How Are You?

Thursday, May 12, 2011

How are you? These three ubiquitous words can stop me in my tracks. With each passing day the question becomes more complicated. How are you? We throw around this question all the time. I do. At the grocery store, as quick recognition in place of good morning, when opening the front door in greeting, breaking the ice of a telephone conversation. How are you? Do we expect an honest answer? Even in the best of life circumstances?

“Fine.” I answer aloud. Or, “Hanging in there,” my mouth says on its own. Well, maybe, I think. How am I today, or now? Or, “Good, (pause) under the circumstances,” comes the qualifier.

Often there is a second “But, really, how are you?” look or the question may even be asked aloud. The expectation is that I must be doing (feeling?) horrible so I must be lying. Am I? I can, and do, have days that are productive, comforting and peaceful in the midst of this time of our lives.

Because this question is so common I have to go through mental gymnastics each and every time before I answer… Who’s asking? Have they been visiting Dave? Is this someone who knows me well?  Does she know Dave is ill? Has he read the blog? Am I willing to expound? What if I am having a good moment and I am doing well? Should I be “fine”?  What if I am feeling vulnerable and I don’t want to admit it?   If I say, “Crappy,” then what? That’s a downer.

How’s Dave doing? The next question. That’s even tougher. Dying, I might think. Don’t you know? He often answers, “I’m still here.” More context about the inquirer runs through my mind before I can answer. I can’t remember who knows what and I’ve found myself realizing that some people are asking about Dave’s health with little information behind the question. When was the last time you heard about him?

What’s amazing is that all these thoughts rush in the tiny span of “How are you?” and whatever answer comes out.

What is on the outside and the inside does not mesh sometimes. Especially when I think about: How is Dave doing? I’m not really sure how Dave is doing. I’m confused.

To drop by in the afternoon and chat with him is a delight. He doesn’t look like he is dying – as in seeing an end-of-life, semi-conscious, unresponsive shell of a person we once knew – thank goodness.  He has good color, relaxed in bed, comfortable, engaging, entertaining. I’m sure it is a relief and surprise to many visitors. Plus, nothing’s wrong with his mind.

Or is it? I find small changes, maybe only a wife would see. Or someone who is trying to compare this week’s health with last week’s health as we do during nurse visits. Perhaps I look too hard so I don’t miss anything. Do I read something more into a small change?

Yet, beneath the bedcovers is a very thin man with lung cancer. His pajamas hang loosely upon standing. His breath is often shallow, his shoulders sometimes curling up with each breath to bring in more air. He sleeps most of the mornings now. When I walk by the bedroom I might catch him with his mouth open in a perfect circle, his head back on the stack of propped up pillows, his cheeks red. I can’t help but call him my choir boy as I expect a song to come bounding out angelically. Then I realize he is simply positioned to breath more efficiently.

He is declining on an incremental scale each week; inch by inch. There is the rise and fall of good days and not so good days, punctuated by an overall slight downward trend. It’s the Loch Ness Monster diving deeper under water with its serpentine body mimicking our undulating days, tail unseen. No dramatic changes but some changes nonetheless.

This is the stuff that makes “how is Dave doing?” a difficult question.  It seems each week we add another dosage of something, tweak the current delivery of a medicine, or fix a symptom that arises. Pain medicine is on steady 24 hour management now. Managed so well one can forget there is pain.  Coughing and throat clearing has become more frequent, but not constant. The man who can remember everything has lost touch with day and time. (who wouldn’t with 24 hour cable as a companion?!) There are moments of blank and silent stares (is he asleep or awake?), foreign to his usually over-active inner dialogue. The bedroom is his only home. Food is a task, not a pleasure.

We have different milestones. He wonders if he sleeps more. More than when? Last week, last month? I measure independence as I see him struggle more to get out of bed. Is it lack of energy, because he doesn’t eat, or is it because of the cancer spreading?  Does it matter?

Mostly when asked, “how is he?” I’ll say “Dave is still Dave.” He thinks, acts and comforts the outside world in ways he is best known.  These are the most important qualities for me to know, to see and sit with in the present. His physical health is slowly deteriorating. There is no time frame of reference to consult, to predict our future. So, how am I, really? I’m doing the best I know how, thank you. And, hey, I’m especially good with knowing “Dave is still Dave!” today.

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