In the winter of 1986, my mother came into my bedroom in the early morning hours crying. She sat on my bed and said she just got off the phone with my stepmother. My father had a stroke and was in the hospital. By the way my mother was crying, I knew it was serious. I could tell she was crying for me, or rather for me and my brothers, and not herself. I didn’t know what to think. I was 18, taking my second semester of community college and working part time as a waitress while living at my mother’s house with my little brother. I was taking some time to find myself before committing to a major at an expensive four-year university.

Mom kept apologizing. Was he dying or was he going to need some hospital care for a while to recover?

Colonel Charles D. Madden

My dad hated going to the doctor and the dentist. He only went if it was serious, you know, the kind of serious where you do everything on your own and take all advice from others before it was absolutely necessary to go to the doctor. He was a United States Army Colonel through and through. He was stationed at Fort Clayton in Panama. Shortly after my parents divorced six years earlier in the Tidewater area of Virginia, my dad accepted a post in Panama. It was a wonderful career opportunity for a young officer taking the fast track up the ladder, and it gave him the opportunity to run away from a failed marriage and reinvent himself. My little brother and I would fly down to Panama for the summers. My two older brothers were essentially out of the house by then.

At the time, society had labeled my family as “dysfunctional” because my parents were divorced. But it wasn’t. To this day, I do not know why my parents married and had four kids – well, the four kids were the result of my parents being practicing Catholics. Because we were Catholic, the divorce was a shock to my dad and those around us, but we weren’t a dysfunctional family yet. The divorce was the end of the numerous late-night heated arguments, stress, and tension that filled the house consistently.

If Only

But at 2 am in the winter of 1986, two days before my dad’s 50^th birthday, my family truly became dysfunctional. The following events did not have to happen. If only living wills and advance care planning had been a known legal option in 1986, the rest wouldn’t have happened. If only the Center for Practical Bioethics opened a few years earlier than 1984 to promote advance care planning my family would have remained a highly functional “dysfunctional family” of the 80’s.

If my dad filled out a Durable Power of Attorney for Healthcare before the winter of 1986, all the seeds of anger, doubt, guilt, and suspicion would not have been planted for the future of our family. We would have known what dad wanted given the situation we were in and respected his wishes. Next, we would have gone through the phases of mourning and maybe even come out of it with stronger, loving relationships. Who knows? But that opportunity was off the table without a notarized sheet of paper filled out and signed by my dad.

Instead, what followed was twelve years of negative emotions and conversations – and the lack of honest communication between family members.

You know how the next twelve years went. You’ve heard the stories.

Massive Stroke

Colonel Charles D. Madden had a massive stroke while watching TV home alone on a Wednesday night while his wife of only a few years was playing guitar at a Catholic Mass. Doctors think he was lying on the floor for a few hours before my stepmother found him. He was rushed to the best medical facility in Panama where great surgeons removed some of his frontal lobe and put him on life support.

The Red Cross flew me down by military hop before lunch that day believing he would not live much longer. Shortly after they deemed my father stable to transport, he spent months at Walter Reed Army Hospital in Washington DC. His wife stayed by his bedside every day praying and following all Catholic recommendations to get him to “wake up” any minute. Some of his family would visit him at Walter Reed as much as they could, while others found it too painful to acknowledge his situation.

Throughout the next 12 years, my stepmother visited him daily full of the Lord and hope. She bought a handicap-accessible house near one of the best VA medical facilities in the United States anticipating the long but full recovery. My oldest brother and I would ask the medical staff about his prognosis and if he had a DNR when we visited or called.

One hundred percent non-responsive, what the doctors called a persistent vegetative state. No improvement. He had pneumonia every couple of months which involved CPR, breathing tubes, and antibiotics. My siblings and I had no legal power to request a DNR order. My stepmother had all legal power and would follow her devout religious beliefs.

Occasionally, my mother would exclaim, “Your poor father. He would never have wanted this for himself or you.” One of my brothers was convinced my stepmother was keeping him alive for his financial benefits. Another finally went to visit him with me once, but after a few minutes of looking at a contorted, toothless, shrinking body, he left to go throw up outside and did not return. I don’t know if my third brother ever visited. My grandmother was heartbroken that he was suffering this fate and that she was outliving him.

Twelve Years Later

After 12 long years, and at the outrageous expense of our federal government, my stepmother found out from the medical staff that my oldest brother was asking about my dad’s medical condition and about a DNR. My stepmother contacted my brother to ask if we still wanted a DNR. Two siblings voted yes, and the other two left it up to the first two. A DNR was signed by my stepmother, and two weeks after, my dad flatlined and died. We all attended the funeral, exchanged awkward hugs, acting catatonic, and went home to our lives. At the burial in Arlington National Cemetery a few months later, same thing.

We spend a lot of time protecting our families out of love. We buy the best child car seats, carefully plan family vacations and quality time together, ensure our parents are living the best quality life we can provide. But you really need to take an hour to fill out, notarize, and distribute your Durable Power of Attorney for Healthcare, so all those loving actions you took so far won’t be for naught.

By Monica Delles