Authors: Stephen Dixon
“I want you to first let them put in a feeding tube. You have to try it. It's a painless procedure and they say you need it to live. The food will give you strength.”
“You awful person. I wanted to say much worse. Why are you acting so despicably to me?”
“Mommy, don't be so hard on Daddy. You know how he feels. And Daddy, you have to do what Mommy wants.”
“I don't have to. I want to help her.”
“You do have to. And you're hurting her with your demands.”
“Let's give it one more day. Please, my darling Abby. If you haven't changed your mind about the feeding tubeâ”
“I won't.”
“I know. But if you haven't by tomorrow morning, we'll take you home. Is that fair? Is that fair?”
“All right. Now all of you leave. I want to be completely alone in my room tonight. Not with you, one of the kids or a private nurse hired for tonight. I just want to think.”
“Okay. We'll be here, or only I will, bright and early tomorrow morning. Now will you let me kiss you good night?”
“Of course. Have a good dinner at home. Or all of you go out for dinner. There's still time.”
Phone rang very early the next morning. It was still dark out. My first thought was that she had committed suicide, or tried to, in some way. That that was why she wanted nobody to stay overnight with her. Because I would have. I had no intentions of going home. It was the head nurse in ICU. Abby was hysterical, wanted to know where I was. Wanted to be discharged from the hospital right away. “I told her she couldn't be discharged till much later this morning. There were forms, procedures, instructions. The people who took care of that don't come in till nine. We almost had to keep her down with wrist restraints.”
“Are you in her room?”
“Yes.”
“Can you give her the phone receiver?”
“She doesn't want to speak to you. âNo more malarkey,' is how she put it. I've tried to explain things to her. But she says she only wants you to get here immediately and take her home.”
“Tell her to relax. I'm coming. That I just have to wash up and dress. Did she say anything about a feeding tube?”
“That's mainly what she's so hysterical about. It's a no.”
After dealing with the paperwork and instructions how to take care of her at home, we left the hospital around ten. She went home by regular ambulance this time, not the big emergency medical truck. The previous time I drove her home. She died in her hospital bed at home fifteen days later. Was conscious the first five days and then slipped into a coma she never came out of. She refused food, drink, medicine and oxygen. The visiting home hospice care nurse, who came every morning for about twenty minutes and, once Abby was comatose, resupplied me with morphine whenever I was almost out of it, was surprised Abby was still alive on the sixth or seventh day of her coma. “No medicines? Nothing to eat or drink or for her breathing since she came home? I thought she'd be gone before I got here today.” The only thing she drank the first five days other than ice chips every so often, and I suppose you can call that drinking, was a sip of champagne from a glass held up to her lips. Only foods she ate during that time was a chocolate-covered strawberryâit was around Valentine's Day, so something the bakery at the market I go to hadâand a small piece of nova on half a rice cracker that had to be placed in her mouth. Both of these and the champagne on the second day she was home, when we had a little party in her room with our daughters and her best friend and her best friend's husband who came down from New York. She didn't want to see anybody else. “I don't want to scare people with how I look.” I don't know whose idea the party was. Maybe it was mine. I remember wanting to lighten the mood in the house, and it seemed to work for an hour or so, at least for her. “My last bite,” after she ate the nova and cracker, or part she bit off. “I might throw it up, but oh, it tasted so good. This is one of the foods I'll miss. Nova. Sturgeon. Smoked whitefish. Russian caviar. Raspberries and artichoke hearts. Quite a spread. And the champagne. Such a good one
too. Everybody: eat up. So much good food I can't touch. Finish the champagneâit can't keepâand open another bottle for yourselves. Phil, we must have another good bottle of champagne around. What we didn't drink but intended to last New Year's Eve. There's no law saying it has to be chilled.”
I haven't got all this down exactly right. I could ask my daughters for help with some of it, but I don't want to bring any of it up to them again. It only makes them sad and me sad and they don't want to be. Me? I don't mind, and the truth is, sometimes it feels good. I don't even know if I got the order right of what happened those last fifteen to sixteen days. But I think this is how it generally went. I didn't take notes or keep a journal. I never do about anything. It's all memory, in my head. If it doesn't come out when I'm thinking of it, it usually comes out sometime later. But to get back to where I started from: I've been wondering if she would have lived longerâand I'm not talking about a few days or weeks but months; years, even, where she still might be alive todayâif she hadn't gone to the hospital that last time. Crazy thought? You bet. But possible, I'm saying, possible. A thought just to make myself feel even worse than I already do about her? Maybe that too. But maybe she would have gotten betterârecovered completely from the pneumonia, that last timeâif she hadn't gone to the hospital. No threat of a feeding tube or of being intubated again, which is the worst thing that can happen to you there, the air tube or whatever it's called forced down your throat into your chest and kept there, with you on your back the whole time, for God knows how long. For Abby, the three times it was done to her, it was more than a week. And the fuss and discomfort and anxiety, too, of being driven to the hospital in that truck and wheeled into the emergency room and then the intensive care unit and tests and x-rays and oxygen mask and IV's and everything else including screams all night from
patients in other rooms and nurses and aides waking you up every two to three hours to take your temperature and blood pressure and draw blood and empty your urine bag and maybe change the catheter and check your IV's and ask if you need to use the bed pan or are in pain and give you medicine in liquid or pill form. Maybe it all got too much for her, just as she might have thought it would, once she was in the hospital for a couple of days, and she gave up trying to fight the disease and complications like pneumonia that often go with it, and thought what's the use? She'll only be back here in a few weeks under the same if not worse conditions, the ICU doctors and palliative team giving up on her even faster than they did the last time, and got the idea, or finally settled on one she'd been thinking about awhile, to starve and dehydrate herself to death at home. So what am I getting at? I lost what I was thinking. Then what was I thinking? That maybe I shouldn't have pressured her the way I did to go to the hospital. Not “maybe.” I shouldn't have, period. And also not got Marion to urge her to go to the hospital too, which Abby absolutely didn't want to do. She wanted to stay home. She might have got better. I should have done what she wanted, or at the very least thought about it more. No, done what she wanted and not just what I had it in my head she should do. Getting ganged up on the way she was and being so unhappy and frightened in the hospital, and because she'd gone through it a few times in the last two years, weakened her to the point where she couldn't fight me or anything anymore and just wanted to die. I don't know. But I definitely think I did something very wrong. Weeks after Abby died, or monthsâI forget; could even have been a year, twoâMarion so much as told me so. We were having drinks in the living room of my house. Marion, just tea. Her husband was there. Actually, we were sitting in the enclosed porch off the living room, it was the last time they came to the house, alone or together,
though I'd invited them for drinks a couple of times after that, and I haven't been to their house since Abby and I had dinner there a few months before she died. I've no idea why. Maybe some things I say depress them, and I cried the last time they were at my house and Marion then started crying too. Or being with me reminds them of Abby and that depresses them; at least it does Marion. I'd put out a plate of different cheeses and a bowl each of hummus I made and crackers and olives and a small dish for the pits. We talked mostly about Abby. How much we all miss her. She's not someone you can ever forget, Marion said. The last book she translated that Patrick was reading and enjoying. “It feels like I'm reading the actual Russian,” he said. “I don't know how she did it.” That I think of her many times a day and have a dream or two that she's in almost every night. “Sometimes she loves me in them and says so. More times, though, she hates me or is very angry at me and won't let me make up to her.” And those last fifteen to sixteen days. How it became, Marion said, more and more difficult for her to drop by for even a few minutes to look in on Abby and listen to her lungs and take her pulse, which she wanted to do daily. “It broke my heart to see her deteriorate so quickly once she went into a coma. Though I thank God she didn't seem to be in any pain. So thank God, also, for morphine. But I want to tell you something, Philip. To get it off my chest, so to speak, or out of it, is more like it. Patrick knows what I'm about to say. I've prepared him. And I don't want to make us feel any sadder than we already do about our Abby. But okay. I'm stalling, so here it is. I think we should have, that last time, since we knew her chances of surviving another round of pneumonia were rapidly decreasing with each hospital stay and that this one could easily be her last one and she'd never come home from itâ”
“You don't need to go any further. I've had similar feelings myself sometimes. And don't blame yourself, remember, since I was
the one to ask you to come here to help me convince Abby to go to the hospital.”
“Thank you. I still feel guilty for my part in it, but what you just said makes me feel a whole lot better.”
“I have to say I don't feel any guilt. What I thought then, and I haven't changed my mind about it, was that we had no other choice.”
“That might be true too.”
So where was I? My tendency is almost always to get off the track. Guilt. Hospital. Abby dying before she had to. I've said to myself the last two nights when I was in bed and trying to go to sleep: “I did something terrible to you at the end.” And the first night: “The you is you, of course.” And both nights: “I helped keep you alive for years and then I hasten your death and maybe even have caused it.” That's what I've been getting to and finally got there. I failed her. I failed her. I should have done what she wanted. Abby. I should have said “You don't want to go to the hospital, you want to stay home and not leave our house and take your chances here, then that's what we'll do. Anything you think is good for you is good for me too.” Should have said that. Also: “Anytime you change your mind about it, if you ever do, and it's all up to you, I'll take you to the hospital in our van, not the big EMS truck. The hell with that. Who needs another uncomfortable ride? I won't even call 911. I'll just make sure you're dressed warm enough for the outside, because I don't want you catching a cold on your way to the hospital. Then I'll get you in your wheelchair and wheel you up the ramp in the van, fasten the wheels to the floor, get your seatbelt around you and maybe a little blanket over your lap tucked in at the shoulders, and drive you to the hospital's Emergency entrance. We could even wait, if you want to, for the kids to get here from New York, and we'll all go together in the van. And I'll stay in the room with you
every night there if you want me to, or hire an overnight private nurse to stay with you if that's what you'd prefer. And everything will be all right. But we'll only go if you want to, I promise. If you don't ever want to go, and I know I've said this before, that'll be fine with me too.”
H
e's almost sure he's done this one before. Or one very much like it, but which definitely included Sibelius's
Fifth Symphony
. He was driving a rented car in Maine. She was asleep in the front passenger seat. Last stretch of the trip from New York to the cottage they rented in Brooklin for two months. Route 175, he thinks it is, or 174. There was also 176 nearby, and 177 or 172 not too far from 174 or 175. They'd started out early that morning, alternated driving every hour and a half or so. She got tired at the wheel last time and had been sleeping for two hours with a towel across her chest and arms to keep the sun off her or because she was cold. He wanted to wake her to make sure he took the right road out of Blue Hill to get to Naskeag Point Road, where the cottage was, but thought it best to let her sleep. That way she'd have more energy to help him get the cats and the groceries and all their things into the cottage and clean and set up the place for the night. And he thought he knew how to get there from all the times they did it last year, their first summer together, when they rented the same cottage for two months. So it's 1980. Second to last week in June. They always, even after they got married and had their first child, liked to get there and settle in before the renters and owners of vacation homes really started populating the area the first week of July. In the fall he'd start teaching in Baltimore and she'd finish up her postdoctorate at Columbia and continue teaching there another year. Two courses the first year, one on Dostoevsky. She had about ten of his books and a couple of
biographies and several books of criticism of his works in a carton in the car's trunk.
She woke up, looked at her watch and said “That was a good nap and a much needed one. I didn't get much sleep last night, anxious about getting the car and setting off on time. Oh,” she said, looking around, “we're almost there. You remembered the way. Did you notice any changes in Blue Hill?” and he said “It all seemed the sameârestaurants, stores, galleriesâfrom last year. Still no bookstore or simple sit-down lunch place like the one in Bucksport, which I was hoping for. I can't stand fancy restaurants up here or ethnic ones. French, German, Thaiâanything like that. They all seem out of place. Just give me a plain haddock burger, with lettuce and tomato, and not greasy, and made from today's catch. Or a fresh crab roll and some crispy onion rings and the local cole slaw. And, of course, to share a slice of blueberry or raspberry pie with you.” “Well, Blue Hill caters to a fairly ritzy crowd, but give it time. Maybe the economy will flop and you'll get your wish. Mind if I listen to the news? It's almost five.” “Could I see what's playing on the Bangor classical music station? I haven't listened to anything for two hours. I didn't want to wake you.” “You and music,” she said. She turned on the radio and went up and down the dial till she found something. “No, that's the sister station in Portland, I said. It's too faint to be the Bangor one. A little further up or downâI forget the exact numbers, but it's still in the nineties, and it'll be playing the same thing,” and she found it. Same music that was on the Portland station, but clearer. An orchestral piece, he thought, early twentieth century, he guessed, and one he didn't think he'd heard before. “It's lovely,” he said. “All right if we keep it to the end or until it starts getting too brassy or schmaltzy or loud? If it stays as good, I want to find out who it's by and what orchestra and conductor.” “Anything,” she said. “The news isn't going away, and they'll just repeat
it at five-thirty, if I remember from last year.” They let it play till the end. Sibelius's
Fifth
. Lorin Maazel. Vienna Philharmonic. “That final movement was one of the most stirring and luscious things I've ever heard,” he said. “And that ending. Chord, silence, chord, silence, etcetera. Really unusual for a finish. Thanks.” “Now can we listen to the news?” “You didn't like it? You were just putting up with it for my sake?” “I liked it, I liked it, but obviously not as much as you. I remembered I'd heard it before. But forgot who composed it and what number it was. When I finally realized it was by Sibelius, I was going to guess number seven. So I was off by two. I went to a concert where it was played. Bernstein. My favorite conductor. Same orchestra. In Vienna.” “You went alone?” “No. Going to hear Sibelius would never be my idea.” “The Russian poet, who I remember you said liked to ski in Austria?” “No. My boyfriend in Paris. We took a trip.” “Don't tell me about it. And I've never heard it before. All the music I've heard and some pieces on the radio twenty, thirty times, and never that one? How can it be, a piece that great? I'm going to get it when we get back to New York.” “That's a long time,” she said. “Think you'll remember?” “Maybe there's a record store in the Ellsworth Mall on High Street.” “There is, if it's still there, in the rear of a paperback bookstore, but they don't carry classical music. I've tried. When I had a working record player at the cottage, before we met.” “We should have brought mine up, with some records. Yeah, but that's we said we'd do last summer, and look at us, we again forgot. We're stuck with just a radio for good music. If you want, you can switch to the news now. It's coming up.” “No, the announcer just said they're going to play my favorite Bernstein piece:
Symphonic Dances from West Side Story
.” “What a coincidence,” he said. “You and Bernstein and the West Side.”
He bought a recording of Sibelius's
Fifth
when they got back to New York, brought it to Baltimore with about fifty other LP's
and his old record player, and listened to it a couple of times. They got married a year and a half later, had a baby eight months after that, kept their apartment in New York but lived most of the time in a much larger apartment in Baltimore. The baby slept in a pram in their bedroom her first few monthsâfour or five; six, maybe; he forgets how long. She awoke one night and started crying very loud and, unlike previous times, they couldn't get her to stop. She didn't need to be changed or fed, and he checked and both diaper pins were fully clasped. He thought maybe some music and the motion of the pram being wheeled about the apartment will get her back to sleep. Whenever she was in the car seat in the car and they drove off, she fell asleep almost immediately. He wheeled her into the living room, wanted to put on Rubenstein playing Chopin's Nocturnes, but couldn't find the record in the milk crate he thought it was in. Mahler's
Fifth Symphony
was still on the turntable. He'd played it when he and his wife were having dinner that night. He put on the slow movement, turned off the lights and wheeled her around the apartment in the dark. She continued to cry. He took the Mahler off, put on the second side of Sibelius's Fifth and pushed the pram around. The baby fell asleep in about ten minutes. He lifted the needle off the record, which he was going to do before those final chords came if she hadn't fallen back to sleep by then, and wheeled her back to the bedroom. “Good job,” his wife whispered.
A week or so later the baby woke up around 2 a.m. and started crying loudly again without letup. He got out of bed and checked her and everything seemed all right: double diapers dry, safety pins closed, and his wife said she fed her just an hour ago while he was asleep. “We've got to do something,” he said. “The neighbors.” “Want me to handle it this time?” and he said “No, I like doing it, and you should sleep.” He wheeled the baby into the living room, put on side two of Sibelius's
Fifth Symphony
, adjusted the volume
till he could only faintly hear it, and pushed the pram around the room, staying pretty close to the speakers. She continued to cry. He picked her up, held her against his chest, her blanket still covering her, and walked around the room with her in the dark, kissing the top of her head every now and then. She fell asleep in a few minutes. He sat on the couch, still holding her close to his chest and kissing the top of her head and her fingers till the record was over and the needle returned to the holder automatically. The volume was set so low that the final chords didn't disturb her. He put her in the pram, felt her diapersâthey were dryâand wheeled her to the bedroom. “Everything okay?” his wife said, and he said “Fine, wonderful, couldn't be better. What a doll we got,” and he got back into bed and held her from behind and soon fell asleep.