Asphyxiation

His face had once been one of warmth and happiness. Now it was cold and miserable. The tongue that had once spread nothing but cheer and humour now had more contempt – disdain for the cruel world that had punished him so. He’d wake breathless in the morning and spend his day thinking about where it had all gone wrong. At night, he would literally crawl to bed where he’d lie on his side, coughing and gasping for air for hours before falling into an uncomfortable doze which was disturbed not only by his wheezing lungs, but by visions of what he feared was the Reaper, who’d come closer and closer with each night, calling out his name.

He was a solitary man, but it hadn’t always been that way – in 1983 he had married Linda Brown, a beautiful woman twelve years younger than him. He’d thought he was the luckiest man alive, and together they’d had two children, boys that he loved beyond anything the world could offer him. Then he’d gotten sick, diagnosed with a life threatening condition. That was 1989.

Cigarettes. That’s what had done it. He’d smoked his lungs to a blackened and premature collapse. He’d heard the adverts on television, read the warnings on the packets of tobacco – “WARNING: Smoking causes cancer”, “Smoking is seriously bad for your health”, “Call the stop smoking helpline today”. He’d never really believed all the hype and publicity; everything these days was supposed to cause cancer – sunburn, x-rays, petrol fumes, drinking too much coffee, picking your fucking nose on a Sunday. Nonsense.

In the end his diagnosis wasn’t cancer at all. Chronic obtrusive pulmonary disease. They called it COPD for short. Either way it was a bitch – your lungs basically started shrinking until you suffocated to death. Irreversible. You could have twenty, thirty years. You could have one.

He was the old fashioned type – he made no effort to cut down his smoking habit. In fact, the first thing he’d done upon leaving the doctor’s office was to light up a cigarette to see him on his way home. He made no issue out of the matter when he had told Linda, and the nonchalant way in which he described his diagnosis had led her to believe that it was no major concern. His boys – four and five at the time – would grow up watching their father cough and choke every day, sometimes to the point where he would be near throwing up. It was nothing abnormal to them, it was simply their father.

He continued to work; Linda had always believed that one couldn’t “have a career and a family”, and so opted to stay at home and be a housewife. She often listed it as a job on official documents, and brought the boys up to respect her position of cleaning up after them, and cooking them all their meals. While she was home, her husband was out trussing roofs – a very physically demanding job, particularly for someone whose lungs would never be the same again.

In 1995 the roof truss company began running out of money. The trade had become one of the many casualties of the modern age, and business was extremely slow. Whisperings of cutbacks became a reality when eight men were made redundant, and he of course was one of them. Given his increasing age and declining health, he never found work again. The government helped he and Linda out with the benefits that they were entitled to (and a few that Linda had deviously engineered), but his family’s income would never be what it once was.

Due to his being home all the time, and being old and ill, things began to fall apart at home. He would argue every day with Linda about the most trivial of matters. At first he’d thought it was just a phase that would pass. But in 1997 Linda had wanted a divorce and because he didn’t want to see her unhappy, and because he still loved that beautiful young woman, he granted her request.

In 1998, the boys – now thirteen and fourteen, and both at high school – became accustomed to visiting their father in his small and dingy flat. Linda would often accompany them, and if the boys hadn’t known better, they’d have guessed that they were still husband and wife. Nothing had changed between them, except perhaps one more sly dig than usual every now and then. He had to use a frame with wheels to walk now, as his lungs were crying out in apocalyptic fashion: the end is nigh! The end is nigh!

***

In January 1999, William Hamilton’s wife Linda, and their sons Sean Hamilton and Mike Hamilton – now aged fourteen and fifteen – sat by his bed as they watched him dying. He had been admitted to hospital four nights earlier after struggling to breathe as a result of a simple chest infection. Linda and her sons had come to visit him the next day and he had appeared shaken but also recovering. They had left him that day relieved that he’d been looking well, and hopeful that he would soon be discharged.

But fate had other ideas – the next day William’s lungs protested the extra work of having to struggle through his chest infection, and refused to allow him to breathe. Linda took a distressed Sean and Mike to the hospital that night where they witnessed their father turn into a frightened man, tossing and turning in his hospital bed, claiming that he didn’t need to be there, and even attempting to get out of the bed and go home. For three and a half hours they sat with him and struggled to get him to stop taking off the mask that was pumping oxygen and other chemicals into his lungs, the mask that they were convinced would save his life.

The next night they had returned to find a much more docile man, slipping in and out of consciousness. He wore the mask, now properly glued to his face, with no struggle to remove it. In between his furiously rapid inhales, Linda and the boys could make out faint moans of anguish, along with an occasional nervous jump from his arms that the doctors had assured them was only his nervous system adjusting to the poison being sucked out of his lungs. In the concise moments of his awareness, he would open his sad eyes and gaze upon his family for a brief moment, before closing them again and falling back into an unpleasant sleep.

The doctor on duty that night had told them that he was becoming increasingly concerned for William. He was pleased that the mask was doing its job, but anxious that it wasn’t doing it fast enough. He’d told Linda and the boys that his currant, more passive condition was better because he hadn’t been fighting the mask, but if his condition had worsened, he may never wake again.

And that’s how a young fifteen year old Sean Hamilton had found himself by his father’s hospital bed, along with his mother and his younger brother Mike, watching William Hamilton – now completely unconscious – breathing much slower than he’d seen any human being before. They had initially been in the room for only five minutes, when the doctor on duty – a young man who looked only in his twenties – called the family in to his office.

‘It’s very bad news I’m afraid,’ the doctor said. ‘William’s lungs have filled with carbon dioxide, because they have become incapable of flushing it out. The mask is currently the only thing keeping him alive.’

This was when Sean watched his mother, for the first time he could remember, cry.

The young doctor handed her a box of tissues. Sean fought hard to keep back his own tears while he looked across at Mike, who only looked confused, and a little scared.

‘Is there no chance for him?’ Linda breathed through her weeps.

The doctor sighed. ‘We could keep the mask on him and see what happens, but I have to be honest with you Mrs Hamilton, the odds aren’t in William’s favour.’

Sean silently observed that for the first time in the last couple of years, his mother hadn’t corrected the man when he called her “Mrs Hamilton”.

After a few seconds, Linda asked the doctor what Sean had feared she would ask. ‘How long will it take if we take the mask off?’

‘There’s no easy answer I’m afraid,’ the doctor replied. ‘It could be minutes, it could be hours. But let me assure you that if that’s what you decide, in his current state, he would pass away quite peacefully.’

Sean couldn’t believe what he was hearing. He couldn’t understand how his mother and this man, this complete stranger, could be discussing whether or not they should allow his father to live. Why was something like this even under consideration?

In the end, his mother had agreed that the best course of action was to take William’s mask off, and wait in the hospital room with him until his time came. Before the young doctor left the room she told him that William was a Roman Catholic, and if he really was dying then he’d need a priest to come and bless him. She had never been a religious person herself, and Sean would always respect her decision that day – it was what his father would have wanted. The doctor promised Linda he would send for the hospital’s priest straight away, and Sean found himself hoping that he wouldn’t have to be in the room when the priest was saying prayers or blessing or whatever it was that priests did.

Linda hugged both of her sons before they re-entered the room, and told them to be brave, because their father would want them there. Sean sat with Mike on their father’s left, and Linda sat to his right, holding William’s hand, and stroking it while watching him through sodden eyes. She had put a cassette tape on for him on a player she’d found in the room – an REM album, one of his favourite bands.

Sean’s own breathing began to strain. His eyes began to dampen. Realisation began to dawn on him that they had been watching his father suffocating to death over the last few days. He tried to shake it off, but the tears came rolling down his cheeks. He wondered if his father could hear them, and if he knew he was dying. He didn’t want his father to be afraid. If only there was some way that he could comfort him. And if he could hear them, he didn’t want his father to hear how upset he was.

It wasn’t until Mike asked him if he was okay that he realised that he couldn’t reply; he was sobbing too hard. By this time the REM album had arrived at the song Everybody Hurts and it had just been enough to tip Sean over the edge. Linda ran around to tightly squeeze him and they wept together for a few moments.

‘I just...’ Sean began as he tried to compose himself. ‘I just need a few m-minutes. I’m-m gonna go and... and wait for a while and... I’ll come b-back.’

Sean left the hospital room and entered the waiting area in floods of tears. He sat on a chair and buried his head into his hands, trying desperately and unsuccessfully to regain equanimity. The time was now 12:14pm, and he had awoken early that morning after a restless night. He hadn’t eaten anything since about six o’clock the previous evening; partly because the thought of nourishing himself while his father lay dying made him feel a little sick, and partly because he generally felt nocuous, and altogether anxious.

Perhaps a cup of coffee would do the trick? Sean had begun to drink coffee the previous year. Linda had taken he and Mike to visit an aunt that they had never met before who had proclaimed that Sean “looked like a coffee drinker” and asked him how many sugars he took. Sean, not knowing what else to say, had replied that he took two. And that was that. Sean had become a coffee drinker.

Presently, he left the waiting area hiding his face as he passed by doctors, nurses, patients and visitors. He wondered how used to seeing people crying the staff in the hospital were. He guessed they seen it often; he remembered one of his teachers saying that something like 60% of people in Edinburgh are killed by cancer, which he took to mean that at most, only 40% of people reach an old age and die peacefully. The rest all must surely at least come to hospital a couple of times after their diagnosis, and most of them would die there. That’s not even to mention all the people like Sean’s father, dying of something completely different to cancer. What a terrible job. He suddenly felt sorry for the doctors and nurses.

And my father is about to add to that number. Is that all he is? A statistic?

As he approached the hospital entrance his tears began to stream down his cheeks once more. Through watered eyes he could just make out the charity shop, positioned across the gigantic hallway from a W H Smith, the same one his father used to take him in for a sweetie and a magazine when they used to come and visit their granny the year she broke her leg falling down a set of stairs. Next to that was the little newsagents that only managed to compete with their next-door giants by serving hot food and drinks. It was a dull and dreary place. Two of its strip lights had burned out long ago, and a third was flickering on and off. The magazine rack was a beleaguered mess of disarrayed publications, everything from woman’s weeklies to obscure geeky magazines like White Dwarf. Next to that was the coffee machine that appeared to have come from before Sean was born. It didn’t even serve Nescafe, or any other recognisable brand, it was something called Jumbo Coffee which Sean was sure wouldn’t be great, but for the first time in his life he had felt that he needed this coffee in order to face this day.

Sean walked with his head down towards the coffee machine inside the shop. When he arrived he placed one of the paper cups underneath the machine and punched the “cappuccino” button. He had no idea what a cappuccino was, but he didn’t like the idea of standing around in this shop for too long before someone noticed he was crying.

He paid for the coffee and took it to the main waiting area in the hall. A huge place with countless blue seats, some of which were occupied with worried and anxious looking people just like Sean.

I’m not the only one who’s waiting around for bad news, he thought glumly.

He sat with the warm cup gripped with both hands, staring at the wall in front of him. He didn’t want to sit there long in case wither his father woke up, or...

I’ll finish the coffee, he thought, and go right back in there. I just need enough time to get a hold of myself. To stop the tears.

Just then he spotted a short and stocky man hurry towards a part of the hospital Sean had never seen. He was old, with receding grey hair. He wore thick rimmed dark glasses, and behind them, restless and worried eyes. In a matter of seconds he had disappeared behind two swinging doors.

Another one, Sean thought. How many people are dying today?

His tears had still not subsided. He hadn’t taken a sip of the coffee yet. How long would it take for this dreadful feeling to diminish? How much longer would he have to sit there? How long did his father have left?

In his heart he held on to the belief that somehow the doctors were wrong. After all, they didn’t know his father. They didn’t know that he worked for years, building roofs while his body told him to stop. They didn’t know how tough a guy his father was. However much his lungs were telling the body that they couldn’t cope, he would be screaming that it was nonsense. Nobody was going to die today, not on William Hamilton’s watch. He still had work to do – he still had to see his boys leave high school and go on to graduate with honours degrees from university. He had to be present for their weddings to the beautiful women that they perhaps hadn’t even met yet. He had to come and visit them in their homes, where he’d be offered a cup of tea (or coffee), and maybe he’d even stay for his dinner. Maybe in time, when Linda had had enough months or years by herself, she would see how stupid she had been and they would get back together, and he would move back in with her and they’d sleep in the same bed together because if it had ever been plain at all it was never any plainer today – they still loved one another.

Sean began to weep once more.

He didn’t care if this event would turn his father into a vegetable who needed twenty-four hour supervision – Sean would do it. He would look after his father night and day if that’s what it took for death to bugger off and leave him alone. He’d feed his father, dress him, take him to the toilet, wash him.

This, Sean thought, is probably what they call the “bargaining phase”.

Sean composed himself for enough seconds to look up from his warm coffee cup to see the same small, stocky man he’d seen only two minutes before. He burst through the double doors and Sean instantly noticed that he had changed his clothes. He was wearing a black shirt with a white collar, and across his shoulders was a purple garment of some kind that looked to Sean like a fancy scarf. He was also wearing a pointed hat that reminded him of that man he’d occasionally see on television they called the pope.

The priest!

The realisation hit Sean like a Mike Tyson knockout punch. His hands began to tremble and he tried to stop them in fear of spilling the full cup of coffee. The priest had arrived in a hurry to bless his father before it was too late.

As the man raced into the same corridor that Sean had for the past three days, he spotted a familiar face coming out of it. It was his teary faced younger brother. Mike spotted Sean and walked slowly towards him.

If the previous realisation had hit him like Mike Tyson, the next one came more at the pace of a tortoise.

No, he thought. He’s just checking to see if I’m alright. Nothing’s happened. Nothing. The priest isn’t even there yet.

Mike silently approached him and sat beside him.

‘Wh...’ Sean gasped. ‘What’s happened? H-has he?’

Mike simply nodded through his tears for a moment and then spoke up.

‘He’s gone.’

***

In another part of the hospital, an elderly man had also been breathing his last breaths. He had his daughter and three grandchildren at his bedside, and bravely told them not to pity him, because he was going to God’s golden gates where he’d be among the company of his mother and father, his brother, and all the good, good people he hadn’t seen for years, but had never forgotten their faces.

This was the man that Father Alfred had rushed to see.

‘I’m very sorry for your loss,’ the priest said upon entering the hospital room to find Linda and the boys, all now silently weeping. Linda was still stroking William’s hand.

Father Alfred continued. ‘I’m afraid that because he has already passed I am unable to give him his last rites, but I can say the prayers for the dead.’

‘Thank you Father,’ Linda whispered.

The priest went on with a long prayer, some of which Sean paid attention to, and at other points he was lost in his own thoughts. When he was finished, Father Alfred sat with them and once again offered his condolences.

‘It’s sad that our lives must overlap,’ he said. ‘But we will all meet again one day, in heaven.’

For a moment, these words had actually somewhat comforted Sean. He imagined a person’s timeline simply crossing over someone else’s. Everybody dies. Maybe he should simply feel glad that his father’s timeline crossed with his own at all. But nothing that day and indeed in the days and weeks and months to follow could comfort Sean enough. His father had been cruelly taken from him far too soon.

The days that followed were dark and full of questions. Where was his father now? Was he in this “heaven” that the priest had talked about? Was he a ghost, watching over the family?

The one thing Sean knew, and promised himself that day, was that he would never smoke a single cigarette.