Not responding to treatment....

Fri afternoon, May 17th.
3:30 pm

No Bernie in the lobby room. We go to his room and find Father dressed, sleeping with a blanket.  He does not respond to either Kathleen or myself.

We go out to find Connie, the on-site hospice nurse.  How's Bernie doing? "He is not getting better."  His cellulitis did not respond to the first course of antibiotics. We're using the second and third set of antibiotics. It will have run it's course on Monday, but so far we are not seeing any response.  Monday we will reevaluate again.  "What is the next course?" "Unless you have changed your wishes, we are running out of the normal courses of actions. The next steps are against your wish for non-heroic measures."

This is why we make difficult decisions ahead of time. The hospice nurse looks at Kathleen, the hospice social worker. Without words being said they confirm the other's understanding.

The reality is Bernie is not fighting a deteriorating condition. "The next steps are hospitalization and intravenous antibiotics.  That is beyond the measures of your health directive." "And then what usually happens?" "The infection enters the blood stream and spreads.  If it does not respond to antibiotics it saps strength and health." "A matter of months?," Kathleen asks, probably for my benefit.  "More like a matter of weeks. If we saw a vibrant, active Father then I would be more positive.  However, Bernie has almost totally withdrawn. He resists getting out of bed and sleeps all day. He does not have a robust appetite. He is confused."

"What are the next stages?" "If the infection enters the bloodstream we should expect Bernie to weaken."  "What about lucidity." "It will fade. Usually the last two weeks or so there is little awareness. Days are spent in bed."

We go back to Father's room and see him being wheeled into the dining room for dinner.  It is now a little after four.  "Have you had any visitors today?", Kathleen asks. "No, they get me up about seven, and we are now waiting for breakfast. So there hasn't been time for anyone to come."  We tell him dinner will be soon. "Well Ok." In the dining room there is a combination CD, Radio and Cassette player. Maybe fifty well used CDs and tapes are kept in the basket below. We put a Strauss CD on the player. Bernie taps his nails on the table in rhythm to the waltz.

We ask about his dinner table-mates. (Last week Alice reported she deliberately seated Bernie with other priests for meals.  One day, mistakenly, he was seated at a different table, and Bernie complained.) Today he is unaware of who they are.  He furtively glances at the clock as though it he was worried about making a train connection. "Are you worried about something?" "How will I get back to my room?" "After dinner the nurse will take you." "Oh, Ok."

Bernie answers all questions in a whisper, and only the minimum of words. He starts a sentence, and then trails off. He cannot remember what he was saying.

When his eyes are open, he only looks down. Mostly, he keeps his eyes closed. He asks what time it is each five minutes -- wanting us to confirm what he sees on the large clock over his right shoulder. We repeat this  maybe twenty times.

Gradually the room fills with other residents. Some on their own power, but most wheeled in. Just before dinner, we hold Bernie's hand. (It is cold to the touch.) We tell him we love him, tell him we pray for him, and ask for his prayers. He raises both hands to wave goodbye in papal style -- his trademark.