An Education

I see the familiar skyline. Portland, Oregon, is all bridges and rivers, running from the airport across the Willamette River and spilling down into the city. Like a waterfall of cold steel cables and rushing cars, bringing me down.

I see it. But I am not thinking about it. I am still on the inside. We are driving to Saint Vincent’s Hospital and I am being carried along.             

Saint Vincent the patron saint of horses and hospitals.

                It is happening now in stanzas.                                                            

Blink, I am pulling

                          open the white door, in the white hallway of the white hospital.

        Blink, I see my mom, my grandmother,

and my uncle.

                                               Blink I see my grandfather. Blink,

I need to get the fuck out of here.

Now the nurse is saying they have all been waiting for me. Everyone is staring. Mom tells me I should give my grandfather a kiss. The nurse is cleaning out his mouth with a straw. Mom is saying, "Here let me do that." We are all watching her. I see my grandmother. She is frail. I notice my uncle reeks of pot. I notice there are construction workers outside the window. Inside, I notice my grandfather. He looks very tan in the white room, under a white blanket, with a white plastic coated bracelet on his arm. Everything is white. My brain is white. I have no idea what to do or what to say and now everyone is looking at me.

I say, "He looks thin."
                                                                 

The nurse leaves and we talk. Mom fills me in on what has been happening with his care. She said yesterday he could nod his head and hear our words, but today he isn’t responding. "But that doesn’t mean he can’t hear you, Amanda. Go say something to him," she pushes me forward.      

His breathing is in-out, in-out, in-out, in-out, my grandfather’s breathing is everywhere in this room. His breathing is the whiteness in my head. 

I walk over to him and I bend close to his ear. I see that he hasn’t shaved in a couple of days. His cheeks sag a little more than I remembered. I stare at his earlobes. I used to rub them. When I was little I used to sit on his lap while he read me a book and rub his earlobes. I would run my hand over the top of his shaved head. I loved to feel just the tips of those short gray hairs. I know exactly where every mole on his head is. I whisper, "I love you," and then quieter because I really don’t want anyone to hear I say, "I should have come home for Easter."

Then I cry.

My uncle asks me if I want to go for a walk.

Okay.

We walk out to his white, 1987 Subaru. We sit down, me in the passenger seat and him in the driver seat. We don’t say anything. Two things occur to me at the same time, we aren’t walking and I don’t know my uncle very well. He reaches across my lap and pulls a pipe out of the glove box.

"Do you want a hit?"

I almost say no. But then I don’t. Sitting outside the hospital while the rest of my family is inside makes me silent.

He lights up and I take a drag. I don’t smoke too much, just enough to change things. Except even after I smoke, nothing is different. 

Back inside my mom looks worse. She is tired. And my grandfather is still dying.

"I think we should have the nurse remove the respirator," my mom tells us. My grandmother nods. My uncle and I nod. "Let’s do it in the morning," my mom says.

Okay.

That night my grandmother and my uncle go home. My mom and I go downstairs and eat dinner. We get to eat in the cafeteria with all the doctors and nurses. We can have all the food we want. I actually feel hungry. We talk like things are fine. Like my grandfather doesn’t have cancer. I have a turkey sandwich on wheat bread, a diet coke and even soft-serve ice cream. Then we go upstairs and he does. My grandfather does have cancer.

We sit with him for awhile. His breathing fills up the room and our minds, it steals our voices. We don’t talk, we just sit. Nurses come in and out just like they did during the day. Mom knows their names and she knows which one will come back and which ones are off for the day. There are certain nurses she says she likes and some whom she watches more closely than others. She writes down their names because after this is all through she wants to be sure and send them thank you cards.

 "We should get some sleep," my mom says. Next door is a room filled with indestructible furniture, solid and square. The sofa and the loveseat have thin cushions. It’s like a waiting room. But there is a waiting room downstairs, so I am not sure what this room is for – unless it’s just for people like us, who are just waiting for tomorrow.

Even though I am uncomfortable, I do sleep. When I wake up my mom is gone. I know she is in with my grandfather.

I go to his room. My grandmother is back and so is my uncle.

"Do you want to make a coffee run with me?" my uncle asks. I say no. Mom tells me that breakfast is downstairs where we ate last night.

"Can you take your grandmother with you, Amanda? I don’t think she ate."

The two of us go downstairs. My grandmother has on big glasses, her gray-white hair is cut close to her head in tight curls, she weighs less then 90 pounds. I give her a hug and my arms wrap completely around her thin frame. She doesn’t cry. In fact, I haven’t seen her cry, but she does say in a very thin, very deep whisper, "This is hard."

At ten, when the right nurse comes in, my mother tells her we want the respirator removed. The nurse looks around the room. I think she wants to verify that we are all in agreement. None of us say anything, but we all know it’s what we want. She understands our silence.

Okay.

Now my grandfather’s breathing is excruciating. I try to hold my breath when he does, hold it until he breathes again too, but I can’t do it. We are all waiting. We don’t sit back in our chairs. We don’t move around the room. We just listen, each breath is so long we wonder if he has died and we have missed it.

Once I count sixty-five ticks from the round white clock with the black numbers and the black arrows. Sixty-five ticks between breaths. I can’t take it. I have to leave the room. I say I am going to the bathroom. 

I unzip my jeans, the same ones I was wearing when I arrived. I try to pee but instead I just sit on the cold white toilet seat, with my legs in front of me and shoes pointing straight ahead.

I remember his old brown recliner, the one my grandmother had reupholstered green. I remember how we would play, or read for hours right there, cuddled together. He would tell me a story about an injured mustang or a recently escaped mountain lion and I would become that animal. By listening to him and running around on my hands and knees I was able to feel like a lion, snarl like a lion and swipe my hand-turned claw like a lion. Those games were so vivid that I was sure anyone walking in would see a mountain lion, instead of a five year-old girl with brown hair.

My grandfather smelled like comfort. He was gentle, he read a lot, he listened a lot, and he hugged me whenever I wanted. My grandfather had a heart and a head full of stories. He was my best friend.    

At the same instant I cry, I pee.          

Tonight my mom makes another announcement. She calmly says, "I think we should have his pacemaker turned off." We all stare at her. My frail grandmother, my stoned uncle, and me. I am scared.

"It makes sense. I talked to the nurses. His pacemaker is the only thing keeping him alive. His body keeps trying to die and then the pacemaker kicks on and jolts him up. It’s the right thing to do." She looks at us.

Silence.

"Really," she says quietly.   

I don’t think I get what she is saying. Are we going to kill my grandfather? Grandma looks around the room. I think we all are waiting to hear what she has to say, it’s really her decision.

Okay.       

So, when the right nurse comes back in, we talk. She says she understands what we want, but she has to run it by her superiors and they will probably have to run it by the ethics board. Euthanasia.

We eat dinner in the same cafeteria, but this time I am not as hungry. I only eat the soft serve vanilla ice cream. My mom keeps telling me about the Pacemaker and how artificial it is. "He could go on like this for… for who knows how long," she says between bites of salad. "Reaching the edge of dying and then being electrocuted back…it’s not right."

 I notice she doesn’t say electrocuted back… to life. Maybe she thinks he is already dead. I don’t have anything to say. So I just nod and listen. I think figuring out all the details helps my mom. She needs people to take care of.

We come back after dinner and my uncle tells us he is leaving, he is going to take my grandmother home. After they leave my step-dad and my siblings come by. They don’t stay very long, they have school. They are so young I don’t think they really understand what is going on anyway. None of us knows what to say to each other. We end up talking about hospital procedures, what the nurses have been doing, what the doctors have been saying, and the weather at the hospital.

When it’s just the three of us alone again, the nurse comes in and tells us that she has received permission from the ethics board to arrange the pacemaker to be turned off. A man will come tomorrow and he will turn down the electricity in the room.

We call everyone and tell them. "Bring her back around ten," my mother is telling my uncle over the phone. "It will just be us here tonight, me and Amanda."

After she hangs up, my mom sits down in the chair next to me. "The cancer has spread into his stomach, his intestines, his lungs, and of course his pancreas. They can’t operate on him because of the medicine they give him for his strokes – the blood thinners. So he is going to die. Amanda, it’s okay that we do this."           

I tell her I know and then we just sit. It seems like the way to deal with death is to repeat things.  We hold hands and then I go to bed in the kind-of-waiting room. My mom doesn’t come in. She keeps her vigil.            

At noon on Friday April 27, the man comes. He has a black computer case. He is followed by an entourage of nurses. They uncover my grandfather and expose his body. We stand around and watch. The man with the magnets, the one who has come to turn down the pacemaker, starts crying. He is setting up his machines taking readings and crying.  He tells us that you actually can’t turn a pacemaker off, but you can turn them down to the point where the electricity no longer re-starts the heart. "I’ve never done this before," he explains as he unzips a laptop computer and takes some readings. This man knows that what he is doing will kill my grandfather. He knows it and he has never killed anyone before. I cry for him.

After the pacemaker is turned down, all the staff leave. We are alone with my grandfather. This time I tell him that I love him. That he was a wonderful grandpa, that he was my best friend, that I will miss him.

We all take turns with him. My grandmother sits on the edge of the bed and strokes his head and whispers that she loves him. That he should go and be with God. That we will all miss him. That she will see him soon. His eyes are closed and she kisses each lid.

His breathing is different now. I know he is dying. It has only been ten minutes since the pacemaker was turned down and I know he will die any minute. We are all standing around his bed. My mom’s favorite nurse comes in and she stands with us. We are looking at my grandfather; we are all willing him to die. We want him to pass on in peace. We know he is going to heaven.

And then it happens. He breathes and we know it was for the last time. The nurse takes our hands. We stand in a ring around his bed, holding hands, and then the nurse starts to sing.            

"Amazing grace – how sweet the sound that saved a wretch like me," I try to sing but the words get bunched up in my throat. My mom is belting out in her classically trained voice. My grandmother and even my uncle are singing.                          

I manage to choke out, "Was blind but now I see." We sing all the verses all the way through. By the end I am crying and belting out too. We are all singing to my grandfather. We are wishing him a safe journey. My mom says its time for us to go home. For the rest of the day I worry. It doesn’t seem like I said the right things.

On Saturday, I ask my mom if I can say something at the funeral.

I tell everyone about imagination games and how my grandfather was my definition of love. I tell them he was my best friend, I even tell them about his wrinkly earlobes. I tell them how two years before he died he bought my grandmother a dog. How he was teaching her to drive and balance the check book. I talk about his generosity and I do start to cry, but I keep going. I say it all. Because, "In the end he taught me how to die."

Gordon Elwood Wilson 1924-2001