I’m walking in the backyard at dusk with the dogs. The papaya trees that we grew from seeds are five feet tall. You would be amazed. And the fact that you are not here hits me in my gut. I want to throw up.

We will be asked to get a CT scan that will confirm that the blood flow to your brain has been horribly, irrevocably disrupted. We will meet with the organ procurement team. I hold your hand and am amazed how tan you still are against the white sheets. I want to imprint the feel of your skin because I know I will lose this physical connection with you in a matter of hours. I love the feel of your skin. It is soft. I will remember that you love me but I will not be able to touch you.

There is a vacantness about you now. The fact that your heart still beats and your lungs inflate are irrelevant. 

We will sit with the organ procurement team member and fill out the requisite forms. While we are there they test you by removing ventilator support to see if you will breath on your own. You pass the test. You do not breath. They tell us it may take up to 72 hours before you go to surgery and I don’t know if I can survive another 72 hours with you lying there.

They will call us at midnight. You are unstable and recipients are already being located. We have a few hours with you before they take you to surgery. Yuri, Caitlin and I walk to the hospital in the dark. It feels awkward. For the most part we walk in silence. It is a death march. I want to reach out and comfort them but fail. I refuse to be comforted. I want to wail and fall down like I have seen family members do but it isn’t my nature. We walk on.

I’d like to tell you that my last hours with you provide solace but they do not. The kids take turns in the room. I go in. I yearn to climb up in the bed beside you and go to sleep with you. Can’t we just go to sleep now together forever? Why are you leaving? Why have you left me? There are still people coming in and out of the room and the nurse sits at the window outside. It’s not very private. When we are all together again beside you the anesthesiologist comes in and meets with us. He details your care prior to the surgery. They will be very respectful.

Should I stay with you until they wheel you away? I am torn. I think you have already left the premises. Still, I’m unsure. I don’t want you yelling for me and I’m not there. We walk away. I’m panicking inside. I resist the panic that grips me and makes me want to run back to your side. I can’t leave you like this surely.

In the morning I am filled with unreasonable anxiety. I wish I had elected to have them call me when they took you to surgery instead of upon completion. No one calls to tell me it’s over and I don’t remember when but I call the organ donation contact number. It’s confirmed that the procurement was completed around 9:30 that morning. 

It’s dry. Can you believe it? Hot and dry. Things are starting to burn up. Your cashew tree is doing well though.

Thought you’d like to know.

So…what do I do when I don’t want to do anything without you or go anywhere without you or talk to almost anyone except you? That’s a tough one.

This morning his heart rate is much improved. Back down in the 70’s. He is relieved that we (Yuri and I) talked. And in above message it was thrombolytics (TPA) he was given.

Excellent tell him I love him and let me know of plan when there is one. Is he still on all the medicine or since he’s stabilized will they start weaning him off some of it until they can get him into surgery? Have they also found a course of action in regard to what type of surgery he needs?

Any developments?

No developments. I’ve been working with air transport all afternoon. Doesn’t look like he will fly out until about 8 a.m. tomorrow. His heart rate is good. His oxygenation is not as good as when I left this morning. The doctor is supposed to come in and talk to me.

Ok so does that mean too much fluid in his lungs? And what’s average oxygenation?

Good is > 90 on room air but Dad is on a mask at 100% oxygen and we’re hanging at 90-92%. When I left this a.m. It was at 99%. Going backwards.

So what could that mean? And where are u flying to?

It means his heart has taken a real hit. It’s injured and can’t pump well so fluid is collecting in his lungs. We will go into Miami. Last I heard they were close to finding a bed at Miami University Hospital. We were trying there or Mount Sinai. We won’t know much more until we can get a heart cath scheduled. Just wanting him to stay stable. Augh! Yuri, the goddamn airport closes here at 6 p.m. So that coupled with difficulty in finding an available bed is delaying the flight out.

Ok is there anything they can do in Belize to keep oxygenation up beside mask?

Dr. here now. He’s had lots of Lasix to take fluid off. They are conferring.

Ok let me know what’s the prognosis.

They are going to shoot another chest X-ray at 6 tonight. Need to see how it compares with yesterday. He’s exhausted and trying to sleep.

What did the other xray show and do they have other imaging devices like sonogram or Ct scan and would that be.

It showed pulmonary edema, fluid. Ct not appropriate. I know you are worried. Sonogram maybe but doesn’t really address problem he is having. I am on the phone with Miami transport docs. They are calling back in a minute to talk to the doctor here. Yuri, honestly in my opinion they need to intubate and place him on a vent so he doesn’t work too hard to breath. Besides when we fly we will be at altitude. But they are talking and deciding not to do it right now.

“Reeling from the shock” still describes us all, Margaret. Don’t be sorry that you didn’t come to Miami. David was kept under sedation the entire time. I am sad that he didn’t see Yuri beside him. I hope he heard his voice and that it comforted him.

I honestly, don’t know what to write. I lost the love of my life. You lost a brother. I know your heart and the hearts of your family ache for him as well. You have so many memories of him that I do not. I’m envious.

He always told me that he was living on borrowed time because of his family’s heart history. I don’t know if we truly believed it but it turned out to be prophetic.

I believe David was happy. He liked Belize. He surprised me. I always talked about traveling to different places but he turned out to be the truly adventurous one. He made our retirement here happen. He seemed to adapt to this climate and culture easily. We were beginning to talk about the possibility of even more adventures. We were just getting started. I will try to be like him, self sufficient and kind. He was always content with who he was. How many of us can say that? He was quirky, funny and very, very smart. When I get really sad I must remind myself that I had twenty one years and more with him. It has to be enough.

Thank you for the picture.  

The week we were with him at the hospital in Miami gave us time to have a sense of closure. The kids and I will lay a wreath when we scatter his ashes on the sea. There was no ceremony for you. I’m sorry for that but could not bear it and I needed to get home. Please forgive me.

Give my best to everyone. Hold him in your heart.

Dari

WTF! David! Went to get the shocks loaded into the Honda but neither of the door key locks would work. I looked up that email you sent me back in December on how to reprogram them. It was only when I inserted the key into the ignition that I discovered the battery was dead, dead, dead. I left the light switch in the on position after driving into town yesterday.  Read both vehicle manuals and a Car Talk how-to on the use of jumper cables. It took a while but it is finally running and recharging.  😕

Father’s Day.  We are up as usual. David goes to the golf course. The Sunday golfers don’t go out super early.

9:21 AM  -Happy Father’s day, Pops!

12:35 PM  Oh yeah, thanks! How are you guys doing?

-We are in Newport right now and next stop is Martha’s Vineyard.

Cool. Say hi to the Kennedys for me. Things working out on the new boat?

1:18 PM -Yea pretty swimmingly. When we get back to Panama City we will get time off and I can finish up engine swap before we head to Caribbean for winter. Woo woo

We head to lunch as usual. Once home we acknowledge we are both tired. David settles down on the couch for a nap and I am typing letters for the sailing club. Around three o’clock David literally pops up off the couch. He says nothing when I ask him but it’s obvious something is very wrong. I scream at him to tell me. He is pale, his skin cold and clammy. He is making little grunting noises and admits to left sided chest pressure. He is not nauseated. I have him chew a 5 mg. Aspirin and we jump in the car calling a doctor we know in Corozal. He will meet us at his office. I leave the back door open. 

In Corozal we stop to see the doctor who wants to send us on to  Mexico or Orange Walk or Belize City for EKG, labs and observation. The physician unsuccessfully tries to contact a colleague, a cardiologist in Belize City. We are wasting time. He gives David sublingual nitroglycerin which lessens his pain (from a 6/10 down to a 3/10 where it will remain) and monitors his blood pressure. We look at one another and the weight of our choices hangs heavily upon us. I have left our passports at home and must retrieve them if we are to make the border crossing. I’m trying to calculate how much time everything will take. The language barrier looms large in our heads but Mexico is known to have better healthcare. Is it the right choice in this emergency? We hesitate. All the while David’s heart muscle is dying.

I will never know if the outcome would have been different had we gone to Mexico and it tortures me. Instead we drive to Belize City bypassing Orange Walk Town. We stop for gas. I fly where I can but it seems to take forever. We talk. We hold hands. He is stoic. He is vulnerable. I take his pulse which becomes increasingly rapid and irregular. I tell him to hang on. I  joke that if he arrests in the car I will have to stop to administer CPR. We both know the outcome will not be good and are grim. It is nearly four and a half hours from onset before he receives thrombolytics, a medicine to dissolve the clot that is blocking the blood supply to his heart. Four and a half hours. It’s only two and a half hours from our house to Belize City. How can it have taken so much time? 

I have called Caitlin but I can’t reach Yuri by phone. I message him but get no reply. I don’t know what reception he gets onboard the boat.

7:56 PM Yuri, we are in a private hospital in Belize City. Your Dad is having a heart attack. He is stable at present, on O2, I.V. & thrombolytics. All appropriate measures. He will be stabilized and transported to the U.S. within 24 to 48 hrs. Don’t know all options yet.

I did try to call and will try again in the a.m. or if things change.

9:20 PM See? He’s alive and kicking. But seriously, he is more ill than he knows. They have lowered his heart rate, BP is stable, has fluid on his lungs (heart not working well). They have given him diuretics and he is on 100% O2

He is saturating at 99 on that now. It has improved. There is nothing for you to do right now. I am satisfied with his care here. Of course, he needs a heart cath and ?

Sometime after 9:30 PM I reach Yuri via Facebook Messenger calling. David is relieved. 

We didn’t have much paperwork left after downsizing for the move here. Thank goodness for that. I’m almost all through it. I need to talk to you about the E-diets menus you printed off, at least a hundred pages, from 2001? I get it. You didn’t want to have to pay the monthly subscription again. And you very much liked the convenience factor of the plan. But, David….!

Yuri is in Maine now. Caitlin tattoos but seems to want to be involved in urban gardening and horticulture. The dogs are a little lost. They lie around close to me all day. Their brains must be vegetating for lack of stimulation. Connor snuggles my left thigh as I write. I can’t tell if he misses you, David. Sometimes I cry looking at him. He was your buddy. I remember how you laughed when he ran like a fool throughout the house bouncing off furniture, stopping only to grab a drink of water. He sleeps on the bed every night still. The other two start off in their own beds but sometimes in the morning I wake to find all three of them cuddled beside me. The chickens are fine. Even the little ones survived.

There is a hum of a sugar barge in the distance. It’s hot and close in the house in the late afternoon.

I need to obtain a Grant of Administration.  I say I’m in no hurry, that I will take my time to decide where to go and what to do. I think about it.