by David Winner
1976
All sixth-grade summer, the name of the Greek historian Xenophon pounded in my ears like a minor chord banged upon a piano. I had borrowed a book by him from my father’s shelves but misplaced it in the last days of school. Fearing the wrenching disappointment that accompanied misplaced articles and forgotten tasks, I would slip nervously past the empty space in the bookshelf where Xenophon belonged. An English professor rather than a classicist, he would hardly have need for it, but still might sense its absence like a missing limb.
2021
The night before my father’s last health crisis, Hurricane Ida came to Brooklyn. My wife, Angela, and I heard lightening, wind, distant branches crashing downwards, but next morning’s mild weather made it seem like the storm had underwhelmed.
I was playing with my computer the following morning, waiting for 8:30, the hour at which I had been calling my father each morning since my mother’s death ten years before when the phone rang. 434, my father’s area code, but not his number.
Ninety and frail, he’d been struggling alone in the old house in which I grew up.
“Your dad,” said Rick, the man who drove him around and took care of his yard, “isn’t doing so good. He wants you down here right away.”
But getting down there required planes or trains, and whatever was happening could run its course before I arrived. Tony (my father) had spent two days in the hospital with an infection a few weeks before and had sworn never to return. Thankfully, a visiting nurse was scheduled to come over later that morning.
I called Rick again, and he put my father on the phone. His vision was blurry, he told me, he was dizzy, short of breath and “pathetically weak,” a phrase he’d been using in recent months. He was okay sitting down, but the slightest movement left him panting.
He was sitting tight, waiting for the nurse but would “under no circumstances” go to the ER.
I felt a knot deep in my chest, as what seemed like the right course of action occurred to me. I should let him die at home if it came to that. He’d kept a store of oxycontin from a series of minor surgeries for when life got unbearable, and I shouldn’t try to stop death from coming for him on its own.
A death, I’d been rehearsing in my mind to try to prepare myself, as it, in his own cryptic words, lay in the “foreseeable future.”
Very ill towards the end of her life, my mother had insisted that she was going to London. Stern, domineering, a “martinet” according to his neighbor, my father had informed her that that “was absolutely impossible, darling,” though he’d only needed to wait a few moments for her to forget all about it.
“You have to go to the emergency room,” I asserted to my father, finding my inner martinet, “You can’t be my father if you don’t.”
Years have now passed, and I still can’t figure out what I possibly could have meant. His life had shrunk as he’d aged. Being my father was his main identity. I could not strip that from him.
About an hour later, the visiting nurse called me to say that my father was on his way to the hospital in an ambulance. His ten-day trudge towards death was set to begin.
*
An Insomniac and an inveterate napper, I put my head down most afternoons and attempt to sleep, even on subway trains or men’s room stalls if they’re the only option. Clinging to normalcy, I got myself a flight to Richmond leaving that afternoon, lay on my bed and closed my eyes.
Before leaving hysterically early for the airport.
A nurse at the ER who I managed to reach from the cab, told me that my father had a pulmonary embolism. Blood thinners, she told me, most likely two days in the hospital. It didn’t sound so bad.
After a long and circuitous journey, navigating streets flooded-out by the storm, I confronted a massive line at airport security. Despite both bad (skipping ahead of someone) and pathetic (explaining about my father) behavior, I missed the flight and booked a new one for that evening.
Rick texted me to say that Tony was now in a hospital room, so I called him from the airport. It had always been his role to gravely announce the results of healthcare determinations, but I jumped the gun when he picked up the phone to tell him that I knew about the embolism.
“No,” he replied with relish, “at least not really.” There was a small embolism, but the real issue was an internal bleed, a bad one. A colonoscopy and endoscopy would determine the source. Now, there were two problems but Tony (back in the driver’s seat, back to being my father) seemed to think things were in control.
Home in Brooklyn later than evening after my second flight was cancelled, the obvious occurred to me. Blood thinners for the embolism would be fatal for the bleed.
*
By the time I arrived at the hospital in Charlottesville the next day, they’d already located and cauterized a duodena bleed. The crisis seemed averted. If it didn’t start bleeding again, he would be released the following day.
Back at my father’s house, I attempted normalcy again, a lunch and a nap before my return to the hospital.
But soon the house phone rang. My father couldn’t remember my cell off-hand but could call his own number. He begged me to come back as soon as possible though I hadn’t remembered him ever begging for anything before.
“Okay,” I told him, “soon.”
A few minutes later as I was lying awake in my childhood bed, he called again.
“Please,” he pleaded, “I’m lonely. I need you.”
*
When I reached his floor at the hospital and approached his hallway, I heard an urgent announcement over the intercom. I was waiting for reassurance that the crisis did not involve me when I recognized the room number.
About ten people surrounded his bed.
“This man is dying in here,” one nurse barked at another. Then someone recognized me, a person not wearing scrubs, a middle-aged man resembling the patient.
The cauterization had failed, catastrophically. More than loneliness had driven him to reach out for me. His abdomen was filling with blood.
The nurses removed his gown, slipped on a diaper, and changed sheets stained red and brown.
They talked to him while doing so, trying to keep calm.
“How are you doing, Mr. Winner,” one of them asked.
“Mommy and I,” my father would tell me frequently after my mother’s death, “really had nothing in common.”
“I’m not at my best,” said my father to the nurse, the exact words my mother had used while in the ER towards the end of her life.
“What is your favorite season?” someone asked my father.
“Fall.”
“Why?”
“It begins to get a little bit chilly.”
A doctor approached me, in his fifties with a fraying Eastern European accent. He shook his head.
“Can’t they cauterize it again,” I demanded as if the bleeding ulcer was like a broken shelf that you could keep nailing in rather than the broken body of a very old man.
No, but a staple could possibly be inserted to stop the bleeding. The doctor didn’t seem confident about that, though. The doctor didn’t seem confident about anything.
Soon, another doctor arrived, an interventive gastroenterologist from India, a surgeon. The staple procedure was happening now. My father, the obvious dawned on me later, would bleed quickly to death if something weren’t done. The surgeon could give me no odds as to success but got my phone number in case we needed to talk about anesthesia.
I peered at my father, awake but still. Avoiding an ominous goodbye, I took off.
I like to control the reception of potential bad news, but I couldn’t return home, take an actual nap, drink some wine, check my phone, and learn the outcome. I had to stay at the hospital and wait to hear from the doctors.
Everything had changed, I called Angela to explain. We were not weathering a crisis. We were staring death in the face.
I embarked on a long, repetitive journey through the halls and parking lot of the hospital, gazing occasionally at my phone. The hospital was nestled in the foothills of the Blue Ridge, hills in the distance, mountains farther away. It was a sunny early fall afternoon.
After about forty-five minutes, my phone rang.
There was too much blood. They needed my permission to intubate and put him on a ventilator, a word with dark associations in the Covid era.
Tony wanted no “heroic measures,” stressing again and again his desire to be allowed to die.
I told the anesthesiologist that I would call my wife and call him right back. Angela’s answer was simple. Don’t let him die. I recalled my last glimpse of Tony’s face before I left the room, aware of a crisis, of efforts being made to save him. Pleased by that, maybe not, but acquiescent.
The phone rang many times in the ICU before a nurse picked up, and I passed on the message. Intubate him.
In the last decade, Tony had undergone three surgeries. Each time, I had fretted beyond measure despite minuscule chances of mortality. Wasted energy, I thought, while watching the mountains fall into darkness on what might be my father’s last night on earth.
The phone rang. I breathed a bit easier when I heard the surgeon’s South Asian tones, calm, a bit business like. It did not sound like the sound of death.
A staple was in place. Angela whooped when I told her.
*
When they finally took him off the ventilator the following morning in the UCU, he talked to me about a son in Brooklyn, unaware that that son was me, the first time I’d known him not to be lucid.
That afternoon Angela arrived in Virginia with our dog. When we went to see Tony, he was lucid enough to realize that he hadn’t been before. “Can you explain this to me,” he asked. And I did, summarizing as best I could the last few days of his life, starting when he’d begun to feel so ominously ill and had summoned me to Charlottesville.
Apparently, there was still some blood. But possibly (probably) according to a kind and optimistic doctor from Ghana who came to talk to the three of us, it was residual.
“I thank you, doctor,” my father told him, “even from Ghana.” Each white person’s racism (my theory) comes in its own peculiar flavor, and this did not seem like my father’s, more a surreal comment than a racial one. The doctor smiled. Surely, he’d heard worse, an African doctor in a Central Virginia hospital.
*
The following morning when we returned to the hospital, we learned that he had struggled to breathe during the night. He’d also grown agitated and ripped out his catheter.
After his rough night, Angela offered to sleep at the hospital. A familiar face could calm the agitation, the confusion. That familiar face should have been mine, but I was too scared and too upset.
Angela slept fitfully. Every time she looked at my father, his eyes were open, alert.
Apparently, she worked some magic. His blood count held steady, and he was moved to a regular hospital room the next morning.
*
I arrived there to find him with a young doctor who explained what I’d already suspected. The embolism and bleed were a dangerous combination. He would confer with gastroenterology to determine when blood thinners could be introduced for the embolism.
Becky, a retired physical therapist and close friend of my father, suggested that Tony go into rehab after the hospital to regain some strength before returning home. Rehab facilities double as nursing home, which were his worst nightmare, but understanding how weak he was, Tony agreed.
In another text exchange with Becky, I mentioned the embolism for the first time.
“Wow!,” she responded with her usual frankness.
The following morning Tony seemed more frazzled and upset. A nurse told me that he’d once again struggled to breathe during the night.
After seeing him, I found a lounge in the hospital to give a virtual class. As I was preparing, my phone rang, the young doctor with whom I’d spoken the day before.
He didn’t directly address the question of blood thinners. Rather, he went on a rehearsed-sounding spiel about frail, old people and their fruitless voyages to the hospital. Was he going to suggest a nursing home, I wondered, my mind leaping anxiously away from his more likely conclusion.
I managed to sound calm when he suggested hospice. I wasn’t a child. I could take the truth. But the hospital walls spun around me. The once-inviting cup of coffee on the table looked murky, harmful. I had agreed with the doctor’s suggestion: no blood thinners but immediate release to rehab where there was at least a small chance that he might recover strength.
I called Becky. Kindly, coolly, she avoided discussion of what I had presented as a premature suggestion of hospice and focused on rehab.
Upstairs, Tony looked calm. He’d also spoken with the doctor. And felt more in charge of his situation.
Good news/ bad news was how he framed it. The good was getting out of the hospital and on to rehab.
“Everyone dies,” he described the bad, looking neither relieved nor disturbed. Death was still amorphous – no real way to predict what it would consist of and when it would take
Tony liked to plan, but his plans kept getting dashed. He had to go to rehab instead of home and wasn’t even allowed to drop by his house and pick up necessary items. A nurse had convinced him that a stretcher transport would be more appropriate.
The list of items to pick up at the house was a marvel of precision. Opposite of me, the same chaotic being who’d lost his Xenophon book, Tony knew where to find each item.
Most important was a silver watch given to him by Dario, his beloved uncle, but there were two identical ones in the drawer to which he’d directed me. He’d given me the name of the Swiss watchmaker, but even with reading glasses and an iPhone flashlight, I couldn’t make it out. Therefore, I took both.
*
The thought of rehab had been a slight comfort, an improved situation, at least a bit, but the sick and dispirited patients, the industrial cooking and cleaning smells disoriented him. Slowly, once again, we bought him through the sequence of events that had landed him where he was. No one mentioned the shadow of hospice.
I handed him both watches, and though he could barely see, he took the one that seemed right and bid us goodnight.
At one in the morning, my phone rang, the rehab. He’d tried to get up but had fallen. A few hours later, they called again, another fall. They’d put him in the nurses’ area for monitoring.
Which recalled for some reason, the gloomy little room near the principal’s office in elementary school where they kept if you were sick, and no one was available to pick you up.
When I got to the rehab, he was not at a nurses’ station but on a chair in a lounge waiting intently for his breakfast. His appetite was pathetic, the food discouraging, but he had little to focus on other than meals.
His eyes flooded with joy and relief upon seeing me, but gloom soon descended.
“They,” the rehab staff, had been unconscionably cruel and incompetent, bothering him for no reason but never coming when he rang for them. Now, they refused to let him return to his room even though he was finally tired.
Most people at the rehab were doing their best, but there were so many disconnects between these young, lucid working-class southerners, and this poor little rich New York California kid grown old.
Again, my presence calmed him, and I was able to return him to bed where he promptly slept.
When I returned that afternoon, he recounted a pleasant interaction with a physical therapist also called Tony. They’d developed a routine. My father had told him that he was Tony 80% percent of the time but could pass for Anthony. He would temporarily surrender his Tonyness to keep things straight. A few tears floated from my eyes, a simple, sentimental anecdote from a cynical, pessimistic man.
On my way to Tony’s room the next morning, I was stopped by a nurse who warned me that my father had taken off his clothes. He’d always been a species of nudist, strolling back and forth to the bathroom with pajama tops but no bottoms.
Which was the exact situation when I entered the room. He wore a shirt and sweater but no pants or underwear and looked agitated and disgruntled after another night of sundowning and struggling to breathe.
“They took my clothes off,” he told me, but when I looked at him quizzically, he navigated his way back to the truth. “I took my own clothes off.”
He wanted me to help him put his boxers on, but that involved taking his penis and testicles in hand, and I was too squeamish.
Later that afternoon, Tony was even more despondent. He couldn’t stomach the food. The staff was dreadful. And, stuck alone in his room with his thoughts, ghostly images crawled the walls like yellow wallpaper.
“I have to get out of here,” he told Angela and me. “This place,” he went on, pausing for effect, “makes me suicidal.”
But absent his store of oxycontin and basic mobility, that was not an option. A dreadful irony: when you are too disabled to wish to live, you may no longer be able to end your life. Absent suicide, he wanted to go straight home, however impractical.
Another thing that bothered him was that he had the wrong watch. He handed it back to me and took the other one. I slipped it deep in the pockets of my short pants, but then forgot all about it as the slow-burning drama of my father’s last days droned on.
*
About five the following morning, my phone rang, and Angela picked it up.
“It’s okay,” she said, shakily, “it’s going to be okay.” Tony’s blood oxygen had sunk precariously low, about thirty percent, but somehow he’d survived and it was back up to ninety.
When we got to the rehab, he looked chastened and scared. We waited silently with him for about an hour until his oxygen appeared to stabilize. Angela decided to spend another night by his side.
I was asleep by myself in my father’s house very early the following morning when, yet again, the phone rang. His oxygen’s had dipped precariously again, and they were taking him to the ER.
After picking me up and heading there, Angela told me what had happened. With the help of a new sleep medication, he’d had the first uninterrupted sleep since the beginning of the ordeal. He’d woken up smiling, feeling hopeful for the first time in days, but only minutes later, his oxygen levels plummeted, and the darkness returned to his face.
In the ER, he seemed calm, grateful for the attention that he was receiving. Doctors and nurses came in and out. They managed to temporarily stabilize him with intravenous steroids and an inhaler. While they were processing blood work and doing scans to determine the cause of his breathing difficulty, we returned to his house for a brief break.
I’d always been scared about losing my parents, and I blame my dad, at least in part. When my mother had a series of nosebleeds when I was a kid, he said it might be a brain tumor. When she’d had something that I didn’t really understand called a vaginal discharge, he again brought up the shadow of cancer. A short educational film that they played us every year in school about a woman receiving terrible health news over the phone made me want to skip out of the auditorium.
For years, I’d feared the phone ringing with bad news about my parents, but when it first happened it was me who made the call. “I know my mom won’t be the same when I come back for Thanksgiving,” I’d stumbled after I’d called the house and reached one of her caretakers. “I’m surprised she made it through the night,” she’d told me.
Soon after we returned to the house, the phone rang, a nurse practitioner at the ER. A scan had revealed that the embolism had spread throughout his lungs. This was that conversation.
Six months on blood thinners could give him a ghost of a chance, but he had opted for hospice.
This time the hospice suggestion was concrete, undebatable. “Your father seemed totally lucid,” she told me, and I could only agree. Two days to two weeks was her estimation.
When we arrived back at the hospital, Tony was working out arrangements with the hospice liaison. Later that day, he would be transported to the Hospice of the Piedmont, a facility on the outskirts of Charlottesville, not far from the university where he’d spent his working life.
After she left, Tony turned to me and turned to Angela, and, with a liturgical sense of ceremony, grabbed our hands. He told us how happy he was, how relieved. “We are so lucky, the three of us, so lucky to have each other.”
Then he began to rapid-fire instructions, the post-surgery delirium evaporated. First, we needed to call the lawyer. Then he listed friends around town to which he wanted us to send post-mortem affection. Sandy, an old friend with terrible MS who ran a bookstore downtown. Tashi, a woman from Nepal who’d cut his hair and, years before, had cut my mother’s. Bill, the man who ran his favorite restaurant. “You can tell him I became sick sooner than I did.” Tony told us, to explain his absence over the last year.
He requested that more items be brought from the house, including the correct watch, which was somehow missing from my pocket.
At home, I searched for it without success. Perhaps someone stole it at the rehab, I thought hopefully to myself, as that would absolve me of responsibility.
Would I have to confess the loss to my dying father? Should I fess up to the Xenophon disappearance while I was at it? The ominous chorus started back up in my mind, a symbol of my failings, Xenophon, Xenophon, but I had to give up my search as we were due at the hospice and there wasn’t much time.
In his clean quiet room far from the chaos of the rehab, Tony spoke not of watches. Rather, he reiterated how happy he was, how at peace, how “excited” by his death. He told us never to forget how fortunate we were to have each other, the three of us, which saddened even as it moved me as there would soon only be two. He asked Angela to help get to the bathroom to brush his teeth. Ignoring signs ordering the dying not to leave their beds without summoning nurses, Angela tried to oblige. He wanted the contact, the personal touch. An alarm went off, and a nurse rushed in, scolding us kindly. After taking him to the bathroom, she moved him back into bed, pulling him to the most comfortable position.
Tony farted while being moved. “There was an eighteenth century French philosopher named Rousseau,” he informed the nurse, “who stood at the bed of a dying countess. While he and the other mourners wept, she let out a magnificent fart. The countess, who according to Tony was “even closer to death than I am now,” told Rousseau not to cry as, “the dead don’t fart.”
Then Tony sent us away because he wished to sleep, the morphine plus Xanax finally giving him the rest that he had been seeking. “Given the situation,” he said, “let us say Ciao rather than goodbye,” and we did.
*
We came by a few hours later on our way to celebrate our anniversary at a restaurant near the hospice. He was asleep, breathing heavily. Lungs pocked with clots were somehow still functioning.
His eyes opened, and he came to his senses as if he were emerging from a long deep dive. He smiled but did not wish to talk. Sleep wanted him back in its clutches.
“I really like this place,” he told us, looking around him at the pleasant hospice room and smiling sardonically, “but it somehow lacks edge…like a Swiss department store for death.”
Back at his house early the following morning, the phone rang. It was the hospice letting us know that he was dead.
Angela and I held each other tightly and spoke quietly for hours. When I finally crawled out of bed, I thought about searching the house again for a watch and a volume of a Greek history whose master had fled the earth.