In Memory of Grandpa Tuffy

For the past couple of weeks, Frankie's great-grandpa Tuffy has been in and out of the hospital. He turned 80 in July, and at that point he'd already outlived our most optimistic expectations by about a decade-and-a-half. The accumulated wear and tear of eight decades of hard living have landed him in the hospital for a variety of complaints over the years, and each time he's proven amazingly resilient, repeatedly defying his doctors' worst prognoses. Still, something seemed more dire this time. His condition grew increasingly worrisome toward the end of last week, so much so that Anna and I decided to ignore our doctor's admonition against traveling with Frankie. We didn't want to miss our chance to introduce Grandpa to his newest great-grandson, so we loaded up the car and headed to Oklahoma City on Friday night. We reached Ardmore when my mom called to tell us that Grandpa wasn't responding. He passed away less than an hour before we made it to OKC.

I got to spend some time with Grandpa during one of his last extended stays in the hospital. That was before this blog existed, even before we knew we were pregnant. I recorded the following thoughts on a now-defunct blog. I think they deserve a reprint here.

I'll miss you, Grandpa.

Jan 5, 2005. 8:39am

If I believe my mom's message, left at 5:23 this morning, the situation is dire. Grandma checked Grandpa into the hospital last night. He was confused, shaking uncontrollably, and having trouble catching his breath. The message said something about a sodium deficiency and pneumonia, but the overall diagnosis was pretty vague. As for the prognosis, her tone of voice suggests things are grim. Then again, I've received messages like this at least half a dozen times. My grandfather's health has been going downhill for at least the past twenty-five years, so much so that the family was long ago forced to come to grips with Tuffy's mortality.

That's right - Tuffy. Carl Herschel "Tuffy" Cunningham. How fucking cool is that? What kind of badass must you be to earn a nickname like Tuffy? He was an oil field roughneck when they drilled Oklahoma, a freelance ambulance driver for one or two lawless weeks or months, depending upon who's telling the story, a long-haul trucker for as long as I can remember until his late-fifties, and a wise-ass doorman at his son's beer joints until he just couldn't physically do that anymore, which was a couple of years back. He's as wide as he is tall, with granite arms, and smiling, grandfatherly eyes set deep into his otherwise imposing, world-hardened face. He smoked like a chimney until his mid-fifties, when emphysema got the best of him. He's taken oxygen treatments four times a day ever since. He's had an aortic aneurysm repaired, twice, and had experimental surgery to place stints in his carotid artery, all in the last ten years. Due to complications created by his severely impaired lung capacity, the odds of him waking up from any surgery are always strongly against him. He has already defied the linemakers a half dozen times, though on every occasion I have believed my mother, and fully accepted that even the best run of long shot wins must come to an end.

When the call comes, I either pack a bag and head to Oklahoma City, or I chastise myself for thinking that whatever I'm doing at the time is more important than being with my grandpa. More often than not, it's been the latter. For one reason or another, I just couldn't get away. I'd cross my fingers and sob my regrets, knowing that I was never going to live down the guilt and shame of my decision. And I never felt relief when he pulled through; instead, I felt an even stronger since of guilt and shame over my failure to take advantage of the second, third, fourth chances I'd been given to spend time with him before...the next time. And the longer you wait, the harder it becomes. Guilt and shame are paralyzing forces.

This time, I am in Denton when the call comes, less than three hours from Oklahoma City. I've fulfilled my judging commitment at the tournament, Jenny and Loren can handle the coaching duties, and even the rookies are more or less self-sufficient. They'll survive for a couple of days while I head up to Oklahoma. I'm not saying I believe the situation is as dire as Mom's making it out to be, but I can finally do what I should've done every other time, whatever the prognosis.

An ice storm is blowing in this afternoon, threatening to destroy the interstate between Ardmore and Norman; so, as soon as my cellphone has a little juice, I'm hitting the road for OKC.

Jan 5. 11:55am

It’s hard seeing my grandpa like this. The invincible giant I remember from my childhood has been gone a while, but this is the first time I’ve seen him looking not just old and frail, but scared. The skin hangs from his once powerful arms. Over the last few years, dark patches have slowly spread from the back of his hands, up his forearms, and now they’re crawling around his elbows, heading in the direction of his shoulders. It looks like someone beat him with a hammer. His hands shake uncontrollably, sometimes so severely that he can’t hold a fork, much less navigate it into his mouth. He piles blankets on his legs and feet to compensate for poor circulation. The expression on his face oscillates between placid detachment, forced concentration, and panicked confusion. His eyes betray the intensity of his fear.

Jan 5. 3pm

Grandpa introduces me to Melvin, the man behind the curtain divider separating the A and B sections of room 506. Melvin tells me he’s in for a pulled groin. He’s in his early seventies, short, with the same sort of hard-worn face all septuagenarians in Oklahoma seem to share. His most distinguishing trait is an ill-behaved shock of red hair. When Melvin’s back is turned, Grandpa points to his own head and mouths the word: dyed. Melvin is lonely. After our first half hour of conversation, I could tell you about Melvin’s time in the Army during the Korean War (at which time he was stationed in El Paso, Texas, working as a typist), either of his two marriages, including the reasons the first one didn’t work out, and the totally legitimate excuses each of his family members gave for not yet visiting him in the hospital. I have also helped him tie his gown, filled his plastic water decanter, and served as an interpreter when his doctor tried to explain the implications of, and potential treatments for, diabetes. Melvin is not shy.

Jan 5. 11:30pm

From what I've been able to gather, Grandpa is going to be fine. The doctors haven't exactly been forthcoming with information. It's no wonder he feels bewildered by the whole experience. The kidney doctor, as he introduced himself to us, asked a question, which Grandpa clearly didn't understand, then furrowed his brow at the awkward, inappropriate response. Instead of rephrasing or attempting to explain himself, the doctor moved on, asking another question, equally perplexing but seemingly unrelated to the first. Grandpa still didn't understand. He tried an answer. The doctor smiled condescendingly, and Grandpa smiled back, thinking he must have gotten it right.

I followed the kidney doctor out of the room. I wanted to know why Grandpa's primary physician had requested he be looked at by a "kidney doctor" (my fingers mimed quotation marks around the patronizing phrase). I wanted to know how the low sodium problem was related to his kidneys. Is this an indication of renal failure? Are we talking about dialysis? Will he have to be anesthetized to put in a catheter? Or is it the other way around - does low sodium damage the kidneys? Are the problems even related? Would he care to venture a guess or even share his general suspicions about why this happened? Can it actually be, as Grandpa keeps insisting, that he just drank too much water, diluting his sodium levels? I launch this tirade of questions at the kidney doctor. He opened Grandpa's chart again, read silently to himself for several moments, then ticked off his responses. "Any other questions?" I think he was actually offended, the smug fuck. I explained it all to Grandpa, and I think he followed me about 80% of the way.

I've listened to Melvin's interactions with his doctors, and it pains me to keep my mouth shut. Melvin's alone. His wife had an accident while visiting family in Ohio, and she wouldn't be back to Oklahoma for another two weeks. His stepdaughter and her husband stopped by once in the two days I was there, staying for all of about half an hour. I can't actually see the conversations between Melvin and his doctors, but the thin sheet that divides the room doesn't otherwise afford much privacy. Melvin is slightly hard of hearing, and he speaks in a low rumble with a thick Okie accent. I understand every word he says perfectly, but I've been listening to this dialect since I was born. He catches about every other sentence the first time around, and rarely needs you to repeat one more than once. Still, our conversations require patience. One of Melvin's doctors has a very thick accent, Indian or Pakistani maybe, and very little patience. He tries to explain that Melvin needs a pacemaker.

"You have said you do not wish to have the pacemaker. It is necessary. Your heartbeat is very irregular, and this worries me. The pacemaker is necessary. But you say you do not want it, and if you do not want to reconsider that, then we need to consider other options. But I must tell you Mr. H_______, you really should reconsider."

"I'm in here for my groin," his voice is raised, but matter-of-fact. When rednecks encounter foreign accents, they raise their voices, presuming the volume will help bridge the obvious language gap.

"I understand, Mr. H_________. I am not concerned with your groin. I am a cardiologist. I am your cardiovascular surgeon. I want to talk to you about a pacemaker."

"I was lifting the luggage, but it didn't hurt until later that night. It was cold. I collapsed. My groin." Melvin tries to simplify his story. He is pointing at the soft area above his left hip. He repeats, "It's my groin."

"I understand, Mr. H_________. You should reconsider the pacemaker. You have an irregular heartbeat, and it requires treatment. This is very serious, Mr. H__________. Get some rest now."

This guy didn't understand shit. Melvin had no idea why this guy was talking about a pacemaker, and he certainly didn't want to buy one of those just because he was getting old. As Melvin explained to me later, they try to get you to opt for what they call "election surgery," because the insurance companies were paying for it anyway. But Melvin wasn't going to be having any election surgery. He hadn't needed a pacemaker up to this point in his life, so he really couldn't understand why he should buy one now. This same logic guided Melvin's thinking on diabetes. "They've been telling me I'm a borderline diabetic for forty years, but I haven't been diabetic yet, so how can I be diabetic now, all of a sudden?" In all of the conversations I heard between Melvin and his team of physicians, I never heard one of them provide an adequate refutation of either of these misguided beliefs. I'm glad Melvin and I are going to have some time to talk.

Jan 6. 2am

It's two in the morning, and I'm having a slumber party in a hospital room with Grandpa and Melvin. I am wedged between Grandpa's bed and the sink, suspended between two chairs made of vinyl, metal and right angles. I have a blanket, but no pillow. I am wearing the same clothes I put on when I woke up this morning, before I knew any of this would be happening. Had I known I'd be sleeping like this, I'd have worn different pants.

If I had been around during Grandpa's past hospitalizations, I'd have known this is how I'd end up spending the night. There are no posted visiting hours on this floor, but I assumed I'd head home around 11 or so, after Grandpa takes his last breathing treatment and his sleeping pill kicks in. Grandpa swears by Ambien (Zolpidem), by the way, and not just when he's in the hospital. He made me confirm with the doctor, the nurse and the nurse's aid, who had absolutely no say in the matter, that they were going to let him have his Ambien. When the nurse finally brought it, he hadn't yet received his last breathing treatment, so he told her he'd take it later. She looked at me sideways, remembered my persistent inquiries about the Ambien, then pocketed the pill. "I'll bring this back later, then." Should I be concerned or offended that she thinks I look like the kind of sketchy fuck that would scam medication from his bed-ridden grandfather? At any rate, my plan was to leave when the Ambien tagged in to carry Grandpa through to the morning. At 10pm, when the technician arrived with the nebulizer for his last breathing treatment, I called mom to give her an update, and to tell her I was getting ready to head to Grandma's. She seemed confused. "They're making you leave?"

"Well, I don't know. I assumed so. Aren't there visiting hours?"

"Oh, no. Not usually. They'll usually let you stay as late as you want. I mean, unless you don't want to stay there..." Her voice trailed off, hammering home the point of her disappointment.

"No Mom, of course I'll stay. I just didn't think..."

She cut me off, my concession apparently not convincing enough. "It's just, he'll call Mother if you go home. He gets scared, so he'll call her, and she'll go up there." She was piling it on thick.

"Well, they wouldn't let her stay up here last night, but I'll check."

"They wouldn't let her stay in the room, but she stayed all night in the waiting room." Damn. That's serious dedication. There is no actual waiting room on this floor. A half dozen chairs face each other along the hallway between the elevators and the nurses’ station. I imagine Grandma slumped in one of these chairs, trying to sleep in spite of the constant hum of nursing activity.

"Of course I'll stay, Mom. I just didn't know."

"Well, it's just that Daddy gets really scared, and he doesn't like to be alone."

Scared doesn't really describe it. Grandpa's longevity defies medical explanation, but I believe it's largely attributable to his profound fear of dying. Grandpa simply refuses to quietly accept his mortality. He will not be going gently into that good night. When his cardiac specialist asks him what he can do for him, Grandpa answers, "I'd like to live to be a hundred and fifty." The specialist tried to explain that some procedures might prolong his life slightly, but at the expense of significant discomfort. He said that sometimes quality of life is more important that quantity. Grandpa stared at him blankly, eyes wide, mouth hanging open. "Shee-it it is."

I've wondered if Grandpa is afraid of dying because he doesn't have the comfort of a religious expectation of an afterlife, or because he does but doesn't like the direction he's headed. Don't get me wrong - Grandpa is a good man, but he's a heathen, like me, at least in the eyes of Christians. He's not a church-going man, and I can't recall him ever talking about his own religious beliefs. He always demonstrated perfunctory respect at weddings, funerals, and the few other religious events he was compelled to attend, but he always made it clear that he was there against his will. I've wondered for a long time whether his discomfort was the result of an absence or excess of faith. If half the stories I've heard about my Grandpa are true, he's an unrepentant sinner by even the most lenient of Southern Baptist standards. If there is a God, and a Heaven, he's got to think he's going straight to Hell. I don't know if Grandpa's afraid of dying because he knows he's damned, or because he knows there's not a goddamn thing after this life is done, and holding on as long as possible is the best you get. Whatever the explanation, Grandpa is afraid of dying, and being in the hospital only exacerbates those fears.

I hang up with Mom and head back to his room. The nurse is delivering the Ambien. She tells Grandpa I can stay in the room, and he beams like a child. I pull up the chairs and she offers to bring a blanket.

"You comfortable, Davey?"

"Oh yeah, Grandpa, this is good."

"Do you need another blanket?"

"No, I'm OK, Grandpa. How about you? Too warm, too cold? You need anything before we turn in?"

"Well, no. I'm alright." He leaned toward me and whispered, "That sonofabitch didn't turn the furnace up again, did he?"

"I'll check, Grandpa."

Melvin and Grandpa have been engaged in a battle over the thermostat for most of the day, although Melvin doesn't know it. Melvin is cold, which makes sense, given that it is 17 degrees outside and the thermostat is set at 70. Grandpa would like it a couple of degrees lower. He says it helps him breathe. He lies in bed, covered in blankets. Melvin is up and around, and his gown offers little warmth and about as much privacy as the curtain room divider. Every half hour, Melvin turns the thermostat up to 75 degrees, and a half hour later, Grandpa asks me to turn it back down to 70. I'm not exactly sure why, but Melvin has decided that the nurses are to blame. He confides in me, "That goddamn nurse keeps turning down the thermostat." I didn't immediately confess, figuring that neither of the roommates was going to be happy with the temperature, and that this little dance probably represented the best we were going to manage by way of compromise. I told Melvin, you gotta watch those nurses.

It's midnight before the technicians and nurses and nurse's aids have finished poking and prodding Grandpa and Melvin. For the past several hours, I have been an uncomfortable witness to various indignities. The nurse's questions are embarrassing. There are persistent inquiries into the frequency, magnitude and consistency of bowel movements. Melvin walks around in a gown that doesn't quite cover his ass. It takes every ounce of energy and concentration for Grandpa to piss into a plastic container. He hasn't been out of the bed since he checked in last night. When things finally quiet down, just as I am beginning to fall asleep, I hear Melvin cussing behind the curtain. I ask him if everything's all right, and he tells me he's fine, and asks me not to come in. More cussing. I hear him fumbling with something in his bed, then his bare feet slapping the cold, tile floor. He's at the sink, and I catch a glimpse of him washing his underwear. He's still cussing under his breath. He is cold, and alone, washing his soiled shorts in a sink. Grandpa is snoring loudly, his body still quietly shaking.

Jan 6. 7am

The hospital staff resume their activities at a little past 5 in the morning. A technician rolls in the nebulizer unit for the first of four breathing treatments Grandpa takes each day, everyday, even when he's at home. Someone disappears behind the curtain, and I hear Melvin wake, startled and confused. "Here to take your blood pressure, Mr. H_________," the nurse's aid explains. His voice is either compassionate or condescending. I close my eyes, and when I open them, the room is dark again, and Grandpa and Melvin are snoring contentedly. It's a quarter to 6, and the hallway is now abuzz with nursely doings. In spite of Melvin's best efforts, I have won the battle for control of the thermostat, and the room is cold. I imagine Melvin rolling out of bed, barefoot and wearing only his inadequate smock, and decide to commit a minor act of treason, nudging the thermostat up to 75. Grandpa is still firmly in the grip of the Ambien, and he won't be awake to complain for at least another hour.

At ten past 6, two nurse's aids enter the room, with various monitors and instruments in tow. They each turn on the fluorescent panel above their patient's head, and Grandpa and Melvin are greeted with a synchronous, cheerful, "Good morning, Mr. ___________." It takes Grandpa a good half-minute to figure out where he is, and what's going on. I put my hand on his shoulder, look into his eyes, and say Good morning, Grandpa. He smiles up at me, not quite certain of anything, but happy just to see a familiar face. "Good morning, Davey. Did you sleep there all night?"

"Yup, right here. I told you I wasn't going anywhere. The nurse is here to get you all fixed up this morning. Think it'd be OK for me to run down for a cup of coffee and some breakfast?" His eyes have focused, and he is rattling off a list of questions and complaints to the nurse's aid. He doesn't answer me. I pat him on the shoulder again. "I'll be back in a minute Grandpa."

"Well, where ya going? Are you leaving? Where's Ellen?"

"No, Grandpa. I'm not leaving. I'm just getting out of this guy's way so he can take care of you. I'm going down for a coffee. I'll be right back. And Grandma will be here in a couple of hours." He smiles at me, and I'm uncertain whether anything I've said makes sense to him. "I'll be right back, Grandpa."

"OK, Davey."

It's half past 6, and I'm seated in a booth in a diner about two blocks from the hospital. It's 9 degrees outside, and the roads are covered in black patches of ice, invisible in the pre-dawn darkness. I've ordered the Big Boy breakfast - two eggs (over medium), sausage, biscuits and cream gravy - and already finished a second cup of coffee before it arrives. Over the past couple of days I've been working on a syllabus for a public speaking class I begin teaching next Tuesday. At the moment I'm scanning a copy of Malcolm Speaks, the collected speeches of Malcolm X, looking for course material. When the food arrives, I lay the book on the table, cover up, and a bespectacled Malcolm X points a finger up toward the waitress. She stares back, mouth slightly agape, then looks back to me, "Uh, enjoy your breakfast, sir." I get the feeling it could be awhile before I get a refill on the coffee. To my pleasant surprise, it isn't.

I'm sitting in a booth at the front of Friendly's, a diner frozen in the 1970's. The illuminated sign out front advertises this as "The place you want to eat." If you could pick it up and transplant it to Austin, building, menus, waitresses, clientele and all, you'd make a small fortune off the clever and stylish hipster crowd. The decor would be described as kitschy Americana or retro hillbilly chic. The regular patrons, who embrace the place without any sense of ironic detachment, would be regarded with amusement, as if put there merely to add an element of authenticity to the scene. A group of regulars have gathered at two tables in the center of the restaurant, and they are talking loudly, calling the waitresses and busboys by their first names, and greeting everyone who walks in the door. Except for me. They smiled and nodded, and I smiled and nodded back, and that was the extent of our acknowledgments. I have an urge to reassure them that I am not one of those hipster assholes, but I know they don't really care one way or the other.

But I'm not a hipster asshole, I reassure myself. I know this because the sensation I experience here is not ironic amusement but overwhelming nostalgia. This place is a well-preserved slice of Oklahoma City circa 1975, the Oklahoma of my youth. The brown vinyl benches and glittered Formica tabletops could easily be thirty years old, or they could've been installed last month. The wood-paneled walls are decorated with oil paintings in ornate, gilded frames, all depicting various nature scenes - the profile of a stag drinking from a placid mountain stream; a snow-capped mountain glistening in the sunshine; a bass splashing at the end of a taut line. A four-foot wall divides the booths, proudly displayed atop which is a collection of wood carved roosters, a tin coffee pot, plastic tulips in a crystal vase, and several pairs of ceramic salt-and-pepper shaker figurines - boy and girl skunks; a corncob and an eggplant, both wearing top hats and spats; a hen and a rooster; two sombrero-wearing cacti. This could just as easily be my Grandma Doris's kitchen, and I could be five years old. There is nothing ironic about this place. I feel homesick for a past life.

Jan. 7, 9am

I was sad to leave Grandpa, but he's doing much better. Grandma tagged in at half past 7, and I left shortly thereafter to shower before hitting the road. I'm about to leave for Denton to pick up Loren and the debaters, then heading on to Dallas for the second half of the swing at UTD. My back is killing me, and I'm going to need a quart of coffee to make up for last night's awful sleep, but I'm glad I could do this, and wish I could stay until they let him go home. I imagine my mom stretched between those chairs tonight, and feel slightly guilty about looking forward to the bed awaiting me at the Crowne Plaza.