Not with his boots on

After thirteen months of helping sustain my father's life, his pacemaker has turned on him. First, the tissue around the appliance began to break down. Then, it appeared infection was setting in.

The backstory: A year ago at Thanksgiving, after he was found semi-conscious in his bed at his nursing home, his heart rate at 12 beats per minute, my mother asked his doctors to give him a pacemaker. She was clearly not ready to let him go. Neither were other family members.

Yet even then I could hear his voice in my head, expressing his own take on the matter, in no uncertain terms: "When I go, I want to die with my boots on." I was ready to let him go then. His heart was clearly incapable of keeping him going without intervention. After the pacemaker, though, for a few months he did seem to have a temporary reprieve. His confusion lessened. He communicated more clearly. We realized he had likely not been getting adequate oxygen for some time. Eventually, however, with every visit, the relentless decline once again proceeded.

Then, he fell and broke a hip. The pace accelerated. It became more and more difficult to witness, helplessly, the losses, the indignities, the death by increments.

These days, he is non-responsive, spoon-fed liquids, his swallowing reflex almost non-existent, cared for by the efficient staff of the Alzheimer's ward where he has been living for three years.

So when I heard that the pacemaker, keeping his heart beating even as the rest of his body shuts down, was opting out, all I felt was . . . relief. For his sake - as well as my own.

To myself, I thought, "At last, his body is saying, enough. No more intervention, no more last-ditch efforts to keep this Alzheimer's, lung-and heart-disease ravaged body around."

However, my dear mother has been conditioned through her 80+ years to defer to the opinions of others. With her husband's opinion no longer available, she is frequently at a loss when faced with an important (or everyday) decision. When really stuck, she has turned more and more to polling her offspring to a) reach a consensus she agrees with or b) until she feels her grown children cannot fault her for failing to seek their advice. (Sometimes, the outcome is murkier, and it seems she may have decided to favor the most persuasive argument, or alternately, the opinion of the person she is most worried about, or another who will be visiting her soon).

Knowing the opinions of most of my siblings, it appears that this was no democratic vote; nor should it have been. In the end, it was my mother's decision to make. She is the retired R.N. who will anxiously second-guess every step taken, wondering if indeed she did everything she possibly could to help her husband, or if every decision she made was the right one, or if she should or could have done things differently.

After questioning doctors closely and hearing there was some possibility her husband had some discomfort around the infected pacemaker site, my mother asked them to administer antibiotics.

For her, it was the only decision to be made.