with Facebook politics when a soft knock stopped our conversation. We asked the visitor to come in, and a doctor entered. He smiled and waved to us, reviewed what were presumably Dad’s latest stats and then bellowed, “Hi George! How are you, George? How are they treating you?” He then introduced himself as the admitting neurologist, the physician that worked with Dad the night of the fall.

He listened to Dad’s heart and breathing, then tucked the blanket under his chin and said, “I’m glad to see that he has company.”

After some idle chitchat, Leanne said, “We’re surprised you spoke to Dad when you came in. The doctor told us earlier that he can’t hear us or feel our touch, and doesn’t know we’re here.”

The doctor was aghast. “That not true! The bleeding in his brain isn’t causing swelling, so he can hear every word you say. He may not understand what’s being said, but he recognizes your voices. Trust me, he knows you’re here.”

Whether he was truthful or not, it was what we needed to hear.

I tried to sleep, but at 1:15 a.m., I lay awake on the pullout chair bed, listening to Dad’s breathing: soft breath in, long gurgling breath out. A knot formed in my stomach as the silence between breaths lengthened but the gurgling shortened. I dreaded the moment when the horrible gurgle stopped. It’s an indescribable anguish that I don’t wish on anyone.

We both gasped when Leanne turned on the overhead light. Dad was very pale, which made the black bruises and scrapes appear even more horrific.  His thin frame seemed even smaller in the bed. His forehead was warm, but with a tinge of coolness, like he came indoors from a chilly night. It would be soon.

Leanne first called Lori back to the hospital and then summoned the nurse.  Kevin walked into the room and his smile fell into a concerned frown. He took one look at Dad’s pallor and confirmed death was imminent. As they talked, I stood between them and Dad, listening to the conversation, but somehow still attuned to Dad’s breathing.

I heard a short gurgle and then nothing. “Wait!” I exclaimed. I moved to Dad’s side and raised my hand for silence. I don’t know what I was thinking at that moment. Relief? Dread? Maybe a mixture of both.

Our father passed away on August 12th at 1:34 a.m., eight hours after I arrived at his bedside. There would be no homecoming with excited dog barks, no recuperation, no more calls with his grandkids. In one unfortunate misstep, he left us.

We never had a moment to grieve because we had a funeral to plan. My sisters and I were conflicted about how to handle COVID best practices. Yes, we’d offer masks and hand sanitizer at the funeral home, as well as bottled water and safe snacks. But enforce mask-wearing? Not likely. Social distancing was possible, but it depended on the number of people in attendance. Short of putting tape on the floor and arrows directing mourners through the room, past Dad’s casket and out the door, social distancing was also a likely no-go. These were relatives and friends who loved our father. They wanted to participate in a celebration of his life, so we were reluctant to police the event.

The first guest arrived when the funeral home doors opened, and the rest of the evening was a blur. Since the funeral was Monday and many relatives from Wisconsin couldn’t stay, the visitation was packed with people. When it came time for the memorial service, most of the eighty seats were taken. I’d say about eighty-five percent wore masks, but still removed it to give me a kiss on the cheek. We come from a family of huggers, so social distancing wasn’t a thought in their heads.

Can you call a crowded visitation a success during COVID? If it’s measured in attendees, I think Dad would be happy, but doctors would disapprove. However, as far as we know, no attendees got Coronavirus (and with our family and friends, we would have heard about it).

At the end of the evening, we said goodnight to Dad one final time.

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