Tom and Ena McIntyre
One downside of living on another continent from your parents is that you're sometimes asked to play the angel of death. When I got the opportunity to live and work in the US I knew that part of the Faustian bargain was that one day I'd get a phone call. The call would tell me to get to the airport, get on the first plane back to Scotland and make my way to either a hospital bedside or a funeral home. Not so much prodigal son as harbinger of doom. My arrival signalling the beginning of a final act, or maybe just a walk-on part in the epilogue to a life.
The call came one Sunday morning in the summer of 2006. My older sister telling me that my 74-year-old father wasn't going to make it. He had collapsed with a chest infection a few days before and a respirator had been keeping him alive. Now the prognosis was that congestive heart failure was imminent and there was nothing that could be done. I'd delayed flying home as he'd come back from the brink multiple times before. He'd had diphtheria as a child and his parents were told that he wouldn't survive, so he was left alone in an isolation ward in Darnley Hospital for six weeks. He survived, but lost the hearing in his right ear.
In his late 40s his blood pressure was off the scale and should have killed him, but instead it took his sight by rupturing the blood vessels in his eyes. Of the group that went on experimental blood pressure drugs with him in 1980 he was the last survivor by over a decade. Finally in 2003 he was in the Western Infirmary in Glasgow with kidney failure, a perforated bowel and septicemia and we were told he wouldn't last the night. But he did, thanks to a high-risk dialysis treatment that was more likely to kill him than cure him. Thankfully what didn't kill him did in fact make him stronger, and within a week he was sitting up in bed complaining about the food.
Unfortunately this time there was to be no reprieve. That Sunday morning the intensive care consultant had wielded his euphemistic axe: 'it's time you let him go.' My mother was presented with a simple but awful choice. Assent to her husband having a managed and likely pain-free exit from this life or risk the traumatic and possibly distressing death that was at best a few days away. So now it was time for me to go home.
When I got to Glasgow the next morning my mother was calm. Calmer than you'd expect for someone with the certain knowledge that her partner of nearly 50 years was going to die that day with her consent. We did what we always did when I got off an overnight flight from the US. We sat and talked in the kitchen of the terraced house in Renfrew where I'd grown up as she made me Weetabix and a cup of real tea. As we waited for my sister to arrive so that we could all head up to the Western Infirmary together my mum fussed around, keeping herself busy, steeling herself.
Before seeing my dad the doctor took us aside into the family room. They wanted to review the situation, confirm the prognosis and make sure we understood the sequence of events that would unfold over the next few hours. He told us they'd tried again to remove my dad's respirator during the night to see if he could make it on his own, but within minutes he was a fish out of water, gasping and drowning, putting more pressure on his already enlarged heart. So there would be no 11th hour commuting of the death sentence. My sister and I probed a little, looking for some glimmers of hope, some possible options that hadn't been explored, but he gently but firmly shut us down with the finality of 'I know it's hard to accept, but I'm afraid this is the end.'
Then he added something that redrew my carefully constructed picture of how the next few hours would play out. An expectation that had been shaped and solidified through quiet hours in the cab to the airport, waiting in the departure lounge at Newark and a sleepless flight to Glasgow. 'This situation is very unusual,' he began. 'Despite the seriousness of your father's condition he is fully conscious. He obviously can't talk because of the respirator, but he is awake and alert. However, we're not sure he recognises the seriousness of his condition.'
Seemingly by this point it's normal for the patient to need sedation, or for the body to have taken things into its own hands and walled off the outside world in preparation for the end. That was certainly what I had assumed and expected. However, occasionally, in rare cases like my dad's, the paths of the mind and the body can diverge. This wasn't going to be a death-bed vigil with the family surrounding an inanimate object waiting for a final denouement. This was going to be an engaged and intense process, a chance to say a final goodbye, a real-time fading out of an active and lively consciousness for the last time.
What do you say? How do you broach the subject? 'Dad, do you know this is the end?' 'Would you prefer a managed death or would you like to ride the rollercoaster to the end?' The doctor's advice was to say nothing, and we quickly agreed. Convincing ourselves it was the best for my dad, while also recognising it would be a lot easier for us. We would just spend time with him and then at some point during the day the staff would gradually turn up the sedation and we would 'let him go'.
While our desire to protect my dad and ourselves from the finality of the situation was well intentioned, it became apparent that he was actually very well informed and no deception was required. My protestations that I had just detoured from a business trip to London cut no ice. His eyes told me that I might as well have been wearing a black cloak with a scythe over my shoulder. But he played the game for a couple of hours, listening to our rambling monologues covering everything from the health of his grandchildren to the state of the Rangers team. He nodded in all the right places, occasionally a slight smile touching the corners of his lips that were visible beyond the mouthpiece of the respirator.
We didn't play the usual intensive care game of letting the bleeping, flashing, oscillating monitor beside his bed dictate the mood and determine our anxiety level. We hardly looked at it. Instead we just focused on the right-angled triangle of four people around and in the bed who had been a family for close to 40 years.
It could have gone on like this for many more hours. None of us would willingly have been the instigator. As we floated into this no man's land between a life still being lived right in front of us and imminent death, my dad unexpectedly blessed us. He lifted a burden we'd have carried for the rest of our lives. He signalled to my mum with his right hand. A weak rotating gesture, not easy given the tubes in his hand and arm. 'What do you want?' my mum asked. 'Do you want the radio on?' This only elicited a more aggressive signalling and some obvious frustration at not being understood. 'Do you want turned over? I'll get the nurse.' Clearly exasperated – and with some difficulty – my dad lifted his hand clear of the bed, pointed at his chest and then drew his index finger slowly across his throat with an intent that was unambiguous.
We didn't acknowledge it directly. Instead we grew quiet; the need for an upbeat commentary now gone. Not long after that the process of dying officially began. As the nurse came in every so often to fuss around the bed she would casually adjust the IV which was out of his field of vision. After a couple of these visits he began to get noticeably drowsy. He obviously knew what was happening, but there was no struggle, no distress, no raging against the dying of the light. We took turns holding his hand and he shared an iPod with my mum; one small white earpiece each for one last shared experience after a lifetime of them. Now we did watch the monitors tick down like sand in an hourglass and waited for the nurse to confirm he was officially gone. There was no defining moment, no death rattle, no urgent beeping and flashing lights, just flat green lines and zeros.
He died in the early afternoon as he would have chosen to live much of his life; listening to Glenn Miller and holding my mum's hand. We let the nurses clean him up while we had the obligatory cup of tea in the family room. I was the only one that went back in to see him. It was the right decision. When we left him he was at peace, visibly my dad, the only evidence of death rather than sleep the stillness of the room and the silence of the machines. When I saw him later, unplugged and laid out, it only confirmed what I had always believed about death. At some point Elvis truly does leave the building. His body was there but my dad was gone.
When we got back to Renfrew my sister and I started the calls. The seemingly endless reeling of the final days and hours. 'Bill… Betty… Agnes… Tom. I've got some bad news.' In hindsight I can see it as the beginning of the process that would help put structure and narrative to both his death and the life that had preceded it. The bottomless cups of tea, the living room full of people, a rolling cast of characters from my childhood, others just names up until this point. They comforted my mum and paid their respects. The chronology of each conversation worked backwards from the events of the last couple of days to earlier better times. Reminiscences from months before or decades before, depending on the vintage of the friendship. Tears but also the humour he'd have wanted. 'He'll be happy it wasn't the Dunhills or the Bacardi that got him in the end'.
He deserved and he got a good send off. A church funeral, a big turnout and a good spread afterwards. He was quite literally a dying breed. His parents had a pew in Renfrew Old Parish Church, he was baptised there, was a Sunday school teacher and Boys Brigade officer, his kids and one grandchild had been baptised there and my sister married. When he died he'd been an elder for close to 20 years. Only my mother had broken the cycle, taking him off to the wilds of Clydebank on his wedding day. I stood beside the coffin and gave him the best tribute I could. A brave life summed up in about 10 minutes. A eulogy I'd guiltily started sketching out somewhere over the north Atlantic six days before as he lay that night – his last night – in the Western, with who knows what going though his head.
Finally there was the scattering of the ashes. This was where specificity and forward planning became a problem. My dad had been very clear about his wishes. He wanted his ashes scattered on the West Sands in Millport. His grandmother had a house there and it featured prominently in his happiest childhood memories and remained one of his favourite places. When he was alive we didn't pay much attention to this particular request. But it didn't take us long to figure out that as a municipal beach with dog walkers, sandcastle builders and – Scottish weather permitting – the occasional sunbather, it wouldn't be as straightforward as he had intended.
A quick call to the council confirmed that you couldn't just go scattering remains on a public beach, no matter how specific the deceased had been. So we compromised and honoured the spirit if not the letter of his wishes. On a beautiful summer's night two days after the funeral we chartered a small motor boat from Inverkip Marina. We sailed down the coast past Skelmorlie and Wemyss Bay, recognising familiar landmarks from countless Sunday trips to Largs to play putting and eat ice cream at Nardinis. Our captain took us right into Millport Bay and cut the engine a couple of hundred yards off the West Sands. 'You're lucky,' he said. 'The tide's going in. He'll be on the beach in an hour or so.'
With the formalities complete my Faustian bargain then had another payment due. Eight days after I arrived in Scotland I got back on a plane to Newark, New Jersey. Back to my heavily pregnant wife and three young children. Back to a life where, unlike my mum and sister, I don't need to look at the empty chair every day.
Alan McIntyre is senior managing director for banking at Accenture, and is based in New York City. He is patron of the Institute of Contemporary Scotland
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