The first time my dad died I was only two or three years old. In fact, he died several times that day. My father has the misfortune of being born with a congenital heart defect. The aortic valve that he was born with couldn’t quite do the job it was meant to, so at the young age of 23, my father had his first open heart surgery. This was in the early 1970’s and heart valve replacement surgery was still relatively new, as were artificial aortic valves. His first valve lasted for about a year. The second valve didn’t even last that long, which was evidenced by the multiple temporary deaths he experienced. On the day of my dad’s third open-heart surgery, less than three years from the first, his heart stopped beating and was resuscitated three different times. The third operation was ultimately a success and the new aortic valve lasted almost eleven years.

By all rights, I should have been fatherless by the age of four. But for the dedication of some fine surgeons and their high-tech medical devices, I would have been. At the time though, all I knew was that my dad was sick and couldn’t play around as much for a while. I remember visiting the hospital, vaguely, but never did I have a real grasp of what was really going on. Eventually, my dad healed up from the surgery and got back to being his normal self.

Just as I was entering my teen years, the third artificial valve decided to call it a day. This is the second time I almost lost my dad. By the time he made it to the hospital, after feeling rather out of sorts all day, he was at the verge of death. His doctor asked for a helicopter transport to the nearest competent cardiac hospital but couldn’t get one. She told the ambulance that they had 45 minutes to get to their destination. It was a two-lane highway through mountains and rain and about 100 miles away. Somehow, they made it in time and my father’s fourth open-heart surgery was a success. His new valve would last 21 years.

Each time my father underwent a heart operation his life was literally hanging on the edge. Each time, he was saved from certain death because of the dedication and skill of his doctors and nurses. Men and women trained in the best schools, using the finest tools, in the nicest hospitals in the world.

My father has never been a financially wealthy man, and medical bills have been a constant feature in his life. Even with medical insurance, the operation he had 21 years ago cost him over $10,000. He has been on a daily pill regimen for over 30 years, which has probably cost ten’s of thousand’s of dollars. It’s a small price to pay though for your life, for the ability to be a father to your kids, to be a grandfather to their kids.

There are times when I know my father didn’t think he was long for this world. If he had been born twenty or thirty years earlier, he wouldn’t have lived past that first operation. Yet despite the costs, the odds, and the limitations of medical science, my dad is 56 years old. He is still a young man in the eyes of many, including me, but he is a man who has beaten the reaper four times. This last week, he made that five times.

After 21 years, the artificial valve in his heart needed to be replaced. The surgeons did their job as they always do, replacing his tired, old valve with a new and improved model. Once inside, they also noticed severe damage to his aortic bridge (or arch) and had to spend considerable time rebuilding that valuable piece of the circulatory system. They had originally scheduled a bypass to alleviate some arterial blockage too, but with the unexpected work were unable to complete that part of the surgery. They finished the delicate work in about four hours, but for some reason, my father would not stop bleeding and the doctors couldn’t close him back up. After about six hours, the doctor came out and told us that they were having difficulty controlling the hemorrhaging. The had to lower his body temperature, as well as pump special blood agents into his system, but so far, no progress had been made to stop the bleeding. It was looking grim. Another three hours passed and the doctor came back out and told us that they had finally stopped the blood and had finished up the surgery. But because my father was under anesthetics for over nine hours, and because of the lowered body temperature, there was no way to know how he would come out of it. We went to see him for a moment in the ICU, all hooked up to pumps and monitors and tubes. It was an eighteen-hour day and there was nothing more to do. We went to sleep, albeit restlessly.

Needless to say, my father is recovering nicely at this point, regaining strength every day. His doctors and nurses are amazed at his progress, especially after the traumatic surgery experience. This new valve should be the last one he’ll ever need.

The morals of this story, if there are any at all, could be that America still has the best medical care in the world. The doctors that saved my father’s life performed a heart-lung transplant the night before and performed several other heart operations that same week. The hospital was clean and modern. The nurses were caring and patient and knowledgeable, and in most cases very friendly. Even the housekeeping staff was comprised of hardworking people, friendly people. Maybe the moral is that we should be trying to make sure everyone in the world has this kind of care, regardless of income or social status.

Or maybe it is that the world is getting smaller. The staff was a blend of cultures: the young Sudanese man who immigrated here legally, learned English (in addition to his native Sdanka and Arabic), and is studying to learn medicine so he can return to his home someday and help his people; or the young man from Bosnia, who escaped from a life of turmoil and civil war to become a citizen with his family; he is now a nurses aide helping people alleviate their suffering while making his best efforts to assimilate into American life and maintain his cultural identity. My father’s chief surgeon is from India. Is the moral of this ordeal that we can all get along?

Before the operation took place, my father filled out a living will, giving me his power of attorney and directing the conditions he would or would not to continue living in if the operation did not go well. A formality to be sure, and one you don’t think about much. Not until you think you might need to actually follow through. For about three hours, I had to accept the fact that I may have to implement my father’s desire not to be maintained artificially in the face of brain death or irrevocable mental damage. I read the paperwork before the surgery, so I knew the score. And he knew he could count on me to make the hard choice if it had to be made. After the debacle in Florida last year, this is simply common sense. Perhaps the moral is in learning what it means to honor the wishes of another person despite your own emotions.

This surgery will cost a good deal more than my father has, but because he has Medicare, he’ll only be out of pocket about twenty per cent. He’s not any wealthier today than he was twenty years ago, living on a disability income and a small union pension, so this medical bill will really pack a punch. Like the other times before, he’ll find a way to make it work. Is the moral an allusion to the need to find a way to control the costs of health care? I know when I see the itemized bill I’ll find some very expensive boxes of Kleenex.

Or is the moral much simpler? We never know when our time has come, or whether we have many second chances. We should always try to remember that we must not stop living just to keep living on.