Lottie decides to stop suctioning her father

Lottie decides to stop suctioning her father during his final decline, choosing to remain with him rather than continue a procedure she knew how to perform. Recalled by Frank after Tina’s death, the decision joins a private act of care to the family’s larger struggle with prolonged dying, and offers a sharply different context for the book’s later questions about who should be able to choose the circumstances of death.

Background and the prolonged decline

Lottie’s father had once been an energetic, independent man. After a stroke, however, he remained in bed for nine years. Frank remembers the length of that dependence as a stark break from the life that came before it: a man who had been vigorous was now unable to live as he once had. By the time his lungs began filling with fluid, the family understood that he was nearing death, but his dying involved repeated care rather than a single, decisive moment.

Members of the family took turns suctioning his lungs. Lottie, Tina, their children, and the children’s spouses all shared the task. The arrangement made his care a collective responsibility, distributed across relatives and shifts; it also meant that the decision eventually fell to someone who knew both the routine and its purpose. Lottie was a nurse and had been trained to suction him. She was not acting from ignorance of the procedure or inability to carry it out.

The final night

The turning point came during Lottie’s turn with her father. It was late, and she was alone with him. He called out to his dead wife and said that he was coming to her. Frank understood this not as a mistaken impression but as an encounter: he insisted that his father had seen her. The account thus places the father’s words at the point where the family’s practical work of sustaining him meets his own apparent movement toward death.

Lottie could have suctioned him, but she decided not to. As his lungs filled, she held his hand and stayed with him. The account describes no argument among relatives and no consultation with a doctor at that moment; the choice is presented as hers, made while she was alone with her father. Her action brought the repeated suctioning to an end, and he died. It is important to distinguish this from literally disconnecting life-support equipment: Frank specifically clarifies that no plug was pulled. The change came when Lottie stopped performing the care she had been providing.

Lottie’s decision and its meaning

Frank calls the decision the best thing Lottie could have done for her father, while also acknowledging how hard it was. His judgment rests on the contrast between the father’s earlier vitality and nine years in bed after his stroke, as well as on what he understood the father to be expressing in his final moments. The story does not present a general rule for when care should stop, or claim that every relative would have made the same choice. It gives the decision its meaning through these particular circumstances: a long decline, a family sharing the work, Lottie’s nursing knowledge, and her father’s final appeal to his deceased wife.

Frank’s response also makes clear that the act did not erase its emotional difficulty. He recounts it while grieving Tina, his wife, and connects the memory to his own view that lingering is the worst way to die. His words place the old decision within a family that has repeatedly faced illness and loss, but they remain his interpretation of what Lottie did for their father. Lottie’s own account of the moment is not given in this recollection.

Recollection and narrative significance

The episode reaches the reader through Yolandi’s conversation with Frank after Tina’s death. Frank is sitting alone and crying; in speaking about Tina’s quick death, he turns to the much older memory of Lottie and their father. The shift links two losses without making them equivalent. Tina’s death follows a heart operation that had initially appeared successful, whereas their father’s death comes after years of severe decline and a decision to stop one form of care. Frank’s recollection gives the family history a concrete precedent for confronting the point at which continued intervention may no longer be the same as helping someone live.

That precedent sits beside, but does not settle, Yolandi’s earlier deliberations over taking Elfrieda to Switzerland for assisted death. The situations differ: Lottie stops a recurring procedure for a father already dying after a stroke, while Elfrieda asks for help ending her life amid mental illness, and Yolandi weighs legal, practical, and moral concerns about how to respond. The novel’s juxtaposition does not make these choices interchangeable. Instead, the family memory shows that questions of death and care have already taken a deeply personal form for Lottie and Frank, before Yolandi confronts her sister’s request. In Frank’s telling, Lottie’s decision remains both an act of love and a painful choice whose force depends on the particular life and decline it ended.