When I parented my father

My dad's cancer forced me into the unlikely role of caretaker -- one I cherished and dreaded in equal measure

Published March 4, 2013 11:57PM (EST)

This article originally appeared on The Nervous Breakdown.

The Nervous Breakdown My father’s urologist projected the CAT scan on his computer screen, pointing out the major organs like battle sites on a Civil War map. My father’s body, my homeland. Bladder. Liver. Intestine. Spleen. “Here’s the right kidney,” he said, using his pen to mark the perimeter. “You can see its recognizable shape, a healthy shape and size.” We nodded, my mother, my father, and me. We knew pointing out normalities meant an abnormality was coming. Dr. Petroski inhaled. “And now here’s the left kidney,” he said, moving his pen to a dark area that did not mirror its right-hand counterpart. It was as large as my father’s liver, but misshapen, a bulge in the center like a football. “You see the difference in the shape? That’s a tumor. That’s the problem.”

Until this moment, all I wanted was a baby. I had recently turned thirty, and my husband and I had begun trying to get pregnant, or rather, we had taken the first tentative steps toward trying—a pelvic exam, a review of my monthly cycle, a bulk purchase of pregnancy tests and an ovulation predictor kit. When my father was diagnosed with cancer, I made a pact with myself: I would shepherd him through his illness as preparation for motherhood; I would give everything to that swollen left kidney as though it were the most vulnerable newborn. Once my father made it to remission, my husband and I would have the karmic green light to try to get pregnant in earnest. This, I thought, would be worth the wait.

I imagined the details of my task. My father’s kidney and corresponding adrenal gland had to be removed, and I was squeamish. There would be blood. Incisions that needed suturing. Suturing that needed cleaning. Because the kidneys process waste, there would probably be urine and fecal matter, and these would need to be disposed of in a sanitary manner during my father’s recovery. His house would need to be cleaned. His meals cooked. His business—a small bar a few blocks from where he lived—managed.

I was his only child, and this is just how I wanted it. Because I wanted all of it. I adored my funny, loving father, and I wanted his every necessity—his dependence on me alone—to rip my heart open, and for compassion to fill in the fissures. Pulsing magma of compassion, alive and viscous and virile, hardening into pure, rocky strength. The way so many of my mom friends describe the sensation of holding their babies, the very seams of their bodies gashed by love. If I could see my father’s cancer through, all the way through without flinching, without ducking, without drugs, then I would know I was ready for dirty diapers and nighttime feedings and near-constant worry and crazy, consuming love. Ready to be someone’s mother.

So I set about cancer cheerily, preparing for the day of surgery with a nesting instinct. I took time off from teaching to pick up my father’s prescriptions and take him to doctor’s appointments. I went to the grocery store and agonized over nutrition labels to stock his kitchen with fortifying foods. I went to his bar and kept his employees informed of our schedule, filled in the ledger, ran errands for more chicken wings and limes. All this I did mostly smiling, running on a seemingly endless surge of adrenaline that made it possible for me to motor through the days on five hours’ sleep and food consumed on the fly—granola bars, vending machine potato chips, the occasional sandwich Saran-wrapped by my husband. My parents had been divorced for twenty-eight years, but had remained such close friends that my mother didn’t miss a single doctor’s appointment. She helped in every way she could, keeping records, making lists, enforcing doctor’s orders, but as the days passed, I found myself pushing away her efforts. He was my father, and I would do this, I said. I want to do this. Let me do this.

A few months before this, I had helped my mother euthanize her horse, a beautiful Morgan named Limerick. We’d had animals my whole life—dogs, cats, horses, a hamster, a goldfish that I won at the county fair, who lived over fifteen years—but my mother had always taken on the agonizing duty of putting them down. The same was true when it came to family members who died. I did not witness either of my grandparents’ deaths, as my mother did; I always arrived too late. When Limerick fell ill, I happened to be home visiting, and I insisted on staying when the vet came, insisted on holding Limerick while the vet searched for a vein, insisted on standing in the frigid pasture in February while the second shot of Percodan took hold, and Limerick reared up, flashed us the whites of her eyes, and fell over in a thunderous heap. It took more than an hour to complete the grisly process, more than an hour before we covered Limerick’s body in a blue tarp and shuffled inside.

That night, my mother grabbed my shoulders and apologized through her tears. She knew it was the first time I had seen anything die. But even as I felt the bricks of grief pile up on my chest, I was grateful to have been there. To have borne witness. To have participated in something essential, something from which our culture takes great pains to avert its eyes. I felt grown up. I felt wise. I felt alive.

When we discussed my father’s upcoming surgery, Dr. Petroski warned that my father’s previous heart attack made him high-risk for anesthesia. The stress of the drug sometimes caused cardiac arrest, he told us.

“So you’re saying I could die during the operation?” my father asked.

“Yes,” Petroski said, “that’s what I’m saying.”

I’d long imagined it would be a heart attack that killed my father. All my life, I’d been dogged by dreams about him clutching his chest while driving down the highway, collapsing in the frozen foods aisle, slumping in his stool at the bar. For one, he wore the physical profile of heart disease, carrying his forty extra pounds in his abdomen, leaving his arms and legs stringy and unmuscled. His diet consisted of an unadventurous mix of pasta, white bread sandwiches, deli meats, sodas, and packaged snack cakes that he ate by the sleeve when he came home late after a night of drinking beer. And then there was the smoking. My father had smoked two packs a day for over forty years.

It finally happened on New Year’s Eve, three years before his cancer diagnosis. My father was at the bar, not working but partying with friends, awaiting the ball drop with the rest of the nation. A slight tingle in his arms. A tightening in his chest as though someone was pressing against him in a crowd. He brushed the symptoms off, but his companions, perhaps more sober, convinced him to go to the emergency room, where he was utterly shocked to hear he’d had a mild “cardiac event.” So mild that he didn’t bother to call me until the next morning.

My husband and I finished out what was left of our semester, and then quit our jobs and moved eleven hundred miles north to be closer to my father. Despite his heavy smoking, which conjures up images of charred, ruined lungs, I was unprepared for cancer. We had no history of cancer anywhere in the family. The idea that I would lose my father fast and without fanfare had been ingrained in my psyche to the point where I’d casually discuss it with my husband, musing about where my father would be, and who he would be with, when his heart finally shut down for good. I wanted at least the chance that I would be there, holding his hand.

It disturbed me that this could happen in surgery, where nobody who loved him would be able to touch him, to talk to him, and during the next two weeks, as I shuttled him to appointments for more tests, panic festered beneath my upbeat disposition. I felt a wildness spreading through me. Though I strove not to waver in positivity around my nervous, despondent dad, I took on the pale, sleep-deprived, dehydrated look of the primal love that makes mothers rise in the middle of the night to attend their babies’ cries. A viciously protective, territorial nurturance.

It turned out not to matter. Three days before my father’s surgery, his chest x-ray revealed metastasis in his lungs. The white splotches looked like nuclear spitballs, and they were everywhere. Renal cell cancer is unique in that it doesn’t respond to chemotherapy or radiation; the survival rate of metastatic renal cell is only 9%. Since removing my father’s kidney would not likely prolong his life, Dr. Petroski canceled the surgery. “I really didn’t expect this,” he said, his Army doctor demeanor softening with sadness.

In my car, a lit cigarette balanced between his fingers, my father asked, “Will I be in pain?”

“No,” I said. Without going into the specifics of hospice and morphine, I told him there were options that would keep him out of pain, and that we would exercise them without question.

That was a Friday. I know this because I spent the weekend cleaning my father’s house. A small group of friends came over to help—it was a big job. My father’s bachelor life had accumulated years of filth we needed to rid so he could avoid infection. We scrubbed the grimy floors and combed the fridge for expired food. We wiped the fingerprints off his cabinets and shampooed the rugs. We did load after load of laundry and cleared the place of anything broken or unnecessary—all nonessentials went into a huge, rented dumpster. The bathroom was so bad that my husband wore a mask and latex gloves that went up to his elbows. I duct-taped them to his skin so the chemical cleaner he used on the bathtub wouldn’t burn him.

Again, a strange merriment took over. We joked about my father’s small collection of pornography (he’d been single for almost three decades). We marveled over my grade school pictures found in a closet. We filled a cooler with beer and drank it as we scoured. In the same way parents-to-be assemble cribs, paint nurseries, and baby-proof their homes with covered outlets and cleaning products moved out of reach, we cancer-proofed my dad’s house, readying it for this mysterious arrival.

My father wept with gratitude when he saw the work we’d done.

I was, of course, devastated that my beloved father was going to die. Dr. Petroski scheduled a battery of tests for the next week to determine where else the cancer may have spread. Typical sites for renal cell metastasis include the brain and the bones. My father could lose cognitive function and memory, become unrecognizable or unable to recognize me. His bones could be eaten away like termite-infested wood; they could pop and break in my hands as I turned him over in bed. Thoughts like these left me breathless with fear. How would I hold back my anguish then, I wondered. When would this façade crumble? My father had been looking to my mother and me to reflect what he should feel about his dying, and I worried that I would ruin what little time he had left by projecting the very worst that tumbled around inside me.

But from this fear, unanticipated calm percolated. Okay, cancer, I thought in my best moments, we will commune together. I will help you kill my father in the most humane way possible. Morphine like Percodan. A protracted euthanasia.

In this way, I made another pact with myself. I would usher my father through death and be wrecked, and the wreckage would anoint me. Saint me. I pictured my belly beginning to grow of its own accord, as though I could reproduce asexually, my love for my father big enough to become life, to take shape and breathe on its own. Death dovetailing into birth. Death creating my baby. This was the only deal I was willing to make.

Creating and ending life: they require superhuman courage. We reproduce ourselves with ourselves. We grow second selves. Because we have to. We need another self to face such destruction, such violent creation.

But this, too, would not come to pass. We finished cleaning my father’s house on Sunday. On Monday night, after a day spent together running more errands, he called me in the middle of a massive heart attack. “Don’t hang up,” he plead into the phone. “Just talk me through this. Please, honey.” But I did hang up. My mother called 911, and my husband and I rushed to meet the paramedics at my father’s house, where we saw him shrugged in his recliner chair, shirt off, an oxygen mask covering half his face. He died on the way to the hospital.

When the attending doctor delivered the news, he asked if I wanted to see my father’s body. They could tidy the room, prepare it for me. I hesitated and looked to my mother. She said I should do what I want, but that she would go in with me if I needed her there. Despite myself, I shook my head. I cannot tell you what my father looked like dead because I declined to see his body before it was cremated. I had reached the end of my bravery; the fissures in my heart once filled with compassion had turned to mica, flaking, breaking. I could not bear witness to this, and I feel now that I failed him. Ultimately, I turned away. For this, I carry an abiding shame.

Hundreds of people attended my father’s wake. Because of his bar, I’d always shared him with the public. The line shuffled slowly as people told stories and mooned over the portrait we set up, my father smiling proudly at my wedding with a vodka-cranberry in hand. It seemed so fast, people said in hushed tones. They asked how long he’d been sick. Each time I recounted the whirlwind two weeks from diagnosis to death, they said, “I’m so glad he didn’t suffer.”

I nodded in agreement. But secretly, I was not so grateful. I kept thinking of the sunny afternoon we learned the cancer had spread to my father’s lungs, when we knew he would die. In the car, he’d asked if he would be in pain. His dark eyes—the eyes I inherited, eyes I imagined passing down to my own child—flashed with the same terror as Limerick’s when she rose on her hind legs, railing one last time against death.

And I’d said no, he wouldn’t be in pain. What I meant was, I wouldn’t let him be in pain. I did not want my father to suffer; what I wanted was to keep him from suffering. Me. His only child.

Somehow, I’d come to want the cancer. Without it—with the mercy of the heart attack I’d long anticipated, an insufficient mercy if ever there was one—I felt cheated of my daughter duty and robbed of my maternity pact. My father and an unconceived baby both taken from me.

Three months have passed. My husband and I have not yet resumed our quest for pregnancy, and we don’t know when we will. Most of the time, I can hardly tolerate being touched. I wince, I cry. I inch away from the heat of his love. When I do reach for his body, it’s almost always when I menstruate. I beg him to enter my barren place. The place where whatever life I might have carried has already slipped away.

By Amy Monticello

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Cancer Civil War Death Disease Heart Attack Illness The Nervous Breakdown