The decision was made, this morning, after consulting with Dr. Stadtmauer and our attending physician, to move Dad into hospice care. Though the CTscan of Dad's head came in negative last night, and Dad was looking livelier this morning, it quickly became clear that in fact Dad's condition had only deteriorated further.

The new attending, Dr. Nair, took the situation in hand immediately on seeing Dad and looking at his charts. She examined him carefully and explained his status to us, frankly and clearly, including many details that the doctors over the weekend had neglected to share with us. The long and short of it was that, while Dad's brain did appear to be clear of any bleeding or tumors, an older MRI indicated that there was cancerous growth within the actual bones of his skull. In addition, he has apparently been in acute renal failure, and his liver also is failing, in both cases due to the plasmacytoma discovered last week. In short, the doctor said, Dad's body is in a self-induced coma, and is essentially in the process of shutting itself down. The cancer, Stadtmauer said, is now moving throughout his body, and its effects are at this point non-reversible, including its effects on his mental state.

We questioned him carefully on what measures might be available to Dad now, and he said that the few things they could do could not save Dad, and would be so invasive and cause so much discomfort and additional suffering--with only a slim chance of success--that he could not really recommend them. We had to agree, especially given that these procedures, even if they "worked," could offer no promise of any real increase in his quality of life for however much longer he might survive. Add to that the fact that Dad, in his living will and in conversation with Mom and us kids, had indicated that he did not want his life prolonged merely for prolongation's sake, i.e. with no real hope of recovery. Dr. Stadtmauer said that what Dad is going through now is the "natural" way the body brings things to a close in this situation. In the end, we felt that the decision to move Dad to hospice and halt any further medical interventions in the course of the myeloma was the merciful and loving choice, and the choice Dad himself would make.

Christine had spent the night with Dad, and Mom and I arrived this morning at around 7:30; by about 9:30 the call had been made. Katherine, Daisy, Sandy and Cara have joined us here, along with Dappie (Mom's Dad), Uncle Chuck (Mom's brother), Aunt Diane and Colton. Dad's brother Bill is arriving from France in about an hour, and Nana, Uncle Wayne and Aunt Sue (Dad's bro and sis) will be coming in this evening. Marc Davis came to encourage and pray with Dad this morning, and stayed with Dad while Christine, Mom and I grabbed some lunch and spoke with the folks from hospice. John Yenchko and Mom and Dad's friend John Freeman also came to pray with Dad and say good-bye to him.

Dad will be transferred to Penn's brand new Rittenhouse hospice unit this evening. He will have a large private room, one of just 12 in the facility, which has large common areas, a kitchen and a dining room where the family can gather and be near him during this time. Please pray for Dad, for courage and confidence, and peace and relief from any suffering, that the Lord would make his presence felt to him. Pray for us as we seek to love and bless him in these final moments--however long they may turn out to be.