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It's blazingly hot here today. We're in the midst of a heat wave and it's now 102°. It is at least a dry heat; were we dealing with a humid heat, it would be more than stifling. I had wanted to get out and get some landscaping done, at the very least get the weeds knocked down, but the morning got away from me and it got just too damn hot to do that now. Maybe early evening will be bearable to do so.

I was listening to the moth radio hour last night as I drove home from Santa Rosa. Given that today is Father's Day, the stories they featured were all father related. The bulk revolved around new fatherhood, but the final installment was by a young man who as a graduate student abroad, lost his father suddenly. It focused on what he learned about his father during the morning period after his death. I nearly had to pull off the road.

I was physically present in the room with my father breathed his last, along with my mother, my sisters, and an an aunt & uncle. My father was dying of leukemia, then only a few years older than I am now. It was the culmination of a 13 year battle. Up until a few months prior, I had been in denial that my father would succumb to the disease. It had been a chronic leukemia & he'd had health crisis after health crisis for over a decade in and after surviving each of them, he'd gotten back up and went back to work. I'd been called home too many times, that he had had a "terminal" event and I would be needed to help with funeral arrangements, only to have him sitting up and reading the newspaper in his hospital bed upon my arrival. There are chronic leukemias where the patient survives 30 odd years with the illness. Most of my father's aunts and uncles made it well past 80. My grandfather didn't retire until 90. I honestly expected my father would do the same. However, 2 1/2 months prior to his death, the leukemia became acute.

At the end of June in 1995, Pop called and said, "my absolute neutrophil count is under 100." It was his way of telling me, "This is it." My response? "I will be there this weekend." It was Thursday afternoon. I caught the redeye the following night. I was able to arrange for cross coverage; 2 rent-a-docs, actually a married couple just out of their residency came in and worked my office for the duration. Nearly 3 months later. my father died on September 26. I returned home the beginning of October.

This time together left us time to talk and to simply be with one another. When Pop died, we had each said what we needed to say; we had no unfinished business with each other. A few days before he passed, I said to him not to try and hold on for us, that if it was his time to go, we would miss the hell out of him, but we would be OK. I said it, because it was something I thought he needed to hear. He was suffering. I was lying through my teeth. My inner child, the little boy within me, was not ready to say goodbye to daddy. He still isn't. 22 years later he is still hurting, & he is still grieving.

There was much I learned in the process of losing my father. Four days before his death, his calcium levels became dangerously high, not a rare side effect of his malignancy. The residents working at the hospital (an Ivy League medical school no less), responded by opening Pop's IV line wide, pumping him full of fluid, and chasing it with a diuretic. I was sitting at his bedside reading, when I noticed Pop hop out of bed for the third time in half an hour to take a leak. Now as he was not a diabetic, that made me look for the why & seeing that his IV line was wide open, I went to the nursing station to find out why. There the resident, not realizing he was talking to a fellow physician, informed me that if he didn't do something about my father's hypercalcemia he was going to die. Talk about not seeing the forest for the trees. I responded, "I'm sorry, but is treating his hypercalcemia going to cure his underlying leukemia, which is killing him at the moment? He is still continent and neither needs nor wants a catheter. What you are currently doing to him is not going to lengthen his life significantly and its decreasing the quality of what time he has left. Please, Stop it now."

The day prior to his death I bathed him. He was too weak to be able to do that for himself. I was my honor. I knew the end was close, and I knew that at the funeral home that there would be a ceremonial mikvah, to cleans his body one final time. I had the satisfaction of knowing that I had allowed him to feel clean while he was still able to feel it. I heard him say it. That I could do that for him still gives me some solace.

As a physician, I thought I understood death. With my father's passing, I realized I understood nothing. In my youth I struggled to be my own person, to individuate from my parents & see our differences. It was in losing him that I finally came to see how much of my father remains within me. I have his gregariousness, his sense of humor, and even the timber of his voice (though thank God I don't need a basket to carry a tune as he did). I have his flat feet and his lousy eyesight, as well as his insanely low cholesterol (likely the reason most of my his parents' generation made it into their 90s). I came to recognize just how generous he was with me emotionally, how much he was in my corner. I recognize that I had, no, have his unconditional love and that's what sustains me in enduring his loss.

To each of you reading this a happy Father's Day. And to you Pop, I love you. I wish I could hear you say it again.


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