Himself Until The End

My parents rented a condominium in Delray Beach from December 30 thru April 30.  On December 12th my father was admitted to the VA Hospital in West Haven, Connecticut and was diagnosed with a GI bleed and congestive heart failure. The physician cauterized the bleed, sent a tissue sample for biopsy, made adjustments to his baby aspirin regimen, added a diuretic, told him to avoid salty foods, and assured him that he would feel better in 4-6 weeks. My father passed away on February 5th, at the age of 86.

“I get short of breath just walking up the steps,” he told me over the phone.

“You need to rest, dad,” I assured him. “The doctor said it would take 4-6 weeks to recover.”

“He just needs to get to get up and move around,” I could hear my mom nudging him in the background. My parents were married for 59 years. There was a lot of love there, and you could see that love and hear that love when they weren’t bickering or screaming at each other.

On December 20th, my sister and brother-in-law drove with my parents to Penn State for my niece Alana’s graduation.

Text from Risa, December 20: I seriously have no idea how they’re going to FL. Dad can’t walk well at all and is tired and he has just been sitting all day! I’m really afraid that going is a bad idea.

Text from Risa, December 21: We r sitting in Alana’s apt for two hrs watching tv. Dad mentioned FL to Mark and I. Not sure how he’s doing it. Mom thinks he could do a lot more and is milking the situation which clearly he is not. Huffing and puffing and exhausted. Barely talks at all like he’s out of it. No idea how he can drive and be safe which is super scary.

Text from me: What is the weather like on the planet mom lives on?

My mother was diagnosed for the first time with breast cancer in 1991. She was diagnosed with breast cancer for the fourth time in 2019. In that 28-year time period, she never complained once about anything.  She’s tough and stoic and stubborn – just some of the qualities you need to beat cancer four damn times.  Sometimes I think that if there’s ever a global pandemic or nuclear holocaust, the only things to survive will be some deep-sea plankton, a few termites, and my mother.

Text from Risa, December 28th: I’m with Wendy my friend MD and she is worried about dad and thinks he needs to be further evaluated before getting on a plane so if I tell him that it will be a mess. He had a panic attack in the middle of the night and I’m worried about him going on the plane.

Text from me: I agree with that. I think he needs to be on more Lasix because he is still SOB and he is only taking 2 pills 1x per day. Or maybe he needs to be on supplemental oxygen. Do you have a pulse ox?

Later that day, I spoke with my father and he could barely catch his breath. I called my sister and we agreed that he needed to go to the ER immediately.  He was admitted with congestive heart failure, again. We cancelled their plane tickets to Florida. He spent New Years Eve in the hospital.  My mom was with him from early each morning until late each night.  

Text from Risa, January 2: Hi  just talked to cardiologist. Getting out today. Lungs clear. Still has dry cough but not infection or from fluid in lungs. Has to follow up with cardiologist next wk and if all ok can then go to FL. Diet restrictions and able to do whatever activity he can.

Telling my father that he had diet restrictions was like telling a fish that he had swimming restrictions.  Wally loved to eat.  He was slow and steady at the table.  I don’t think I ever saw food go from his plate into the garbage.  But he was never over-weight, because he was always very active.  

Throughout January, my father continued to complain of feeling like crap. He had no energy, and got short of breath with minimal activity.  He had a follow-up appointment with his cardiologist on Monday, January 27th, at 3:30.  Risa was busy treating patients, but I was available to speak with the cardiologist.  I told my mom to call me when the doctor got into the exam room, but I never got the call.

“The doctor said I’m fine to go to Florida,” my father told me later that night. “He said my heart is fine.”

“He still sounds like crap,” Risa said to me later that night over the phone. “The cardiologist said the distended abdomen is gas.”

“Gas my ass,” I said. “It sounds like ascites to me. He can’t speak without getting short of breath. It doesn’t make any sense.”

“I’ve got a bad feeling about this,” she replied, and unfortunately I couldn’t disagree.

“It’s just a matter of time before we’re flying down to Florida to quarterback this,” I said.  At the time, I had no idea we would watch the Super Bowl in Florida. 

——

My parents flew down to Florida on Wednesday, January 29th against the better judgement of everyone, except my father’s cardiologist in Connecticut.  

Text from me, January 30th, 9:38 a.m: I just spoke with Wally. He sounds like shit. Very short of breath. He has a doctors appointment this morning at 10:30. Primary care doctor. I explained what ascites is to him. Suggested he call Risa at the doctors with any questions to go over. He can call me also but Risa I assume you are not treating on a Thursday.

Ascites is a build-up of fluid in the abdominal cavity that is often seen in patients with congestive heart failure. The pressure caused by the increased fluid presses against the diaphragm, making it difficult to breathe.

Text from Risa, Thursday, January 30th, 11:33 a.m: Glenn I spoke to DO thankfully she seems intelligent. Worked on C3-5 phrenic nerve in neck to stop hiccups. 😊. I worked on him the other day also. They are doing blood work and US and when I said he aged a decade in six wks and shortness of breath never resolved she agreed to do another chest film. Holding off on CT at this point. Giving him regimen for bowels. Said it could be constipation but need to rule out ascites- no shit!  And btwn that and bld work will check liver. BP 112/80. Pulse 80. O2 99% thankfully.  Following up next wk for results.  At least she sounded intelligent and didn’t turn to more meds and actually touched his neck and abs !!

Risa is a chiropractic physician. She is very smart. She takes a holistic approach to medicine with her patients. She takes a combustible approach to diplomacy with doctors.  

My parents went back to their condo in Delray Beach.  At 5:15 p.m. they got a call from the doctor, who advised them to go the the emergency room. The lab tests came back and were positive for a kidney infection.  

It took them over 4 hours to get seen by the ER doctor. The doctor now ordered a CT scan of my father’s chest, abdomen and pelvis, and told him they were going to admit him to the hospital as soon as a bed became available.  

Text from me, Thursday, January 30th, 11:03 p.m: Just spoke with mom. Waiting for CT results. I’m going to sleep. Will be awake around 6. 

Friday morning I spoke with my mom. They got the CT scan results, which showed suspicious spots – possibly stomach cancer, but they were not sure. I asked Juli for help booking a flight.  

Text from Scott, Friday, January 31st, 9:25 a.m: Booking the 155 flight that gets into west palm at 634 ok.

Text from me: Perfect. I’m getting into west palm at 624. 

Text from Risa, 6:17 p.m.: We are landing now.  What airline ru. We are American.

Text from me: I am at the Alamo counter at baggage claim. Waiting in line which is long.

We met at the Alamo car rental kiosk, took the shuttle to get the car, and then headed directly to the Delray Medical Center.

Up until now, I had been texting with Scott and Risa. I added Mark and Juli to the text, and titled the text group “MASH.”

By the time we got to the hospital, it was after 8 p.m. My mother was sitting in a chair, and she looked exhausted. My father looked even worse, as you would expect, since he was laying in the hospital bed. We hugged my mom, kissed my dad, and would spend the next 5 days and nights wondering how the hell we got there.

My father was dressed in that typical blue and white hospital gown. It looked like it had been worn by about 1,000 patients already.  Tied around his neck was a portable cardiac monitor, with wires to leads on his chest. IV pole behind the bed, bed tray with uneaten hospital food and an un-opened deck of playing cards off to the side.

“Dad, your belly is massive,” my sister said. “What did the doctors say is going on?”

“They don’t know,” my mother said. “The doctor was here earlier. They did a CT scan and said he has some spots on his liver, but they don’t know what the spots are.”

To my mother, spots on the liver was no big deal. She had metastatic disease with malignant spots on her liver, and it didn’t slow her down a bit.  

It was Friday night. I doubted any doctors were going to speak with us that night.  

“I’m going to find the nurse and look at his labs,” my sister said.  She was going to take the lead on all of the medical stuff.  Scott and I did not protest.

I know the ins and outs of a hospital setting, though, and I knew there was no way a nurse was going to let my sister look at our father’s medical chart.  

Risa came back to the room and told us that the nurse wouldn’t give her any information, except to say that he was admitted to the hospital with a suspected kidney infection, and after the results of the CT scan, an oncologist had spoken with my parents. My sister asked to speak with the oncologist immediately.

At 10:30 p.m. I went outside to call Juli. I had been wearing a mask since I got to the hospital to try to minimize my exposure to germs, the corona virus, etc. It was the mask that I wore to synagogue when I was going through chemo. I had it custom made. It’s got a gold background, with the Star of David on it. It gets itchy, though, especially with a goatee.

While I was talking with Juli, the oncologist came into Wally’s hospital room and spoke with Scott and Risa, and my mom and dad. Scott took notes on his phone.

Text from Scott, 10:38 p.m: 6 ml on right side of lung. Irritating- Ill defined soft tissue mass on upper abdomen concerned about malignancy. Could be gastric. 1 lymph node on the right.  Might be able to biopsy. Pancreas unremarkable. Tumor markers – within normal limits Dr The oncologist (pronounced Tay).

I told Juli what Scott texted to me, hung up the phone and went back to my father’s hospital room.

My parents spent $15,000 on a condominium rental through April; paid $700 to have their Camry shipped down to Florida; paid for airfare, etc., only to find out that my father had cancer. That’s a long way to go and a lot of money to spend for a diagnosis.  

The attending physician came into the room to speak with us. She was a third year resident. She gave us an update on his recent lab work, and told us that his kidneys were failing.  

I looked down at my father. I know what it’s like to look up from a hospital bed. You feel vulnerable because you’re sick; you feel helpless because your family can’t rely on you to do anything. And of course, you’re scared because you don’t know when you’re going to feel better, or if.  

“This sucks,” my father said. “I’m sorry you had to schlep all the way down here. We should have stayed in Connecticut.”

“Don’t worry about that now,” Scott said.  

“We just want to get you better and get back home,” Risa added.  We were all crying.

The last time I was in Florida was three years ago for Aunt Elaine’s 100th birthday.  Aunt Elaine was my father’s aunt. We always believed my father would make it to 100 as well.  

It was late. We needed to take my mother home to get some rest. My mom thought we should all stay at the condominium they rented, but Scott and I had other ideas.  

“We’re not 10 years old anymore.  I’m not sleeping on a pullout couch with you, no offense,” I said to my brother. “Let’s get a hotel room.”

“You read my mind,” Scott said.

We decided that Risa would drive my parents’ Camry back to the condominium and stay with my mom.

Scott and I booked a room at the Hilton in Delray Beach.  We checked in, brought our bags up to the room, and made it back down to the hotel bar for last call.  

We ordered vodka on the rocks, my father’s favorite. Scott had a lime, and I asked for some olives.

“To Wally.”

“Why don’t you sleep late tomorrow morning?” Scott said to me. “I’ll pick up Risa early in the morning and get to the hospital so we can speak with the nephrologist while he’s doing morning rounds. You can pick up mom later and come to the hospital.”

I’ve been in remission since July, but my family still likes to keep a close eye on me and make sure I don’t get worn down. I imagine Juli spoke with Risa and Scott about this before the trip, though I also know she didn’t have to say anything. Other than Juli, no one had been more on top of my medical care than my siblings.

Scott woke me up the next morning at 8:15, as he was heading out the door.

“I’m going to pick up Risa and head to the hospital. Give mom a call to let her know when you’re going to pick her up, but we all agree she doesn’t need to be at the hospital for twelve hours today.”

“Agreed,” I said.

I got in the shower, had some oatmeal and coffee at the hotel breakfast, and decided to walk around Delray Beach for a while before I called my mom. I graduated from PT school at the University of Miami in 1996, and it had been close to 25 years since I had enjoyed a warm winter morning on the beach.  

I took my sneakers and socks off, rolled up my jeans, and stepped into the ocean. I stood there, looking out to the horizon, and contemplated my father’s illness. I didn’t need a doctor to tell me his prognosis was not good. I knew the metastatic disease in his liver, lungs and peritoneal cavity was the least of his medical problems, and that meant he had big problems. His kidney function would determine how long he had to live.  

We were hoping to transport him back to Connecticut so he could be in his home, near his grandchildren, and surrounded by his artwork. I stepped out of the surf and Googled Medical Air Ambulance. My best guess after a brief Google search was that it would cost $25K to get him back to Connecticut in his current condition. We could afford it, but could he survive the flight? What could be worse than dying on a damn airplane? 

I picked up my mom and drove to the hospital. It was Saturday afternoon. My father’s roommate was a gentleman named Palmer, and he had been admitted to the hospital for a triple stent placement. His wife’s name was Chesley. They were originally from Virginia, and retired to Florida. 

I caught Palmer’s eye as we walked into the hospital room.  

“He didn’t sleep much at all last night. He was up coughing all night,” Palmer told us, words he had already spoken to Scott and Risa.  

“I’m sorry,” I said to Palmer.  

“No need for apologies,” Palmer said. “I have ear plugs. I just hope he feels better.” 

The nephrologist hadn’t rounded yet, so I hadn’t missed anything from a medical standpoint.  

Risa and Mark and Scott were having conversations with their daughters because the girls wanted to come to Florida to see their Poppy. Juli and I had already decided that we didn’t want our children to fly to Florida. We didn’t want their last time with their Poppy to be in a hospital room. We had all celebrated my parents’ 59th anniversary two weeks earlier. That should be their final memory, Juli and I decided; not their grandfather in a hospital bed with an oxygen tube in his nose and an IV in his arm. Not to mention the damn hospital gown. Wally was a man of fashion, and this was not a good look for him.

The nephrologist showed up some time on Saturday afternoon and gave us a detailed explanation of his kidney function. His albumin level was fair, and his creatinine was fair, but it would be a waiting game to see which way things would turn. If his kidney function improved, then we might be able to get him on a plane to Connecticut. If his kidney function worsened, we would need to consider dialysis in order to get him back to Connecticut.  

I’ve worked with a lot of patients over the years that go through dialysis, and I know it’s not a picnic. Patients go to dialysis three days every week to have their blood filtered through a machine.  They leave dialysis completely worn out, and have to return the day after next to do it all again. And in my father’s case, the obvious question was: What for?

“So I can die of cancer next week?” my father asked.

Wally told us who he wanted us to call. His friends and colleagues from FIT. The cantor in Connecticut. Eddie. Sol. Kenny. I called our Aunt Babette, Wally’s sister, and she arranged to fly down from New York on Sunday.  

“Call Green’s Funeral Parlor in Fairfield. Everything’s arranged already. I have a plot.  Ask for Jon,” he said.

“We’re not there yet, dad,” I assured him.

I called Eddie Berger, Wally’s oldest and best friend. He retired and moved to Boca Raton 20 years ago with his wife, Harriet. Wally and Eddie met in Basic Training on May 1, 1955. They were in the back of a transport vehicle on their way to Fort Benning.  They looked at the other. Eddie asked, “Jew?” and they’ve been friends ever since. We grew up a few houses away from the Bergers in Monsey. Their home was our second home. Their sons Marc and Bruce have been lifelong friends.

Eddie and Harriet visited with Wally later that day.  Out in the hallway, Eddie said to me, “I’ve been telling him for 20 years, ‘You go to the VA for your hearing aids and your glasses, and that’s it!’”

Wally had other visitors as well –  his cousins Kenny, Cathy and Janie, along with Kenny’s wife Stephanie. Janie’s daughter Debbie visited with her husband Heath. Kenny and Stephanie’s daughter Jessica visited. Wally’s old friend Sol came by, and my mom’s cousins Gail and Jim McKay stopped by as well.

We stayed in the hospital all day and into the night, talking with doctors and trying to help my dad get comfortable. His abdomen was filled with fluid. He looked 9 months pregnant. His back hurt, his neck hurt, he couldn’t get comfortable no matter what he did, and he was having trouble breathing.  

Scott, Risa and I huddled in the lounge area outside his room. There was a vending machine for chips and candy, and another machine for soda. Good, healthy snack options.  

“We need to talk about a Do Not Resuscitate order,” I said to them, choking back tears. “He could end up going into cardiac arrest.”

Risa was crying. “How the hell did we get here? We were out to dinner with him on Sunday night.”

“It’s crazy,” Scott said.

Sheila came out of the hospital room and was walking towards us. She’s got severe arthritis in her knees, and sometimes it looks like she’s walking more on a pair of sticks then on legs. She’s too proud to use a walker, but on occasion she will use a cane.  She sat down on the couch next to Risa.

“Mom,” I said. “We need to talk with Daddy about a Do Not Resuscitate order. He’s at risk of having a heart attack, and if the cardiac monitor starts going bonkers, the nurses are going to run into the room to do CPR.”

“Do Not Resuscitate?” My Mom asked. “You’re kidding?”

“No, Mom,” Risa said. “This is serious.”

My mother was struggling with the gravity of the situation. In her mind, her husband would be out of the hospital in a day or two and back to the condominium to start their winter in Florida.

I was frustrated with her unwillingness or inability to comprehend the gravity of the situation, but I couldn’t be too mad at her because, after all, it was this same attitude that had helped her beat breast cancer four times.  

We continued to talk about the DNR, and I got up and walked back into my father’s hospital room. I sat down next to him and held his hand.

“This really sucks,” he said.

“Yup,” I said, fighting back tears. “I hate to see you like this.”

“Trust me,” he said. “I hate to be seen like this.”

“Dad,” I said. “We need to talk about Do Not Resuscitate orders. Because your kidneys aren’t working well, and you’ve got all this fluid in your belly, you’re at risk of having a heart attack. If that happens, the nurses are going to do CPR.  You could end up in ICU with broken ribs, you could have a stroke….”

Scott, Risa and my mom walked back into the room.

“And end up like a vegetable? What for? So I can die of cancer next week or next month? Forget that,” he said.

Risa and Scott were crying, as was I. My mom was stoic throughout the entire ordeal.  She’s not much of a crier.

I went to the nurses station and asked the nurse to ask the doctor to complete the DNR paperwork. I went back into the hospital room.

“I want to be buried in a nice suit. Not that nice, but with a nice tie,” my father told us.  “And I want to be buried with my wedding ring.”

“Please say kaddish for me,” he said, and we all said we would.  

“Can I have your tefillin?” I asked.

“Middle drawer, cabinet in the den,” he answered.

“And I want a military funeral,” he said.

“You want a military funeral?” I asked, a bit surprised.

“Why not?” he said. “If I’m not getting blown, the least they can do is blow taps.”

It wasn’t all tears. We had some laughs as well, and were not surprised that the cancer and the kidney failure could not kill Wally’s sense of humor.

I took out my phone and started taking notes. He went through a lot of his paintings and told us who should get which painting. He told us again who to remember to call.  He told us which gowns should go to which people. He wanted his cantor at his synagogue in Connecticut to have some of the gowns he designed.  He wanted Raquel and Blake to have his art supplies.  He wanted to make sure that Randy Fenoli, the host of ‘Say Yes to the Dress’ and a former student, got to pick a painting. He wanted Scott and me and our sons to have his jewelry.  

This went on for about an hour. He was getting more and more tired.  

“In 60 years,” he said, struggling to speak “I never looked at another woman.  Why should I? I had the best. Through everything she’s gone through, all the damn cancer, she’s always looked beautiful.”

It was getting late. We kissed him good night, and said goodnight to Palmer and Chesley.

“Sorry you had to hear all that,” I said. Chesley stood up and gave us all hugs.

We went to a pizzeria for dinner and some drinks. Risa took our mom back to the condominium, and Scott and I got back to the hotel in time again for last call. More vodka.

Text from me, Sunday, February 2, 6:50 a.m: Spoke with nurse. He slept thru the night and is still sleeping. No docs in yet. Albumin went up from 2.0 to 2.6. Good sign. Still waiting for wbc info. Creatinine is up to 3.5. BUN went up from 101 to 115 this morning. Creatinine was 3.2 yesterday.

Normal albumin levels are 3.4 to 5.4. Low levels of Albumin are a sign of liver disease, which was no surprise because we knew he had a mass on his liver. Normal creatinine levels are 0.6 to 1.2, and elevated creatinine levels are a sign of kidney dysfunction.  Normal BUN (blood urea nitrogen) levels are below 20. Elevated BUN levels are also a sign of kidney dysfunction.   

We would spend the next 72 hours obsessing over these lab results. If there was going to be any chance of getting our father back to Connecticut, his albumin needed to go up, and his creatinine and BUN needed to go down.  

My father was still asleep, and I was hungry.  There was a deli about a 10 minute walk from the hospital which was ironically called “Poppies Deli and Restaurant.”

Text from me, 10:16 a.m: I’m at deli across the street. Anyone want a bagel, egg sandwich etc ?

Text from Scott: Toasted scooped out bagel w scallion cream cheese and tomato slices. Thanks. OJ as well please. 

Text from Risa: Vegetarian brunch wrap

Text from me: There are more toupees in this place than alligators in the Everglades. I think I see the guy that bought Uncle Albert’s toupee on eBay. 

We ate breakfast in the lobby near the nurse’s station, and after breakfast I picked up our mom from the condominium and brought her back to the hospital.  

Mark and the girls had landed, and were on their way to the hospital. Aunt Babette had already gotten to the hospital.  

Text from Scott, 1:49 p.m: Meds are zonking him out. We need to make sure girls understand what they are walking into for Dad and Mom. 

Mark and the girls got to the hospital. Wally was happy to see them, and there were a lot of tears. The girls pleaded with him to stay strong. Juli, Sophia, Ben and Raquel all had a chance to FaceTime with him, as did Blake.  

It was dinner time, so we decided to go to Duffy’s Sport Bar to eat dinner and watch the first half of the Super Bowl. We went back to the hospital for the second half of the game, and to say good night to Wally.

Text from Scott, Monday, February 3, 6:28 a.m: Risa, Glenn is in shower. I just got out but am exhausted and think I am going to stay here, rest an hr and get Sammy packed up and head over a little later. If drs come you can fill me in. He will be ready by 7.

I picked up Risa at the condo and we drove to the hospital.

Text from Risa, 7:58 a.m: Dads worse. Heart is in a-fib so they are giving him another med to calm him and doing ekg now. He is alert tho and has alot of back pain. Didn’t sleep well. 

Text from Scott, 7:59 a.m: Fuck.

Text from me, 8:28 a.m: Please let the girls know that they don’t need to race over here. He is okay. Risa is massaging his back and it looks like he is going to fall back to sleep. Doctors haven’t been in yet and we haven’t really gotten any info re lab update from the nurses. 

Text from Mark: Did they run ekg?

Text from me, 8:38 a.m: Cardiologist just saw him. He said that his heart is fine and lungs are clear. He has a history of a-fib and cardiologist said his lungs are clear and he can live in a-fib for years. We are going to get him out of bed to sit in chair and doc said he is fine to walk around.  Abdomen filled up again with fluid and cardiologist thinks it should be drained. Need to wait for nephrologist. 

Risa and I spoke with the nephrologist. He told us that he wanted to drain the fluid from my father’s abdomen to relieve the pressure on his kidneys and to make him more comfortable. The fluid build-up was a result of the organ failure caused by the cancerous masses on his liver, lungs and in the peritoneal cavity. It was not from congestive heart failure.

The nephrologist transferred Wally to a different unit of the hospital where he would have a private room and two nurses dedicated to his care.

Text from Risa, 9:48 a.m: Too much info. Deciding life saving measures. Kidneys will fail soon if he opts for no dialysis. Dialysis if tolerated is only option to get him home so if that’s main goal now then he may need to opt for at least short term and then hospice.

Text from Scott, 10:10 a.m: Here. Getting mom coffee if anyone wants anything. Told her they are draining fluid and kidneys aren’t responding as they were hoping and need to discuss options including dialysis. 

Text from Scott, 11:03 a.m: He is in bathroom trying to poop

Text from Scott, 11:08 a.m: No luck

Text from Scott,  11:27 a.m: Mom also wants a grilled chicken Caesar salad w dressing on side.

Even when someone is dying, other people still need to eat.

Text from me, 2:21 p.m: Procedure went well. He’s on his way back. 

Wally got back to the hospital room and was sitting up in his bed.  Scott had gotten him a pastrami sandwich.  The nephrologist said he could eat anything he wanted.  I guess if you’re going to start dialysis or die of kidney failure, there’s really no harm in a pastrami sandwich.  He really didn’t have much of an appetite, though.  He had a few spoonfuls of matzo ball soup.  Mom was picking at her chicken caesar salad.  I went into the hallway to make a phone call.

A minute later I heard choking noises from Wally’s room, and Risa was screaming. I ran into the room, and yelled “Nurse, Nurse!” Several nurses came running into the room, probably thinking Wally was having a heart attack. Risa was slapping my mother on her back. She was choking. My father lay in his hospital bed, petrified and helpless.  

“She’s choking,” Risa yelled to the nurses.

One of the nurses took over slapping my mother on her back. After about 20 firm whacks, she finally coughed a red grape across the floor.

“That’s because you don’t chew your damn food!” Wally yelled at her. My father wasn’t scared of dying, but he was afraid to leave my mother alone.  

My mom frequently chokes on food. Her granddaughter Alana just graduated from Penn State and is applying to Speech Language Pathology programs. I hope she gets admitted to an accelerated program.

Wally felt somewhat better after having another 4 liters of fluid drained from his abdomen, and was breathing better. He was able to spend a few hours with Mark, Gabby, Alana and Sammy.  The girls were talking about coming back down to Florida later in the week to visit with him again.  There were a lot of tears as they said good-bye.

Text from me, Tuesday, February 4, 7:38 a.m: He slept well. Belly already pretty full. 

They had drained 4 liters of fluid out of his abdomen less than 18 hours earlier, and it was already full again.  

Text from Scott,, 10:22 a.m: At clubhouse. Mom is wearing down. Told her she needs to try to rest and take care of herself today as well.

Text from Risa, 10:33 a.m: Mark said a Rabbi came in. I was thinking we should say mishaberach for Dad.

Text from Mark, 10:37 a.m: I thought I read it in one of the email strings. With your Dad going to Shul weekly I think the Rabbi will provide comfort and strength.

Text from Juli, 11:08 a.m: Hi. Relative to mishaberach – I said one for Wally on Saturday and my friend Ilene did for him on Sunday. If your Rabbi is not looped in I agree with Mark it’s a good idea. Can anyone confirm Wally’s mother’s (Rose) Hebrew name. If possible… know you have other things to manage.

Text from Scott, 12:06 p.m: Beinish and Rahel (Rachel).

I had stepped out to get some fresh air.  When I returned to the hospital room, there was an elderly gentleman sitting in a wheelchair next to my father’s hospital bed, and he was holding my father’s hand. He was a retired rabbi. He was visiting with his wife, who was ill and in a room down the hall. He heard the nurses talking about sending for a rabbi, so he volunteered. He was a very sweet man, and I know my father took great comfort in having him there. After about 30 minutes, I pushed him in his wheelchair back to his wife’s room.

Later that afternoon, they drained another 3.5 liters of fluid from my father’s abdomen.  All of his lab values were going in the wrong direction.

The nephrologist and the oncologist came to see him. We were all in the room with him.  Wally was sitting up in a recliner chair.

The nephrologist said, “I don’t think your kidneys are strong enough to survive dialysis.”

My father didn’t hear him.

“You have to shout,” Scott said. “His hearing went long ago.”

My father waved for them to step closer. He looked at them closely.

The nephrologist repeated, this time much louder. “You’re kidneys are not strong enough for dialysis.” I was afraid the patient in the next room would think his kidneys were failing also.

“Nice blouse,” my father said to Dr. The, the oncologist.  She was a young woman.  

“And that’s a nice tie,” Wally said to Dr. Margaryan, the nephrologist.  

They both smiled. “The only thing we can really do for you is to make you comfortable.”

“You mean drain more fluid out of my belly?” Wally asked.

“No, Dad,” I said. “They mean hospice care so you’re not in any more pain.”

“Dad, you can still try dialysis if you want,” Scott said.  

I’ve been a physical therapist specializing in treating the elderly for over 16 years. I’ve witnessed many families struggle with managing their parents end-of-life decisions.  Some children want their parents to go through every possible medical procedure known to mankind just for a few more days of agonizing life.  Other children don’t struggle as much, and accept their parent’s fate more easily.  It’s never easy when it’s your own parent, but I guess I was at least prepared. Or as prepared as a son could be. 

Risa, Scott and I knew that what was most important to our father was that we remain close, committed to one another, and that we remain a family.  We weren’t going to upset him by arguing.  

It was difficult for him to speak. He hadn’t eaten much that day, and his throat had gotten very dry because he wasn’t drinking either. “For what?” Wally said. “So the cancer can kill me next week? This is no life.”

Throughout his life, Wally was famous for not being able to make decisions easily. This was always a source of aggravation and humor to his family. I think one of the reasons he had so many close friends is because he relied on them to help him make decisions throughout his life. The most prevalent Wallyism was always “Let me ask you a question.”  The mundane decisions of life. What flight should I take? Should I rent or lease the next Camry? Salmon or chicken? Aisle seat, or window?

Wally was also famous for trying to make life as easy as possible for those he loved. This was also a source of aggravation and humor to his family.  If Juli, the kids and I were going to visit my parents that coming weekend, he would want to know on Tuesday when we would be there so he could have dinner on the table. He tried to change every plan he ever made, if he thought it would make things easier for the people around him. This desire to make everything perfect for those around him lended itself well to his inability to make and stick with a decision.

In the end, though, we were blessed that he was able to make his own end-of-life decision. Ironic that after a life filled with indecision, the last decision of his life he made without hesitation, without doubt, and without consulting anyone else.  

The doctors left the room to make the arrangements to transfer him to the hospice unit in the hospital.  

“Dad, do you want anything to eat?” Risa asked him.

“Ice cream,” he replied.

“What kind?”

“Swirl.”

I volunteered to get him ice cream. I went outside and had myself a good cry, and Googled Ice Cream Near Me. There was a place across the street.

Losing a parent is a terrible ordeal, but it is the natural order of life. Children bury their parents. That’s the way life is supposed to work. When I was sick, I was heart-broken at the possibility that my children would grow up without their father, and that my wife would be without her husband. But my heart broke most for my parents, at the possibility of having to bury their son.  

I have had the pleasure of working with many people who lived well into their 90’s and even into their 100’s who woke up every morning and found the excitement and beauty in every day.  But they are the exception. Far too often people’s body’s survive long past their brain’s ability to fully appreciate their lives, or to make decisions for themselves. My father made it easy for us until the very end.

I got to the ice cream shop, and looked at the menu. There was a family in front of me and they were being served. I saw only yogurt listed on the menu.  There was no way I was going to get him yogurt for his final meal. 

“Hi. Do you have soft serve ice cream?” I asked the young guy behind the counter.

“Yes. What flavor?”

“Swirl?” I asked.  

“Sorry. No swirl.”

“Okay. Let me have one small cup of chocolate and one small cup of vanilla.” I figured Wally could alternate between chocolate and vanilla if he wanted.

I got to the hospice center in the hospital. The room was dingy and tired and overlooked a small courtyard with one lonely palm tree. There was only room for one hospital bed, and a few recliners. “Chocolate or vanilla?” I asked my father.

“Vanilla,” he said.

“We’re transferring him to another hospice center. This place is just a hospital room. He has absolutely no view,” Risa said.

While I was getting the ice cream, Risa and Scott researched other hospice centers in the area and made the decision to transfer him. Transport was on the way.

He had a few spoonfuls of ice cream, but wasn’t very hungry.  

Risa was texting with her daughter Gabby, the oldest grandchild.

Text from Gabby, Tuesday, February 4, 7:56 p.m: Can poppy move his hands.

“Dad, Gabby wants to know if you can still move your fingers,” Risa said.

My father wiggled his fingers.

Text from Risa:  Yes.  Why?  He’s looking at pics on uncle glenn’s phone now.

Text from Gabby:  I really thought he was going to make my wedding dress and I wanted him to sketch one for me. But he can’t sit up.

Text from Risa: He’s laughing.  When ru getting married he wants to know

Text from Gabby:  In two years

“In two years,” Risa said.  We all laughed through our tears. Gabby is a wonderful and beautiful young woman. She doesn’t have a boyfriend, though, so saying she was getting married in two years was a bit on the hopeful side. But who am I to say what the future holds?

Risa ran to the nurses station and asked them for paper and a pencil.

Wally started to sketch.

The transport ambulance from the hospice agency was at the door.

“Please wait a few minutes,” Risa told them.

Wally continued to sketch. “With love, Poppy,” he wrote at the top of the page.

He had been sketching wedding dresses for over 55 years, cutting the patterns, choosing the fabrics, and creating beautiful gowns. His final sketch was for his oldest granddaughter.

The ambulance drove him to the new hospice center, about 15 miles south to Boca Raton. Risa rode in the ambulance with him.  Scott drove the rental car.  I walked slowly through the hospital with my mother, thinking of how I used to walk slowly next to her mother, my Nanna Yetta, when I was a small boy. We got in my parents’ Camry and I drove to the hospice center.   

It was a beautiful facility. It looked more like a luxury hotel than it did a hospital. Scott and Risa arranged for Wally to have a private suite. He had his own room. Two nurses helped to shower him and shave him and then got him into bed in a new hospital gown.  It was still a hospital gown, but at least it was new. If Wally had been feeling better, I’m sure he would have ironed it.

The suite had a large bathroom with a walk-in shower. There was also a full kitchenette with a Keurig and a fridge. The living room had a couch and several recliner chairs that turned into flat beds. Outside, there was a large patio with furniture, and past the patio was a fountain. The patio was shaded by tall palm trees.  

The head nurse closed the curtain separating my father’s room from the living room.  

“I gave him some Ativan to calm him down because his breathing was so rapid, and some morphine so he’s not in any pain,” she told us. She spoke in a calm, soft voice. Several assistants entered the room with a tray of fruit, bottles of water, and pitchers of orange juice and cranberry juice.  

“If there’s anything you need, don’t hesitate to ask. We’ll be right outside the entire night,” the nurse told us.  

“How long do you think he has?” I asked her. I’ve worked with a lot of hospice nurses over the years, and I know they are very accurate with their predictions.  

“He’s not going to pass tonight,” she said. “The doctor will be in tomorrow morning to speak with you, and he can talk to you about what to expect towards the end.”

“Can you put one of the beds in the room with my father so my mom can sleep in the room with him?” Scott asked. “And can you ask a Rabbi to come in the morning?”

The nurse and one of the assistants rolled one of the chairs into Wally’s room. They converted the chair into a bed, and showed me how to convert the other chairs into beds. The nurses put sheets on all of the beds, and gave us a lot of blankets.

“He’s going to sweat a lot during the night,” she explained to us. “It’s just a natural body reaction. We’ll keep the air conditioner on high, and we’ll change his bedding and gown in the middle of the night.”

We were all concerned about my mom sleeping in a cold room, so we made sure she had extra blankets. It was after midnight. We all climbed into our beds.  

The bed chairs were 24” wide. The armrests of the chairs remained in place, and as a result it was impossible to lay in any position other than flat on my back. Eventually, though, we all fell asleep.  

At least I thought we did.

“Holy crap, you snore like a wild animal,” Scott said to me in the morning.

“Sorry,” I said. “I snore if I sleep on my back. Juli insists I sleep on my side every night, but there was no way to roll over on this chair bed thing.”

I got out of bed and poked my head into my father’s room. I saw his chest rise and fall, rise and fall. The nurse was true to her word. He had made it through the night.

“How did you sleep, mom?” I asked.

“Okay,” my mom said. “They really kept the air conditioner cranked up high. What do you mean, Juli won’t let you sleep on your back?”

“Well, when I sleep on my back my mouth opens up and I snore. If I sleep on my side, my mouth stays shut and I don’t snore as badly,” I explained to my mom.

“What?” My mom asked. “You mean I should have had him sleep on his side for the last 59 years?”

That was the funniest thing I had heard in a long time. My mother had slept next to my father every night for over 59 years, and after her last night ever sleeping with him, she learned how to get him to stop snoring. I’ve heard old people say that in a good marriage, people learn new things about each other all the time. For my folks, this was true until their last night together.

The nursing assistants brought us fresh pastries. They washed and shaved my father and changed his gown. It was a beautiful day. The sun was shining. It was warm. I had a cup of coffee on the deck and called Juli. Then I called Green’s Funeral Parlor in Connecticut.  

Each time we walked into the room we kissed my father. We sat on his bedside and held his hands. He didn’t say anything on Wednesday, and barely opened his eyes.

The doctor came in. “Hi,” he said. “I’m Dr. Luck.”

This is not a fictional piece of writing. Everything you’ve read so far is true and accurate, to my memory.  

“Yeah, I know. I hear it every day. An ironic name for a doctor in a hospice center,” he said.

He engaged us in some small talk, asked where we were from, how we got from Connecticut to Florida, etc. We asked him about his personal life, and he said he had two children. His son, it turns out, was in a training program at CBRE, the commercial real estate company where Scott is a SVP, in NYC. Scott said he would call his son and take him out to lunch when he got home.  

“He’ll probably pass some time today,” Dr. Luck told us. “His skin is starting to get splotchy and mottled. That’s a typical sign. You may see him take some deep breaths, and then some shallow breaths. It may seem like he won’t take a breath for a while, and then he’ll take a deep breath again.”

It was all very surreal, sitting there in a luxury suite at a hospice center in Boca Raton.  The back porch door was open and a warm breeze came into the room.

“The nurses will be right outside, and I’ll be here if you need anything,” he said. We all shook his hand. He said it was a pleasure to meet us all, albeit under difficult circumstances.

A little while later, a Rabbi knocked on the door and came into the room.  Rabbi Larry Schuval was originally from Monsey. What are the chances? He was a member of Temple Beth El, which is the congregation where my mom worked and Juli’s Uncle Lou was the Rabbi.  Uncle Lou fixed Juli and me up on a blind date. We made small talk about Money, and he asked us to talk about my father. Risa took out her phone and showed him pictures of a smiling Wally from just two weeks earlier, out to dinner with the family.

“This was him two weeks ago,” she said.  

The Rabbi put a yarmulke on Wally’s head. We circled his bed and held hands with Wally, and the Rabbi led us in prayer. We said the Shema, made a Misaberach and the Viddui, the final confessional prayer.

May my prayer come before You.

Do not ignore my plea.

Please, forgive me for all of the sins

That I sinned before You throughout my lifetime.

I am ashamed of deeds that I have committed.

I regret things that I have done.

Now, O G-d, take my pain and suffering as atonement.

Forgive my mistakes, for against You have I sinned.

May it be Your will, Adonai, my G-d and G-d of my ancestors,

That I sin no more.

In Your great mercy, cleanse me of the sins I have committed.

But not through suffering and disease.

Send me a complete healing along with all those who are ill.

I acknowledge before You, Adonai my G-d and G-d of my ancestors,

That my healing and my death are in your hands.

May it be Your will to grant me a complete healing.

If it be Your will that I am to die of this illness,

Let my death be atonement for all the wrongs that I have done in my life.

Shelter me in the shadow of Your wings.

Grant me a place in the world to come.

Parent of orphans and Guardian of widows.

Protect my dear ones,

With whose soul my soul is bound.

Into your hand I place my soul.

You have redeemed me, O G-d of truth.

Shema Yisrael, Adonai Elohenu, Adonai Echad.

Here of Israel, The Lord our G-d, The Lord is One.

Adonai Hu Ha ‘Elohim, Adonai Hu Ha ‘Elohim.

Adonai is G-d.  Adonai is G-d.

My father opened his eyes for the first time that day, and for the last time. He looked up at the Rabbi.

“It’s okay to let go, Dad,” Scott said. “We’re all here together and we’ll take care of mom.”

That’s what my father needed to hear.  

The Rabbi left.

We went back into my father’s room. His head was turned to the left, and his cheeks sunk in with each breath. My mother sat in a chair and held his left hand. My brother stood by his right side, held his right hand and cradled his head. My sister sat on the left side of the bed and held his left leg, and I sat on the right side of the bed and held his right leg. He clutched a picture from Blake’s Bar Mitzvah to his chest. The picture was of him and my mom, surrounded by their 7 grandchildren, all beautiful smiles. The picture rose and fell, rose and fell, and then laid still.

Wallace Emanuel Sloves, Wolf ben Beinish v Rahel, was himself until the end. We should all be so blessed. 

July 9, 1933 – February 5, 2020