John S. Smith M.D.

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10/18/1929 - 5/6/2009

Good morning and aloha to all of you. Thank you for coming to celebrate my father’s life on this earth. I am Gigi his youngest daughter and want all of you to remember the memories that my dad gave to you in his special way.

Dad’s passing was fairly quick. He just went on oxygen 24/7 about 2 weeks prior to his passing and quit working in the OR a week after that. What a role model and inspiration for all. He ended up in the hospital on Monday the evening of the fourth, due to difficulty breathing. We were hoping to move him home to a possible hospice setting, but it was not in the cards. The poker player he was told him he was playing his last hand. That night after having no sleep and nightmares of my dad reaching out for me and saying he couldn't breath, I called in at the hospital Wednesday morning. Dad said he was having a real hard time breathing, could not even eat breakfast, and had no sleep for days now. I asked him if he wanted me to visit then or come at 2 pm when my sister arrived from Kona. He said to come down for a bit. I did not get the usually when you are able. He was tired and sometime that morning he finally accepted the fact, he was ready to move on.

When I arrived I knew it was getting close. An ultrasound showed a strong heart, but a man very short of breath, on a normal rebreather mask fighting to breath at 40-50 breathes a minute. I spent some time with him and told him I would be back with Tane around 2 pm. His friend Sandy showed up to keep him company, the stories we have shared since his passing have been very comforting. I went over to his office and chatted with his secretary Linda and picked up his mail, which of course included a hunting magazine and a mailing from the NRA. I decided to run home for lunch and a possible power nap, but shortly after getting home, dad's long-term friend Stephanie called and said I needed to come down right away, because he was saying he just couldn't breath.

Pulmonary Fibrosis is basically a disease that leads to no lung capacity and basic suffocation and to a man who never smoked. Just not fair. I encourage all to understand this disease, if caught early things can be done, but more research is needed. Please explore the Pulmonary Fibrosis Foundation and support their mission.

Back to Wednesday the 6th, Stephanie called back again after I called my sis who was at Kona airport working to get to Honolulu. Steph said to pick up my brother and head to hospital, since dad was asking for him. My brother and I made it to Queen's hospital at about 1 pm. I immediately saw dad's distress and asked if he wanted to be intubated or have CPR, and he said no. I then asked if he wanted some morphine for comfort and he said not at the moment. I spoke with his doctor and he and I decided we would offer a morphine drip anyway. My dad accepted, but he wanted to wait for my sister's arrival. About a half hour after Tane's arrival around 2:30 pm a morphine drip was started, which I asked to increase per dad's request and additional orders with some painful delays. It was a somewhat hard time for dad. He was coughing up blood, in pain, and fighting to breathe with oxygen at the highest level possible. He looked at me several times asking for more morphine as I made an effort to get a higher drip rate. There were several moments over those last 3 hours, that for the first time I saw fear in his eyes. He was able to say goodbye to many physicians, family, and friends at bedside or on the phone. We also were able to have some spiritual peace with prayer from a chaplain and a priest. Finally after being asleep on morphine drip for about an hour we stopped NRB mask and kept him on a nasal cannula for oxygen and he passed about 15 minutes after that around 5:45 pm. We all noted that as the mask was removed you could almost see him take a breath of relief. I think as I pursue my Master’s in nursing, dad is pushing me into another area of healthcare, which is caring for the dying.

I only wish that a stronger Hospice experience could be in place for these dying patients in hospitals. As a nurse, I have tried to do what is best for my patients and sometimes letting them leave this earth with dignity is best. I often wonder how it would be to be a dog and be able to enjoy a life playing, eating and scratching on average for 15 years and then be able to be put to sleep, so quickly, verses how humans struggle more leaving this existence. I guess that is why dogs wag their tails with their hearts. Dad loved his dogs and could communicate with them so well.

Dad contributed to this state as a orthopedic surgeon for over 50 years, a teacher, a medical policy maker, husband, father, grandfather, great grandfather, friend and of course The Great White Hunter. He loved everyone and accepted all no matter what his or her faults were. He survived a pelvic fracture as a teenager, a heart valve replacement, kidney and bladder cancer, pacemaker, but over the last 7 years pulmonary fibrosis took him. I remember him getting short of breathe on the golf course initially, then short of breath in Santa Fe in 2005 when he attended my graduation from Nursing School. He told me that morning that he couldn't believe how quickly this was happening. I only hope I can be the excellent medical provider he was. He raised the bar for all. I was told by many that my dad had such an awesome bedside manner and I believe his personal life experience and the strong family he grew up with in Ohio gave him the foundation to be such a great doctor and remain so strong for all as he left this world. Also I believe that is why he loved to work with Hansen patients and crippled children at Shriner’s hospital. He had compassion for his patients.

Dad was a member of a dying breed; he was so loved by all because of his diligent, professionalism in all he did. He never wanted to put people out. I only wish he would have asked for more help from others these past few years, but he was proud.

Dad said he was sorry to do this to us and asked we all be good to one another and, of course, " I am a member of the American Legion, and I want a military funeral." He is now up there looking over us, with all the loved ones that have gone before him. I hope he got that big deer he wanted and that he has many dogs and activities to occupy his time like cooking up some venison and making one of his killer herb salads.

By the way, dad was the best Santa ever. In an article put out by Aloha magazine several years back, he was honored for playing Santa for hundreds of the patients at Queen’s hospital on Christmas for over 40 years. One story put is so clearly in my mind how great and quirky he was. “Being a surgeon and Santa provided some interesting moments in the hospital. On a few occasions he was suddenly called into the emergency room, with no time to change his attire. “It really must be something for someone to walk into the emergency room and see Santa Claus reading X-rays.

In closing lets all learn to live like dad a giver and lover of life. As he passed, my ring tone went off on my phone twice, once saying, "Everything is gonna be all right," and the second call, "I wanta go home, let me go home." Take that as you want to, but it sums in up in a nutshell for me. Dad you have given me the foundation to be a strong person and compassionate nurse. You always said it is about the patient and nothing else. I will continue on my life journey until we meet again over the rainbow. You took the express elevator to the penthouse the evening you left us with no stops on the way up. I never saw a shooting star head up from earth so fast, but you did it. I love everything about you. I have enjoyed going through pictures and your accomplishments in life this past week and see you had a happy, full life and you were such a joy for many. Many will celebrate you for years to come. I had to chuckle many times this past week as I kept fining your writing pens and calendars everywhere. We will pass those onto you friend and loved ones. Also Linda gave me a plastic bag she took from your desk at work and I said what is this. She said, “ It is about 8 reading glasses, you know he was always loosing his glasses.” God Bless all of you and let us now meet with God in a mass of passing for a wonderful man.

We discovered this gift in a plain unaddressed envelope.

Do not stand at my grave and weep
I am not there I do not sleep
For I am the fair winds that blow
The brilliant hues of the rainbow.
I am the peace at sunset hour.
The soft and gentle trade wind shower
When you awake in the mornings hush
am the swift uplifting rush
Of the egrets in flight
The timeless stars that shine at night
So don’t stand at my grave and cry .
For I am not there, my spirit did not die.

John

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