LONDON, UK: It's just after 9.30pm on a Tuesday in the intensive care unit of a hospital in south-west London. A vast spaceship dashboard of drug delivery systems is silent, monitors displaying the word 'Privacy'. I sit by the foot of the bed while the other four crowd around the top. An empty bottle of scotch is propped in the sheets that cover the stricken, thin form of my father, along with a crucifix on a chain and a Dr Seuss book. I gradually become aware that he has died.
My father's de facto nephew Charlie, a boisterous Irish lad in his mid-twenties, starts up a Hail Mary over the body of an atheist of Jewish extraction as if it might push life back into him. My aunt weeps. My half-sister in a red woolly hat, herself on six different types of medication, is on the phone to her mother, brightly telling her what she had for dinner. (It was stuffed aubergine.)
Charlie's younger brother Tommy, a sweet skinny boy of 20 who I last saw when he was a six-year-old potential serial killer, dissolves into my arms, sobbing. Positively radiating serenity, I stroke his head and let his grief wash over me. I have a headache from the scotch we've all been sneaking around the bed. I hate scotch. It was Bill's drink. It was Charlie's idea. I look at my father's body. He looks very dead, but then he has looked dead to me this last week, from the first time I saw him crumpled in the sheets, plastic tendrils curling from his head, one green eye stuck half-open.
I am quite aware as this is happening that it probably represents the single biggest headfuck and heartfuck of my life, and also that if it were happening in the US, the place of my father's birth, it would probably be considerably worse.
In the UK, we treat any old fucker for free. This is why that is important.
* * * *
The place of Bill's death is a foundation hospital, not directed by the government. It's a beautiful building, with open corridors around a vast central atrium filled with natural light and dotted with sculptures and fish tanks. You can't get lost in it, nor can you feel that antiseptic claustrophobia you get in hospitals.
The tax-funded UK National Health Service is now 65 years old. Foreign nationals get free treatment when they've been here for a year or otherwise have legal residency. A San Francisco native, Bill rocked up and made a home for himself in London in 1976. Since then he's had three (count 'em) artificial hips and been treated for cancer of the larynx, and is now spending his final week in intensive care. When I saw him last year for the first time in ten years, to interview him about the election for NSFWCORP, he mused on how much this country has shelled out to keep him upright: "Oh man, if you were to add up what the NHS has spent on me, it's phenomenal."
He was a charming, damaged, charismatic, fiercely intelligent, dissolute individual, who lived entirely on his own terms. As a professional gambler, it is unlikely he paid much if any tax in 37 years. He had no will, no funeral plan. He never did fill out the forms necessary to vote in the last election, or the one before that, as I discovered. He just hated forms. I could sympathise. Had he stayed in the US, it is – how you say – dollars to doughnuts he wouldn't have got it together to fill out the forms, and would have had no health insurance. He considered the US system "absolutely unmanageable".
* * * *
Bill goes into hospital on Tuesday complaining of dizziness and disorientation. We talk briefly on the phone and he sounds chipper as a chip. Some little heart arrhythmia thing, chest infection, in overnight for observation, no biggie. By Thursday he has plummeted into the subterranean limbo of the gravely ill, having most likely suffered a heart attack. He is being hauled from acute assessment up to the ICU.
Thursday afternoon I sit by his bed. Talk to him, say the nurses, he can probably hear you. With this type of sedation, the hearing is the last thing to go and the first to come back. I try. Hi, Bill. An inveterate gasbag, I find I've got nothing. I am accustomed to showers of aphorisms and miles of monologue from him. There's nothing to respond to.
An hour by a bed in the ICU is long. I bring some Vonnegut to read to him – I figure it's the sort of thing he might go for. I don't even open it. I just sit.
Late in the evening the doctor comes to talk to me. I'm the only one here so far. The friend who brought him in has yet to return, my aunt is on her way from Washington.
Bill's heart is fucked, hammering away at 150, 160, and it's fucked everything else. The kidneys are fucked. The liver is fucked. This could go on for days or weeks, the doctor says: "But my feeling is that he will pass away tonight."
So this is how it ends. I had always figured this fighty bastard – whose own father died two months ago almost to the day, aged 96 – was impervious to the usual quotidian sources of bodily doom. He beat cancer, shrugged off booze, swore that "when they come for me, which they will, I'll get 'em with my stick". When he goes, of course he's going down a manhole, under a Mercedes driven by a coked-up supermodel, into the belly of an escaped jaguar.
I'm prepared for this. I am sad, but ready. The distance from absence to departure doesn't seem so far, and it sucks, but it's OK. I go to bed in the small, snug visitors' room – the existence of which amazes me – in assurance they will wake me when it's time. Next morning he's still there. He will cling on for five more days. The notices will say 'a short illness', but they don't give any sense of how long and hard that can be.
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https://www.nsfwcorp.com/dispatch/this-is-how-you-healthcare
