PCa

In his sixty-second year my dad was informed of unwelcome growth; malignant, metastatic prostate cancer. In spite of his yearly visits to the urologist undifferentiated over-enthusiastic cells had divided, multiplied in and burst the confines of his prostatic capsule.

Cut it out, cut it off, irradiate, inject.

Close the stable door.

Post-op my father went about his business. He visited his children, drank with friends, smoked a pipe, laughed, tended his garden, he welcomed the birth of grandchildren.

Doctors are reluctant to share the prognosis, to open the curtain and give the audience an awareness of the last act. We are growing to death, but Medicine denies the denouement. HealthCare professionals treat but they are reluctant to let you in on The Knowledge.

"If I were to share the probable course and outcome of this disease it might shorten your dad's survival."

The patient isn't clever enough to contemplate or plan for the future.

In his 70th year my father ached, his bowel habits changed, his body was failing. What could the matter be? The medical answer was at the end of a gauntlet of tests. The medical answer was also in the prognosis which had never been shared with my dad. For men with metastatic prostate cancer the Mortality and Morbidity graph slopes precipitously, eight years and farewell.

On Sunday we drove to the hospital in my ancient car, hints of spring afoot. His doctor telephoned orders ahead for the introduction of a large gauge catheter into my father's arm. A big bore proboscis, 10 gauge, like a fat pencil lead, sufficient in diameter to inject him with crème of wheat or grits.

My father had reached his three score and ten, the biblical span of a life. He was ready for home, ready to be with his parents and sister, ready to lie down and die. Dying follows life. It's straightforward for the pure of heart.

The MD resented my questions regarding the utility of the big needle. "I want large diameter so we can transfuse."

My father said no thanks to the transfusion. He took some IV fluids, we asked about controlling his pain, we went home.

The second week in April my dad signed his name to a tax return, he laughed, "death and taxes."

Lets call him by his name. Bill. Bill was a lucky man. Bill went the distance. He married the woman he loved. He saved money. His taxes were paid. He was looking toward dying at home, in his room, on the ground floor. Leaving in the youth of Virginia springtime, a shroud of violet and green, forsythia blooming outside the window.

He was brave, he was courteous, he was set to leave. He couldn't stay. He was listing, cancer man, he was full of unreliable tissue.

He stayed a little longer.

He stayed a week. The dogwoods bloomed.

He stayed another week, the dogwoods shed their petals, white on asphalt.

Eight years of being a father afforded me insight into how fathers think. I caught my dad on a good day, when no one was home, in forsythia time, on a solo run. I looked at him and said "I'll be o.k. I'll be o.k. when you go. You are my sun, you are the center of my universe and I will be o.k., you have grown me good, you have done your job, you can lie down now. I will be o.k."

Weekends, my daughters and I drove east to Richmond. Out of the Piedmont to the coastal plain. Granddaddy doesn't get out of bed anymore. I can kiss him all over, I tell him I love him. He can't get up and run.

Being a father made me a better son. Bill and I talked about everything. We said goodbye. These meetings were a gift from God.

He was a fiercely independent man, a powerful force. He worked in the predawn, he worked in shadow, he worked for peanuts. He worked for the joy of astounding. He worked alone.

He had this yule log thing.

Santa couldn't come to our house, no room, In the fireplace Christmas morning, without fail, a tree section that could have corked the sepulcher of the Nazarene. A hulking prehistoric cylinder of wood, oxen couldn't move it. How did he put it in place? We never knew, he wouldn't say.

In the shadows he made it happen.

Rattling, pausing, Bill was doing the scary breathing. The girls and I balanced on telephone-pole timbers, we walked, we stayed out of the house. I returned Emma and Helen to the Piedmont and doubled back to Richmond. I wanted to be with him. "yea, though I walk through the valley of the shadow of death I shall fear no evil."

I wanted to be with him in the valley, I wanted to be at his hand.

I stayed awake all night, his last night. Sat on an extra bed in his room and read. I sat on the bed and looked at him, now very gone. His body decimated, his mouth open, his eyes not seeing. In shadow.

Morning came. The tulips were blown, the azaleas beyond their prime, it was time to plant tomatoes. He didn't die.

I returned to the Piedmont.

That night he died. He waited until no one was in the room.

I planted my tomatoes and hated spring for years to come.

I lied about being ready.