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THE REAPER COMETH
I had seen and spoken to many people in the last stages of cancer when I was in hospital. I’d heard their moans and watched them struggle with dignity as they dealt with excruciating pain and slipped ever closer to the fateful day they knew was coming. As much as I resented my dad for the childhood abuse I endured, I also recognized that he was a human being that deserved to be treated with as much compassion as I could muster. I had no problem compartmentalizing my feelings and was efficient at changing his ostomy bag, so I wasn’t worried about looking after him. After all, I didn’t get all that free training living in the hospital for nothing!
I drove to the beach to pick up Dad and his little beagle, Lady. Dad knew he couldn’t manage on his own, and to see him struggling with his pride was something. He would have never asked for my help, and I knew he would never thank me for it, either. He expected me to look after him, and I obliged because I knew it was the right thing to do. When I got to the beach, I saw that his pain was way out of control, so I made him take some morphine. When it didn’t seem to make any difference to his pain twenty minutes later, I knew I would need a referral to oncology to get a more potent dose.
For the trip into the city, I found the fluffiest pillow I could for Dad to sit on. Loaded his and Lady’s things into the car, helped him down the stairs, and got him into the car. He was squirming, shifting, moaning, groaning, and asking me to drive faster. Again, I made the trip in just over twenty minutes, thankful that the RCMP didn’t have speed traps set up.
We got to my house, and because I had my landscaper build stairs to suit my physical capabilities, it was easy for Dad to get into the house. I got him settled on the couch, then made him something to eat. Even though it had been a couple of hours since I gave him the morphine, I gave him another dose convincing him that a longer time period had transpired since his last dose. He ate, and this time, the meds started working. It wasn’t too long before he said he’d like to have a nap. He ventured into the spare room and was surprised to see how the bedroom had been set up for him.
“Gee, this is a nice bed,” he said. “Where’d you get it?”
“Yeah, I lucked out when I went shopping. I got it at Coast.”
“It’s a nice mattress too!”
“Glad you like it. Do you need help getting into bed?”
“No! I can manage.”
As soon as he was sleeping, I got on the phone and called his surgeon’s office. I needed to get Dad into the Allan Blair Cancer Clinic.
“Hi, it’s Penny Hodgson calling on behalf of my Dad, Frank. I need a referral for oncology at the Allan Blair Centre for my dad.” I said to the receptionist.
“Ok, let me pull his file,” she replied before putting me on hold. “Ok, Dr. X doesn’t usually refer for oncology without seeing the patient, and it usually takes about six weeks to get into Allan Blair.”
“Six weeks? He doesn’t have six weeks!” I said, not knowing that my estimation was accurate.
“Is there any way you can just put the referral through? I just had my dad at the ER a couple of weeks ago. He had an emergency MRI that showed the cancer spread everywhere. I don’t need Dr. X to validate what another specialist has already confirmed. Look, my dad’s pain isn’t being managed with the morphine I got at the ER, so what I need is an appointment at the Allan Blair clinic. Can you please arrange that?”
“Oh, I see. I’m sorry to hear that,” she said, clearly hearing the urgency and command in my voice. There was silence on the other end for a couple of minutes, then she said, “Ok. I have a plan. What’s your number? I’m going to have to call you back.”
I recited my phone number, thanked her, then hung up, hoping her plan wouldn’t take too long.
Dad slept for over an hour. When he got up, I asked how his pain was.
“I feel a lot better, thank you,” he replied. “Oh, I called Dusty last night to let him know I would be staying with you. I don’t know why he’s mad at you, but you two will have to work that out.”
“Yeah, I know,” I said, wondering how Dusty would treat me with Dad here. I wasn’t looking forward to another outburst, and I didn’t know how I would react a second time.
Dusty came over when he was done at work to see Dad. I was making supper when he arrived, so Dad asked if there was enough for him to have something to eat.
“Yes, of course.”
I was still hurt from being blamed for stuff way beyond my control. It wasn’t my fault that Dad became delirious after his surgery and needed to be tied to the bed! I realized that Dusty didn’t understand what was happening, but I still couldn’t get over how violent he had become that day in Dad’s hospital room. For the first time in my life, I saw a darkness in him that I had never seen before, and it was a little scary!
The next morning, Dr. X’s receptionist called me back.
“Hi, Penny. I got your dad an appointment at the Allan Blair Clinic for next Tuesday at 1 pm.”
“That’s fantastic! Thank you so much.”
Thankfully, the Allan Blair Clinic was only blocks from my house, so Dad didn’t have to be in the car long. We used the fluffy pillow anyway because my car's seats were pretty hard. I dropped Dad off at the main doors and told him to wait while I parked the car. He wouldn’t use a wheelchair, so he was plenty tired by the time we walked all the way to the clinic.
It’s always fascinated me how clueless architects are when building hospitals. Why couldn’t they build a wing with a separate entrance so that people don’t have to walk far to reach specialty areas?
Dad was already exhausted and in pain when we got to the waiting area. Thankfully, we didn’t have to wait long to see the doctor. When they called Dad’s name, I went with him. The doctor looked like he was run ragged! He had Dad’s folder and scanned the report before speaking.
“Hi, Frank. I’m Dr. XX. I see you’ve had a couple of surgeries for the cancer in your bladder. Your bladder has been removed, and according to this report, it appears that the cancer has spread. I understand that you’re having a lot of pain…the morphine isn’t working properly? We can definitely help you with that, and there are therapies that you can try. What do you want to do? Do you want to try chemotherapy?”
Like most people, my dad was terrified of dying, but he wasn’t about to admit that out loud.
“Ok. What would be involved with the chemotherapy?” he asked.
I sat there wondering if he had read through the entire MRI report. When he was finished explaining everything I said,
“So, don’t his kidneys need to function properly for the chemotherapy to work? You do realize that the cancer has spread to his kidneys, right?”
He flipped open the file again and started reading.
“Oh. Ok. Let me see. Yes, you’re right; the kidneys need to be functioning. Are you having kidney problems?” he asked my dad.
“Not that I’m aware of,” my dad answered, glancing over at me with that look that said ‘ why are you questioning the doctor?’
“The cancer has spread to his kidneys, spleen, and into his lungs. Do you not have the MRI report there?” I asked, dismissing Dad’s attempt at shutting me up. “Does it make sense for him to go through chemo when his organs aren’t functioning properly?”
He keeps reading the report, then says,
“Ok. Yes. I’m sorry. I see from that report that you’re right. The cancer has spread extensively. I’m sorry. In this case, it doesn’t make sense to go through the chemo at this point. Why did it take so long to get a referral to the clinic here?” the oncologist asked.
“Well, you’d have to ask Dr. X about that,” I replied.
“Oh. That’s your surgeon?”
“Oh. Ok. Are you a nurse?”
“No, I’m not,” I replied.
“Really? You seem to understand quite a bit.”
“Yeah, I’ve spent a lot of time in hospitals.”
“Oh, I see.” He looks over at Dad and asks, “I see you live at Regina Beach. You’re not out there alone now are you?”
“No. I’m staying with my daughter, Penny, now.”
The doctor looks over at me. “That’s you?” he asks.
“Yup. That’s me.”
Regina is technically a city, but it’s small, and the medical community behaves like a small town where everyone knows almost everything about everyone. Dad’s surgeon had quite the reputation and was the stereotypical God Complex surgeon. Most people were intimidated by his demeanor and never challenged him, which could be one of the reasons the nurses at the General were so snarky with me. I questioned everything, and that didn’t always go over well.
“Good. I don’t think it’s a good idea for you to be alone now, so how can I help?”
My dad looked at the doctor and then at me, “I don’t know,” he finally said.
I took over. “We need a stronger prescription. This dose of morphine isn’t controlling the pain,” I said.
“Ok. There are morphine patches that you can put on, plus continue to take the oral doses. I’ll write you a prescription and get you hooked up with palliative care. They will get you any supplies you need, and they’ll arrange for nursing support. Did you know that you don’t have to pay for the pain meds once you're in palliative care?”
“No! I didn’t know that. That’s great!”
This was a turning point for Dad. He realized that this was it. There was nothing anyone could do, and he was going to die. Soon.
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