In My Hands

It’s a weird thing, to hold a human life in your hands. This happened to me yesterday, from a quarter I never expected.

I came back from voting to work, where two people I didn’t recognize were waiting to talk to me. Turns out, while I’d never met them, I was quite familiar with their names: Becca and Jake have been taking care of the cats, house and one of my many friends named Bob for the better part of a year.

I told you about Bob back in July: his health was precarious then, and medical personnel were predicting his fairly imminent demise. Prior to this, and since then, the same dire prediction had been made several times, and each time Bob has defied the odds, sort of, returning home for short stints before ending up back at a hospital.

Yesterday the level amped up, and Becca was there to tell me that the last time Bob executed legal papers was 2004 — and I, 15 years later, still hold his power of attorney.

This suddenly matters because Bob, whom I have not spoken to in a month, turns out to have been sent back to Swedish Medical Center in Denver, where some time in the last two weeks they amputated a foot and/or leg in an attempt to literally cut off a bone infection. This amputation has been threatened for at least a couple of months, eventually becoming actionable.

I made a lot of phone calls after speaking with Becca and Jake, one of them to a woman named Sandra, who told me she was Bob’s caseworker “today” at Swedish. She told me Bob’s surgery had gone well, but then over this past weekend he took a turn for the worse. The infection survived the amputation, and so far is strongly resisting the antibiotics. And now he has encephal-something, fluid collecting on the brain. It has rendered him confused and unable to make decisions on his own. Thus, the power of attorney.

Once upon a time, Bob and I were close enough that this made sense, but as noted above, I hadn’t even spoken to him in a month. I only recently heard that he was “in Denver,” which obviously meant some medical facility, but Denver has a lot of those. I didn’t know he was scheduled for the amputation, and had recently wondered out loud at work if we would even hear about it if something happened to Bob.

The last conversation I had with him, one month ago, didn’t go particularly well and explains the philosophical gap that has increased between us over the years. I thought it was his birthday, but he was irritated that I was a day early (he barely can remember what month my birthday is in, let alone the day). Then he told me he was “back on Facebook,” which I initially took to mean he was home and able to access the internet, although I had brought him a netbook so he could get on-line while in the hospital.

But he meant he had been kicked off for 30 days (not for the first time). He said he didn’t know why, but these were the next words out of his mouth: “I guess I’ll need to quit referring to our brethern who wear rags on their head.” At which point I immediately lost interest in continuing the conversation. He was worn out by then, so we hung up. And I just couldn’t work up much enthusiasm to check in with him again, although periodically someone at Pat’s would remark on how we hadn’t heard from Bob for awhile.

There are many people assuming that his current scare is just that, and he’ll be back home at some point. He’s done it multiple times before. His caseworker told me he was stable and not in intensive care, but then she made it sound like a possibility that doctors might need to call me to make decisions as early as last night.

In addition to the bone infection, he has congestive heart failure, renal failure and diabetes. Infections have never been kind to him, and at some point his body is not going to come up with any resources to fight back. That point sounds like now.

I spoke with one of Bob’s cousins last night, a cousin who has been listed by Bob as eligible to talk to doctors about Bob’s condition(s). A cousin who has urged Bob multiple times to give him power of attorney, a conversation Bob wasn’t interested in having. Not because Bob was opposed to the power of attorney, but he has never been interested in end-of-life planning. He didn’t want to hear about it when his mother tried to tell him of her plans, and Becca tells me he wrote on one of the pages of his 2004 will, “This is a joke,” which sounds very Bob-like.

Swedish Medical tells me I can defer my power of attorney to a family member, so that’s what I’ll do today, turning these difficult decisions over to Cousin David. David is hopeful that this will give him better access to Bob; when he tried calling Swedish he got repeated busy signals and had trouble getting through to anyone. And while I feel like I’ve known Bob long enough and well enough that I have insight into what extent he would like care extended, his cousin has been far more involved with his medical issues over recent months than I have.

I called Sandra, the caseworker, back after I spoke with David to tell her about the plan and got another shock. She seemed put off that I had called her personal cell number, the same number I had been instructed to call an hour before. She was having trouble hearing me and didn’t seem quite sure who I was talking about.

In hindsight, I’m guessing she was on her evening commute home when I made the second call. She had told me she was caseworker “for the day,” so perhaps she was already absolved of her responsibilities with Bob. I don’t really know what a hospital caseworker is, nor how many cases such a worker might have on any given day, particularly when those patients are indigent. And perhaps, to not get too invested in too many ends-of-life, you shut it all off when you get in your car and head home.

But she’s my only point of contact, and so far this morning no one from Swedish has called, so I will need to try her number again to get David set up to make the decisions he will need to on Bob’s behalf.

Without having seen the 2004 legal papers, and not recalling clearly 15 years later, I’m not sure if I only have medical power of attorney. But today I’m going to exercise a power I might not even legally have and sign relinquishment papers to turn Bob’s two beloved cats over to the Gunnison Valley Animal Welfare League.

Everyone at GVAWL knows Bob and his devotion to his cats, and they will be well cared for there. Better than the last seven months, in which they have lived semi-autonomous lives mostly without Bob, fed by friends like Becca and Jake and (not cousin) Dave, all three of whom have gone way beyond and their efforts not particularly appreciated.

I suppose matters like these are rarely expected, and the news about Bob’s health isn’t unexpected at all. But that I might need to be a central figure in all of it certainly wasn’t on my radar. I can do this, if I have to, but both Cousin David and I would prefer that these decisions be made by Bob’s family member, a family member who immediately asked, “Do we know what Bob’s wishes are?” I believe Bob will be in good hands — hands that aren’t mine.