Archive | July 2017

The Id and the Man

My father-in-law introduced me recently to the Freudian concept of the id, ego, and superego.  If you are ready to skip the rest of this post already, I don’t blame you.  I didn’t want to get into these concepts either.  But based on my dad’s current state, and what just happened, they are really top of mind.

For psych majors out there, a word of warning: I am going to butcher this.  Here goes anyway.

When we are born, we are all “id”.  It’s all desire.  Hunger, thirst, sleep, salt, touch.  Later in life, this also includes sex.  These are instinctive needs that underlie our will to live to ability to reproduce.  In Judaism, this is “yetzer hara”, the evil impulse.  It’s not evil per se; it’s what drives us to survive and without it, we would die.  They are inseparable from us, part of the whole us.

But if human beings we all only followed these impulses, we would collapse into anarchy.  So we have society, and society has rules.  Different societies have different rules but many are similar.  Thou shalt not kill, for example, is on one extreme.  Don’t wear white after Labor Day, I would argue, is on the other.  Now that I live in Wellesley, I get that not everyone would find these to be such polar opposites.  These ideas are implanted in the “superego”, which is aware of society’s customs and norms.

Between what society says and what desire demands – desire never asks, it only demands – is the “ego”.  The ego is the regulating force that understands when it’s time for sex and how to ask for it.  It is the director of the play that decides which actors to bring on stage.  Sometimes thirst is front and center and all else must cease while it has its moment in the spotlight.  It is the ego that calls it onto the stage, lets it speak its lines, and then moves it off to the side.  It is “yetzer hatov”, the good impulse, the part that understands that long-term love and commitment and good deeds also benefit the person demonstrating them.

It is said that as we age, we regress to what we were like when we were born.  Independence starts at zero, then increases, then decreases again.  So it is with my father right now.  He is turning into all id, all an unquenchable and bottomless desire to get every need met at the instant he feels it.  This is why he calls 20 times a day.  It is why he refuses his medication; he is convinced that the people dispensing it to him are trying to kill him and his survival instinct is kicking in.  Nowadays why when I don’t give him what he thinks he wants, exactly when he thinks he wants it, he will do or say anything to get it.

Hence the real purpose for this blog post.  It is not about psychology.  It is about the terrible things he says to me, how much I wish they didn’t hurt, and what I plan to do about it.

My father ordered an electric wheelchair on Amazon.  Everyone told him not to: doctors, nurses, my brother and me, the director of the community where he lives, everyone.  It was unanimous.  He won’t be allowed to ride it around the halls anyway.  He’s not safe to operate an electrical means of conveyance because he tends to fall asleep and doesn’t have the judgment to know whether he’s going too fast.  But for him, ability to move around has reached “id” levels.  So when it arrived, I asked the staff at Brookdale to send it back.

So he launched into a series of diatribes, including a long one about how I have been doing nothing but trying to steal from him.  I had made a bank transfer into one of his accounts from another so that I could pay his bills, which it turns out was incontrovertible proof that I was siphoning off his money.  I have made this same kind of transfer a thousand times.  Didn’t matter.

Then he insisted that he has an attorney visiting tomorrow to take away my brother’s and my proxy powers.  I don’t particularly enjoy making decisions like whether or not he should get an intubation tube if he has trouble breathing.  Who would?  But I am doing the best I can, and so is my brother.

This after a lovely morning where I organized for him with his hospice group to have a hot shower.  I don’t know how much time he has left, and before it is too late, I wanted him to have the sensation of warm water rolling down his body.  They needed me at one point so I helped lift him slowly while the nurses cleaned him off.  I held him under his right arm and supported him and watched the beads of water run down his back.

And this after I had convinced myself that I could work from his apartment during the week and had rearranged his desk so that I could be there as often as possible.  This way, when he woke up from his frequent naps, he would see me and know that he wasn’t alone.

Later I connected with the Executive Director, who is a prince of a man and has been so kind and supportive throughout the past difficult weeks.  I wanted to let him know that I was concerned, and also that this same lawyer somehow had spoken with my father about suing their assisted living community.  Apparently this scam is common and some unscrupulous attorneys reach out and find the vulnerable elderly to extract whatever legal fees they can before the end comes.

He could see how upset I was from how I was shaking.  He has seen this movie and starred in it himself as the son of someone deteriorating into an angry id and not much more.  He told me that it wasn’t really my father talking.  I don’t know.  I want to believe that.  I want to believe that this is just id, not ego, not the man who most likely brought me into the world.  I never thought I would write that sentence but I suppose it’s possible that he’s not really my father.

But it is also true that this version of the man isn’t really my father anyway.  That man disappeared sometime in May or June and I never saw it happen.  I fought hard to keep the universe from taking him from me, and while I wasn’t looking, it went ahead and reclaimed him anyway.

My time pondering this is almost done now; I convinced a relative to come visit him and she is on her way as I type.  I realize in a moment of calm that It’s only his id and not the rest of him.  I shouldn’t care about winning arguments with his id.  Ids will fight to the death because they know nothing else.  So really, the time for arguments is over.  The time for winning is over.  Now it is about honoring the man who was by dealing firmly but kindly with the man who still is.

 

The Time Shift

(deleted this by mistake – sorry for the repeat)…

Back in the days of visits to my father’s old apartment, we would have a pre-agreed upon time when I’d be arriving.  Then circumstances would come up.  I’d get Sandwiched Man type of responsibilities, or Route 9 would back up, or once in a while, I’d be attending something fun early on a Sunday afternoon and lose track of time.  A few times I even got lost in a book.  So instead of walking through my dad’s door at 2pm, it might be 2:30.  Normally I am a pretty punctual person but Sundays would be particularly challenging for some reason.  It happens.

Eventually he got used to this, even generous about it.  It’s not like he had other pressing engagements and at one point, a thousand years ago now, he was just happy to see me and spend some time together.  Because he didn’t have obligations anymore, he would refer to himself as the “time millionaire”, a reference to my once having had millions in stock options back in Silicon Valley in 1999 and 2000.  That ended for me as it did for most people back then, so for years, I was his “ex-millionaire” son.  I didn’t think it was as funny as he did.  Such was the nature of many of his jokes.

Before that transition though, in his early years of being here, he would really lay into me for being even ten minutes late.  He would tell me I was unreliable, for starters.  I couldn’t be counted on.  I won’t continue with the adjectives and invectives thrown my way.  Suffice it to say that they got to a point where even I, who until recently didn’t realize the need for shields with respect to him, had to tell him that he couldn’t talk to me that way.  Maybe that is a superpower I should have developed more quickly.

The irony is that now he has no sense of time whatsoever.  He calls so often during the workday that I’ve had to block his number from hitting my cellphone directly; I always get the message quickly, but after multiple days with over 20 phone calls per day, sometimes 5 calls in under 10 minutes, I had to put those shields up too.  Because he is sleeping so much, day and night have lost meaning for him.  He called this morning at 4:30am, a frequent occurrence.

Time has changed for me too.  People frequently use the expression “taking it one day at a time”.  I know what this means now.   I have to pace myself differently, slow things down, remember to conserve energy.

If you’ve been a caregiver, you know that conserving energy actually burns a lot of energy.  Usually by the evenings, I am pretty tired from trying hard not to get tired.

Also, I am remembering the days I spent sitting with him at his desk instead of crouched over his bed.  In those days, the biggest problem we’d have is that the YouTube classical music playlists that he created on his iPad hadn’t transferred correctly to his AppleTV.   He would insist that I stock his refrigerator with beer so that I could have one while I sat with him for an hour or more and tell each other stories.  Now he gets winded after less than 10 minutes.

I know that was only 2 months ago.  But it feels like 4 years.  I don’t know yet how to characterize the 4 years that we’ve been together.  Ask me 4 years from now, I guess.

The last time shift is that our time together is finite now.  I always knew it was true and never thought about this much before.  It didn’t seem to matter.  Now it pops into my head constantly, and I find myself trying to suppress it on most occasions.  Too much to do and for all I know, it could be months.  My father has cheated death so many times before that it’s hard to imagine that he won’t hold him off longer now than the doctors reasonably think he could.  But sometimes I let myself drift a bit, and into thinking about what time must be like for him now, and into how to make to the most of it.

The Corner Stool

Recently after some of the tougher visits with my father, I’ve made a detour to my favorite go-to, which is Jack’s Abby in Framingham.  It’s a beer hall with relentlessly knowledgeable serving staff, a huge and newly outfitted brewery, better-than-passable bar food, and most importantly, a long bar with plenty of stools.   Yesterday my family was away in Maine, so rather than come back to an empty house, I detoured there instead.

Jack’s Abby mostly makes lagers; I discovered them about 3 years ago and they’ve been my go-to beer pretty much ever since.  They moved to a downtown Framingham location about 2 years ago from a more remote outpost, and although I’d been there a few times since they opened, I didn’t realize how close they were to my dad’s place.  I actually re-discovered them during my dad’s most recent hospital stay at Metrowest hospital not far away.  I didn’t realize how not far away it was until I looked up how to get there on Google Maps, only to discover that the brew hall was 0.2 miles away.  Less than 1,000 feet actually.  How did I not realize that before?

Pathetic.

Anyway, I arrived and the place was mobbed.  There were no seats at the bar.  Then I looked again and noticed a lone barstool jammed in a corner between 2 couples.  Ordinarily I am not that guy.  Nowadays I am feeling less constrained by those kinds of social norms – so I went for it.  I jammed into the corner and asked them all to move so that I could have the spot.  One couple thought it was pretty funny.  The other displayed a reaction that can be described best as more typical in Massachusetts than in states where people have a sense of humor.  Just to tweak them further, I took a selfie.

I sat for about a half hour and had 2 half pints, one of the spicier version of their dark lager, and one of the fruitier version of their hoppy lager.  They were good – the beers there usually are, even the ones that are experiments.  But really what I had was time alone without actually having to be alone.  Anonymity in crowds is one of my go-to comforts.  I paid $20 for those 2 drinks and a salad; what that $20 really bought me was a transition from being by my father’s bedside to pivoting back to my regular environment.

I am interested in brewing so I talked to the eager bartenders, who never seem to be the same people twice, about what’s coming next and why certain things get brewed at certain times of year and what day parts are busy and whether those 2 people across the bar are on as awkward of a first date as it seemed and if the Sirius station is going to play any song by Tears for Fears, why “Head Over Heels?”.  Really I just wanted to talk about anything besides hospice or the paperwork I had recently signed that no child ever wants to sign, but someday might be forced to.

Jack’s Abby has been very good to me in recent weeks – yes, the beer is good, but the corner barstool is especially good.  I have my beer and a bite, let the din wash over my fears and return me to regular life, and then am on my way.

 

 

The Good Boy

I know it has been a while since I wrote — more on that later.  For now, I wanted to relay a conversation I had with my father today.

Quick note to get everyone up to speed on plot: about 6 weeks ago, my dad started acting in a way that I most charitably could describe as erratic.  He started forgetting to take medication, which for him is very unusual.  Or it was anyway.  He started being borderline abusive to the team helping to take care of him.  And he started arguing medical results with his doctor.  In early June, I was in Atlanta on a work trip and I’d heard that he had refused hospitalization after his physician had found his kidney numbers plummeting.  At the time I understood his viewpoint because once in the hospital system in America, all bets are off, and really, what could do they do anyway?  More tests?

Since then, here is the sequence: another doctor appointment, a week-long hospitalization over July 4th for severe edema and CHF, my father refusing enough tests that they booted him from the hospital, a terminal diagnosis with a one-month time frame, a last-minute scramble to move his apartment to assisted living, hospice sign-up, a visit from my brother, firing the original VNA and replacing them with another that actually returns my phone calls, and most of all, a highly diminished quality of life.  Really, the bottom fell out.

On that last point: my dad until 6 weeks ago could shuffle around his place and get himself to his favorite spots.  The desk where his iPad lived.  His reclining motorized chair.  The stove which he never lit but on which he ate everything.  His refrigerator which housed his Diet Coke.  The living room table where occasionally he would take a meal.  His scooter which he would use once a week to get his mail and terrorize the other residents.  The bed that he and my mother probably bought in Cleveland in the early 1960’s where he slept every night.

The picture I’ve shown is his old living room — now empty.

That world is over now.  Even that bed has about 2 more days to go before it’s replaced with a hospital bed because he can’t get out of the one he has and it’s too hard for the staff to reach down to where he normally is.  He can barely move.  He can see the Diet Coke on the nightstand, but can’t quite reach it.  It is Tantalus, come to life.

Today I sat with him on that bed, maybe for the last time.  I used to sit with him at his desk, but now usually he is half asleep in a wheelchair or in bed.  Recently he has been having nightmares where my mother visits him and tells him about everything he has done wrong.  How he was too cheap to visit his grandchildren in California, how his English should be better, how he should have been a better husband and father.  Then he looked up at me with moist eyes — and I mean up, because he was laying down and I was sitting – and he told me that he was trying to be a good boy.

In a way this broke my heart.  My dad was known for many things as a father but reassurance was not among them.  I can see him turning the voice that he employed on my brother and me on himself and unlike the two of us, he doesn’t have well-developed defenses.  Boys who grew up 80 years ago did not develop those kinds of defenses against their fathers the way that those of us reared in the Reagan era did.  It also broke my heart a bit because there is some part of him that knows that although he has cheated death so many times — so many times — the end is coming soon.

But then, I know that already.  Soon might be a week, or a month, or 3 months.  That part I am almost ready for.

So over the past few weeks, it has made me think about the last 4 years and all the things I did right, and all the things I did wrong.  I made a lot of mistakes.  And yet — I know I did the best I could.  There is really nothing more I could have done while still being the Sandwiched Man and keeping the rest of the plates spinning.  I had a lot of plates going, still do.

I think that is true for many of us.  My father wasn’t raised to be the kind of father that I try to be.  Being a husband and father and son and friend and volunteer and breadwinner and also being oneself is hard.  Being Sandwiched is hard.  It might be the hardest thing.

Hospice can help him with the physical symptoms that are about to come his way.  Kidney failure is kind – it’s a sleepy end.  Already it has begun to lay its fingers on him; the insomnia that he complained about 6 weeks ago was actually narcolepsy caused during the day that rising creatinine levels.  It’s sleep, and it’s natural, and nightmares aside, it is peaceful.  Congestive heart failure is less kind.   I can’t solve that.

What I tried to do and hope I can do is help ease his guilt, and keep telling him what I did today.  Which was not about being a “good boy”.  I don’t even know what that means, and I know for myself now that striving for it implies that there is an alternative to avoid.  It’s simple: you did the best you could.  The best you could.  That’s enough.

It’s also the best I can do.  I’m OK with this for myself now regardless of what comes next, so hope I can get this to be OK for him too.