“I don’t want to live with this,” read a note we found afterward. “Just let me die.”
At the time he wrote the note, Dad had recently been diagnosed with cognitive impairment, often a precursor to Alzheimer’s; years earlier, his uncle had suffered from what was then called “senile dementia.”
My father had an extraordinary life. A West Point grad, he served in WWII and then went to medical school on the GI Bill. After running a general practice in our home, he found his niche in academic medicine.
While working at Temple Medical School, he was one of the founders of the new specialty of family medicine and served as an early president of the specialty’s national society.
He later moved to Arizona and became president of Scottsdale Memorial Hospital, added a North Scottsdale Hospital, and brought “the Mayos” to Arizona.
Following a divorce from our mother, he had married a very successful businesswoman 20 years younger.
But when he was in his late seventies, his cognitive impairment began to get in the way of their active lifestyle—exotic travel, golf, fancy charitable events—and she removed him from their upscale home to a small apartment with his old, incontinent dog.
My sister and I intervened and insisted he move closer to us on the East Coast. There, he lived for the next decade at a facility near my sister, slowly moving from independent living to assisted living to memory care.
It was only later that we learned my father knew exactly what he was in for. In the early days, he grieved as he could see himself slipping away. He had always prided himself—and us—on accomplishments, proper comportment, grammar, and manners.
Yet in important ways, he remained himself. Toward the end, he didn’t understand food or utensils. But he was infallibly gentlemanly, courteous, and polite, still always saying please and thank you.
The last time I saw Dad, he was in the hospital with recurrent bedsores and sepsis. We had recently discovered a living will which made it clear he wanted no “heroic interventions.” The plan was to put him on hospice care.
He didn’t recognize me. It was sad, but understandable, as I lived a few hours away and visited perhaps less often than I should have. But when my sister sat down beside him, he struggled but eventually said, “You … look … beautiful.”
Within a few days he was gone.
Carol Nelson Shepherd
Philadelphia, Pennsylvania