This Is For You, Dad

Dad and I at Todd and I's commitment ceremony, 2009

It's been a year since I was transplanted. Holy cow! As much as I've been anticipating this day coming it still seems unreal.

I started out today wanting to write about some random "one year" things - what a tough wait it had been, how much I struggled; the difficulty of switching to a new center for transplant; and that I'd lost a cat and my father along this journey. But when I started writing about my dad, the words just kept coming, and I realized that I'd never really dedicated a blog entry just to him. So this is for you, dad.

Thankfully my father, Charles Nicholas Smith, was alive to see me transplanted and slowly coming back to life in the early months. Unfortunately he passed away in early May, about six months after I was transplanted. He was 65.

My father was always a very important person in my life. He had the knack of being able to always say the right thing at the right time when I was feeling down. He could pump me up - he was my cheerleader. But he was always genuine and his words and very rational opinions were always kept very close to my heart.

Dad with his first two grand babies, Maria and Elise

My father was very sick with end-stage emphysema for many years. We (the family) had taken advantage of so many "borrowed years" we expected he may not live through - but he just kept chugging along. He was often either increasing his steroids or starting on an antibiotic to feel better. We all knew the day would come when that was over, but when it finally happened that didn't make it any easier.

He spent the last three months of his life on the ventilator. They tried everything to get him off of it - he'd done it five times before! But nothing worked, he had too much anxiety breathing on his own, and his body started to wither away. It was an awful three months: every time the phone rang I'd think the worst.

I went up to Cleveland to see my dad in February or March, when things first got serious - what would become the beginning of the end. He had been admitted to the hospital because of pain from a pulled muscle in his side from coughing. However, being on a blood thinner ended up causing major internal bleeding, which started to push on his lung making it more difficult to breath. Since he was barely stable on a good breathing day, this led to an anxiety attack during which he had to be intubated.

When I visited, he was ventilated, partly sedated, and hardly with it. He squeezed my hand to show he knew I was there. He opened his eyes a little but not much. It was a hard way to walk away from someone you love, knowing that might be the final "goodbye."

Finally he was stable enough to leave the hospital (after dealing with kidney failure and a list of other things) for a rehabilitation center. The place he went to was known for being able to ween patients from the vent with their rigorous physical therapy (getting even the most bed-ridden patients up in a chair at least once a day) and respiratory therapists constantly dialing back the vent to see how the patient would do. If he was going to get off the vent, he would have been able to do it with these people.

A picture years ago before hitting the road from Cleveland back to NC - dad, me, and dog Lily

Weeks become months. The more time that passed, the less likely it was that dad was going to make it off the vent. He had been living purely with the assistance of a machine. He wouldn't have wanted that, and none of us wanted it for him once the opportunity for improvement was gone.

There was a day or so during which things like hospice were discussed. But no one thought he was strong enough to survive being transferred out of the facility, and besides there were very few options. And so, after all that time "waiting to see," it was rather quickly decided among the family that we would turn the vent off while keeping him comfortable. As difficult of a thing as this is to decide, when the time was there, we all knew it was what had to be done.

Todd and I packed and left for the 10-hour drive to Cleveland the next day - the day the vent would be turned off. I believe it happened around 9am. The staff had all come to say goodbye, and my step-mother, sister, brother and his wife were all there. I was getting text updates from my sister-in-law.

There wasn't much to report while we drove through North Carolina. Dad was relaxed and breathing on his own. His blood pressure was stable. Who knew how long this would last. He was intermittently waking up from the morphine they were giving him, but once he had more he was okay again. In Virginia, the updates started getting more serious. His blood pressure was dropping, slowly. His respirations were beginning to slow a bit. I told Todd it was time for him to start driving.

Dad and I in front of a hot spring at Yellowstone

My step-sister said that they were all happy to be there. But it was uncomprehendingly difficult. My step-mother was curled up beside my dad in his hospital bed. It seemed like the saddest, most pure expression of love one could give at that time. They were two going through a painful fracture to become one.

There was a little more up and down, but when I got the final word he had died about 1pm there was an incredible emptiness inside me, all around me really. I didn't know what to say or do. I wanted to cry but it seemed unreal. Did I wish I was there in person? Not especially, although I felt a little like I "should" have been. Did I have any doubt that dad had died in the most peaceful loving manner possible? Not a chance. What more can you ask?

We ended up being in Cleveland for a week. I held up through that time pretty well, but I'm sure it was because it hadn't sunk in yet. It was sad, so sad. But we were thankful, as I said, for all of the borrowed time that we'd had, and we were all glad he wasn't struggling to breath anymore.

During that week in Cleveland, I made it a point to do some "dad" things. We went to the art museum for an afternoon - my dad loved the art museum. And we went to see an Indians game - my dad LOVED the Indians (and we had the most fabulous seats). We ate in Little Italy, bought expensive bottles of wine and toasted to dad. He wouldn't have wanted it any other way.

And so life goes on. I wanted to share each transplant milestone with him. I wanted to tell him about my 100% oxygen saturations that seemed simply unbelievable. I wanted to tell him about my exercise progress, my climbing pulmonary functions. And today, more than anything, I wish he was here to celebrate with me.

So here's to you, dad. I know you would have been proud of me. I know you would have enjoyed all my milestones as much as the rest of us have, and that you would be proud of all the volunteer writing that I'm doing. Still, I wish you were here in person to give me a giddy phone call congratulating me. I will be thinking of you tonight when I raise a glass to all that's happened in the last year. And I will be thinking of the most important person who isn't here to celebrate with me.

My brother Nathan, me, my dad and step-mom Mary Ann