The Strength of the Human Heart

My dad's real sick.
He has been, for as long as I've been alive. He had his first heart attack years before I was born--he was 30. A congenital defect in his heart mixed with, well, bad luck, mostly, put him in the hospital for a bypass on his mother's birthday.
As a child, I rarely understood how his "condition" affected him, or my mother, or any of us.
It was the source of funny stories--looking up in the ambulance on the way down to Boston with our family doctor's face all he could see: "Mark, you dead yet?"
The weekly drives to a clinic in Boston, and the Jamaican nurse who once brought out 16 vials for his blood tests: "Ah, I'm just fookin' witcha, man!"
The one time, when I was ten or so, that his doctor wrote a prescription that spend the winter attached to our refridgerator: "Kids must shovel snow. Use as often as needed."
And every February we celebrated, on one day, two events: his mother's birthday, and his "anniversary." I was never entirely sure which one was the most important, though I knew which one he tried to ignore.
But mostly, it didn't affect us too much. Not us kids. We knew, eventually, that money was tight because of all the pills Dad had to take--stacked up on a side of the counter and in the two medicine cabinets, with strange-tasting names like Lipitor, Lysinopril, and Plavix. But for the most part, all we knew was that Dad was sick.

Starting around twelve, when I was rebellious and sick from my own birth defect (this one in the chemicals that create emotional rationality), I'd go with Dad on trips to pick up take-out. We'd listen to NPR and mostly, we'd sit in silence with each other. Dad would sometimes mention about how he and his own father rarely spoke when they were alone--words weren't needed. I learned from my father the joy of comfortable silence, and I felt sincere pride when I thought of how we could be comfortably silent together.
But there was one night, crossing the bridge on Route One, when the report on NPR was about prescription drug coverage, and prices, and how over-medicated our American society has become. Then, we talked. I remember how angry I was at the report; I was just reaching the age where I really understood how much money my parents spent on medication, and felt helpless to stop it, and guilty for contributing to the need. I said as much. "What can you do? You have to take the medication. Pharmaceutical companies know that. You have to take it! You die if you don't! So you have to pay them this money! There isn't any choice!"
"No," said my father. "No. You don't have to take it."
And it was then that I really began to understand that my father really was sick. I remember him telling me that maybe, eventually, when we were all out of school and out on our own, maybe then he'd just stop taking the drugs. "There is a choice. Everyone dies. If you get to choose how..."

When I was just past fourteen, on his fiftieth birthday, my father had another heart attack. I remember seeing him in the hospital bed--sitting up, conscious, smiling wryly and cracking jokes about how he knew how to make a birthday special. But he was, for the first time, someone other than my father. He just didn't look real. His skin was gray. Literally gray. And he looked thinner than he had that morning. Covered in tubes with the "whoosh-tick-ping" of the machines surrounding him, I couldn't be sure who he was.
They put a pacemaker in to his chest. And for a while he joked about him and Dick Cheney--two men with BMWs in their chests, or at least something which cost the same.

I've been noticing, the past two years, as he lost his father and then his mother, that each time I come home from college, he looks older. Paler and thinner. I try to pretend that it's just I haven't seen him in a few months, and the man I'm remembering is from when I was just a child. He's lost a father and a mother in the space of two years. He is fifty-seven, and he has heart disease, a bad back, and diabetes. Of course he looks old.

My dad's real sick.
Even the doctors admit it now. Dad wouldn't have mentioned, but my sister and I both asked how his last appointment went. They're sending him to Boston to talk to some transplant doctors.
There is a part of me, the small bit that always claps for Tinkerbell, the bit that knew the soccer team freshman year would win State Champs, even though we'd never won a season, that says things will be okay. That each thump of his fist, that each early night, that each deep breath, that each pvc, that each electric shock he feels in his chest is okay. We'll take it one day, one night at a time. I will wait for him to go to bed, and then I will go to mine, and when I wake he'll be at work, and when he comes home we will have dinner and watch "Two and a Half Men" and he will take the dog for a walk while I do dishes. And he will make it. That yes, everyone dies, but I don't have to worry, he'll be here for twenty, thirty, forty more years.
There is this other part of me, which I try to keep pushed deep down inside, that my father often called a pessimist, and my pessimist of a grandmother often called a realist.
This part knows that transplant committees follow an inverse age ratio, and my father is fifty-seven. This part knows that transplant committees want hearts to go to healthy patients, and my father has diabetes. This part knows that even if everything goes well on the medical side, this may be the time when my father simply says "Enough."
I've done enough research since I was fourteen, and I've seen enough episodes of "House." Assuming one gets through the surgery and the transplant is never rejected, the average time a person can assume to get from a heart transplant is five to ten years.
If the doctors are pushing him this time, that means they think the risks (and there are so very many) are worth it. That means they think an average of five to ten years is probably more than he's looking at now.

My dad's real sick. And I can't fix it. And I don't know what to do.