Early in the morning I see Jorge at the nurse’s station. I tell him that I am worried about the continued high white count and the antibiotics. “Why don’t they just give him some vanco already and get it over with. What are they waiting for?” Horde replies that you can’t use vancomycin indiscriminately; doing so can do more harm than good. “Harm to society or to my father?” I ask. He acknowledges my point but says that vancomycin can actually harm my father if it is not appropriate to the bacteria he has. He thinks that my father is on the other teaching team and if so I can be assured that each day the nature of the bacteria is assessed and the antibiotics adjusted accordingly.

I leave to pick up Nomeda and bring her to the hospital. I just have a good feeling about today. It is a warm day and I play music in the car. I tell Nomeda “today will be a good day. You’ll see.”

Back at the hospital I speak with charge nurse Darlene about the ultrasound test that was to be done yesterday. She checks and says there is no record of any order for a test. She has a call in to Dr. Riar & Shamim’s office. Dr. Riar will look into the matter and get back with her.

Quite suddenly around 10:00 am my father’s eyes open and he starts talking and moving his arms. He has not been this awake since he sat up in the ICU last week. He is asking questions (where am I, why am I here) and gently humming. He is smiling and affectionate. Nomeda and I take turns leaning over to him and engaging him. Now he is not falling back asleep or getting groggy. He is wide awake. His speech is very soft. He asks when he will be discharged to go home. Can we make it to the Mincha prayer? I am translating the Yiddish for Nomeda. My father says “I am so thirsty. Give me something to drink. Give me something to eat. If you don’t give me something to eat you’re killing me.”

The stomach feeding had been stopped from noon in preparation for the ultrasound test now scheduled for 4:00.

I got an apple juice with ice and dipped a foam lollipop into it for my father to suck. (We’d been doing this with apple juice or water for the past few days, always wringing out the foam before putting it to his lips or his tongue.) Now my father was sucking for dear life. He was pulling so hard on the lollipop we had difficulty getting it out. I would say “open up so I can get you more.” Nomeda and I took turns giving my father these lollipops.

During the afternoon I call Dr. Shamim’s office to inquire (and request if needed) that my father is assigned to a teaching team. Mrs. Altschuler answers. She wants me to know that she & Dr. Altschuler visited my father the previous week. I tell her that my father is awake and talking and she says that is a very good sign.

Caroline Williams comes in to see me about my complaint regarding Dr. Weiner. We meet in a room across from Susan King’s office. She takes detailed notes as I describe the way Dr. Weiner screamed at me and waved his finger. She tells me such behavior is unacceptable and will be investigated. I will hear back from her within 30 days. I tell her how relieved I am that my father is finally on the road to recovery.

Dr. Shamim walks into the room to examine my father and is very surprised to see him this awake. I introduce him to my father, and demonstrate to him how my father is sucking. “Oh good,” he says, “He’s swallowing.” My father is put on a gurney to go down for the ultrasound. Dr. Shamim rides in the same elevator and says goodbye to him. My father smiles at me and talks throughout the test.

Nomeda waits outside while the ultrasound is done. Afterward we go back to the room, put my father back in his bed and Nomeda is ready to leave for the day. I apologize for not being able to take her to the metro, but won’t leave my father even for a few minutes now that he is awake.

Very suddenly my father’s breathing becomes rapid and he is fighting for air. I call for help. First the nurses increase the airflow to his canula and soon they give him a mask. Dr. Kariya comes in for his rounds. I tell him what happened and he listens to my father’s lungs and quickly goes out to the nurse’s station. After a few minutes I go out to look for him and a nurse tells me he is gone. “Wasn’t he in to see your father?” she asks? An x-ray is taken. The nurse tells me it shows “aspiration pneumonia.”

My father is still awake and pulling the mask off every few seconds. I gently hold his hands and kiss them and tell him that he has to keep the mask on. I move back to watch him. He pulls the mask off. As I come toward him he looks straight at me and screams in pure anger, “Gey Avek. Avek!!” Sleep takes hold and my father is never to wake up again.

I see his sat levels going into the upper and even middle 80s. I see nobody in the hallway or the nurse’s station to ask for help. I go into the waiting room to call Anita and ask for her advice when I see a young resident, Dr. Al-Quatami, getting into the elevator. I stop him and say I need his help. He follows me into my father’s room, takes one look and quickly says “he needs to be intubated.” I ask if they can try suctioning first, explaining how good things had been all day. He replies that he will call respiratory but that suctioning is not going to help. He runs out to the nurse’s station while I stay with my father.  I recall feeling a sense of relief, as my impression of this doctor was extremely positive.

When Dr. Al-Quatami comes back in, the discussion takes an unexpected turn.  He tells me that in looking through the record he sees reluctance on the part of the doctors to intubate my father because of his age. “We know from experience that older people don’t do very well on the respirator. It is also a very uncomfortable procedure. Do you know that even when you stick someone over and over with a needle to draw blood you are hurting them. If I were to tell you that intubating him would only prolong the inevitable would you still want it done?”

I recall contemplating the utter ridiculousness of that remark about needles as I explained to him that there is no certainty at all that this is a hopeless situation. “My father was walking around our apartment buildings 2 weeks ago,” I told him. “He comes here with no co-morbidities, a healthy heart and lungs. He deserves the benefit of any doubt.” I contrasted it with my mother who passed away of lung cancer where I did not request a respirator or CPR. “Even more importantly,” I tell him, “I am my father’s advocate and he would want to follow Jewish Halacha. He has complete faith in the guidance he receives from his Rabbi, who made himself very clear on the matter.” Dr. Al-Quatami asks “If I show you the records and the doctors’ opinions about this would it change your mind?” I say no!

He asks if he might talk with the Rabbi about this, and I give him Rabbi Anemer’s number, relieved to be over this hurdle. I thank him for all he has done for us, noting that I pulled him out of an elevator and he came to our rescue. “This white coat obligates me to help anyone anytime,” he replies, “even someone in the street.” He leaves the room and a female respiratory tech begins suctioning my father. His rough breathing doesn’t change but the tech says she suctioned out quite a bit. Dr. Al-Quatami returns and says “Your Rabbi doesn’t want to budge. We’re gonna need to intubate.” I reply “ok, do it.”

My father’s mask is replaced with a 100 % oxygen mask (this mask has a plastic air-filled bag under the part that fits over the nose and mouth) and his breathing immediately becomes easier. He is in a peaceful sleep and I am staying by his side and holding his hand waiting for the doctor to return.

A nurse soon comes in and replaces the mask with his previous mask. His respiration and heart rate immediately go up. His breathing is labored. I go out into the hallway asking for Dr. Al-Quatami. I’m told he is on another floor. I reach him on the phone and ask what became of the intubation. “It won’t happen tonight,” he replied. “The situation is under control and we’re keeping a close watch. We have your father on oxygen and his breathing is better.” I pointed out that since they switched masks this wasn’t the case any longer; now his breathing is labored once again. “We can’t keep him on 100% O2 for very long,” he tells me, “his respiratory muscles will become accustomed to it. They have to be kept working.”

I go home exhausted, gratified that we apparently dodged the intubation bullet and that the hospital is on top of the situation. I was very worried though; I knew we’re in trouble.