Scene 1: Interior of the Kimmeridge Ward in Poole, Hospital. A gray-skied, early afternoon, window shades which take up the top half of an entire wall are open, revealing rain and another brick-walled, 2-story wing of the building. October, 2023
Camera focuses on a 20-something, well-built, male in medical scrubs, seated in a chair, peacefully blocking a patient into the corner.
Voice over from American Daughter-In-Law-
Captain Peter has been sleeping off and on, sitting upright in that chair for two days. And when he does wake up, he is frequently displeased. But the new bodyguard here keeps him from wandering around the ship.
Roll clip from dinner the previous night. Peter throws his cutlery onto the floor with a flourish and yells, "VAT FOOD BELONGS IN DA BIN, VAT'S WOT I FINK!"
Today he is markedly calmer, and when I mention the change, my father-in-law Mike, says, "We'll never know what, but I'm sure they've given him something."
Another clip from earlier today. Female nurse administers a variety of mental acuity tests for dementia to Captain Peter. She asks him word puzzles and to repeat a set of five numbers, things like that. He's just as happy as can be. When he has trouble he says, "Ooooh, I don't fink I quite understand vis one."
She says, "No problem!" and they try another test.
Tasks completed, she thanks him and walks away and he says aloud to himself, "Whot a lovely person!"
Just before dinner he stood up and asked all of us in the room if he was here to die. Then when dinner was served to him at his bed he said he didn't want to eat because he didn't know how many days he had until he'd be dying, as if it were a rigid sporting event he was preparing for.
He still wanders around the room, looking at Mike's swivel table to see if he can recognize anything Mike may've stolen from him. Apart from his outbursts, he's downright loveable, though still covered in oozing sores. I wonder how the nurses figured out which medication would calm his rage. He's not comatose, like Normal Peter, but at least he's not upset or scared most of the time.
And speaking of Normal Peter, on Thursday, when Naked Peter's family returned to find him (shocker!) still alive, Normal Peter (the Castaway) was taking off his own diaper while lying in bed. His eyes were still closed, but his curtain was open, so I caught the male-nurse's attention and said, "Could you cover him up, please?" Peep show!
Roll clip of the nurse walking over to close the privacy curtain around Normal Peter. We see him realize Normal Peter has had a poo and is trying to clean himself up with his hands.
Once the curtain is closed and two of them are working to get things sanitized, the male nurse makes a loud request, "STOP TOUCHING YOUR HAIR! WE'VE GOT TO CLEAN YOUR HANDS FIRST." Across the room, AmDIL turns her chair around to face the wall and buries face into her sweater to keep from gagging.
I don't know how much of this foul-smelling diaper debacle Mike is catching. He's prone to daydreaming these days, caught up in thoughts of his own diagnosis. He hasn't had the energy to shave since I've been here, and his white whiskers are too long for a straight razor now. We'll have to get him an electric one.
Most of our conversations are about going home, so earlier today I found a social worker to give us some insight about how Mike will be released. Mike is not a man to stay still for very long. In 1991, he met my MIL in Fiji where they were both traveling alone, him with a group, but not a partner or even a travel buddy --just fiercely independent Mike.
They continued traveling together, usually taking a trip to a foreign country once a year. And for the duration of their life together they lived alternately between their respective homes in Southern California and the South of England. Even though they were exclusively committed to one another for twenty five happy years, they spent at least 3-4 months of every year apart. You can never know how other people's relationships work and Mike is a very private person. But I've heard him say his relationship with Diana was the best thing in his life. Since she's been gone, the two of us have gotten closer, me filling a gap in female companionship. My sister in law and I are the only ones to buy him new sweaters or ask about his house cleaner. Mike and I are regular pen pals when he's in England, and drinking buddies when he's in California.
Still, I haven't heard him speak about his health much, apart from his bad knees. The knee pain doesn't bother him as much as its effect on his mobility. A large part of his identity is being free to walk around and do as much physical activity as possible. But here in this hospital room I haven't seen him get out of bed all week. I've never seen him so sad or angry as he is in here. So I thought talking about his return home would brighten his outlook, which turned out to be true. However, when the social worker looked at Mike's chart to see when he would be able to get released we were surprised to learn the chart said, "Medically unsound."
Scene 2: Same location, 2 hours later.
Camera shows two men wearing scrubs and surgical caps standing at Mike's bedside. The older of the men introduces them both and asks Mike if it's alright if the American DIL is present for the discussion about his procedure this morning.
This morning Mike had a scan. They call many things "a scan" here in England, and Mike didn't elaborate when I asked how it went. Turns out this one was what we call in America: a colonoscopy. Now it's 430pm and here is this GI surgeon with an assistant bringing us a message which is basically this, "Not so fast, Pal!"
The surgeon has an Indian-English accent and speaks slowly. "The blockage in your colon is very severe. In fact, they were unable to perform the procedure this morning. Did you realize that?"
Mike barely gets out the word, "Yeauuh." He struggles to sit up and pay attention after so many days of lying in bed doing nothing.
The doctor further explains how small the camera is (<1 in wide,) and how the failure to complete the scan is very concerning. "We will perform a CT scan to determine more about the blockage, but in the meantime we need to discuss your options. I recommend you get a stoma in order to bypass this blockage. But you are taking _______ for your heart, correct?"
"Yes."
"Right, so in order to perform this surgery, we'll have to take you off of that medication for 5 days prior. We can start this tomorrow and perform the surgery at the end of the week."
At this point Mike is focused and sits more upright.
The surgeon continues, "You need to decide whether or not you want the surgery by tomorrow." The patient stammers a bit and finally asks, "By tomorrow?"
Mike has been entirely positive about his failing health while he's been in this hospital. You could call it denial, yes. It is his preferred coping mechanism. Whenever I start to hand him his water or reach for his pillow, he reaches past my arm to do it himself. I've been mentally whipping back and forth all week, agreeing with him that he's great and will be traveling! again! soon! And in the next moment I'm trying to get straight answers from the staff about why he's so lethargic and why he can't go home. Days ago I asked the nurse to see Mike's medical chart, because he can't articulate what exactly has happened to bring him here, and why he can't leave. She showed it to me privately, and the list of ailments was long. Many of his organs, including his heart, are failing. That's my first thought when this surgeon talks about taking him off of his blood thinners -- his heart won't be able to handle that! My second thought is of Mike's words to me over the years about his aging friends.
Every winter for the past 25 years Mike has come to California to spend the holidays with Diana and her family (us) and also to avoid the bitter cold, dark English winters. When Diana passed away seven years ago, we assured him he should continue his traditional visits. He stays at an apartment down the block from us each December and January. When he leaves us, he spends every Carnival season on Tenarife, one of the Canary Islands. He's been slowing down physically a little bit each year, but mentally he's still at full speed. And his main concern is quality of life. Countless times, he's told Jeff and I about visiting friends in care homes.
"What quality of life is that? No one is talking to each other? It's just horrible." He said. And then his specific disdain of incontinence, "If you can't even get yourself to the toilet, I just…"
So this ultimatum from the GI surgeon is a nightmare decision for him: to have to wear a colostomy bag, or to die of a bowel obstruction.
Has he understood this ultimatum? He can't pretend he's in perfect health anymore because I've heard every word of this conversation. I'm right here with him for the dropping of the ax.
I can't look him in the eye. He must be devastated.
The surgeon again acknowledges that not having the surgery could very quickly turn into a "big problem." He apologizes for his blunt manner but assures us both that it is a very serious decision and his recommendation is to have the surgery ASAP.
He leaves and Mike looks at his daughter in law. Neither says a word.
Scene 3: Flashback to the interior of Mike's golf club in England. It's summer, 2017, and the American daughter in law walks into the restaurant inside the clubhouse with Mike and her 12 year old son, his grandson. A wall of large pane windows reveals a partly cloudy sky and perfectly manicured greens which roll on and on over hills with ponds and trees dotted all around.
"They've come over from America!" he boasts to the greeter, and then again to the person who seats them at a table near the windows. Everyone here has known him for years, and while he hasn't been physically able to play an entire round since the previous summer, he still shows up multiple times a week for the social aspect of the club. He helps sign people in for tournaments. He has a round of drinks with the guys after they've finished playing.
"I know what I want: steak!" says his grandson after they read their menus.
"Oh, I don't know about that. It's not as good here, steak isn't," Mike warns. But the grandson thinks everything else on the menu sounds weird, so he orders steak and loves it. The three of them have been sightseeing all week in London -- a robotics exhibit at the science museum, a tour of London Bridge, and even a play at Shakespeare's Globe Theater. In the coming days they'll explore a medieval castle in the countryside, see a live cricket match, and have a golf lesson, all arranged by Mike, who prides himself on his traveling prowess. Everywhere they eat, the grandson will order steak, and every time, his British grandpa will issue another unheeded warning.
Also at each stop on their tour, Mike and his American daughter-in-law have a gin and tonic before which he will strike up a lively, though shallow conversation with any other bar patrons in the vicinity. This is how he travels alone all over the world, by exchanging pleasantries with anyone who'll join him and buying them a drink as a matter of principle.
Scene 4: Back to the interior of Poole Hospital, Kimmeridge Ward. We see Mike looking at his AmDIL and her staring at a spot on the wall. Mike seems indignant and she is defeated.
"What does he mean 'decide by tomorrow?!' I don't know a thing about this surgery!"
There is nothing she can offer as consolation. She nods.
Voiceover:
This is a nightmare. I'm sitting here completely hopeless! Look at him. He hates this place. He's miserable and now they've put a deadly period on the end of his sentence.
She asks if he's in any pain. "No. No pain." Then they both stare again.
"What about a drink then? I think we could use one."
"Fat chance of getting one here!"
"Well, I can get out and I know where to get one." She raises her eyebrows mischievously.
He gives her a half smile and a sigh. "Perhaps a whiskey?"
"You got it!"
We follow her up the stairs, around the corridor, and out the front door into the same dark, drizzling, cold wind she walks out into every night after visiting hours. She goes into the gas station across the street and marvels that in Britain you can buy alcohol absolutely everywhere. She tells the bored attendant she'd like a small bottle of the most expensive whiskey they have, but the sob building in her throat catches and he can't understand her.
Please. I can't be the first person to cry while buying a bottle of whiskey in here!
13 minutes later. She's back with his whiskey in a paper coffee cup from the hospital cafe which she hands to him without tears. This is the most rewarding moment of her trip so far. Finally, he has accepted her help with something.
Scene 5- Exterior; Poole Park. Partly cloudy with huge puddles in the grass lawns of the park. American DIL is walking around with headphones in, contemplating what she'll say to her father-in-law today, the last day of her visit. She wipes away fresh tears from her eyes and nose every three minutes or so. The park is lovely in a dreary, English way. Lush gardens everywhere, a thin layer of green algae on the bricks and sidewalks where they never completely dry out. Other people are walking their dogs who haven't been out in a couple of days because of the rain.
All Mike wants is to be able to come out here --to go outside. I wonder if he'd be alright in a wheelchair? He uses one at the airport, so maybe that humiliation could gradually extend to his other outings. It's better than not going out at all!
We texted yesterday about his decision to have surgery or not. My suggestion:
Tomorrow we say, "thank you very much for the information. Please send the results and diagnosis of the CT scan to my doctor" and you can talk w him about your options FROM YOUR HOME
If you decide on the surgery, you'll schedule that and return
Mike's reply:
Stop reading my thoughts!!!!
I'd just made a note in my diary as a good way of getting a second opinion without going over the surgeon's head.
I'm so glad you're here.
Love, Mike.
Voice over-
Today is Tuesday. I've been around a little over a week, sitting in the same spot every afternoon until it's dark and visiting hours end. I've learned more about the other patients.
Frederick says his name is Allen, and "Why doesn't anyone call me by my name, Allen?"
Naked Peter had a half an hour of lucidity during which he mumbled a word to his granddaughter. He died 30 hours later.
Captain Peter has remained sedated and sits, staring out of the window, asking for things instead of stealing them now, keeping his few belongings in his own area.
Roll clip of AmDIL asking about a pair of dentures which have been on her FIL's bedside table for two days. Nurse responds, "I found them tucked into the foot of Mike's bed and assumed they were his."
"No. Mike isn't missing any teeth, are you Mike?"
"What? Hmm. No."
American DIL jerks her head and eyes in the direction of bay #3. Nurse acknowledges and walks over to Captain Peter. "Peter? Could you smile for me please?"
"WHAT'S THAT?" Peter is stone cold deaf.
"COULD YOU SMILE FOR ME?"
He still doesn't understand. So the nurse starts smiling, with exaggerated teeth exposure, right in his face. Peter finally catches on and makes an effort to smile, and there, we find a home for the mystery teeth!
END flashback.
I know it's helpful for me to be here, but the challenge of it has taken a toll on me. Today is my last day here, my stomach is a wreck from stress and worry. Jeff and his sister both offered to fly over for moral support, but I think more visitors would make things worse. Mike doesn't want to be hospitalized, and he insists he will recover. If people keep flying in from the States it will only add to the drama of his hospitalization. To be clear, I'm not expecting him to live very much longer. But around him I still keep the dream alive.
Maybe I'm wrong.
Every death is a little different. If we knew what to expect, it sure would be easier to decide how to help. Mike is always full of ideas and advice. He helped me soldier on when the American news cycle was so disturbing a few years ago, he had comforting words when our bank accounts were dipping into the red, and when I couldn't play tennis for a year after knee surgery, he encouraged me then too. But now, he's the one not making any sense -- the one who needs reassurance and I am completely dizzy with confusion about what to do next.
AmDIL pulls another tissue from the pocket of her coat. The path leads into a large copse of trees where leaves are changing color. The woods look magical, but are inaccessible today because the entire asphalt path, along with the grassy areas on either side, are covered by a puddle the size of a house. The ground is soaked through with rain. It can't take anymore.
read part 1 if you missed it: