My dad was in Youville Hospital again. This is an old rehab hospital a few miles outside of Harvard Square in Cambridge, Massachusetts. He had been there the previous spring, but this time the call from my step-mother was more urgent. He was in bad shape.

I entered into the 1930s-40s time-warp that is Youville Hospital. The hallways had an unpleasant green color; the linoleum floor and fluorescent overhead lights gave a bleached but dim effect to the place. It was not like modern city hospitals, which are brightly lit, with comfortable, almost homey-feeling rooms. The worst part was that in every room, people looked like they were dying (many were, in fact, doing just that), and the hallway generally smelled of death and depression. Quite a few were on ventilators—machines invented to keep people alive no matter what, for those who had neither the foresight nor courage to sign “Do Not Resussitate” (DNR) orders.

When my dad had been here the previous spring, he was feisty. Very annoyed that he was uncomfortable and wasn’t getting the level of service or care he wanted. But for me that was good, as much as it pained me to see him so uncomfortable. It showed that he had fight in him. He had had so many “close calls” over the previous 10 years that it had become routine. Except that it wasn’t, because every time, I went through the whole emotional roller coaster of what was going to happen…would he live or die. So part of me numbed myself to the pain and part was in denial. The rest put on a smile and went there to be with him. After he recovered, however—during the summer, when I spent excessive amounts of “me” time, rowing, working, being there for my kids at home and dealing with my strained marriage—I was more in denial than usual. I avoided seeing him, and I had a sneaking suspicion that that was a bad idea, because there was something about his health that scared me. He was always frail, but he had signs of greater deterioration. The one time I visited him in his Longwood Towers apartment that summer, he was on a new enormous oxygen tank for his now-extreme case of emphysema. It wasn’t one of those fire extinguisher types—this tank was about half the size of a typical basement water heater. He had a long tube, which he dragged around the apartment. It was a nuisance, but he didn’t complain. He was all smiles as he sat at his kitchen table doing the crossword. I don’t even know what we talked about that bright sunny day. I just knew that he seemed much closer to death than ever before. He was so much mellower, slower, relaxed…and that was saying something, because he had become very slow, mellow and relaxed in his senior years—a big change from his “younger dad” years, when he was extremely temperamental, moody, domineering and enigmatic. I felt uncomfortable sitting there with him. He was in such bad shape but was so fine with it all. I left earlier than I should have, not being able to think of enough things to talk about, and I felt guilty afterwards. It was my only visit that summer. It was almost like I was waiting for him to die, after all the years of ups and downs. And the guilt of that was enormous, because I truly loved him and didn’t want him to die.

Toward the end of the summer, Libby, my step-mother, told me she had arranged a relatively minor operation for dad. With his oxygen needs now very great, it had become uncomfortable and almost dangerous for him to continue using the breathing apparatus through his nose. They had a procedure in which they’d cut a hole in his trachea and stick the oxygen tube directly into it. It would supply the oxygen more directly, reducing the amount needed and making him much more comfortable. Theoretically.

The problem was that the world-class surgeon at Brigham & Women’s Hospital in Boston didn’t quite get the size of the hole right. He cut a hole that was too big. The excuse was that dad’s trachea was much stronger and thicker than most, owing to his life-long passion for singing (he had been in a cappella groups since college). As a result, the tube didn’t fit properly and leaked. He had to have another operation to stick some kind of filler in there to caulk up the leaks. It sounded like a typical surgical snafu – a “routine” operation that had gotten all botched up.

By the time he was done with operation number two, it was Labor Day weekend, and he hadn’t eaten in many days. His body was starting to shut down. This is where it got interesting. According to Libby, the hospital where he was staying, Brigham & Women’s Hospital—one of the leading hospitals in the world and a Harvard teaching Hospital—“didn’t have the staff available” to provide dad with food intraveniously. I found that hard to believe, but I wasn’t in the decision-making process (I later found out from reliable sources that there’s no way this statement could have been true). So she inexplicably moved him to Youville.

Libby called me sometime the second week of September, after dad had been in Youville for over a week and was in very bad shape. This was the first I had heard from her since she told me about the operation in mid-August. She told me I had better come in soon—he didn’t have much time left. I had heard this before, but her tone sounded much different this time: much more urgent and frightening.

When I arrived, dad had full-on pneumonia, was on morphine and was on a ventilator. He was sleeping so I couldn’t communicate with him. He looked horrible—almost no life in him at all. I was stunned. I had no idea it had gotten this bad. Libby went through the whole explanation about the operation, etc, but I was numb. I talked to the doctor, a tall, gentle black guy, who told me dad was on what they called “comfort care.”

I had no idea what this meant.

I said, but wait, can’t you give him food intravenously?

He said, “That’s no use.”

This was incomprehensible to me. I asked, “What do you mean? Isn’t there anything you can do?”

“There really isn’t,” he responded, gently but directly. “We’re just trying to keep him as comfortable as possible.” He had done this many times before, and I suspect it was not his favorite part of the job.

It slowly sank in. I felt a flood of tears, combined with an ice-cold numbness that held them back, as I realized that dad was on as much morphine as he wanted to keep him comfortable. He was going to die and it would happen soon.

I asked how much longer, and the doctor said, “Maybe a week. It’s hard to tell.”

So here it was at last. All the close calls. All the times dad came back from near-death to defy all the odds. It wasn’t going to happen this time.

I went back home to call my sister and brother. My oldest brother Jay had died 10 months before, and I was the first to break the news to both my mom and dad. It was horrible, happening suddenly and without warning when his aorta exploded out of the blue as he sat working at his home office desk at four in the morning. I sat with dad in tears in his apartment, and he comforted me. I was so glad I was with him as I told him the news. Now I had to announce dad’s situation to Anne and Will. I told them that this was it—the real deal. They needed to get on a plane as soon as possible because there was no telling how much time he had left—maybe a week, but probably only a few days. They got a plane early the following morning, which just happened to be September 11^th.

I went back to the hospital that night. Dad was awake but just slightly coherent. I looked at his eyes very close. He was barely there, but he recognized me. I told him I loved him and that registered. I told him Anne and Will were coming, and his eyes lit up. That was nice. After a bit, I got up to leave with Libby. Then dad did something I’ll never forget and which was quintessentially “dad.” He pointed to the TV—the Red Sox were on and he wanted to hear the game.

He died early the next morning, and I wasn’t there for it. I was so sad…I really wanted to be with him when he died. But I had my cell phone off, which was completely idiotic, and Libby either forgot or didn’t think to call my home number. It doesn’t matter in the long run—he was out of it, and he died comfortably. But at the time I was an emotional wreck, racing into the room hours after he had passed. I shut the door and cried as I held his cold arm, saying over and over “I’m so sorry Dad…I’m so sorry…” through my tears. They had removed his ventilator, so his mouth was in an open and contorted position. It was a horrendous sight and I could barely look at him. Libby, who had been a nurse all her life, was unphased by this image of dad – she probably looked at it differently…his soul was gone, so who cares what his corpse looks like? It makes sense to me, but at the time I could barely stomach her care-free attitude. Her closest life-long friends from her fancy Nantucket social circle showed up. They all seemed as happy as they could be. What in God’s name were they so happy about? It mystified me, but she and her Greenwich-Nantucket crowd had always set me ill-at-ease. They were beyond fake.

I didn’t realize it at the time, but my dad’s death, followed by my brother’s the previous November, would lead to the third event in what I now call my Mid-Life Trifecta, with the third event being the end of my marriage three months later.