Dad's Death

Three years ago today, my dad passed away unexpectedly from complications resulting from Covid-19.

From January 2018 to June 2019 my parents served in the Boston Massachusetts mission. They spent the duration of the mission near New Haven, Connecticut. I only visited them once, but on that occasion, I and all five of my brothers went and toured Yale and attended the BYU vs. UMass game at Gillette Stadium. I believe BYU won the game, but my main memory of the occasion is that I was very cold the entire game.

As the mission drew to a close, my dad began to itch terribly, and was unable to determine the cause. After returning home and meeting with multiple dermatologists, it was finally determined that the cause of the itching was not any kind of rash or reaction, but was due to a follicular lymphoma. Additional testing and scans showed that it had evolved to Non-Hodgkins Large B-Cell Lymphoma. Four tumors were found in his body, two in his chest, one in his stomach, and another near his right knee. All of this transpired in the tumultuous time of March 2020.

He started chemotherapy almost immediately (his first treatment was April 6, 2020) and had 6 treatments over 18 weeks. Following that, they did radiation on his chest, which in some ways was harder on him than the chemo.

His cancer doctor was extremely worried about him getting Covid, especially with his immunity compromised from the chemo. The doctor insisted that my mom and dad essentially isolate themselves from everyone, which they did.

Following the treatment, and some follow up scans, he was declared cancer-free December 15, 2020. He was told that he still needed to stay in isolation until he could get vaccinated, which he did in February of 2021.

Over the next few months, my parents took advantage of their long-awaited freedom. They visited my dad's oldest brother Dale in Gig Harbor, made a trip back to Connecticut to visit their mission, and went to Hawaii with Al and Meg.

On August 16, the day before their 48th anniversary, my parents went to BYU Education week. The next day they celebrated  their anniversary by attending the temple and eating dinner at Texas Roadhouse, but my dad began to not feel very well. The next day, Wednesday, the 18th, Scott came and tested them and my dad tested positive for Covid.

The 19th, my mom began monitoring his oxygen, but for the most part it stayed in a good range. The 20th, my mom felt like he was improving. At some point over that weekend though, my mom decided to take him into the emergency room at the U. They discussed monoclonal antibodies somewhat, but no one seemed clear on what his eligibility was. The U sent him home with oxygen.

Sunday morning, Dad still had a fever and his oxygen was in the low 90s. Mom said he wasn't taking anything to lower his fever and wasn’t using the oxygen they'd sent home with him because he felt he didn’t need it.

On Monday, Mom tested positive for Covid as well. She felt like she contracted it while waiting in a small room with Dad when they were at the ER. Fortunately, Mom’s symptoms were mild and she never became seriously ill.

On Tuesday, August 24th, my dad said he felt better than he had the day before, but he'd been sweating profusely. We initially hoped that was a sign of his fever breaking, but it also seemed to be a symptom that roughly half of people with Covid were reporting.

On Wedneday, the 25th, my dad's oxygen levels started to drop and I think he could sense that things were getting worse. He finally agreed to let my mom take him back to the emergency room and after they got in the car, she asked if they should go back to the U or if she should take him to Mountain West. He replied that he thought they'd better go to Mountain West. His oxygen had dropped into the 50s while they were driving.

They tried various treatments at Mountain West, but were unable to keep his oxygen up and ultimately decided that he needed to be intubated. My mom was not able to to be with my dad during most of his time at Mountain West and wanted him to be given a blessing. A friend and neighbor, Curtis Ence, worked at the hospital and he and his son were able to administer to him.

After he was intubated, my mom and Brent were able to go in and see him, though he was not conscious. He was going to be transferred into the U, which he was later that night.

With the Covid protocols at the hospital, there were supposed to be two designated visitors and those two would be the only people able to visit during my dad's stay, but somehow, there was some confusion on that first day he was at the U and they just insisted that he could only have two visitors at a time. This was a blessing because all of my siblings were able to visit him that day. My brother Carl and I went in later in the day. He was still intubated and so couldn't speak, but he was conscious and could communicate with us by writing and gestures. While Carl and I were there, he wrote "Am I going to die?" I scoffed and said "No! Not today!" I of course didn't know it at the time, but that was the last time I would see my dad in person.

On Friday, the U tightened up their visitation policy and it was determined that Kevin and McKell would be the two designated visitors. (My mom was not able to visit due to her own recent positive test of Covid). My dad improved enough that they removed the tube, but found that once they did, they had a hard time keeping his oxygen up using other methods.

Carl and I had a previously planned trip with the Jefferies family to go see the Yankees and Athletics play in Oakland that Saturday, the 28th. Not being certain of the severity of my dad's condition and feeling like there wasn't too much we could do in any case, we went ahead on the trip. I remember going to the game and Devin catching a foul ball bare-handed, but beyond that I was monitoring my dad's condition on our family Slack.

Some of what they tried to keep my dad oxygenated after removing the tube were a cannula and mask, but when that wasn't effective enough, they switched to a bi-pap, which was essentially an enclosed helmet that creates pressure. They tried breathing exercises to get him to open his lungs more.

One of the complications at the time is that they wouldn't give him a feeding tube because they were worried he might have to be reintubated and that could make things worse. Saturday evening he did fairly well and with the bi-pap his oxygen had remained at 98 for most of the evening. The nurse had been able to turn down the setting on the bi-pap from 90 to 85.

Sunday they took him off the bi-pap and tried what they called "double oxygen". His oxygen was lower than with the bi-pap, but they wanted Dad to be doing more of the work. He hadn't had a drink of water (he had an IV) for several days and finally on Sunday he was able to have some ice cubes. My dad liked to eat ice cubes under normal circumstances, so this was a real treat. Sunday ended up being a better day than Saturday. That evening he got an orange-flavored Italian ice as a treat.

Sunday night, they put him back on the bi-pap so that he could sleep. The next morning they switched him back to the "double oxygen" configuration with the mask and cannula. That day was a little bit of a plateau or maybe even a regression. Dad got to have some applesauce on this day, but a doctor told him he would likely be in the hospital for several weeks, which I think was disheartening for Dad. But later that night, we got what was temporary positive news that they were going to remove his catheter the next morning. We all thought that must mean significant improvement, but that hope turned out to be short-lived.

The next morning, Mom got a call from the doctor and said they could either put him back on the ventilator which probably wouldn't work or put him on hospice and let him die in peace. The staff at the U still would not let my mom go into visit my dad. They planned a video call to talk through the options for a little later that day.

In the meantime, a new non-nonsense nurse came in determined to save Dad's life. He rolled Dad onto his stomach because that would allow him to open his lungs more. But Dad hated it.

That afternoon, we had a call with a new doctor. She said there would be no point in putting Dad back on the ventilator and that they could continue to treat him as they had been for as long as he was able to fight. She didn't feel the ventilator was going to change the outcome. She put his odds of survival at 25%, but admitted that might be high. We were grateful to her first because she took the ventilator option off the table essentially and didn't force us or my dad to decide whether or not to go back on it. Secondly, while we were on the call, we appealed to her to get my mom permission to come in. I don't know who she went to, but she made the case for my mom while we were still on the call. Kevin, who was at the hospital, heard the conversation and suddenly said "Mom, come in!" Finally, they were going to let my mom go in and see my dad.

Brent, my mom, and I left immediately to take Mom in. On the ride in, Mom let loose with a string of her harshest profanity: "Darn it! Darn it! Darn it!" She was so frustrated to have gotten him through his cancer, just to have him taken by Covid.

We got Mom to the hospital. She went in. At 1:37 PM on August 31, we got word that Mom was finally with Dad. He was awake and they were talking. Dad was still on oxygen at that point, but wanted them to take it off. He said he was done. They were saying their goodbyes.

That afternoon, we had a FaceTime call. Kevin, Brent, McKell, and I were still in Salt Lake near the hospital and went to a park to call. Carl and Alan called from their respective homes. We were saying our goodbyes. I'll always remember that Dad maintained his humor until the very end. When we thanked him for being a great dad, he brought one hand up and moved it side to side, to indicate "so-so." Later, as we were saying goodbye, Alan said "We'll see you soon." My dad’s eyes got big with mock surprise. That call was the last time most of us would talk to Dad.

Following the call, Brent and Kevin and I drove over to Hires Big H to have some lunch. McKell took a break for a bit and came over and met us and the four of us had lunch together. Afterward, we brought some food back to my mom and she and McKell then returned to my dad's room.

My dad fell asleep at some point and when he awoke and saw my mom and McKell still in the room with him, looked surprised, because he assumed he had died.

By this point, he could no longer write so McKell had made a paper with the alphabet and Dad would point to different letters to try to communicate. At some point, Dad became excited and started pointing at "P". My mom and McKell took some guesses, but didn't know what he was trying to say. Dad mustered all of his strength and burst out "President Hales!" He wanted Brook Hales, who had been Mom and Dad's Stake President and was now a General Authority to speak at his funeral. (President Hales graciously did accept the invitation to speak at Dad’s funeral).

My mom returned home hopeful or at least grateful that my dad had made it through another day. But when my mom and McKell went back in Wednesday morning, things had deteriorated further. They took him off the bi-pap and switched to the cannula, primarily for Dad's comfort. Dad squeezed Mom and McKell's hands, but otherwise gave no indication that he knew they were there.

At 9:44 AM on September 1, McKell informed us that they were bringing in morphine. About 15 minutes later, she said they would be taking the oxygen off soon.

After they removed the oxygen, Dad lived for almost another hour. While they waited, the nurse that was waiting with him asked Mom and McKell to tell them about Dad. Mom said that at one point, he opened his eyes and looked up to the corner of the room as if he could see something. He passed away at 12:05 PM.

Prior to Dad getting sick, we had been planning a road trip to go watch BYU play Arizona at Allegiant Stadium in Las Vegas on September 4. After some discussion, we decided we would still make the trip. We traveled to North Sanpete on September 3 and watched my nephew Gabe and his Cowboy teammates defeat the Hawks. We then continued on to St. George, arriving between 1 and 2 in the morning. We attended the BYU game Saturday evening (which BYU won) and made it back to St. George about 3 AM Sunday morning. We got up a few hours later and made the drive back to Grantsville.

We held Dad's funeral and burial the following Wednesday, September 8. Exactly three weeks after he'd first tested positive for Covid.

So why did my dad die? As my family and I have reflected, he had a few things going against him. One is that the type of cancer he had affected his B-cells, which are part of the immune system and produce antibodies when an antigen from a virus or bacteria is detected. So even though he'd been vaccinated and his immune system trained to recognize the Covid virus, perhaps his B-cells weren't healthy enough to produce the needed antibodies to fight the infection.

The radiation treatment he'd had on his lungs to conclude his cancer treatment could also have played a role, by weakening his lungs.

Finally, Dad got Covid in the midst of the delta-variant wave, which the vaccine was not as effective against. At the time he got sick he had been planning to get a booster, but those plans changed when he became ill.

The last message I sent him was the day before he died, just after we'd learned that it was doubtful he would make it: