Quality of Life / by Paul Peavler

The woman is saying something, but I'm not really listening. All I can do is stare at the floor. This 1993 carpet, with its three layers of magenta, navy, and hunter green. Sometimes I will glance at a chair, also seemingly a remnant from the 90s, anything so that I don't have to make eye contact with this woman, who continues to talk about things I don't want to hear. Finally, she says the words.

Quality of life.

I've heard these words before, but they never really meant anything. Sort of like when you hear the words “I love you” before you've ever actually experienced love. Suddenly, these words have meaning. And before I can process anything, they appear again.

Quality of life.

She says that at this point, it's about quality, not quantity, as if the two are separate concepts entirely. She says that they can make her comfortable. She hasn't been comfortable for years, what does this woman think her hospice can do?

My father is fighting back tears with everything that he has. I don't remember the last time I saw him cry, if ever. That's just not our way. But here he is, reaching for a Kleenex and wiping his face. Choking back the tears, asking the woman for forgiveness. Mom was always the crier in the family.

Now the doctor enters the room. He shakes our hands and says that it's nice to meet us. I wish I could say the same, but honestly, I've already forgotten his name. All I can focus on is the lint on the bottom of his pants leg. His loafers are worn and dull. He says that they've exhausted all of the options they have at their disposal. He says that she has gone septic, and the antibiotics can't stay ahead of the infections, and that they're destroying her heart at the same time. Her heart rate is up, her blood pressure is down, and there's nothing more that they can do.

He says that it's time to start thinking about quality of life.

What does this man know about the quality of my mother’s life? He’s only seen the worst part of it. He didn't see the way she was when I was growing up. He didn't see her when she and my father were struggling to make ends meet and they refused to accept handouts or charity. He didn't see her working hard for years and sacrificing so that I didn't have to go without. He never saw her take care of me when I was in the hospital to have surgery at four, never saw her console me when relationships ended, never saw her drive me back and forth to football practice or the movies. He never saw her be there all the times that I needed her.

That was the quality of her life.

I find myself wondering how they can keep saying these words. How much quality can there be left? She's in constant pain at this point. When she's not in pain, it's because the pain medication has completely taken her out of everything around her. This is not the quality of my mother’s life.

My father continues to talk to these quality people, so I make my way to her room in the ICU. I haven't spoken to her very much over the last few months as she's been in and out of the hospital, and now I'm about to go talk to her about the end of her life. Living in another state has been a convenient excuse to make my presence scarce, but it's not the whole reason. I don't know how to deal with this. I've experienced loss at times in my life, but I was either too young to comprehend what was happening, or I had lost touch. Now it’s staring me in the face, and I have no choice.

She says she loves me. I reciprocate. She says that she’s proud of me and she wishes things had been different. I reciprocate. She says that she will be watching over me and that we will see each other again someday.

Four days later, I get a text message from my father. She’s now under continuous hospice care. He says that she is doing much worse than expected, and that I should probably come home, so I make the interstate drive as soon as I can.

Everything is different. There is now a bed in the living room, and breathing equipment where a couch once rested. People are here, members of her family, but nobody is saying much. She’s slipping in and out of consciousness, and her breathing is heavy and forced. Occasionally, she will make noises like she’s trying to say something, but the words won’t come out. There is no expression on her face, no words in her voice, but the pain is blinding and deafening.

Is this the quality of life they mentioned?

Within hours, she’s gone. The breathing has stopped. The face is the same. The pain is transferred. I cry. My father cries. We hug for the first time in years. Mom was always the hugger in the family.

I’m so sorry. I’m here for you. Let me know if you need anything. She’s with God now.

The same God that put her in this situation?

The thing I never expected about losing someone so close is the guilt. Grief is expected, but it was far less than I ever imagined, and I felt guilty about that. Shouldn’t I be crying more? She’s been gone less than a day, and I’m watching TV. The movies say I should be unresponsive for weeks.

I could have done more. I could have called more. She never saw me get married. She never got any grandchildren. She said she was proud of me, but how could she be? The last time I saw her before going into the hospital, I told her I no longer believed in God, and she broke down and kept asking where she went wrong. Guilt.

I began writing this almost nine months ago, as a way to capture my feelings and emotion in a way that I can’t express in words. Like my father, I don’t talk about my feelings. Mom was always the emotional one in the family.

But it felt incomplete, and so I left it and questioned whether I would ever return.

As the months went on, my father and I began to talk about our emotions, our feelings, our experiences. We share the guilt; could we have been nicer, more understanding? What could we have done to make those final months and days better? I tell him I feel guilty about telling her I no longer believe, and realize that I am now telling him for the first time. He says that he suspected as much, and I realize that he knows me better than I ever understood, despite the fact that we rarely talk about our feelings.

He says that he’s lonely. He’s bored. He goes to work, he comes home, he goes to work, and he comes home. He laments that even when she required extensive care and assistance that he never imagined he would have to provide, at least she was there. Now, there is nothing. A giant void, not just in his life, but in his essence. She was his life, and now she was gone.

Is this the quality of life they spoke of?

It’s an odd thing, how we humans react to grief. We seem to require tragedy to truly embrace those around us. In the wake of my mother’s death, I became closer to my father than I ever imagined. We discussed politics, movies, and games. We contemplated religion, faith, the origin of the universe. He visited my house more often in 6 months than he had in the previous 6 years. Things were difficult, but improving.

Maybe that quality of life was slowly returning.

It’s been 260 days since She passed. I’m working late on a Thursday, and I get a call. It’s the HR department from my father’s employer. The woman on the other end is asking me if I’ve heard from my father recently. I spoke to him this weekend. She says that he hasn’t been into work in two days, and he isn’t answering his phone or text messages. It’s not like him to miss work, and even less like him to not tell anyone. She continues to say some things, but I’m not processing any of it.

He’s okay. He’s got to be okay. He’s just tired of work, and taking a break. Maybe he slipped and fell and can’t get to the phone. I just talked to him a few days ago.

I call some family and ask them to check on him. They call back minutes later. I need to come home, now. My father has passed.

Is this now the quality of my life?

The coroner says that I can’t go into the house until they get things cleaned up. His name is Spanky, which provides an unsettling juxtaposition with his job description. He says something about a massive heart attack. He slipped and fell, and there is some blood. It looks like it happened two days ago. They should be able to get him cleaned up, but they don’t want me to see him this way. We just need to wait for the funeral home to come pick him up.

Everything is a blur. It’s been raining outside, and there is a layer of mist on everything. Is that a tear, or a rain drop?

We move into the house as they take his body away. It looks exactly as I remember it, but it smells of death. It’s quiet in a way that I’ve never heard it be quiet before. The coroner attempts to clean the mess, and the smell of bereavement is replaced by the smell of bleach. He walks me through some paperwork and says some things that I’ve already forgotten, but all I can see is the bleach stain on his pants.

I’m so sorry. I’m here for you. Let me know if you need anything. He’s with God now.

There’s an outpouring of condolences and offers of assistance. Family members I haven’t spoken to in years. Friends I haven’t seen in years. Co-workers of his that I’ve never met. I’ve talked to more people in 12 hours than I have in the last 12 years.

I’ve never felt so alone in my life.

When She went, it was excruciatingly slow. She was sick for years, and passing almost seemed like a relief. A relief for her, a relief for the family, a relief for me. Because of that, the guilt was immediate. I spent so many years expecting it to happen, I never considered what it would actually be like when it did. The grief was entwined with guilt, as if each one fueled the other; I felt guilty for not grieving properly, which allowed me to properly grieve.

When He went, it was excruciatingly fast. There was no preparation. He wasn’t sick. He was still self-sufficient. Our relationship was stronger than ever. He had become more than my father; he had become my friend. I was simultaneously losing three people – a father, a best friend, and the strongest remaining link to my mother, less than a year after she passed. I never got those final days with him, to tell him that I loved him and that I was proud of him. The grief was sudden and overwhelming.

But eventually, it fed the guilt. How could I have not seen this coming? What was I missing? Why was I letting him live alone, with no plan for someone to check in on him regularly? I could have done more. I could have called more. He never saw me get married, and he never got any grandchildren.

After the last time I visited him, as I was driving back to my house, I was listening to the radio. This American Life, episode #438, titled Father’s Day 2011, and it was all about cherishing your father and telling them you love them, because you never know when it could be your last chance. I resolved to myself that when I got home, I would call my father and tell him that I loved him, which I hadn’t done since She passed. But I didn’t. I’ll tell him the next time he comes to visit me. But I didn’t. Mom was always the emotional one in the family, after all.

The guilt is now disabling.

So now, here I am, once again feeding my feelings into this keyboard. This story now feels complete in a way it didn’t just nine months ago, but for a reason I never expected, and with an ending I never imagined. It’s difficult to lose a parent, but to lose both in such a short time frame is disorienting and disarming. To whom do I turn now? Where do I share the grief, and the guilt? How do I express the things I always wanted to say, but never did? There was always time. Even when She died, He was still there. I had time to tell him all the things I ever wanted to say, and he would act as a surrogate for her love.

But now that time is gone, and the words are left unsaid. The emotions are left behind, constipated by my inability to communicate them. 

It's times like this that I understand why people turn to religion. There would be some comfort in not feeling so alone. There would be comfort in having something there – something to turn to, or something to blame.

It’s an odd thing, how we humans deal with grief. These words that I could never write, that I could never share, after my mother died are now flowing forth after my father died. I talked to a friend last night that I haven’t talked to in three years. I spoke with an Uncle this morning that I haven’t seen since high school. But for the first time, I truly understand what my father meant when talked about my mother’s death. There is now a void, not just in my life, but in my essence. Our family has been dwindled to just myself. There is a piece missing that will never come back, that nothing can ever fill. Now, I’m expected to be strong and keep it together, for the family. Dad was always the strong one in the family.

Is this the quality of life they mentioned?