As soon as I saw the CT scan, hanging like a bleak beacon over my father's gurney, I knew. I stood there, trying to take in the black splotches covering the images of his brain, and the terrifying words wafting toward me--massive hemorrhage, irreversible damage, coma.
I was riveted, slack-jawed, not knowing what to do next. There was my father, splayed on the bed, a ventilator violently pumping air in and out of his lifeless body. With all the balled-up, discarded packaging, blood stains on the floor and tubes, it looked like the aftermath of an "ER" segment.
But this wasn't TV. We had to act quickly. Although my father's longtime girlfriend, my sister, Mary, and I were at this small hospital in Delaware, my brother was sitting in San Francisco, awaiting further word. We were fully aware that my dad had a huge rupture of an artery in his brain--an aneurysm. The bleeding, which could not be stopped, was causing a huge build-up of pressure between his brain and skull, squeezing areas that allowed him to breathe, feel pain, speak or have any awareness.
I called my brother from a nurse's station, hysterically breaking the news that he had to get on a plane back east immediately.
We began meeting with the physicians. In our first gathering with a cardiologist and a neurologist, their quick diagnoses made little sense to us--even to me, a medical writer. They emphasized there was little hope for recovery, and strongly suggested we think about "pulling the plug."
The doctors spoke as if we, too, were only connected to my father in some distant clinical sense. My father was young--one week shy of his 58th birthday. Even if it was a form of denial, we could not imagine ending life support just hours after his aneurysm. Besides, we were not making any decision without a second opinion, and certainly not without my brother's consent--and he was now unreachable, in flight.
We could not see the harm in keeping him alive a few more hours--or even another day. But after the first meeting, the hospital staff made it clear they would not be patient. A social worker, after giving some words of comfort, explained how we could apply for Medicaid since my father had no health insurance. After that, the "pull the plug" exhortations--including one from a pulmonologist who accused us of being selfish--became more obvious.
A second neurologist--with a better bedside manner--confirmed that my father was hanging by a thread. He could not breathe without a ventilator, and did not feel pain. In the eyes of the law--and conventional medicine--he was "brain dead," and thus dead.
We tried to absorb the shock--this was maybe five hours after he was wheeled into the ER. My sister, breaking the heavy silence, said, "What if we want to donate his organs?"
The nurses' ears pricked up. If that was our wish, they would do everything possible to keep him "alive." That meant continuing the ventilator and giving him drugs to keep his heart pumping, delivering vital oxygen to his organs.
We had finally bought the time we needed to get my brother to the hospital so he could see my father one last time. And we would also buy some stranger--or strangers--additional time with their spouse, children or grandchildren.
Within hours, the regional transplant coordinator arrived. We began the wrenching process of combing through my father's medical and social history, searching for clues that might prohibit donation of any of his organs.
The coordinator, a gentle, youngish man, soothed the bitterness we had been feeling. His job was never easy, as prime donor candidates are usually those who have been struck down too soon, by shootings, accidents or sudden heart attacks.
Ten hours after our ordeal began, my brother arrived. We were given an hour or so of private time with my dad, who had now been moved to an intensive care bed. The final goodbye. It was the hardest thing any of us had ever done.
Several weeks later we were comforted by letters from the transplant organization: Two men had received kidneys from my father.
The good news did not erase the pain. But it was a fitting tribute to someone who had been so generous in spirit in his life.
Alicia Ault is a writer living in Kensington.