Authors: Stephen Dixon
“Don't talk silly. Enjoy the party. There's a woman coming tonight I want to introduce you to. She's divorced, has three young sons, two of them twins. And is quite attractive and smart and considered tops in her field, and with a terrific sense of humor.”
“No, thanks. At least not for tonight. And I know I'm usually hustling out of your party early, but I have to go. I feel so bad for her. Abigail. And I don't want to see that prick of a guy's face ever again. I could really kick myself. Kick myself till it hurts. Shit. Thanks for inviting me all these years,” and he puts down his glass, gets his coat out of the closet and leaves.
I
'm all confused. What if she hadn't gone to Emergency that last time? She didn't want to go. I told her she had to. “Listen, you're sick. You can't stay at home. We can't chance it. You have what seems like pneumonia again. After four times in two years, I can recognize the signs. You've been talking gibberish. I don't mean to be mean. Not gibberish. Just that at times you don't make any sense. For a few moments you didn't know who I was. Like the last time you went there, they'll move you to ICU and put you on antibiotics and a couple of IVs to keep you hydrated and fed, and you'll be cured in a week. Maybe two. I don't want to lie to you to convince you to go. But no more than two weeks, I'm sure, and this time no post-hospital rehab in some critical-care center.”
“I'm not going to the hospital. Don't take me. Don't force me. Don't have the emergency medical people strap me down on a stretcher and drive me there. You have no right. If I'm a patient, I have my rights. I don't sound confused to you now, do I? I can hear myself talking and I don't.”
“No, you sound good. But you don't look well, my sweetheart.” I put my hand on her forehead. “You have a temperature. That I can tell just by touching you. Your forehead's burning. And your face is red, especially your nose. All those were signs of pneumonia before. An infection in your chest. Your lungs.”
“What before? What are you talking about? Am I sick, do you think? Then I have to stay home. The hospital will kill me.”
“Even there, see? You're saying things you don't know you're
saying. I'm saying, they make little sense. Let me call 911. The EMS, or whatever the fuck its name isâthe ambulance truck. They'll come and the paramedics in it will examine you right here in your bed and maybe they'll say you don't need to go to Emergency.”
“I'm not going to Emergency. If I have to die, I want to die here, but in my regular bed.”
“You're not dying. You're going to be all right. Can I call Marion and have her come over and look at you and speak to you?”
“Why would you call Mary Anne?”
“It's Marion. She was once an Emergency room nurse and she's become your best friend here. You know she'll level with you. If she says you should go to Emergency, will you go? I won't force you. We'll do what you want. You get to make the final decision, but first let Marion have a look at you.”
“Call Marion. Call. Call anybody you want. I don't care.”
“So I'm going to call.”
“Isn't that what I'm saying? Call her. Call my mother, call my father, call the police. But what I'm saying is what I'm saying. Nothing will make me go.”
“Even if Marion says you should?”
“You'll just get her to side with you. But we'll see.”
“Let's hope she's in.” I put my hand on her chest above the breasts. “You're warm here too, and sweaty. More signs. I don't know what I'm going to do if she doesn't answer.”
“I hope she doesn't. I want to stay here. If I am sick, I know I'll get better staying home. I at least won't get worse.”
“Okay. I'm going into the other room and calling. I'll be right back.” I went into our bedroom. Abby was in our older daughter's room, which I had set up like a hospital room. Hospital bed, oxygen if she needed it, other equipment and machines and supplies to take care of her for various things. I dialed Marion's cell phone, her
only phone. It wasn't a working number. I went back to Abby. “You okay?” She just stared at me. “Are you feeling all right?” She continued to just stare at me. “I tried calling Marion. Thought I knew her number by heart. Do you remember it?”
“I don't know what you're talking about. I'm fine. Why are you calling Marion? The house is crowded enough.”
“It must be in your address book. Are you comfortable? Do you need another pillow behind you? Something to drink?”
“Nothing.”
“I'll only be gone a minute.” I looked up Marion's phone number in Abby's address book. Dialed. She was in. I told her Abby's very sick again. “I'm almost sure it's pneumonia. All the same signs. Temperature. Confusion. Everything. But she won't let me call 911. I thought if you came over and told her she needs to go to the hospital, she would.”
“I'll leave right away.”
I went back to Abby's room, pulled a chair up to the bed and held her hand and kissed it and stroked her forehead. “Still warm. But you'll be all right. We've been through this before. We're old hands at it. I love you, my sweetheart. Everything I do is for you. Marion should be here soon.”
“Good. I like her. Better than I like you. She doesn't make me do things I don't want to.”
“I understand.”
Marion came in ten minutes, was in the room with Abby about five minutes, with the door closed. She said she'd be able to reason with Abby more if I wasn't there. “Girls' heart-to-heart, okay?” She came outâ“We'll be right back, Abby. I have to give Phil something”âwalked me to the living room and said “She doesn't want to go, but she probably should. She's not well. Her temperature feels like a hundred-three. I don't need a thermometer. Disoriented. A
little trouble breathing. She should be in intensive care. But we can't force her. It wouldn't be right.”
“Even if it might be saving her life?”
“Even that. She might hate it so much and fight everything they try to do for her, it could make her even worse.”
“Let's try. Maybe the two of us can get her to agree.”
We went into Abby's room. Marion sat on one side of the bed and I the other. I said “Please, my darling Abby; for me and the kids. But for you mostly. Let me get you to a hospital. And by that I mean calling 911 and them taking you to it in a special van. Anytime you want to leave the hospital once you're there, I'll take you home in our van, no questions asked.”
“You're lying.”
“Believe me, I'm not. If I were lying you'd never trust me on it again.”
“What does Marion think? She told me I don't have to go.”
“She meant we can't force you.”
“No, she meant I'm not sick enough to go. And that if I am a little sick, I'll get better faster by just staying home. That being in my own house with you is the best medicine I can get.”
“Marion, what do you think? Be honest. Do you think Abby would be better off staying home?”
“You probably should go to the hospital, Abby. It'll be best for you. You'll get a complete checkup, possibly some medicine to take, and you might not even have to stay overnight. In and out. But we can only do that if you go.”
“Do I have to go in the ambulance? I hate them. They hurt my head and back.”
“That way they'll be able to deal with you faster at the hospital than if Phil wheels you inside in the chair.”
“All right. If you say so. The two of you. You broke my defense.
But when I say I want to come home, I'm coming home, even if it's today.”
“That's okay with me,” I said. “I want you home. And you're speaking so clearly. Great.” I stood up and kissed her forehead. She looked away when I did it. “Okay with you too, Marion?”
“I think it's going to work out. I won't even go with you, and I'll probably see Abby here tomorrow.”
“Oh. You're both such fibbers. Anything to get rid of me.”
I called 911. The EMR truck, or whatever it's called, was at our house in a few minutes. We heard the siren from far offâ“I wonder if it's for us,” I saidâand then it was turned off when they pulled into our driveway. The paramedics examined her quickly. One said she should be taken to Emergency. “Her lungs sound congested.” They got her on a gurney and into the back of the truck. This time they said I couldn't ride with them in the front passenger seat. Some new rules. There was an accident. “We'll see you in the Emergency wing of the new hospital. GBMC good for you? I called in and they have room, not too jammed.”
“That's where we've gone before, every single time. It's the closest and I guess as good as any.”
Marion said she'd call me tonight. “Or you call me if you've time. I'll be at the hospital first thing tomorrow morning. And you better call your girls. I'd do it for you, but I'm sure they'd rather hear it from you.”
“What do you think? She'll make it?”
“Sure she will. She's so strong. Look at those last times. They gave her a one-to-three-percent chance of surviving, and she fooled the experts.”
She was in the intensive care unit for five days. Every day she said she wanted to come home and I always said “Give it one more day. The antibiotics haven't kicked in yet.”
“They'll never kick in. You've gone from being a bad fibber to an even worse liar. You know it's hopeless. They didn't even put me on a respirator. No need to, thank God. I'm finished. They've given up on me. One thing, though. If by some miracle I come out of this, I'll never let you drag me into a hospital again.”
The doctors in ICU said she needed to have a feeding tube put in. It's a simple operation, they said, and the only way she'd get nourishment. She said “No feeding tube. That would be the end of living for me. One tube, the trach, isn't enough? I was told it'd only be a month or two and it's been a year and we all know it's never coming out while I'm alive. And then those other tubes around my waist inside to my back for my baclofen pump. Did I need that too? The MS specialists said I did, but I now think the baclofen pills I was taking would have been enough. Everyone's lied to me. Everyone's a liar except my daughters. And the doctors are the worst liars. Or should I say âhusbands too'?”
“Mommy,” one of our daughters said. “Dad's doing the best he can.”
“You don't think I know that? Everyone is. What a joke.”
The hospital's palliative team is asked by the ICU doctors to examine her. After the exam, what seemed like the head of the team signaled my daughters and me to step outside the room. With the three other members of the team standing around her but not saying anything, she said “We hate to break this to you, but the hospital can no longer help your wife and mother. Nothing more can be done for her, other than making her as comfortable as she can be, and she now needs a different and much less aggressive kind of care.”
“Wait a minute. Slow down. She's dying? Nothing more can be done? Everything's been tried? This time, unlike the last four times she was here, the antibiotics failed and the pneumonia can't be cured
and you've no other medications or antibiotics or any other means to help her, and you've determined this in just four to five days?”
“That's precisely what we're saying. There's been irreparable damage done to her lungs the last few years. If she goes home now, she'll be back here in a week or two, or even less, and in much worse condition and probably in great pain and discomfort, and again there'd be nothing we could do to reverse it. Everything possible has been tried. What hasn't been tried are medications we know won't help her. As doctors, this isn't easy for us to accept and is very difficult for us to tell the patient's loved ones, but there it is.”
“So what now?”
“There's an excellent hospice care facility not too far from here. Gilchrist. Maybe you've seen the entrance to it on Towsontown Boulevard. You should pay it a visit. Just go right in. You don't need an appointment. Tell them you're scouting it out for your wife and mother. And take your time in all this. We're not rushing her out. Make your decision in the next couple of days. I've spoken by phone to her general physicianâfilled him inâand he agrees that this is the course she should take. If Gilchrist doesn't appeal to you, we'll give you the names of others. They're all much the same, you'll find. The one advantage of Gilchrist, though, isn't only its proximity to the hospital and your home. Mrs. Berman spoke with great delight of her love for your cat. Streak is her name?”
“His. Close. What are you getting at?”
“It permits patients there to bring their pets with them. Just one, or one at a time, and to keep it there so long as the door remains closed. That can be an added asset in keeping the patient's spirits up. Another advantage, although I believe they all do this, is that you and your daughters can stay in her room overnight and they'll provide the cots.”
“I'm sure my wife wouldn't like being in a hospiceâI know her.
But we'll visit the one you said, just to have something to report back to her and to give her the final choice.” And we didâtook a tour, as the woman at the hospice's front desk called itâand told Abby about where we'd been the last hour.
“Even if the one you saw were like an Arabian palace and they'd wait on me hand and foot as I slowly expire, I'm not going to it. It sounds like a death camp. The hearses are probably flying out of there several times a day. I also wouldn't want Sleek to experience it, my poor dear cat. Listen, you're wasting what precious little time I have left. Besides making me even more miserable with this repulsive talk. While you were out I came to a decision, and you can't stop me from going ahead with it. I'm coming home. Today, not tomorrow. In the next hour, if it's possible. Don't argue with me about it or I'll scream, I swear it, I'll scream and cry and make you feel even worse than you already do. And once homeâand listen carefully; this is part of my decisionâI'm not going to eat, drink or take oxygen anymore. And no medications, either, except what you give me to keep away the pain before I fall into a coma. And then when I'm in one if I show pain. Morphine. Make sure there's plenty of it around and you don't run out. They'll give it to you if you're taking care of me at home. Home hospice care will. I've heard. But I want to die at home in my own bed even if it has to be the hospital one at home. Now what do you say? Today!”