“I'm Dr. Hartley. Your father is stable. He has aspiration pneumonia, which is unfortunately common in late-stage dementia patients. We've started him on IV antibiotics and oxygen support.”
“Can we see him?” Kate asked.
“Of course. But I should prepare you, he's quite weak. And this type of pneumonia...” She paused, choosing her words. “His body is forgetting how to swallow properly. Food and liquids go into his lungs instead of his stomach. We can treat this episode, but...”
“But it will happen again,” Kate finished.
“Yes. I'm sorry.”
Pop looked smaller than ever in the hospital bed, dwarfed by machines and monitors. Oxygen tubes in his nose, IV in his arm, chest rising and falling with labored effort. Each breath sounded wet, struggling, like drowning in reverse.
Kate took his hand, cold, papery thin, nothing like the strong hands that had hauled traps and built boats and held her when nightmares came.
“Hey Pop,” she whispered. “It's Katie. We're all here.”
No response. Not even a flutter of eyelids. Just that terrible breathing.
Tom stood at the foot of the bed, gripping the rail like it might hold him up. “He looks so small.”
“When did he get so old?” Dani asked, voice breaking. “When did we miss it happening?”
“He’s not old, it’s the illness. We didn't miss it,” James said quietly. “It happened one day at a time, too slow to see.”
They arranged themselves around the bed, Kate holding his hand, Dani stroking his hair, Tom and James on the other side of the bed. Four children watching their father fight for breath, remembering the man who'd taught them to swim, to fish, to tie knots, to weather storms.
“Remember when he taught us to read the weather?” Tom said suddenly. “Red sky at night, sailor's delight.”
“Red sky at morning, sailors take warning,” Dani finished. “He made us memorize all those old sayings.”
“Mackerel sky, not twenty-four hours dry,” James added.
“Mare's tails and mackerel scales make lofty ships carry low sails,” Kate contributed.
They sat there reciting Pop's weather wisdom like prayers, like maybe if they said enough of his words, he'd wake upand correct their pronunciation or add another saying they'd forgotten.
The hours blurred together. Nurses came and went. The antibiotics dripped. The oxygen hissed. Pop's breathing gradually eased from drowning to merely labored.
“It's working,” Dr. Hartley said when she checked in that afternoon. “The antibiotics are helping. But you need to understand, this is temporary. The underlying issue, the swallowing dysfunction, that won't improve.”
“So what do we do?” Kate asked.
“We treat this episode. He'll probably recover enough to return to Coastside in a few days. But next time might be worse. Or the time after that. Eventually...”
She didn't need to finish. Eventually, the antibiotics wouldn't be enough. Eventually, Pop would drown in his own lungs, forget how to breathe the way he'd forgotten their names, their faces, his whole life.
“We should talk about end-of-life directives,” Dr. Hartley said gently. “DNR orders, comfort care measures.”
“He has a DNR,” Kate said. “He signed it two years ago. No extraordinary measures.”
“Good. That helps. For now, we continue treatment. This is still considered standard care.”
After the doctor left, no one said a thing until Tom broke the silence.
“He wouldn't want this,” Tom said finally. “Being kept alive by machines, not knowing us, not being himself.”
“But he's not on machines,” Dani argued. “It's just antibiotics. Oxygen. That's not extraordinary.”
“Where's the line though?” James asked. “When does treatment become prolonging the inevitable?”
