I took my dad for his post-hospitalization follow-up with his pulmonary specialist of long-standing (17 years). Even my dad noticed the alarm on the doctor's face when he discovered why my mom was not there. Before I had a chance to slip him a piece of paper with my phone number on it, he slipped me a piece of paper with his private number and the message "CALL ME."
A while later, while my dad sat in the wheel chair, waiting for someone to get the computer to reboot so they could schedule his next appointment, I turned around to observe the doctor completely lost in thought, looking after us but not registering the fact that I was looking back. I can't describe that look. But I've seen it a few times in my life.
So, I called on Friday. The doctor said, based on what he'd observed during the appointment, during the hospitalization, and the months since my dad's heart attack, that "we're on the downward slide" and he was prepared to recommend beginning hospice assistance under the terms of the health plan.
The doctor said he would be happy to be wrong, but that, in any event, once started it would not be withdrawn as long as my dad was alive. (Apparently, he is not supposed to do this unless he is convinced the patient will not survive 6 months.)
What to do? What to say? When to say it? Hard questions all. Made no easier by the circumstances described below. All of the children agree: Nothing has really changed. And, for now, we'll wait.
(And thanks again for listening earlier today, Amba.)
Public Service Addendum:
My dad quit smoking almost 30 years ago at age 47. COPD has been his constant unbidden and unavoidable companion for the last dozen years, and an oxygen cannister for the last 4. It caused his heart attack. If you smoke, that's your business, but do know there is a Rubicon across which there is no return. Apparently, it happens for most about age 45, according to a simple and understated chart on display at most Kaiser Permanente locations.
By the way, if you didn't know it already, chances of getting cancer from smoking are about 1 in 10. Chances of feeling always out of breath, tethered to an oxygen container for a significant number of years are apparently higher.
This ends the obligatory reminder about the dangers of smoking.