07:13 – Barbara’s dad took a sudden turn for the worse yesterday. When I arrived at Brian Center and got up to Dutch’s room, I first thought he was asleep. I spoke his name and he didn’t react. So I spoke it louder and he still didn’t react. He didn’t appear to be breathing, and for a moment I thought he was dead. So I spoke his name even louder, and he did finally half-open his eyes and attempt to greet me. It was obvious that he couldn’t remember who I was. So I talked to the nurse, who said he’d suddenly declined that morning, which was typical of end-stage renal failure. She asked if I wanted her to call the family, and I told her I’d take care of that.

Barbara left work to get over to Brian Center, as did Frances and Al. Barbara’s friend Marcy brought Sankie over from Creekside, and the nurse from Hospice arrived soon after. She quickly determined that Dutch was eligible for transfer to Hospice and initiated the transfer, even though Dutch had in the meantime rallied somewhat and was sitting up in bed, talking, and eating. That turned out, as expected, to be very temporary, and by the time he arrived at Hospice around 4:00 that afternoon he was again unresponsive. At this point, they’re just trying to make Dutch comfortable. The hospice folks obviously have a lot of experience with people in Dutch’s condition, and the consensus seems to be that he could die at any time, but he may last a few days or a week. It’s unlikely to be much longer than that.

13:22 – Barbara and I just got back from visiting her dad at Hospice. We got there about 8:30 and found Dutch awake and semi-aware. He was shouting that he was being tortured because he hadn’t had anything to eat since noon yesterday, which was true. Of course, he’d been unconscious for all but a tiny part of that time. Hospice had him NPO because of his condition, but Barbara and Frances told them to go ahead and give him the tray he was shouting for. He proceeded to eat his entire breakfast.

These rallies are torture for Barbara and her sister and their mom. Everyone knows they’re illusory. They don’t mean Dutch is getting better or has any hope of doing so. His urine output is down almost to nothing, and the poisons continue to accumulate in his blood. Every bite of food he eats poisons him further. Short of dialysis, which he wouldn’t survive and we wouldn’t approve anyway, he has no way of eliminating these toxins, which will kill him sooner rather than later.

I told Frances and Barbara that their dad’s situation was analogous to a flashlight with very weak batteries. You turn it on, the beam dims and eventually goes out completely. But if you turn it off, allow the batteries to rest a few minutes, and then turn it back on, the batteries will have recovered sufficiently to run the lamp, dimmer than before and not for long. Dutch’s situation is the same. He goes away in an almost coma-like unconsciousness, during which he gathers enough energy to rally. Yesterday, the rally lasted only an hour or so. Today, it lasted from about 3:00 a.m. until noon or so. I’m afraid today’s rally may have taken everything he had left.