Growing Up and Growing Old

I expected to be wise by thirty-one; I thought I would, at least, understand adulthood. The truth is that I had lived away from family for thirteen years and had been relieved of all eldest-child responsibility by my younger brother. A stoic and solid kind of guy, my brother is the one I call when I need to buy a car or get my computer fixed. He’s a wellspring of practical knowledge, a reliable family man, someone to depend upon. I, on the other hand, am a bit flaky, a bit emotional, and not as practical as you would anticipate an emergency physician would be. He owns a big house in the suburbs where he lives with his wife and daughter. I rent a studio loft in the city and spend my money flying off to visit friends on a whim.

When my paternal grandmother called me a week after I had moved back to Hamilton, it was under the guise of a social call. She asked how I was, and I mentioned that I was getting over being sick. She said she was feeling ill as well, and when I pressed her, she described the symptoms of a stroke or transient ischaemic attack, a mini-stroke. Suddenly dizzy and weak, she walked, as she put it, “like a drunk”. She was unable to read the signs in the supermarket and was having a hard time understanding her brother and sister-in-law when they spoke. The symptoms had abated a bit over the past hour, but she still was not feeling quite right.

Had Nana called any time in the previous thirteen years, I would have hung up the phone and called my brother. He would have coordinated Nana’s transport to the hospital, after gentling cajoling her into a vehicle. He would have alerted our father and stepmother, from whom I am never quite fully estranged, but whom I don’t speak with except under duress. But I now lived close to Nana’s house, so I drove there, and  packaged her into my car against her protestations and sat with her in the emergency department overnight as she was questioned, prodded, scanned, and referred to the stroke prevention clinic. I drove her home as dawn was breaking, through now-foreign streets I had once known as a teenager.

Not long after, I received a text message from my uncle, asking whether I was at the hospital. In fact, I was in nearby Toronto, browsing rows of unreasonably expensive superfoods with a close friend. Nevertheless, when I learned that my maternal grandfather had been admitted to hospital in Hamilton, it fell to me to make phone calls. I questioned the senior resident on the other line: Why was Granddad admitted? What was the plan for imaging? What treatment was he receiving? She asked me whether Granddad would want CPR, intubation, an intensive care unit stay, should it come to that.

On the day after his admission to hospital, I visited Granddad on the ward. I arrived in scrubs, a cap covering my short hair. Shrunken and small in his hospital bed, Granddad had stopped reliably recognizing me years ago; there was no chance he would now know who I was, in green head-to-toe. He was tucked into a tiny room at the end of a long hall, largely ignored by the nursing staff, as far as I could tell. The medical team had made it clear to me that they felt he should be offered no further interventions, just comfort care. He was nearly ninety, feeble, and severely demented.

I didn’t disagree with the medical team, and at a family meeting with the junior attending, junior resident, social worker, and speech language pathologist, I encouraged his wife, my Nana Luckett, to agree that CPR should be withheld if his heart stopped. I argued with my uncle, who insisted that a feeding tube should be placed, to give Granddad a fighting chance. I watched my mother cry, grieving the still-to-come death of her father. Suddenly, I was an adult, and everyone in the room was old.

In the coming weeks, I frequently snuck in to visit Granddad. Rotating through the anaesthesia service meant that I had lunch breaks and coffee breaks, and I also took the elevator up before I left work in the evening. Often, I found Granddad shivering in his bed, and I would bring warmed blankets from the metal cabinet near the nursing desk, wrapping them around his shoulders and covering his legs. He was usually polite, save for the time he yelled at me for calling him Granddad. I always called him Mr. Luckett after that.

I didn’t say much when I visited, and he didn’t say much to me. When I asked how he was, he always said he was fine, whether he had oxygen flowing through a mask on his face or was grimacing in pain as he struggled to find a comfortable position on the hard and lumpy hospital mattress. Mostly, I just sat with him and watched him be impossibly old, tucked into a faded and broken corner of a crumbling hospital wing.

It wasn’t so hard to remember being lifted by Granddad to peer into Nana’s antique sewing boxes, stowed on high shelves away from sticky, crumby fingers. Still, it was hard to believe that the feeble arms that lay, motionless, on dingy white sheets were the same arms that had lifted me. It was easy to remember the funny voices Granddad read text in, the exuberance with which he enunciated the most mundane of phrases for my benefit. Still, it was hard to hear that voice in the choked squawk Granddad used now. Unable to swallow without choking, Granddad grew thinner. A feeding tube was placed, through his nose, and he pulled it partway out during the night, thick meal replacement liquid flowing into his shrivelled lungs.

Sometimes Nana Luckett was at the hospital when I arrived. I liked talking to her, but dreaded running into her in the halls; she shuffled slowly with her walker, and I couldn’t help but think about how, with time, that would be me. Someday I would not travel the world with ease, run marathons, and stride purposefully, but would instead grip the handles of a walker and pick my way carefully across a hospital corridor. A misstep could mean a fall. A fall, a broken hip. A broken hip, a death sentence.

I rotated off the anaesthesia service. I visited Granddad less often. His confusion had upset me. His jagged teeth and patchy scruff were incompatible with the tall, strong, funny man I remembered from my childhood.

His death, when it came, was a relief, a release from his suffering and from the dark and gloomy hospital ward where he lived his last months. It was a relief for me, too, an end to the grief and confusion of visiting a man who no longer knew my face, who was a skin shroud stretched over dry and brittle bones.

When I arrived at the hospital to say my last goodbyes, I found Granddad surrounded by family. His nurse had carefully shaved the paper-thin skin of his grey face, and he looked tidier than I had seen him in months. He wore gold-rimmed glasses, and I wondered where they had been these past weeks. His mouth was an “O’” as if death had caught him by surprise in much the same way that adulthood had crept up on me.

We didn’t have a funeral, but held a memorial service several weeks later, by which time Granddad was a jar of dust. I wonder if it’s rare that funerals and memorials truly are a celebration of life; maybe it was our distance from his death that allowed it, but Granddad’s was. We laughed as my uncle talked about my Granddad’s confidence, his love of puns, his life-of-the-party energy. My uncle guided us through a slideshow of photographs: Granddad as a child on the English countryside, Granddad as a teenager in the uniform of the Royal Air Force, Granddad and Nana on the day of their engagement. There, in the photographs, was the story of Bernard Luckett, but there also was the story of me, of my brothers, of my cousins. There we were, from my youngest brother at thirteen through to my older cousins, with spouses and children of their own.

And there, in the photographs, was the story of how we, the youthful bearers of the family standard, would one day be surprised by old age, surprised by death, our mouths stretched in an expression of disbelief.

Further Reading:

• Jennifer Tsai, “Will a Career in Medicine Desensitize Me to Grief?”
• Mark Wien, “Why Doctors Are America’s Most Wanted”