A Brother's Gift

Page One

The last time I saw my brother was 26 August 2013. Two weeks prior he had collapsed while visiting a facility that provided day-time activity for schizophrenic adults housed in assisted-living environments. While attempting to eat a snack he somehow inhaled, instead of swallowing, fragments of food stuffs. With valiant, even heroic effort, Paramedics restarted his heart some 15 minutes after its last natural beat. Unfortunately, that was at least 12 minutes after his meaningful life ended. The neurologist did all relevant tests and informed the family the next 72 hours would be determinative of a long-term prognosis. In fact, those 12 minutes were long enough, but standard medical practices and all the rest had to be honored.

I lay on the bed next to his for nine consecutive nights as his breathing patterns grew more ragged, more shallow, less rhythmic. I’d promised at the ventilator’s uncoupling I’d not leave, the same promise made to Mom and Dad, the least I could do. That of course mattered not to him, electronic synapses to all but the medulla—the primitive brain shared by most creatures on the evolutionary scale—had stopped firing as the minutes beneath pounding hands and pumping arms of paramedics stretched from 3 to 4 to 5 to . . .

We, my sister and I, had no real choice, at least when it came to the end-of-life decision. Neither had we any conflict. If, after the obligatory 72 hours, the doctors were to conclude his life would consist of nothing more than technology dependant breathing, we would set him off to his next adventure. Unfortunately, that was not the only issue time’s expiration would demand of us. There was the not so simple matter of gifting.

Page Two

It seemed obvious to us both—the answer to the surgeon’s request—obvious not to be confused with consensus. She had been there for him; the daily struggles with his decline, the change from his larger-than-life persona to but a hull of that, the voices, the fear, the winnowing. She wanted what he had become, all of it, slipped into the crematorium. So traumatic was any alternative, she had difficulty articulating her actual objection.

“I-I-I don’t know, it’s just all so macabre. You know this is mostly about money. Organ donation is free but transplantation is exorbitant. Name me another industry where the supplier of the raw materials gets nothing and the mining company gets all the money!” She turned away, her eyes filling with tears.

I think her real objection was much less cynical. I think she objected so her memory’s reincarnation of him would consist of what he once was. If a part —any part— of what lay in his hospital bed, were to remain, be given life in another, to another, that presence would somehow diminish her reconstruction.

“Really!? Can you think for a minute what he would want? Not the frightened, paranoid him, the helpless one of these last few years, but the high school kid, that college guy, the man who would fly thousands of miles at the drop of a hat, as often as asked, to help a friend or even a friend’s friend.” I lobbied for memorializing what his life had once been, not what it became.

“If he’d wanted parts of himself spread . . . spread hither and yon, he’d have left that in his will. He’d have told us that’s what he wanted. I will fight you on this. Please do not make me do that.” These were her last words on the subject as she backed out of his hospital room and abandoned confrontation for the elevator.

Page Three

It mattered not to her that a life —lives— could be sustained, altered, saved, or in some way made better. It mattered only that by giving a gift, all that tarnished her little brother would not perish in the heat, the flames, which would otherwise purify his memory. That seemed to me the unspoken part of her argument.

Yet I had no meaningful response, no legitimate counter as to why he’d been silent. In all the years, all the conversations—we’d argued politics, religion, relationships, philosophy, sports, even origins of sexual preference and gender identity—I could not remember a single expression of his desire on the giving of this gift. It was this realization that won the day for her and her pain.

I had asked the neurologist, the attending, the IC nurse, the hospice caregiver, the orderly, when it would come: The end. Each with some version of a managed face assured his comfort and declined any attempt to portend timing. My only clue came the morning of the last day. On each of the previous nine, the morning shift nurse would walk to the window and ensure blinds were positioned to shade an immoveable, helpless face from any intrusion by Dallas’ August sun. That morning, she opened the blinds completely, as the eastern sun gave color to a pale, vacant face; steady blue eyes gazed at him with an expectant, simple smile. She took not his temperature, but instead gathered a limp hand into hers, caressing then patting it twice to return it to his side. Without a word she looked to me with resignation full in sympathetic eyes, then turned and left.

By ten o’clock the room filled with a family’s quiet whispers—some traveled from Colorado mountains—all to support one another at the inevitable terminus of a life too short lived, too unceremoniously gone.

Page Four

It was some minutes past one o’clock, a daylight-saving sun barely passed overhead. Shadows began to stretch through the window, when his breath’s intervals stretched. It was clear warning that we guardians of life need prepare for its departure. That’s when I sat at his side and took his right hand. Cooled from blood gone too long, I touched it to sad lips that had prayed for strength when time for Donald Glenn Smith would stop. There was first a stuttering—not from lips but originating somewhere deep in his throat—followed by an elongated inhale louder, gruffer than its predecessors. The sounds of a consumptive gulp gurgling past excessive moisture, that caught, then fought past a tightening throat, lastly, a several seconds-long silence followed by but a wisp. All a penultimate signal of his failed life source, escaping carbon dioxide—an inevitable final expulsion before the soul’s journey. My eyes lifted from his hand to see this terminal heave as tears filled my swollen eye sacs. That's when I felt it. His final gift. An unmistakable tingle, an electric-like current flowing from a dying hand into a grieving one.

I think of it as a passing. The last impulse of his nervous system fleeing death in search of life. Some infinitesimal remnant of my brother sent to live with me, keeping him alive. So it shall, as long as I enjoy a wee child’s giggle, a spring shower, Maple leaves turned red, orange, tan and yellow. I’ve spoken not of that tingle to my family, my wife or anyone less ethereal than my brother’s memory, and now know that to have been a mistake. There are times I contemplate the how of it. I have never once entertained a notion that it might have been imaginary. So certain am I of it, if asked, I will advise any bedside soul given an opportunity, to risk taking a cool hand at death’s visit.

I was unable to persuade my sister of the value in the larger gifts this death could have resulted. Fortunately, her participation in Don's gift to me was unnecessary. It was a gift from which I reap daily rewards still these seven years past.

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