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The Greatest Gift

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The Tampa Tribune

Published: December 24, 2008

The feelings came back as if it had happened yesterday. My hands and voice shook as I remembered. I was attending a lecture on advance directives offered by Tampa General Hospital through the Community Church College. Thirteen years evaporated as I listened to the lecturer describe planning for the end of life.

"I've been there...I've done that," I thought as I remembered 1995 and giving the order to remove my parents from life support within six weeks of each other.

As the person with durable power of attorney for health care for my parents, I had done all the requisite legal and paper work with them. Their desires were clear and in ink, each page initialed by both of them as they lived out the end of their lives in a nursing home that was 10 minutes from my home.

I felt safe in knowing what they wanted, but something was missing. There was an empty feeling. So one quiet afternoon, I sat with my Dad and began a soft conversation. "Dad," I began, my heart beating a bit faster, "Are you afraid to die?" My father was 82 years old and in the throes of end stage renal disease. Dialysis was beginning to wear him down, but his mind was completely present and he was paying total attention.

"No," he responded, looking into my eyes. "Last month when I went into cardiac arrest and the nurses revived me, I had no fear, no pain at all. If that's what death is like, I'm not afraid."

We talked slowly and deliberately for a long time about his feelings and about mine. I took the opportunity to let him know how much I loved him and was ready for my responsibility, should the need arise.

And it did. Shortly after our conversation, my father began to suffer terribly, bleeding internally, becoming comatose and requiring many invasive medical procedures. "It's time," I thought to myself.

Conferring with my brother who had also spoken with Dad, we agreed to remove Dad from all medical procedures and life support, as his advance directive advised. His doctors agreed with our decision and said they did not know how long it might take him to die. And so he lay in a coma and I remained with him for several days.

Finally, I thought about how much I needed to touch base with the outside world, with my life and my family and my home. I stood at the foot of Dad's bed and asked myself, "What happens if I go home for the night and he dies?" And Dad's words returned to me. "I'm not afraid to die."

I remembered his calmness, his deliberateness, courage and reassurance. And so I went home for the night. The phone rang at 3 a.m. and it was the hospital. Dad had passed away peacefully.

My husband and I drove to the hospital and met my brother. I entered Dad's room bracing myself both mentally and physically for the crushing guilt I anticipated for not being there when he died. It never came.

I looked at my father whose suffering had just ended, and celebrated his life, his courage and his wisdom. He had given me permission to feel and respond to the needs of my own life in addition to his. Our conversation was the greatest gift I have ever received.

And so I stood beside him, grateful for having asked myself before I left, "What happens if Dad dies and I'm not here?"- and eternally grateful to my father for being willing to help me find an answer.

An advance directive might satisfy the requirements of the law, but not of the heart. It's legal and final and cold - words on paper, comfort for the state, the mind and eye. But speaking with my father, hearing him tell me in his own words what he wanted and that he was not afraid was comfort for my heart - and I'm hoping for his.

My husband and I both have advance directives, and each of our children has a copy. But the Community Church College class reminded me that I owe my children the gift that my father gave to me. We will talk with each of them very soon.

Judy Kramer can be reached by e-mail at JudyandOz@tampabay.rr.com.

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