Fathers, Sons, and Books

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In November, 2012, I wrote a post about my mother’s hospice care. Mom died peacefully on January 6, 2013 at the age of 93. This post is about my father.

Over the past three weeks I have spent more “quality time” with my father than ever before. We have had a lot to review about both the past and the future. The last time we spent this much time together was in the mid summer of 1961 when the two of us hastily drove together from Waco, Texas to Columbia, South Carolina and back again on a mission to find a new home to buy in time for my siblings and me to start school. I was the recent owner of a driver’s license and could share the driving on a non-stop trip of a thousand miles in both directions. My mother demonstrated an enormous amount of trust when she let us pick her next home. The task was neatly accomplished; our new home exceeded my expectations and was just a few hundred yards from my new high school. The real payoff for me was the beginning of a new relationship with my Dad as a collaborator to accomplish something that would have been hard for him to do alone.

The last 18 months since my mother’s death have been very difficult for my father. He has had two serious falls since Mom’s death. The first fall resulted in a hip fracture and a lost summer. He fractured his pelvis in the second fall almost exactly a year later. Following both events the biggest challenge has been to his autonomy. Without autonomy he mourns the vulnerability of his sense of purpose and the loss of control of the direction of his life. As a retired Baptist minister, he has read the Bible cover to cover more than 50 times over the course of his life. Now he frequently quotes John 21:18.

Very truly I tell you, when you were younger you dressed yourself and went where you wanted; but when you are old you will stretch out your hands, and someone else will dress you and lead you where you do not want to go.” (New International Translation)

Dad struggles against an ever-present and continuing challenge as described in this scripture and compounded by the death of his partner for life. He readily admits that he was fortunate that with my mother he enjoyed the rare experience of a totally interdependent partnership for 69 years. The contrast between that joy and the realities of this moment make every day an uphill climb that tests his will to go on. I watch closely because I am less than 25 years behind him on the road to the same reality, if I am lucky.

My role as a son is totally different than my role as a physician in the lives of hundreds of patients who were dealing with the same issues. Looking back on what I did as a physician, I am not so sure that I ever really understood their losses as they were experiencing them, and I am sure that many of the quick “solutions” that I offered provided no real relief when what they needed was not so much a solution as a chance to talk to someone who could listen with the deep understanding that I did not have.

There are so many things that Dad misses that are gone and are never to return except in the dreams where my mother comes to him frequently. One of the things that he misses most was their daily ritual of reading together.  With my mother reading and them discussing together what they had read, they digested hundreds of books between their retirement at the end of 1982 and her death. The habit of reading together began on long car trips even before I was born. Now he continues his daily reading of the scriptures and is currently wading through Charles Krauthammer’s Things That Matter: Three Decades of Passions, Pastimes and Politics, but I can sense that without someone to share the book with him, reading has become another relatively empty and unfulfilling activity.

On my visits to see him in North Carolina where he lives in an “odd couple” relationship with my brother serving as the admirable local care provider, I have tried to assume my mother’s role as his reader and co discusser.  I visit for a few days, but those brief visits have not given us the opportunity to do a book together. My brother and youngest sister who have spent much more time with him over the last 18 months frequently read the weekly letters I write about health care to him, but no one has the time to read a book with him.

We are now three weeks into his four-week visit to New Hampshire. I am enjoying routine activities with him as a backdrop for our ongoing conversations about life, faith and an uncertain future. He dispenses knowledge like; “A good sermon (substitute weekly letter) is built on a central idea that is propped up on all sides by good reasoning that moves quickly to a logical conclusion.” Our days have fallen into a routine of complaints about my strong coffee, increasingly faster and longer walks over progressively challenging terrain as he proves to me and to himself that he can improve, daily attempts to catch fish that have inexplicably stopped responding to my flies or his worms, and reading together.

Summer in New England is our shortest season so we must relish every day and waste no weekends. We have one more weekend for a memorable summer walk. Dad thinks the weather is already cool enough to qualify for November by Carolina standards and he walks wearing a fleece jacket.

We argue about the necessity of the walk. I win most days and he responds with “…when you are old you will stretch out your hands, and someone else will dress you and lead you where you do not want to go”. My response is that a few goods walks could delay that moment when you are led where you do not want to go. For the maximum benefit it is best to get into the habit as early as possible. He knows that with the proper maintenance old cars can keep on going.

Gene Lindsey, M.D., 69, retired cardiologist and primary care physician, who is also the retired President and CEO of Harvard Vanguard Medical Associates and Atrius Health, has continued in retirement his practice of more than six years of writing a weekly letter to “interested readers” on the journey to the Triple Aim of quality care for everyone, and a healthier community at a sustainable cost to society. This post is an excerpt of a recent letter.

 

2 Responses to “Fathers, Sons, and Books”

  1. Carol Eblen

    Thank you, good son, good physician, and good human being for sharing this personal experience with readers of this blog.

    I, at 87, read and write on this Blog because I am obsessed with stopping the unilateral covert/overt DNR Code Status in hospitals that shortens life/hastens death without the patient’s or the surrogate’s informed consent, and often for “fiscal” expediency and not compassion.

    The ongoing move by original Medicare since 2006 to managed care and managed death reimbursement protocols and the 27 Adverse Hospital events that Medicare/Advantage Insurance will NOT reimburse to Hospitals because of a law passed by Congress in 2006 has produced this reaction by the hospitals in order to protect their bottom lines.

    As a physician and a good human being, do you believe that single payer would make it unnecessary to target the elderly/disabled and the poor for end-of-life savings even when the life-saving or life-extending medical treatment that is withheld with the unilateral DNR is not proved to be medically futile under some due process procedure approved in state law?

    I am distressed that The US Congress never clarified the provisions of the 1991 Patient Self Determination Act and have never required physicians to seek informed consent from elderly Medicare/Medicaid patients for curative care as opposed to palliative care/transition to Hospice when these patients have terminal diseases that will most often cause their deaths.

    While you, as a physician, could protect your late Mom and now your Dad from both over treatment and under treatment at the end of their lives, this is not usually possible for lay persons.

    What are the solutions when managed care for profit and managed death for profit have taken over our safety net of Medicare/Medicare?

    .

  2. 私は、breitling腕時計のある38の私の最近のレビューで言及したように、ブライトリングのない実際に私自身が描かれたが発見されたブランドが、彼らは私自身の毎日の使用と好みのためにあ

    私は、breitling腕時計のある38の私の最近のレビューで言及したように、ブライトリングのない実際に私自身が描かれたが発見されたブランドが、彼らは私自身の毎日の使用と好みのためにあまりに複雑なような気がします。しかし、ブライトリングのあるコレクションを示す別のものを彼らのラインアップのスライス(と私が言うと、クリーナ)方向である。カルティエスーパーコピーそれは私たちが独立して最初のクロノグラフに対する敬意を見つけることは、このコレクションの中で、1915年ブライトリングトランスオーシャンクロノグラフの形でした。 http://www.bestevance.com/rolex/explorer/index.htm