The drive home that December evening was the first time in five weeks Mom had been outside a two mile radius of Dad’s hospital room. Headlights from passing cars briefly interrupted the gloom in the car causing me to tilt my head and squint my arid eyes to avoid the brightness reflecting in the mirrors. The radio, with the volume turned so low that the voices on the local talk show were barely a whisper, provided the only sound in the car.
The euphemistic dead parrot scene from Monty Python’s Flying Circus had been replaying in my head since we left Milwaukee:
“It’s not pinin’, it’s passed on! This parrot is no more! It has ceased to be! It’s expired and gone to meet its maker! This is a late parrot. It’s a stiff.”
Trying to shake the scene from my thoughts, I looked over to Mom. Her head, rolled back and tilted slightly to the right, remained planted against the headrest. She stared through the passenger window at the bucolic darkness, tears trailed gently down her puffy cheeks. I didn’t know what to say to comfort her, finally choosing to keep silent. My thoughts returned to the parrot scene:
“Bereft of life, it rests in peace, if you hadn’t nailed it to the perch it would be pushing up the daisies! It’s rung down the curtain and joined the choir invisible! This is an ex-parrot!”
I wanted the scene out of my head; it wouldn’t be gone until after the funeral a week later. It was my morbid way of accepting that Dad had died.
* * *
My father died on December 14, 2007. A rare blood disorder slowly consumed him. It was anticipated— yet still unexpected.
Six months earlier, thousands of dead and dying greater shearwaters were discovered floating in the waters off the Bahamas and washed ashore along the southeastern U.S. Media reports suggested the massive die-off was the result of an unknown ecological disaster. Scientists confirmed that spring migration die-offs of greater shearwaters occur almost annually. Ocean currents and offshore winds tend to carry the dead and dying birds southward, away from the coastal areas and out to sea. That that is unseen goes unnoticed.
* * *
Dad had been diagnosed with Essential Thrombocythemia (ET) in 1995 during a routine exam. Medical professionals differ in classifying ET as a cancer. There are no cancerous cells in the sense of being able to spread and invade other organs; however, it is considered a chronic blood malignancy because of the unpredictable and chaotic growth of the platelets in the bone marrow. Some experts consider it a cancer. Insurance companies take varying views. It really doesn’t matter what it is called, the outcome—both long and short term—are comparable.
Dad’s struggles with ET were similar to someone in a fight against cancer. Over time ET took away his ability to compete in lifetime hobbies of softball or golf. He became forgetful, and, at times, irritable.
The treatments were also similar. Dad visited with his oncologist on a regular basis and took a daily chemotherapy pill, along with a cauldron of other pills to offset side-effects.
The uncertainty of life expectancy can be similar. The initial prognosis gave him five years. He would surpass that diagnosis by seven years.
Even with the similarities, it was more comforting for me not to think of it as a cancer.
As the disease progressed, everyday tasks tested Dad’s endurance. As he overcame each obstacle it became easier for me to overlook how sick he was. Simple things such as walking a flight of stairs proved difficult. Yet, I contributed this to age, not a sickness.
At work his performance suffered causing multiple demotions. Still, he said nothing of his illness to his superiors or his staff. In the receiving line during his funeral, countless friends and co-workers offered their condolences while repeating a version of the same comment: “I didn’t even know he was sick.” His pride didn’t allow the sickness to show.
* * *
Bearded vultures were once found throughout all the mountain ranges in southern Europe. Through bounties and repeated persecution, they now number less than one hundred breeding pairs throughout Europe. These vultures gained their reputation as blood-thirsty beasts based mainly from the technique they use to access the nourishing bone marrow which constitutes ninety percent of their diet. On wings spanning eight feet, they soar hundreds of feet in the air, carrying bones from scavenged carcasses in their talons. The drop from such high altitudes shatters the bones on the rocks below, exposing the nutrient-rich life-giving marrow.
ET is classified as one of the four myeloproliferative diseases. “Myelo” is the Greek word for marrow. “Proliferative” means to reproduce or to grow. “Disease” is the improper function of a body organ. Myeloproliferative disease is literally the improper function of the bone marrow. Proper function allows life; improper function slowly consumes life.
* * *
I was at work when I got the phone call from Mom. “Your father has leukemia.”
“What does that mean?” I asked, knowing it was a ridiculous question. Our family had been informed that in unusual cases this rare disease could evolve into acute myeloid leukemia.
“The doctors say he has two weeks without treatment.”
“And with treatment?”
“He has a twenty percent chance of surviving six weeks.”
I left work and drove the twenty minutes to the hospital in Sheboygan. Dad was lying on his side on an inclined bed in the ICU. His legs stretched straight forcing his bare feet to hang off the end of the bed, dangling in the void between the mattress and the footboard. I looked at him, and thought, this is not a dying man; he looks the same as he did the day before.
I asked him how he felt.
“No different than yesterday,” he said with his trademark smile. I let out an uncomfortable laugh.
I asked him if he had chosen any treatment.
“I’m going to fight this.” Knowing Dad’s aversion to hospitals and to being doted on, that was not the answer I expected.
Later that afternoon, Mom rode in the ambulance carrying Dad to St. Luke’s Hospital in Milwaukee; she would rarely leave the hospital for the next five weeks, spending each night on a cot in his room. I would spend the next thirty-five days taking a daily one-hour commute south from Elkhart Lake to the hospital.
* * *
In the spring of 2005, a bald eagle soared over the waters of Elkhart Lake in the village of Elkhart Lake, Wisconsin. According to an eighty-year-old lifelong resident, it was the first bald eagle he could recall in the area. Since then, pairs of bald eagles are frequently sighted in the area. What was once rare had become commonplace by the virtue of repeated sightings.
ET is a rare disease with between 0.1 and 2.5 per 100,000 people diagnosed each year. I was aware how statistically rare it was after Dad’s diagnosis, but I let it become commonplace. The disease was there. It existed within Dad; it was consuming Dad. Ignoring it was easier than accepting it.
* * *
In his final defiant act on the Wednesday before he died, Dad wrapped his frail fingers around the blue ventilator tube that had been filling his lungs with oxygen, and yanked it out of his throat. The concentric ridges of the tube passed quickly over his teeth, as if every tick of plastic on enamel rehashed each year of his life. His frustration was obvious. I feared he had had enough.
I leaned in to him and whispered in his ear. “Dad, is this it?” The words fluttered from my mouth with uncomfortable effortlessness.
Unable to talk from being on and off the ventilator, Dad nodded yes.
“Do you want the rest of the machines removed?” I wanted my words to stop.
His eyelids slowly lifted, revealing his tired, but familiar blue eyes. He again nodded yes.
“You know what this means?” I asked. Mom looked at me; tears streamed down her cheeks.
Dad nodded yes. And then he smiled.
* * *
In the early 1800’s, enormous flocks of migrating passenger pigeons blanketed the skies of North America. Flocks consisting of millions of seemingly connected birds stretched for miles and reports indicated that it took hours for a flock to pass a fixed location. Reports from Michigan state that in 1878, fifty-thousand birds —widely regarded as a cheap protein source— were killed each day for nearly five months. Seven-and-a-half million birds erased in less than half a year.
In 1900, a 14 year-old boy in Ohio killed the last wild passenger pigeon. The species went from the most abundant bird in North America to extinct in less than a century. The communal nature of the passenger pigeon, while it protected individuals from predators, contributed to the species downfall by allowing humans to kill birds in such large quantities that too few remained for successful breeding.
ET is characterized by an unusually large number of platelets developed in the bone marrow. The job of platelets is to stick together to form clots to stop bleeding. A normal platelet count is between 150,000 to 400,000 platelets per micro liter of blood. With ET the bone marrow produces too many of the cells that form platelets and release the excess in the blood. The profusion of platelets includes those that do not function properly, which leads to abnormal clotting or persistent bleeding. Between his diagnosis and his admission to the hospital, Dad’s platelet counts would range between 600,000 and one million. During his five weeks in the hospital the counts would easily surpass one million. As with the abundance of the passenger pigeon, the enormous number of platelets would lead to Dad’s extinction.
* * *
Dad died on a Friday. Arrangements were made for him to go home that morning to in-home hospice care. He wanted to spend his last days in the house that he and Mom built. The house they designed to grow old in—together, with the master bedroom and laundry on the ground floor allowing easy access as age withered muscle, joints, and endurance.
All the accommodations had been set; his hospital bed was scheduled for delivery and the nurses were ready to coach us with care instructions. At first I found comfort thinking Dad would not die in a hospital. I had too many associations with hospitals—the athletic-tape smell of disinfectant; the lost memories of past patients’ footsteps polished out of the overly reflective floors; the handful of patient’s families we got to know whose loved one’s lost their battles with their sickness; my thoughts of a hospital, the cubic concrete walls serving as a surrogate womb to so many altricial patients who, without the uterine walls, would not survive—I feared these associations, conjured each future time I set foot in a hospital, would remind me of the five weeks Dad spent there.
Then I considered Dad dying at home, a place I was sure to spend many more days than a hospital. I envisioned Dad lying in his hospital bed in the dining room of their house (where he would be able to watch the wintering black-capped chickadees, white-breasted nuthatches, and downy woodpeckers, flock to the numerous feeders that he and Mom so diligently kept full), tubes entering his nose, throat, and arms, surrounded by machines doing the duty of his organs that have long since ceased to function.
But he wasn’t healthy enough to make the hour trip home from the hospital. Mom called us mid-morning. Her voice muffled by tears, she made it clear we needed to get to the hospital as soon as we could. We all hurried to the hospital and would spend the last hours of Dad’s life at his bedside.
* * *
Iridescence of the throat feathers in many hummingbird species is structural in origin. It is the result of the refraction of light by tiny platelets on the exterior of the barbs. Like the properties of a prism, the light is split into vibrant colors which are seen as shimmering, iridescent displays of color. Without these platelets and their ability to refract light, these feathers would appear grey or black.
Blood platelets are very small blood cells formed in the bone marrow whose functions are to start the process of blood clotting. Normally, an increase in blood platelets is harmful since it can increase the risk of clotting within arteries and could cause a blockage. In less common cases, the increase in blood platelets can cause problems with severe bleeding. This was the case for Dad. His sickness slowed the clotting process and scratches that would have been minor to most people would drip blood for hours.
* * *
Dad was frail. The skin on his hands draped gently over his withered muscles, bulbous arteries, and thin bones previously hidden by his well toned musculature. His cheeks were concave and framed by his cheekbones and lower jaw. Seeing him like this made me think of how we leave this world much the same way we enter it, in an altricial state—like a blind and featherless newly hatched chick, unable to survive in their new world without outside help.
Most of the life-support machines had been disconnected from Dad. One exception was the monitor that provided play-by-play analysis of Dad’s heart rate and respirations. At his request, the nurses brought Dad chocolate custard—his last supper. It would be the first solid food to touch his lips in three weeks.
Individually we all went to his bedside; he had something to tell each one of us. He was difficult to understand. Yet, it was apparent that Dad was comfortable with his decision. It was the happiest I had seen him in some time. He knew his outcome, in a way he chose his outcome, yet he was smiling, he was joking—he was at peace.
The final machine to be turned off was Dad’s pacemaker; which, according to his cardiologist, was his lifeline: if it malfunctioned Dad would die. When the cardiologist placed the magnet on Dad’s chest to cut off the electrical sustenance, I prepared for his death to come within minutes. Surprisingly, he would survive for nearly three more hours.
His body slowly shut down. Like a time-lapsed stop-action film, members of our family rotated positions around Dad’s bed as we anticipated the predictable. Early on, his eyelids draped his eyes for the final time. After thirty-eight years, I would never again see the warmth of his blue eyes.
Next, his respirations became more gradual and calculated. His chest would slowly rise, then fall, each breath becoming more drawn out as his lungs yearned for additional oxygen. The omniscient green line on the monitor, with the alarms silenced, relegated his heart beat to a series of peaks and valleys, with the valleys widening and the peaks decreasing as death progressed. His heart rate slowly dwindled, staying at rates so low for endless minutes I wondered why his body continued the fight. Each beat—an individual preceded by millions of others—one step closer to the last of their kin. The conception of death was defined. The silenced heart no longer pushed blood; the body molted to dirty-snow grey. The disease died along with its habitat.
* * *
It is Christmas Day of 2007. Eleven days have passed since Dad died, and three days since his funeral. My family has gathered at my paternal grandmother’s to celebrate a solemn holiday. I am outside with my five-year old niece, Caitlin, who is throwing a tennis ball to my dog.
A quick series of knocks on a nearby tree prompted her to stop her toss mid-throw and ask what caused the noise. I pointed to a pileated woodpecker which prompted a smile followed by a drawn out “cool.” Without a pause, she questioned something I wrote in Dad’s obituary.
“Is Grandpa really proud of us?” I wondered if she meant to say “was.”
“He sure was. Both you and your sister.” I summoned up a smile while trying to hold back tears.
“How about you and Dad?”
“All of us,” I assured her.
“I miss him.” She brought her arm behind her head to throw the saliva- and snow-soaked ball. The ball froze to her mitten as she snapped her arm forward; her eyes widened in confusion revealing a familiar blue that I noticed for the first time. Once she realized what happened, she tossed her head back and let out an innocent laugh—followed by a recognizable smile.
After a nearly decade-long hiatus from a career in wildlife research (during which he took the “logical” step of opening a restaurant), Jim Giese enrolled in a writing class at a liberal arts college which ignited an interest in exploring the natural world and its discoveries through words. A native of Wisconsin, he moved to Montana in 2012 to pursue graduate work in Environmental Studies at the University of Montana. He continues to live in Montana where he is contemplating his next logical step.