Letters to Michael:  Guatemala City-Day two

Dear Michael it is the 6:00 am the morning of April 14^th and finally, they let me see you.  You seem so peaceful today.  Just sleeping and breathing on your own.  It is a little more than 12 hours since being admitted to the hospital and thankfully your vital signs are stable and the nurse is taking really good care of you.  The doctor on call for the ICU tells me that you had a little rough patch during the night but now you seem to be comfortable and resting.  I realize that, while I hate to leave, this is the best time for me to get back to Antiqua to gather up all our things and then hurry back to you.  I have called a van service for 11:00 and until then I will just wait here to see you intermittently.  Last night a doctor in the ER let me use his computer to send some e-mails off to Peter and Page.  Since they are planning on meeting us in Huatulco I needed to let them know right away that we wouldn’t be going there with them.  I wanted them to be able to change their plans if they chose to, and let them know that our travel plans had definitely changed.  I was so tired and upset after you left for the ICU that I forgot to tell them what hospital you were in and that they should alert your family.  I figured you would rest for a few days, just like the doctor said, and then we would be on our way home.  This was not the time to worry the family when you would be going home soon. 

At about 10:00 am I got a call from my daughter, Page. An intern found me in the waiting room and told me that she was trying to reach me.  By some stroke of luck, on Page’s part, she found the correct hospital and made arrangements to drop everything and to come stay with us.   She told me she would arrive on a 7:00 pm flight and would be there with me to help with translation and offer support.  As I hung up from talking to her, a new intern on your case told me that the neurologist had been in, evaluated you, and that your neurological signs were deteriorating.  They were just waiting to take you to MRI.  Once again, bad news, and I had no way to contact anyone. I was so angry that they had just left me out in that waiting room for hours without any updates.  I had no one to help me with translation and no way to contact anyone.  I expressed my anger to the intern and demanded that they let me stand by your bed until you were wheeled away for tests.  Seeing you helped me calm down, how could the news be so bad when you were sleeping so peacefully?    I thought you seemed even more relaxed when I spoke to you.  I was sure you could hear me. You even flinched as they took off one of the electrodes on your hairy chest I thought that was a good sign, reacting to pain.  I thought that you were just letting your brain heal from the nasty bleed and you would be fine.  Miracles happen and I wanted one today.  

Since you were off to MRI, I decided it was the still the best time to make that long round- trip to Antiqua.  I needed to get a hotel room near the hospital, and cancel our current one in Antiqua along with the rest of our reserved tours that we’d booked.  Except for the waiting room debacle, during most of this ordeal I did have the support of the American Embassy.  They posted a guy, named John, on call who I could contact anytime I needed him for anything.  I would point to the phone number and one of nurses (none spoke English) would make the call.    John helped me navigate the difficult language barrier so that I could communicate with the hospital personnel.  The trip to Antiqua was horrible.  There was too much traffic making the trip twice as long as it should have been.  I wasn’t able to get to the hospital for more than four agonizing hours.  I was in the dark about the results of the MRI and torn between being beside you and getting our things.  However, I was lucky to have the kindness of another passenger who lent me his cell phone.  I was able to call John and get him to call the hospital for me.  I needed reassurance and to find out how you were. 

John made the necessary calls and called back when we were returning to Guatemala City, stuck in a major traffic jam of Chicken Buses, produce trucks, and families headed in same direction.   John reassured me that you were stable and doing fine.  That would buy me some time to get to the new hotel, drop off all our luggage, shower, change and get back to you by about 4 pm or so.   The doctor had told me that you could sleep like this for days while your brain was healing.  I had heard about people who had devastating strokes llike yours. They go into comas, rest and heal, and recover quite well.  I was hopeful you would be one of these people.  However, I also worried about the extent of your deficits and how well you might handle the difficulties that you were about to face.  How would you do with a long rehabilitation?  What if you could never fully recover?  Stuck in traffic, I had a lot of time to think. 

When I got back to the hospital it was about 4:30 pm.  You had been moved to another room, and again, I found you sound asleep and breathing on your own.  The nurse in me noticed that your heart was a bit irritable with intermittent atrial fibrillation.  However the respiratory team had been in, and the congestion, that I noticed earlier in your lungs, was gone.  Your nurse’s name was America.  What a fitting name I thought.  We will get you back to America!  When I asked America about the MRI results she sent the doctor to talk to me.  That is when the plans to take you home drastically changed.  He told me you were walking a fine line.  You were sitting on the edge of life and death and I needed to decide what to do next.  More shocked than upset, I became the nurse again, and I asked to see the MRI. 

The MRI told the story.  You had a much larger the bleed than the night before.  It had grown from 3 cm to nearly filling your whole left brain.  “This bleed is not consistent with life,” he bluntly told me.  “You need to tell us what you want us to do.”  My educated brain told me that what I saw on the MRI was definitely not compatible with life.  Even if I wanted to have you intubated and kept on life support it would only be a matter of time before you would die anyway.  I used to kid you that my love for you was so great that if anything ever happened I would intubate you and put you in the backroom with a nurse so I could visit you every day.  Then I pictured visiting you in a nursing home with you communicating we me no differently than you were today.  I realized my love for you was now being put to the test.  I needed to tell them your wishes, not mine.  It is shocking how calm I felt. I was having another out of body experience.  It was as if you were just one of my patients and I was the one talking to the wife, giving the bad news. 

Without hesitation I told the doctor that you had no wish to live in any capacity less than what you were before the stroke.  You had told me often in the past year, “If I die tomorrow, let me go.  I am not afraid; I’ve had a good life.  Just cremate me, send my ashes out to sea, or where ever you like, but don’t be sad, you are a strong woman and you will be fine.”  Here I stood, not fine or strong, faced with that decision and your wishes echoing in my head.  I needed to do the loving thing and let you go.  It was another out of body experience as I said, “We should let him go.  He wanted it this way.”  Like most of us, you always said that when it was time you wanted to go quickly, and painlessly, and I need to respect that.  The doctor informed me that this process could take hours to days.  They would continue to give you medications, monitor you and give you good care.  

When I saw you again, lying there, still peacefully breathing on your own, my mind switched over to your wife again. I said "Okay Michael you get your wish, to go as you wanted."  But I hugged you and told you not to go, begged you to stay, asked you to just stop this stupid nightmare and just get better.  Most of all I begged you to wait for Page. When I talked to you it seemed like your heart rate became normal again and slowed a bit.  So I pleaded with you, “Please Michael, don’t go now, wait for Page. There was no way I could face the next few hours or days alone.  It seemed forever before Page arrived.  But you waited with me like I’d requested.  You were always good like that, doing what I wanted most of the time.  It was a relief to see Page walk through the door, and yet, terribly sad to face the reality of the situation all over again.  We hugged you and talked to you about our love for you. It was hard and we both cried.  Being a strong guy you seemed so comfortable, heart beating, and breathing on your own.  I hoped you would last just a few more days so I could adjust to this horrific reality.   But you had other plans and gave us just a few more hours.

Before you took your last breath, sometime after midnight Pacific Time, on April 15th, I remember putting my forehead next to your cheek, closing my eyes and wishing this part of loving you was not a reality.  How could I possibly let you go and walk out of this hospital without you by my side?  Within seconds my mind cleared, and for a moment, the fear disappeared.  Still hanging on to you tight I could feel the warmth of your face against mine, your heart beating beneath my hand and feel your breathing slowing, almost matching mine.  Then, out of nowhere, the vision of you walking across the patio in Boulder, Colorado came into my mind as clearly as the day it occurred, twenty-one years ago.  This was our first meeting, a story you loved to tell anyone who would listen. It was parent’s weekend; both of us were there to see our sons.  I could see you walking toward me, amazingly handsome, wearing that red stripped, long sleeve dress shirt and beige slacks that I loved, followed by that big, toothy, white grin that wowed me.  You stopped, stuck out your right hand and said, “Hello, my name is Michael, did they send you here to do this on your own?”