He has reached a point where the toxins of renal failure have begun to occupy his days and his nights. A by-product are deep episodes of hallucination. He sees ants on the floor, stuffed animals coming to life. Most likely, he speculates, these are the animals my daughter once kept in what was her room before we moved him here to live with us. These animations run through the heating register or stand around staring at him goggle-eyed. From the dining room window, he expressed admiration for the marina in our back yard (I wish).
My father is not alarmed by the visions, not the animals anyway; he is mostly bemused and sometimes finds the antics of the five-inch monkey under the bed humorous. If the creature becomes bothersome he waves his cane at it and it slips away until later.
He slips into a sleep that hovers between actual sleep and something else. During the “something else” he will have conversations with imaginary people, like the girl at the front door who, for unknown reasons, refuses his invitation to come all the way in and sit on the sofa. Or the shadowy man in the corner, who, he insists with great agitation, owes him five hundred dollars for reasons as obscure as the shadow. He dredges up old and strange memories. Yesterday he started reciting miles-per-gallon averages for various makes of automobiles he has owned. When a young man, he would buy a new car every year and keep meticulous performance records on every vehicle. When gasoline was thirty-eight cents a gallon, he recorded the MPG he got from every tank he put in his three-hole Buick. I can probably find it for you from his files.
He spent a day in bed unable to arise, unsteady and weak when he tried. Then a good day followed by again another day in bed, complaining once more of the ants and tossing tissues at them while apologizing, not wishing to call our housekeeping habits into question. Our dog, now his boon companion, enjoys tearing paper and considers these tissues dropped from on high a treat. He sometimes sings—what, I can’t quite make out. His vocal quality explains why he never would do it if lucid.
The hospice folks suggest when he is in this state—talking to himself, carrying on imaginary conversations, even singing—he is “resolving issues” he has not heretofore faced, ”coming to terms” with approaching death, seeking “closure.” The basic premise here, from an article about death anxiety, “is that accepting death is part of developing an affirming and meaningful experience of life.”
While I am very grateful for the nurses and aides, I regard that on the whole as just so much esoteric nonsense. I am more apt to believe that renal toxins are overwhelming his neurological functions along with everything else, and some days the kidneys just work slightly better than other days, and when they work they filter out more of the poisons and some lucidity is temporarily restored. It will be like that until the day when renal failure is complete. Then he will fall into death.
This is hardly in keeping with the “good death” of the hospice component of the death awareness movement: Every death becomes a good death with a final, fulfilling opportunity for personal growth, ultimate maturation, a developing readiness to move on to an affirming and meaningful experience. But I am pretty much of the opinion that death means personal annihilation. Psalm 30 certainly suggests it.
What gain is there in my destruction,
in my going down into the pit?
Will the dust praise you?
Will it proclaim your faithfulness?
If you have to ask, don’t you already know the answer? And if it wasn’t personal annihilation, it was Sheol that awaited the dead, which in my mind is about the same as dying and moving to west Texas.
Either way, the only remedy is resurrection. I believe it will be God’s final word through Christ, a voice loud enough to crack graves open and sharp enough to command the dead to rise.
Meanwhile, I tend my father.
Russell E. Saltzman is a dean in the North American Lutheran Church, and an online homilist for the Christian Leadership Center at the University of Mary. His previous On the Square articles can be found here.
We All Have Fathers
Meaningful experience of life
Hospice in a Death Denying Society
Become a fan of First Things on Facebook, subscribe to First Things via RSS, and follow First Things on Twitter.