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. It gives me perspective, as I go along in my life, to compare my chronological events with theirs.

 

I think I was critical of them at certain times thinking why they didn’t understand this or why they did that and didn’t do something different. This could be a major decision – such as their choosing 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 weren’t born with amenities but were rather poor. They had a university education in India but a 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 media and different mediums are 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. I compare their life to mine now and it doesn’t compare in terms of financial security. But they had something more then what I’ve seen others have who are financially secure and that is…smiles.

 

I always remember my parents smiling. They each had a unique and special smile. Perhaps all children they feel their parent’s smile is 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, 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 and radiation and eventually surgery to his neck. I felt we, and all the doctors involved, were very diligent in his treatment but cancer too was 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 won’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 his stomach so he could get nourishment). He could still speak and smile after the twelve hours surgery to his neck and jaw, 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.

 

Now, this was disappointing at many levels to our family, especially since I had a newborn due at the beginning of January. All the specialist reminded us of how aggressive the cancer was. The cancer reminded us too.

 

He was fine in Chatham and was able to speak but his speech was off a bit because of the growing mass in his throat. But he was still able to smile and he always had one for me and without hesitation for my five-year-old daughter Saveena.

 

He went to Vancouver and Edmonton in Sept and Oct 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 traveled along on his journey, so was the cancer, as it pushed and prodded its way into his throat. By the time he traveled from Vancouver to Edmonton he had trouble breathing and was taken to the hospital and needed a tracheotomy (a tube inserted in the throat to help him breathe). By now his tongue was protruding more and the tumor was engulfing his throat. He was becoming extremely disfigured. He had lost his smile.

 

Well, I said I was giving you the short version; I went out to Vancouver to meet my dad who wanted to get back to Ontario. I was going to escort him back. It was a long flight back and we made it back to my brother’s home in London while I drove 70 minutes south to Chatham to get back to work and be with my family. It was October.

 

The next day my brother calls me urgently because he had to take him to the ER because he was bleeding profusely from the mouth. The cancer had invaded some blood vessels in his throat causing a dramatic rupture of blood vessels resulting in a significant fountain of 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. This 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 2 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. He also wanted to get back to Chatham, his home and be at the hospital here. Oh, how I was wishing he would live long enough to see the newborn before he died and to the Chatham Hospital the transfer of care was made.

 

I said this was a short version so I’ll say this; 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 have a bleed out and die from massive blood loss. We were all instructed that if he bleeds again all that could be done is 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 and was the size of his hands. 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 and was a memory only captured by photographs. Somehow we, and he, made it to Christmas. We all wanted him to see the baby which was 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 him and bless him.” We made it to January.

 

The due date for the C-section was January 7. It was on the third floor on 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 4,5,6 my dad was out of it. Unconscious. Hardly responsive. Not dead, not alive. I remember thinking “so close yet not close enough, please live for one more day.”

 

Jan. 7, 8 am C-section day. 6 am my dad was awake and alert. A total surprise, a total change, a total blessing. 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 after.

 

Now at the time of this writing my son was six months old and my brother Vishal was visiting us and holding Rohan and said: “did you notice that Rohan has dad’s smile?” And my brother was right. I thought I had seen that smile somewhere before and now I could place it.

 

It’s ironic in 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.

Contact Dr.Lalit Chawla