Don't let it snow

My dad hates snow. Passionately. Whenever he tells stories about his boyhood in Maine, “the asshole of the earth” in his opinion, invariably he includes a rant about how deep the snow got, how they’d have to dig out from the house through six-foot drifts (they grew to ten feet in the retelling) just to use the outhouse out back. “And it wasn’t heated,” he would add, as if we couldn’t have guessed.

It’s ironic that he was born on December 12, and so far north, and that he continues to live so far north (Massachusetts), for it means that more often than not he celebrates his birthday surrounded by the dreaded white stuff. Today his best friends came by to wish him well and give him a present – a snowball – which he rejected with the requisite good humor.

This hatred is hardly trivial, however. It runs deep and for good reason. Not least among his many reasons is that it nearly cost him the life of his second daughter, then seven, hit by a car when its driver couldn’t see through the storm and couldn’t stop in time on the slippery road. She survived, and re-learned to walk, talk, count, and read alongside her baby brother – me – amedical miracle, one of several my family would witness in the years to come. The event reshaped our family in countless ways; a psychologist would have a field day analyzing its effect on me alone, the seventh child of nine, suddenly thrust into the care of an elderly neighbor before I was done breastfeeding. Were proper bonds formed between parent and child? Did subconscious jealousies emerge? Does it explain my love of the stage, give me a deep-seated need for attention and the love of strangers?

If it created issues of separation among us, we seem to have moved past them now. But my dad’s hatred of snow abides. Even now, as he suffers from cancer, a steady dose of morphine causing him to sleep most of his days away and endure day and night in a drug-addled haze, his hatred of snow gives him focus. When I arrived a few weeks ago to help my mom care for him in what we thought would be his final days, a winter storm was threatening. He could barely talk, needed help standing, sitting up and walking. But he understood snow. Prior to supplying him with the real thing on his birthday, his friends Dick and Caroline had given him a hard white foam ball and stickpins – his anti-snow voodoo doll. It was 2 or 3 AM one night, time for his meds, when we mentioned the incoming storm. He sat right up in bed, stood under his own power, shuffled with purpose to his dresser, and began stabbing the tacky talisman with a vengeance. This from a man who didn’t even leave his bed for meals and who could barely breathe without an oxygen tank.

Dad has made an amazing recovery since then. He now seems strong enough to survive many more weeks, if not months. While credit goes to the attentions of his many children and some intelligent recent changes to his schedule of meds, I credit his desire to best his life-long nemesis as well. His first two attempts at voodoo succeeded, but he was frustrated on the third try: ten inches of snow dumped down on New England for his birthday weekend. He is determined not to die in the snow, I think. Looking out the window, it appears he still has some work to do on this planet before he leaves us.

If I’m right about that, I have a secret to keep from him. If he’s not leaving until the snow is gone, I’m rooting for one hell of a ski season.

First Impression

Exposing a new girlfriend to my family would be fraught with risk even in the best of times. We Corbins are intimidating, both singly and in a group, but most importantly, en masse: all of the in-laws say so, and they should know.

First there are the sheer numbers. I am seventh of nine, and the other eight are all married with children, some with grandchildren. A family reunion now of only my parents’ progeny and their spouses would require some 45-odd place settings if nobody brings a date. Then there’s the energy level. We are a fast-moving, loud-talking, fun-loving bunch, known for marathon games of volleyball, cards, and board games – and need I mention that we’re also highly competitive? My west coast friends call me intense; my siblings often remark about how laid back I’ve become. It’s all relative, but you get the idea. It’s the sort of family for which introductions really ought to include, as part of the package, three weeks of basic training.

Now layer on top of this situation a serious illness that brings us together, without much warning, with holidays approaching and at a time when new relationships are just taking shape. New significant others like my girlfriend Nancy want to be there for us during the crisis, providing consolation, strength, love, and space – not an easy task to begin with in this crowded arena. But just for grins, let’s add the complexity that she and I live clear across the country and she’s never met most of my family. And, um, immediately upon my arrival I’m given the role of new head hospice nurse for my terminally ill dad, an iconic figure whom everybody loves.

Did I say loves? I meant reveres. No pressure, but, hey bud, don’t mess up his meds, okay? And hey, when do we meet the new girlfriend?

Into this environment we walk late on a Saturday night, into my parents’ tiny duplex currently set up to sleep five: my dad in his hospital bed, my mom in an adjacent twin, my niece Ashley and her five-year-old son Lucas sharing her queen in a makeshift basement apartment, and a new twin bed, originally intended for Lucas but instead accommodating a revolving door parade of my parents’ descendants. (Lucas has not, himself, ever slept in his new bed.) The bad news, of course, is that parents of nine, grandparents of eighteen, open their doors to many more guests than they have beds, as a matter of habit but in particular in times of crisis. The family is used to this, of course; all eleven of us shared a 3-bedroom one-bathroom house growing up, and while we weren’t exactly poor, we were, in fact, crowded. For purely entertainment purposes my mom would have us swap bedrooms at random times, sometimes two or three times in one year. If we occasionally forgot and fell asleep in the wrong bed, it was all understood and forgiven. If nothing else, it prepared us for times like now where the number of people exceeds the number of available beds. It’s not uncommon for us to end the night by asking each other, “So, where do you intend to sleep tonight?” and not blinking when the answer bears no relation to where we spent the night before.

I had living like this for a week and a half, exhausted by a round-the-clock hospice routine while family members rushed in to see Dad in his weakened but recovering state, when I took a break to meet up with Nancy, on vacation in New York. On the night we returned, my sister Patsy from North Carolina had chosen the sofa (or it was chosen for her; nobody, including Patsy, is really sure), Derek (from LA) had Lucas’s bed, and Ashley’s queen had been reserved for Nancy and I. Living room duty means you get up when guests arrive, so Patsy was the first to meet Nancy; Derek, still on west coast time, was second. We sat up in the kitchen eating banana bread from Mom’s oven and telling stories about childhood. One that stands out in my memory is Patsy’s story about the time when she was in fifth grade and the principal, Mrs. Crawford, a 4-foot-something apple-shaped woman with a brown beehive and horn-rimmed glasses and a voice straight out of a Cheech and Chong skit, got very excited when she realized she had Corbins in each of grades one, two, three, five, and six. (Perhaps needless to say, we’re all close in age; all nine of us were born within eleven years.) Having five kids from one family in her school at one time was some sort of grand occasion, and to celebrate, she took each one aside and bought each of them lunch that day. What a grand gesture! Our publicly-subsidized lunches cost a whole quarter apiece back then. Mrs. Crawford’s generosity ran her a whopping buck and a quarter. I suppose that’s a lot on a teacher’s salary in 1963.

The thing that shocks the most people about my upbringing is the single shared bathroom. “Eleven of you? How did you do it?” It strains credulity, but I swear it’s true. Like anything else, you adapt. Baths and showers are short; you get used to seeing each other (and being seen) dressed only in a towel. I still prefer to watch TV in my PJ’s. All flaps carefully closed, of course.

Old habits die hard. My parents still have only one bathroom. This fact freaked Nancy out so much that she never did shower here. Luckily, when six of the siblings and SO’s and a scattering of kids and friends gathered for my Dad’s birthday celebration Sunday at noon, the aroma of spicy pizza covered a multitude of sins. On that point, I won’t elaborate. I’m just glad she’d already made a good first impression.

Homeward bound

Today marks two weeks here in frigid western Massachusetts. How things have changed. How they have stayed the same!

The biggest change is in my dad's condition. Two weeks ago he was barely clinging to life, slept most of the day in a drug-addled haze, and spent his few waking hours taking more meds or coughing until he puked up blood. Today, like many of his recent days, he is up and about, dressed, restless, looking for things to do. He celebrated his 74th birthday on Monday with a huge takeout steak-and-shrimp double entree from Appleby's, played with his great grandson, complained about his meds, and visited with his various progeny who stopped by for a visit or called to wish him a happy birthday. My hospice role has been reduced from "head nurse" to filling in now and then for my mom, the regime having dropped from something every couple of hours to once every six to eight hours, allowing him - and us - much more rest and paying off in much happier dispositions overall.

I look back on the past two weeks and can't help but feel that we all dodged a bullet. I am relieved that he did not continue his painful slide and overjoyed that his condition is so much improved, that we have been able to spend a lot of good quality time together, rebonding and getting to know each other in a completely new way. He and my mom raised me, took care of me, taught me things, and provided for me for two decades, then stood behind me, a silent but ever-assuring backstop, insurance against financial or emotional distress, promoter, instiller of confidence, reminder of his faith in me, renewer of my own faith in myself. Suddenly I became his caretaker, keeping vigil on him and feeding him his meds, letting him know that he was not alone, meanwhile giving my mom a break and letting her know that she was not alone, that she had help at her beck and call; more than that, she had someone willing and able to step in, take on this burden for her while she renewed her energy and shared the emotional burden when we were both awake and wanted to talk. It provided emotional relief to my siblings, too, who had been worried not only about Dad's condition, but also Mom's, and about how her weakened, frazzled state would affect her decisions about Dad's care, and her ability to carry out what was needed. Was she overmedicating him? Was she able to see clearly what Dad's issues really were and communicate those clearly to the hospice nurse, and understand if and when the care regime should change? It didn't take long for me to determine that the meds were a big part of the problem. I didn't know what the answer was, but I did what I do best: I asked questions, raised issues, explored alternatives. The hospice nurse figured out what turned out to be the actual solution just three days after my arrival. Everything since then has been a matter of standing by and hoping it was not all just Dad rising to the occasion of greeting the gazillions of visitors who converged to say goodbye, coincidentally, at the time of his recovery.

So, unbeknownst to me, it turns out there were three reasons for me to come visit: one, for my sake, to see my Dad again before he left us; two, to provide relief to Mom in Dad's hospice care; and three, to help rescue him from a treatment plan that was designed to keep him sedated until he got sick of it and died. I arrived on a Tuesday and had unwittingly achieved all three by the first weekend. My dad's energy attests to his recovery; twice in that first weekend he beat the lot of us at cards, giving rise to the joke that perhaps we should put him back on heavy sedation. On my mom's part, her return to normalcy, such as it is, is evidenced by her nonstop knitting; she discovered ribbon scarves and has produced one for just about every person who has walked in her door, some of them perfect strangers when they first crossed her threshold. (I opted out; I have a terrible history of losing scarves, and anyway, I don't like anything around my neck.)

In its outward manifestation, my relationship with my family has changed, but not in its fundamental character. I doubt that anyone envisioned me as a hospice care-giver. I am a man, after all, and while there is no reason for it, our culture persists in casting women in such roles. Women abound in my family; my parents have six daughters and two daughters-in-law, many of whom are local (even, in once case, living literally on the other side of the wall in the duplex). I also am the explorer, the wanderer, the prodigal son who escaped to a new life on the west coast, 3000 miles from day-to-day family life. But I had the opportunity, I had the ability, and I had the desire to step in, and so I did. Yet it should not be such a surprise. This role speaks to both my character and to my role in the family. I am the one least tied down, perhaps the most independent thinker (although none of them are slouches), and also the solid, rational, dependable one. I am, in a way, the family's utility player. Put me in, coach. I'm ready to play.

But home beckons now. I have been home only two days in the past three weeks. Friends are caring for my dog, work has been put on hold, other relationships have, if not taken a back seat, at least stepped out of the limelight. People have been wonderful to me -- supportive, understanding, helpful -- and I have been able to give little back other than gratitude. My work here is done for now; I have some catching up to do. Time to go home.

And so I shall. Thursday afternoon I land again in Portland's airport. After I restock my larder with food for me and my wonderful puppy, toss some laundry into the washer and delete a few hundred emails, I want to see my friends and community again. And wait for word that I am needed here again.

Hospice 101

I’ve spent the last several nights providing hospice care to my terminally ill father. It has been a trial by fire and has proved both more and less difficult than expected.

The easy part was learning the routine. That was surprising because on its face the “routine” is anything but. Six different treatments occur on independent intervals (4-hour, 6-hour, and “as needed”) and change every few days, and as a result, neither patient nor caregiver get very much sleep. Until I arrived, my mom carried that load alone for months, and I can tell you after only four days of it that she is built of much sturdier stuff than I. On my first night off, I slept twelve hours and would have slept eight more had I not been woken to greet family members coming to visit on a Sunday afternoon.

The more difficult part is acceptance. Dad’s affliction is lung cancer, marked by a persistent, incurable, and accelerating cough and a shortness of breath that alone would be enough to drive anyone crazy, much less in combination with other things. Unfortunately, those “other things” are just as bad: metastasis of the cancer to his liver, pleural sac, and lymph nodes, and severe arthritis, exacerbating a lifetime of traumas to his back and shoulders and aggravated by every cough.

There are pills, there are syrups, there are machines. He gets oxygen from a noisy pump through a thin tube he wears over his ears and inserts into his nostrils, a tube that stretches the length of the house when extended and lays in a loose, often tangled coil at the foot of a hospital-style table next to his bed. Twice on my watch, he has fallen in his morphine-addled state, at least once tripped up by this tube, sending his head crashing into his dresser, leaving bruises and bloody welts on his head. Thankfully, his hair has grown back since he abandoned chemo over a year ago, and his thick white mane covers most of the evidence of this fall.

The morphine itself is administered through a nebulizer, essentially a fancy mister/inhaler, which runs eight minutes at a time, whenever his cough threatens his sleep or peace of mind, on average every three to four hours. This is no average cough. It begins as a breathy wheeze, perhaps enough to rattle the phlegm hanging loose in his throat, but not enough to expel anything except the moisture in his breath. It builds with a rapid succession of frustratingly inadequate hacks, each louder and breathier than the one before, sometimes stronger, sometimes weaker, but each one only a hint of the power he needs in order to satisfy what his body requires: a gale force that would rip the tumors from his chest and lungs for him to spit unceremoniously into the toilet instead of the blood and bile he generates now.

Even so, his cough racks his weak body, rattles his bones to the elbows, and frustrates his soul into a weary depression. That may be the hardest thing to see, and the hardest thing for him to show us – this confident man, larger than life itself for all of my 46 years, stumbling into furniture, swearing at his own inadequacies, his glum mood a stark contrast to the cheerful good humor that has delighted children and charmed women (and men) for decades. This isn’t my dad, I say as I help him shuffle from the bed to the bathroom and back, not the dad I know.

I’ve been told that long-term hospice patients outlive dedicated caregivers as much as 70% of the time, and I can see why. While Dad sleeps, we fret; while he lies sedated, we share his depression and sit nervously beside him. He suffers, we endure. He waits patiently for his death; we worry daily that he will run out of patience, or that we will, and in so doing, fail him. Our pain is but a fraction of his, but so is our courage, as we refuse to accept that with which he has long ago made his peace.

A friend said to me recently that our parents’ final great lesson is to teach their children how to die with dignity. It is hard to maintain one’s dignity while spilling spaghetti and orange juice down one’s pajamas, or requiring assistance to stand, walk, and bathe. But even these moments slide by with decreasing notice and are leavened with Dad’s quirky humor, and it is as we chuckle along with his well-honed one-liners that we begin to obtain the level of comfort with his fate that he desires for us. It is the fate that we all share, after all; “nobody gets out of this world alive,” he likes to say (along with, “I came into this world with nothing, and I’m leaving with half of it”). For if there is any dignity in dying, there can be no greater way to express it than with good humor.

Look out, afterlife. Your dignity quotient is about to go up.