My father lay in the bed, supported by pillows and morphine. He breathed. His breaths were regular as a metronome, deep, snoring, sonorous breaths - hard work, the only thing he could manage. He didn't seem to be troubled by consciousness. Thirty times each minute, breathe in and breathe out. Each exhalation three times as long as its inhaled partner. Deeply in - and o-u-t-t-t-t.

"David? This is Margo at Life Care. Your father stopped responding to us this afternoon and we think he's had a stroke."

No, I think, he's had an epiphany. He's come to a decision. He made up his notoriously stubborn mind.

"Do you want us to send him to Emergency?"

To do precisely what? It's a question they have to ask, but it's a question which I have to answer. His wish was that his life not be unnecessarily prolonged. Another trip to the ED means IV's, bloodwork, repeat x-rays, likely a CT scan and admission. That they could keep him alive is unquestioned. That they and he and I would resent the intrusion of those life-sustaining efforts is without doubt.

"Or do you want us to call his doctor and get an order for Roxanol (an oral preparation of morphine) and keep him comfortable."

I'd heard and asked that kind of question many times at work - "What would you like us to do?" Actually, what I wanted everyone to do is turn back the clock and make all this go away. I didn't want to be a middle-aged man making end-of-life decisions for his father. I wanted to be ten years old, playing baseball in the empty field next to our house on a summer evening. I wanted my mother and father, my sister and brother. I wanted to start over again and do everything differently. I wanted new decisions and everybody healthy and happy and just have things the way they were supposed to be. Except, of course, that this was exactly the way things were supposed to be.

My father lived 87 years, six months and 16 days. For the majority of those days he was of sound mind and body. His life was long and mostly good. He was at the end of it and who the hell was I to stand in his way now? He was tired and, in truth, there wasn't much for me to decide. He had already put all his important papers in a manilla envelope, paid for his funeral service and cremation, even budgeting for flowers. He made it clear that when it was time, he wanted to be let go.

"Yeah. . OK . . . you can get the order. For the Roxanol, I mean. I'll be in."

Thirty times a minute. No variation in pattern or rhythm, His skin pink and warm, eyes closed, dreaming or bargaining or remembering. I shook him and called to him. His only response was to continue breathing. I pulled a chair next to the bed and sat down to wait.

We are stars, miniature bundles of energy, highly organized and specialized. If we exist in any real sense, it is as a collection of specialties and sub-specialties: cells and proteins and neurotransmitters, ion pumps and receptors, smooth muscle cells, neurons and dendrites, helper cells and killer cells, hemoglobin and ATPase. Food being the fuel for our cells, we eat in order to live and live in order to eat. We breathe as one way of maintaining chemical balance. Our kidneys function as another way balancing the demands of cellular metabolism. We are a marvel of organization and regulation, a swirling, seething mass of molecules and electrons and muons and quarks. And we are finite.

He began to moan as he breathed, every exhalation passed between tense vocal chords. Additional morphine had no effect and it seemed as though these were not cries, but a song of dying. He twitched, small muscles spasms in his arms and legs, hands flexed and relaxed, a quick tightening and release of abdominal and chest muscles, legs jerking. The nurse came and we both tried and failed to hear a blood pressure. The urine in his catheter bag was dark, concentrated - malevolent and sparse. His kidneys had nearly shut down. But his heart continued to beat and he breathed. Afternoon passed into night and then morning. The only change seemed to an increase in muscle twitching.

As the hours wore on I wondered if I had jumped the gun, prematurely pronounced him dying when this was just a setback. Maybe with some Tylenol and another antibiotic he'd rally. I tried to feel a pulse and couldn't. As I watched his struggle to be free of his body, it seemed that this was the literal opposite of labor; that his spirit fighting for release was analogous to the fight to be born. He was struggling to give up, fighting with any part of himself that wanted to hold on.

I held his hand. In life, we hardly touched or spoke of things too close to the heart. Now I leaned toward his ear and told him I loved him. And that it was OK to go. I sat, held his hand in mine and closed my eyes, listening, remembering.

On his back underneath the family car, he'd stick out a greasy arm and ask for a 5/16th socket, always asking for exactly the right size the first time. When an ambulance would drive down our country road, ambulances then being specially outfitted Cadillacs run by the funeral home, he'd nervously, half-smile and ask "Want to go for a ride?", hoping to see something unusual. At the supper table, he would look over at the silverware drawer not completely closed. He would put down his fork, sigh in a martyred fashion and get up from the table. Walking around the table, he would wordlessly slam the drawer shut and return to his place. Couldn't ask someone to shut the door - he wanted to make a point. Again. He was condescending to women and teenagers. He had to be right in all things at all times. He was loathe to show any feelings but anger, best expressed as sarcasm. He was responsible and generous to a fault and loved all little children.

I had been with him now for the better part of 24 hours, getting up occasionally for relief or to stretch. The staff brought me coffee, offered me a bed to lie down in. They cleaned him, repositioned him and gave him morphine. The moaning stopped, the breathing didn't. It was more shallow, however, and he rattled as though gargling in his sleep. "You can go." I tried to reassure us both of that. He is a breathing machine, nothing more. His spirit is quiet, his body continues. I got up again to walk and suddenly felt overwhelmingly tired, physically and mentally exhausted. Going into his old room, I lay on his quilt and closed my eyes, the sound of his breathing still in my ears, and slept.

A light knock on the door - "Mr. Fox? He's gone." The nurse came to get me. It had been only 45 minutes since I left. "I gave him some more morphine and when I checked back, he had stopped breathing. He died but I haven't confirmed it yet.." We each took a stethescope and went into his room.

All color gone, all sound from him gone. All movement and animation, all purpose, all wit, all anger and fear and insecurity, all contentiousness and lonliness and weariness gone. The husk of the man lay on the bed in front of me, already cooling to the touch. I listened to his silent chest and was relieved it was over. His battle had not been to live. He had struggled to die and had carried the day. The spark that animated him was set free and I looked at his body, trying to imagine what he was going through now.

We are stars, some piece of us glowing with energy and potential and knowledge. We don't even know all the things which we know, can't conceive of the inconceivable. What we are, the "I" in I, what it is behind our eyes that looks out from this body and sees a world of our making; this spark is a piece of the whole. There is a world, a universe of sparks animating the cellular processes that make us human or bird or flower. There is a spark that begins the process of growth and death. Where does the light go when you blow out the match? It becomes one with our breath, the empty chair, a child playing, rocks on a hillside, kisses not yet given. The light, the spark, joins with all the other potentials in the world, waiting to be born.
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