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Authors: Christopher Buckley

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P
up was smiling. He
was
pleased to see me, and though his love for me was deep and abiding, I knew very well that his maniacal grin might be more
eloquent of my utility to him as an escape vehicle than of paternal affection.

I was entirely sympathetic—who wants to stay in the hospital?—but the situation was plain: He was in seriously awful shape.
Maurice—sweet, kind Maurice—kept saying,
Mr. Buckley, we’re gonna take you back to your room now, okay?
But the Lion of the Right was having none of that. No, no. Pup merely smiled and shook his head at Maurice, declaring firmly,
No! I’m going to have dinner with my son. He’s right here. Christo is taking me home. Let’s go, Christo.

Christo looked at Gavin. Gavin looked at Christo. Good, earnest Gavin tried gamely, in his best
Mister Rogers’ Neighborhood
voice, to explain to his (im)patient that leaving the hospital was not a viable option.
Bill, we need to monitor your kidneys. Your kidneys.

Pup grinned his mad grin at him and gently shook his head, as if Gavin were trying to pull a fast one.

Gavin tried again.
There’s something going
on
with your
KIDNEYS.

I didn’t like the sound of this. It’s one thing when doctors talk about the heart. We all know about the heart. It’s a pump,
basically, and it needs to keep pumping and doing its other hearty-pumpy things. But when doctors start muttering about your
kidneys—organs—it has an unsettling sound.

Pup waved away the kidney talk.
No, no, I’m going home.
He grinned triumphantly.
Christo and I have a dinner date! Don’t we, Christo?

Christo had no thought other than to make his beloved Pup happy. At the same time, Christo sensed that wheeling beloved Pup
out of the hospital, with half a dozen pairs of hands clinging to the wheelchair, heels making skidmarks in the hall… would
not an elegant exit make. And what then? Was I to stop at Barnes & Noble on the way home and pick up a copy of
Kidney Failure for Dummies
so I could fix the problem myself?

Pup
, I said,
tell you what. Let’s get you back into bed, JUST FOR A LITTLE BIT, OKAY? That way Gavin here can sort out what’s going on
with your
riñones
*

No, no, no!
He shook his head, giving the armrest of the wheelchair an emphatic whack with his palm. His grin was now gone, replaced
with a look of something like fear.
We’re having
dinner
. A lovely dinner. I’ve arranged it all….

He was clutching my arm. It wrenched my heart. This was terra nova to me: the delusional parent who must be denied for his
own good. Every fiber of one’s being reflexively inclines to accede to the wishes of a parent. It is
contra naturam
(to use a WFB term) to say no to someone who has raised you, clothed you, fed you from day one—well, even if, in Pup’s case,
these actual duties were elaborately subcontracted; still, it feels as though you’re disobeying and in contravention of the
Fourth Commandment. This is the crushing, awful daily lot of the children of Alzheimer’s patients.
No, Mom, let’s
not
put our fingers in the blender, okay?

There wasn’t anything else to do but give Maurice, our situational Luca Brasi, the go-ahead to get Pup back into bed. It wasn’t
altogether an easy operation. Pup, superbly slender figured all his life, had in recent years added some avoirdupois—as indeed
had I—along with the accompanying complication of diabetes.

Once he was in bed, I stroked his forehead and spoke soothingly of the dinner we would
absolutely, definitely
have just as soon as the doctors figured out the kidney situation. He was babbling now, incoherent. When a Hispanic nurse
came to take his vitals, he sang to her in fluent Spanish, which surprised and charmed her. Otherwise, the most articulate
man in America was speaking gibberish.

Gavin said he’d give him something “to moderate the agitation level.” The nurses injected Ativan (an agitation level moderator)
into his IV drip. Gavin and I huddled in the hallway. Pup had come back from the award ceremony trip badly sick; had for several
days thrown up, becoming dehydrated, which in turn distressed his kidneys, which in turn took it out on the brain and the
heart. I arranged for a cot.

It was a long night, after a long day, which had started in Geneva many time zones away. I did what I could to calm him down,
but despite the Ativan he was feverishly agitated and desperate to leave the hospital. He had to catch a train. Had to get
on the boat. He was now very late for an important meeting.
When are we leaving?
I had to restrain him physically every five minutes. After the fifteenth or twentieth time, one’s patience begins to wear.
Pup,
I finally said, my tone stern:
We’re staying here, okay?

No, I’m leaving. Would you get my clothes?

He tried again to get out of bed, a complicated maneuver given the half dozen tubes and monitor wires, to say nothing of the
catheter, which if yanked out would have caused excruciating pain and God knows what kind of plumbing damage. I had to wrestle
him back into bed, at which point he began to projectile vom—Well, as I said, it was a long night. I pleaded with the nurses
for more Ativan, a drug I would come to revere over the next fortnight. Finally, near delirium myself, I sang an Irish song
to him that I had heard on my first visit there:

If you ever go across the sea to Ireland,

Be it only at the closing of your days,

You can sit and watch the moon rise over Claddagh,

And see the sun go down on Galway Bay.

It’s a sweet, slightly sad melody. He quieted as I sang.

That’s beautiful, Christo.

Yes, Pup, it is. I first heard it in—

Where are my clothes?

Why do you need your clothes, Pup?

We have to go.

Pup—

We’re terribly late as it is.

T
HE NEXT MORNING
, early, I was sitting on a stone wall outside the main entrance to Stamford Hospital, bleary-eyed, texting Lucy.

Handsome, dapper Joe D’Amico, Mum’s orthopedist (
She’s already in heaven
), walked out briskly and, glancing sideways at me, did a double take.

Chris? What are you—Aw, shit. Bill?

I told him Pup was in room 4109. He said,
Let me see what I can find out.
He came back fifteen minutes later.

I’m not a urologist, but from the numbers, I think he may be on the verge of renal failure.

“Renal failure” is not a phrase to lift the spirits. Joe went off to tend to his patients. I texted: “Poss. Kidney failure.”
I looked at the words on the little screen and pressed send and realized that I was crying. (Yet again, at Stamford Hospital.)

Pup was a prominent man, and word was soon out that he was in the hospital. The calls started coming in. They were all well-meaning
and large-hearted and sincere, but it is exhausting. The consoler is himself seeking to be consoled. By the second day, I
was overwhelmed and began sending out daily bulletins by e-mail. If they sound delirious themselves, my defense is that they
were written early in the morning, after generally unrestful nights.

For Family and Friends Only, Please

WFB Jr. Medical Bulletin

June 20, 8 am

He has something called “acute tubular necrosis,” which sounds pretty dreadful, but there’s also good news.

ATN is basically kidney damage caused by, in his case, extreme dehydration and decreased blood flow to the kidneys caused
by a drop in heart rate. (His heart rate is now back to normal.)

Basically, his kidneys are damaged and need to get better. The good news is that they regenerate on their own. This can take
1–3 days, or 10 days.

Within a day or two his doctor, a pro’s pro named William Hines with a lovely bedside manner, will decide whether to recommend
dialysis—as a temporary measure—to stimulate regeneration.

So there we are. We’re here at Stamford Hospital for the duration.

He’s resting. He wakes up every hour to declare loudly to everyone that he can’t sleep and needs “a much
stronger
Ambien.” I take this as a good sign that he’s quite himself.

I’ll keep you all posted.

Love from Hospital World,

Christo

June 21, 7:30 am

From the WFB Medical Desk, this just in….

Today’s med bulletin: heart rate 120. He’s atrial-fibrillating. Heart rate was 40 Monday. Normal is 60. They’re treating it.

His creatonin level (sp?—a kidney chemical thing) is 5.8. Normal is 1.5. At 6, they start considering dialysis.

At this point he has less than 10% of his kidney function. But there are a few small encouraging signs that his kidneys are
starting slowly to regenerate, having to do with details that I think I’ll spare you.

He’s very, very weak, not terribly coherent. Every other time he speaks it’s to say, “I have to get my train ticket.” I’m
trying to figure out where it is he wants to go. (Don’t ask.)

Will keep you posted.

Much love,

Friday, June 22, 2007

9 am

WFB Medical Bulletin

So his kidneys are
trying
to regenerate. There are good indications and some less good. For those of you who hang on my creatinine level reports (I
must really learn how to spell it), it’s now 6.3. You’ll remember from my much-praised Bulletin #1 that normal is 1.5. The
attentive among you will remember from yesterday’s bulletin that it was 5.8. The good part is that the rate of increase has
slowed. You will be responsible for this on the final exam. The urine report I will keep to myself, if you don’t mind, but
I will say this much: he is a river to his people.

In other WFB Organ News, he’s still “fibbing.” Nothing to do with mendacity, but rather the term us medical-types use for
“fibrillating.” His heart rate is in the 100 range. Normal is about 60. Monday his was 40—definitely not good, so you can
see he is making excellent progress there.

No appetite, I regret to say, but I am feeding him little delicious bits of Julian’s snacks.
*

Mental alertness–wise we are sort of in and out. He’s not conversational, though he can be toward the end of the day when
the meds lie quieter in his blood. At which point he reverts to his default imperious position. Last night at 7 he instructed
me that he wanted a Macintosh laptop computer, “Right now,” so that he could write a column “at two am, in case I wake up.”
He was not impressed by my pleas that I would not be able, at this late hour of the day, to a) supply him with a wireless-enabled
computer and an operating system alien to him, and to b) train him on said computer in “less than an hour,” to quote his demand
verbatim. Doubtless this evening he will stir and castigate me for my delinquency, to say nothing of my obtuseness. But then
I have never masqueraded as a perfect son.

Dialysis-wise, we’re at the let’s-give-it-another-day stage. I can’t emphasize what superb care he is getting at the Stamford
Hospital. Was I surprised to learn that Dr. Hines, his kidney doctor, turns out to be a Yale man? Not one bit. I had been
a bit worried that he was Harvard, but am now at peace on that score.

He is doing his best and sends you his best love, as do I.

WFB Medical Bulletin

June 23

Arrived at the hospital at 7 this morning, bearing 50 “munchkin” donuts from Dunkin’ Donuts with which to jolly the (truly
lovely) nursing staff. WFB greeted me stony-faced and furious:
“WHY HAVEN’T THEY OFFERED US A
COCKTAIL
?”

I had no good answer to this. He thereupon said, leaving no doubt as to the urgency, “I need a Stilnox.
Now
.” (Stilnox, those of you familiar with the WFB Pharmacological Encyclopedia—Vol. XXVI—will recognize as his “definitive”
Swiss sleeping pills.) While I stammered fecklessly that perhaps we might wait until the doctors had made their rounds before
we rendered him comatose, he fell immediately asleep.

Urine-wise, until now I have endeavored to spare you details about this aspect. But the high volume of reader mail suggests
that you will not be denied every detail. Have it your way.

Until now, I had never imagined that my happiness could be contingent on the color of my father’s urine. (My life used to
be more exciting, really.)

Today’s is… how do I describe today’s? I would describe it as the color of a fine Riesling: umber, full-bodied, with hints
of creatinine and red blood cells with a nice finish. This is a vast improvement over the Coca-Cola hue of 48 hours ago. Volume-wise,
I repeat yesterday’s med bulletin: He is a river to his people.

He wants to go home. Every other sentence he utters is about that. I want that too for him. Very much. But we’re not there
yet. My mantra, with which he is out of patience—and I don’t blame him—is: “Let’s just take it day by day. And see.”

He sends his best love, as do I.

WFB Medical Bulletin

Sunday, June 24

The daily creatinine report: 6.4. Those of you who made it through yesterday’s WFB Medical Bulletin will recall that it was
at 6.5. So this is simply splendid news.

But wait, there’s more. Since yesterday afternoon, he has been “back on sinus rhythm.” It means, to put it in terms you simple
(and, I am sure, decent and good) folk can understand: we are no longer “fibbing.” (As in “defibrillating.”)

Are we out of the woods? No. Are we going home today? No—a point I spend perhaps 90% of my conversational time with him having
to reiterate. (It’s like being on
Firing Line
, on acid.)

“Have you packed my things?”

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