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Do They Play Bach in Heaven?

My father lay dying in his bedroom, the curtains drawn. He spoke a phrase in German, a phrase in Czech, a little French. His attendant, a middle-aged black woman from Birmingham, Alabama, where my father lived for nearly 50 years, did not speak any of those languages. I tried to answer him—I think I was showing off a bit—but he was out of his head and did not respond. The hospice nurse wandered in and out of his bedroom, helpless. She introduced herself and explained that she had been trying to get his primary care physician (PCP) to consider the fact that his belly was so hard and his digestive system seemed to be blocked. Otherwise, she ignored me. That afternoon, the PCP actually paid a house call but found no reason to examine my father further. I observed the hospice nurse calling the PCP’s office repeatedly the following day in an attempt to increase my dad’s pain medication, but she was met with no useful response. Perhaps, he was out of his head, like my father. A hospice chaplain visited. ‘‘Do you think your father would like me to say the Kaddish?’’ he asked. I was astounded. Why was he in my father’s house? How could a chaplain presume to pray a Jewish prayer of mourning for my father who was a scientist and, unlike myself, had no patience for religious ritual? My father’s religion could perhaps have been called Bach. Yes, he and my mother had been persecuted in Europe during World War II because of their Jewish background, but my father had, as a young man, left the religion of his birth and worked lifelong to better the life of those on earth without consideration of an afterlife. ‘‘No,’’ I said, in alarm. ‘‘He would not like you to say the Kaddish.’’ ‘‘Maybe he would like a silent prayer?’’ the man offered. ‘‘No,’’ he would not like a prayer of any kind,’’ I said. ‘‘Leave him alone.’’ ‘‘All right,’’ he said. ‘‘Here’s my card in case you yourself want to talk about anything later. I’m available to the family as well.’’ It is well known that children of the dying jet in from wherever they may live and mess up the plans of the PCP, hospice, and the caretaker. They feel guilty, says the conventional wisdom. They did not come around enough before their parent got sick, and now they want to perform miracles. Perhaps, another scenario could also fit the facts. Yes, I lived and worked in another state with my husband and young children. And yes, I came around as often as I could. And yes, whenever my parents got sick, I came around even more or called daily, depending on the situation. My father’s longtime PCP had quit his practice to return to teaching, and I did not really know the new doctor. I called him, though, from where I lived when he ordered hospice for my father and questioned why. ‘‘Oh,’’ he said. ‘‘It’s just routine. It will permit your father to have more in-home nursing care than would be possible otherwise.’’ ‘‘Well, do you think he’s dying?’’ I asked. ‘‘Has his situation changed somehow that I don’t know about?’’ ‘‘Oh, no,’’ said the PCP. ‘‘Ordering hospice is just to get more nursing care.’’ My father was 92. He had a variety of health problems, but he had those problems even before my mother died nine years ago. His mobility had declined, and he had some memory loss, but he was far from demented and still had a fair quality of life. He had 24/7 caretakers who were not nurses because he had fallen at night leaving his bed for the bathroom, and we wanted someone present in his house. Plus, he had never learned to cook. He did not want to leave his house for assisted living of any kind. My father, if you have not gathered already, was a little stubborn. He had his own ideas of how he wanted to live. When I called him daily, it annoyed him, he told his primary caretaker who later told me. He valued what remained of his independence. And then something changed and his situation became acute. He could not eat or drink. He could not excrete. He was plugged up, and the hospice nurse knew it. His primary caretaker called me, expressed urgency, and my family and I arrived hours later. Yes, I wanted to believe that he would recover. He had recovered so many times before from acute manifestations of various ailments including quintuple bypass at age 86. No, I was not prepared to understand that hospice was working in my dad’s house because my dad was dying. After all, the PCP had told me on the phone that the hospice presence was for