My Father’s Smile

My mother died of breast cancer at the age of 52. I was 29. My father died of throat cancer at the age of 77. He was a smoker.

As I get older I cannot help but think of the milestones in my life and compare them to the experiences of my parents. My mind says, “Gee, at this age they just immigrated to England from India and were working to save money with three little boys.” When they came to Canada, I thought to myself, my mom was only 29 and my dad was 40. They came with nothing but hopes of making something. As I go along in my life I compare my chronological events with theirs and it gives me perspective.

I think I was critical of them at certain times, questioning why they didn’t understand this or why they did that, or why they didn’t do something different. This could be about a major decision- such as their choice to live and stay in Edmonton, Alberta, or something small as some day-to-day customs and beliefs. But as I mature I realize they acted on the basis of what they knew.

They were born without amenities and struggled. They had a university education in India, but a broad-minded, Liberal Arts education I’m sure they did not have. They grew up in a generation and culture with limited information and resources. Not to say that more information is good; sometimes we have too much information and we are constantly being bombarded with useless information and disruptions. Different medias and different mediums are continually competing for our attention.

They had less than I in the way of money and likely more in the way of worries and uncertainties about themselves and our future. When I simply compare their life to mine it doesn’t equate in terms of financial security. But they had something more than what I’ve seen others who are financially secure have, and that is… an abundance of smiles.

I always remember my parents smiling. They each had a unique and special smile. Perhaps all children feel their parents’ smiles are uplifting and soothing. It certainly was and still is for me.

Now, my dad developed throat cancer, a delayed consequence of smoking. He smoked too long, and quit too late. He had been in great health with no other medical problems. To make a long story short, he had felt a pain in his neck that lead to more tests and treatment. He had chemotherapy, radiation and eventually surgery to his neck. We, and all the doctors involved, were very diligent in his treatment but the cancer was also diligent in not wanting to give up. It was a very aggressive cancer.

He had a radical neck dissection in April of 2010 and they were unable to get all of it. The specialists were uncertain when the cancer would resurface. By June, two months later, the cancer had returned. The doctors told us that he wouldn’t make it for Christmas. I’m sure not everyone reading this has witnessed cancer first-hand, let alone throat cancer, but throat cancers can be very disfiguring and debilitating. My dad initially required a G-tube (a gastric tube that connects to the stomach so he could get nourishment). He could still speak and smile after the remarkable twelve hours of surgery to his neck, whereby the surgeons had to cut open his jaw to get to the tumor. The surgeons were great in that his face was not grossly disfigured; however, as time went on his voice and speech became slurred because the tumor was growing. By June we had already noticed this change. The doctors were saddened by not beating this tumor and the oncologist apologized that he won’t make it for Christmas.

This was disappointing at many levels to our family, especially since I had a newborn due in the beginning of January. The specialist reminded us of how aggressive the cancer was. The cancer reminded us, too. But he was still able to speak with a slur, despite the growing mass in his neck, and he always had a smile for me, and without hesitation for my five-year-old daughter Saveena.

He went to Vancouver and Edmonton in September and October of 2010 to say hello and goodbye to old friends and loved ones. He especially went to say goodbye to his 98-year-old mother. As he travelled along in his journey, so did the cancer as it pushed and prodded its way inside his throat. By the time he travelled from Vancouver to Edmonton he had trouble breathing and was taken to the hospital where he needed to have a tracheotomy (a tube inserted in the throat to help him breathe). By now his tongue was protruding more as the tumor engulfed his throat. He was becoming extremely disfigured, and he had lost his smile.

I mentioned I was giving you the short version; I went to Vancouver to meet my dad who wanted to get back to Ontario. I travelled there to escort him back. It was a long flight back but we made it to my brother’s home in London where he stayed while I drove seventy minutes south to Chatham. I had to get back to work and be with my family, it was October.

The next day my brother called me urgently; he was taking our father to the ER because he was bleeding profusely from the nose. The cancer had invaded some blood vessels in his throat causing a dramatic rupture of blood vessels, resulting in significant blood loss. The tumor was so large that the only way the blood could get out was through the nose, even though the bleeding was below in the oral cavity. He bled profusely for at least two hours as the ENT (Ears, Nose and Throat) specialist tried to stop it. By the time I reached London Hospital he was still bleeding. It looked like this was it. The End. Fortunately it wasn’t. With good luck and my dad’s determination (and a pinch of radiation to occlude the blood vessels) the bleeding stopped. They said he had two weeks left. How he made it this far was amazing to them. Through this he always remained calm. He wanted to see his grandchild, but sometimes that’s not always enough. By now he wanted to get back to Chatham and the local hospital. Oh how I wished he would live long enough to see my second newborn before he died, and to the Chatham Hospital the transfer of care was made.

I said this was a short version: while he was in the Chatham Hospital he had more complications such as febrile neutropenia, pneumonia, sepsis, with the ever-looming threat that he could bleed out and die from massive blood loss. We were all instructed that if he bleeds again, all that could be done was soak the blood with towels and give him morphine to make him comfortable as he slipped away peacefully. By now the cancer was protruding from his neck and his tongue was sticking outside his mouth the size of his hand. Even as a doctor I never realized how large and swollen a tongue could become.

My brothers, my wife and family watched this slow demise. His physical smile had long been gone, now only a memory captured by photographs. Somehow we, and he, made it to Christmas. We all wanted him to see the baby coming in January. My wife told me, “Do whatever you can, don’t let dad die before the baby comes, I want him to hold the baby and bless him.” We made it to January.

The due date for the C-section was January 7. It was on the third floor of the Obstetrics floor and exactly at the other end of the third floor was my father, dying in the palliative ward. Same floor, same hospital, opposite journeys. Life and death together.

January 4- 6 my dad was unconscious or hardly responsive. Not dead, not alive. I remember thinking, “So close yet not close enough, please live for one more day.”

January 7, 8 am C-section day. At 6 am my dad was awake and alert. A total surprise, a total change, a total blessing. At 10 am I ran to the other side to tell him his grandson was born, and he cried like a baby. We put him in the wheelchair and brought him to the Obstetrical ward and he held him. I smiled. My dad died 41 days later.

At the time of writing this, my son was six months old; my brother Vishal was visiting and holding Rohan and said, “Did you notice that Rohan has dad’s smile?” My brother was right. I thought I had seen that smile somewhere before and now I could place it.

It’s ironic that a son is usually comforted by a father’s smile as I had been. That is my duty to my son (and daughter). But now I’m comforted by my son’s smile… my father’s smile.