I haven’t been good at long-form personal communication in the last few years, partly for lack of leisure, partly because, well, these years have been rough on many fronts (outline here). But this seems like a time when telling everybody everything at once will be more efficient, and perhaps easier on me.
My father, Al Straughan, had long been ill – although, as he often emphasized, not with anything that was likely to kill him soon. In spite of 50 years of smoking, no exercise, and a lifetime of being overweight, he had a healthy heart, and there’s no family history of cancer. The lungs… not so good. In the last three years he was in the hospital just about every month with a lung infection, and the doctors seemed unable to find a root cause, except a general diagnosis of COPD.
Several years ago they did a bronchoscopy to examine an obstruction in his lung, and found a pea that Dad must have accidentally aspirated some time before. If you’re a fan of House, you may recall an episode in which a patient coughed up part of a lung for exactly this reason. Dad’s bronchi were weakened or damaged as a result, so a stent was put in at that time. (I may be getting the details wrong because I was usually not geographically close, and such a lot happened that it was hard to keep track.)
Dad had been living in the UK for at least 15 years with his third wife, Ruth, who is British. They met in Jakarta around 1987 or ’88 – he was there on a contract job, she was working for the Hilton hotel chain as a trainer (Ruth, forgive me if I get these details wrong, too). They met at a party when Dad walked up to her and said: “For once, I’d like to dance with a woman I can look in the eye.” Ruth is 6′ tall, Dad was 6’3″.
They came together to my wedding to Enrico in 1989, and soon thereafter moved to Texas, then the Maldives, then “home” to the UK (though Ruth had been away as much as there: she’d lived in Hong Kong for 15 years, then Bali…). As it turned out, the UK, with its National Health System, was the best possible place for them. Though Dad never became a citizen nor even had time to contribute much to the national coffers, the NHS took excellent and expensive care of him. There were a few procedures they chose to pay for privately to shorten wait time when Dad was in pain, but the NHS did most of it, and bore most of the cost. I am deeply grateful for this, and wish we had a national health system here in the US – it’s a matter of social justice.
Dad’s other area of health troubles was arthritis. Being overweight and never having exercised routinely contributed to the degeneration of his bones and joints such as we all suffer as we get older. He had his first knee surgery to clean up damaged cartilage in 1982, and his first knee replacement far earlier than doctors usually like to do them: the artificial joint wears out and will eventually need to be replaced again, and this is major surgery. Over the years they replaced the other knee, had to do repair work on one or both at least once, and one of these surgeries resulted in Dad being in intensive care. He had other surgeries to try to alleviate pain that was being “referred” from his deteriorating spinal column all over his body. Recently they tried implanting electrodes in his spinal cord which he could activate using a device outside his body, to interrupt the pain signals before they reached his brain. Apparently these devices are hard to tune; it was never wholly successful in stopping the pain, which was at times so severe as to keep him confined to bed. He had been effectively disabled by pain for over 10 years.
For most of this time, I was living relatively nearby in Italy, and could get over for visits fairly often, especially once the era of low-cost airlines began (I am grateful to them, too). Those of us who have internationally-scattered families know the pains of being far away when a loved one needs us. There was one week in which my mother, in Iowa, was having a large tumor removed from her ovary, and Dad, in the UK, was having yet another major operation that could have landed him in intensive care again. I chose to stay in Europe in case Dad needed me. Mom was attended by her sister, and her tumor turned out to be benign, but she never forgave me for not being with her – one of the causes of our eventual estrangement.
In 2008 I moved to the US, and visits to Dad and Ruth became fewer. I stopped by on my way to India on my last major trip for Sun Microsystems in March, 2010, then did not travel overseas for over a year. I was finally able to see them again this June, when Joyent sent me to Italy, so I extended the trip a bit and popped up to the UK for a weekend.
I can’t say that the deterioration I saw in June was shocking; I had known most of what was going on with him (I assume), and could observe some for myself in the many phone calls during which he was coughing, quickly out of breath, or simply too tired for sustained conversation. But I was deeply saddened. Caring for him had become a full-time job for him and Ruth both. His world had shrunk to their small home, sometimes just the bedroom, and the TV. This seemed cruel for a man who had lived large, hard, and adventurously all over the world in his 72 years.
I was also concerned for Ruth, who had been his only caregiver in all this time. There was little I could do to help from Italy. Again, international divides complicate everything: neither Dad nor I was living in our passport country, and by the time I moved back to the US, he was uninsurable here and could not risk even a visit to his beloved birthplace, New Orleans. This is why I give very short shrift to the brainwashed Americans who shriek: “Socialized medicine is evil! It’s not the American way!” Justice for all? Yeah. Tell me how it is right that my father could not afford to visit his native country before he died. Then go fuck yourselves.
We all knew that this June’s visit might be the last time I would see my father. I didn’t (and still don’t) understand what all was going on, but he was clearly going downhill, and he even stated baldly that, whenever he did go, there likely wouldn’t be time for me to arrive at his bedside. But he also told me that one of his doctors had said there was no reason he couldn’t live another 15 years. Then, at another moment, he mentioned that he had looked into assisted suicide in Switzerland, but could not afford it. This was all confusing, though understandable. I can’t know for sure how I would react in his situation, and I shudder to think of becoming as reduced and confined as he was. I thought of my aunt Rosie, who told me in January of 2006 that she had had enough (after 10 years of severe health problems) and was ready to go. I had replied: “I will miss you terribly, but if you feel it’s time, you should go.” She died in late March of that year.
Last weekend I was in Austin to catch up with an old school friend who was visiting mutual friends, and for my daughter Rossella’s birthday. My brother Ian also lives in Austin.
I received email from Ruth letting me know that Dad was in hospital again, with what seemed to be yet another by-now-routine lung infection. Ruth and I spoke on Sunday; he was wearing an oxygen mask and unable to talk on the phone. The doctors were not happy with his oxygen levels, and could not get them up.
That evening (would have been the deep of night in the UK), Ruth called again. He was hemorrhaging from his lungs for unknown reasons (they suspected the stent may have got misplaced) and not expected to live til morning.
I called Ross and Ian, we sat together and talked and drank for a while, but there wasn’t anything we could do, even for each other. I guess I slept a bit that night, probably not much.
The next day Ruth reported that he had regained consciousness sufficiently to let her and the doctors know that he wanted to fight for his life. We should have expected that, I suppose – going gently was just not in his character. Later that day he was transferred by ambulance to a lung hospital some distance away. He survived the trip, and another night passed in observation (and no sleep for anybody).
Tuesday he was “well” enough for an exploratory bronchoscopy. They found that the stent had indeed moved, in a way that would require surgery under general anesthesia to fix. His other lung was also “compromised”. His condition was such that he might not survive anesthesia and, even if he did, would be on a respirator. It was kinder to opt for palliative treatment and let him slip quietly away, which he did Tuesday evening, with Ruth beside him.
Ross, Ian and I will be flying over in the next week for a funeral with our English family and friends. Sometime later in the year, we will arrange a jazz funeral and burial of his ashes in New Orleans, I hope in St Roch cemetery where his parents are. It should be one hell of a party. We hope all those who knew and loved Al will be able to join us.
My eternal gratitude goes to Ruth, who (besides being a wonderful person whom I’d love anyway) did so much for him, for so long. Not out of any spirit of self-sacrifice, but because she loved him. We could all count ourselves fortunate to be loved so well. I hope that now the rest of us will have a chance to do some things for her.
photos and other memorabilia here