Authors: Stephen P. Kiernan
WITH CERTAIN PATIENTS
the fading comes almost as a surprise, weeks of minuscule changes, then arriving all at once, and that was my experience with Barclay Reed. In the days immediately after his daughter appeared, he seemed to vanish into himself. The hollows under his cheekbones deepened. His eyes seemed larger.
But when I offered the Professor anything to eat, he would turn away from the plate, tugging at that tuft of white hair at the top of his forehead as if that small nervous gesture could sustain him somehow. As his appetite declined, the cancer devoured him.
I was carrying another untouched meal from his room to the kitchen, while D sat at the table eating yogurt with fruit on top. Blueberries and peaches, lush midsummer peaches, and they looked lovely. Seated facing away so she could enjoy the view, she was using the stoneware bowl the Professor had asked me to put away. The one with the hummingbird on the bottom.
“That is a lovely bowl,” I said.
“It will suffice,” she answered, taking another spoonful.
“Did you make it?”
“God no.” She tossed her head as though a fly had tried to land on her nose. “My doormat of a mother made it.”
“Your mother.” I went to the sink, rinsing off Barclay Reed’s plate. “What became of her?”
“She died.”
“I’m sorry. I didn’t know.”
“Decades ago. But I wouldn’t expect old Barclay to volunteer that information, given that he murdered her.”
I shut off the water. “What did you say?”
“Ask him. He’ll tell you without apology. Look—” She pointed her spoon at the wall of photographs. I remembered that when I first came to the house, I noticed several frames had been removed. “There’s your evidence.”
“I’m sorry, I don’t understand.”
“He’s savvy enough to get away with it, evidently. But the grieving widower in public could not bear to see her face in private. Guilt will do that.”
I scanned the remaining pictures. This time I saw the little Asian girl with her hands on her hips, and recognized her. “I see he left your photo up.”
“Against my specific request.” D bent over her bowl and took a big bite.
ONE OF THE FUNDAMENTAL IDEAS
of hospice is that the patient is not the only person who needs care. The family does too. So may neighbors, co-workers, even the nurse and volunteers if a case requires heroic effort. I know of an inpatient hospice facility that keeps a room unoccupied for forty-eight hours after the patient has died. Family members can come to grieve and celebrate as they remove grandchildren’s art on the walls or flowers from the windowsill. Staff can visit too, remembering the patient and honoring the privilege of providing that person with care. Only then is the room considered ready for the next human life to fill the place with decorations, gather loved ones, and walk the final road.
By that thinking, D was my patient now, too. And she was suffering, whether she would admit it or not. This absurd murder accusation was a troubling symptom. My job was to favor neither her nor the Professor, but to care properly for them both. I stood at the sink watching her eat, wondering what would be a good point of entry.
“What line of work are you in, D?”
She remained angled toward the lake. “I am an academic.”
“Like your father.”
“In no way whatsoever,” she scoffed. “He is a discredited scholar of a discredited discipline, his whole field now recognized as an exercise in subjectivity, sexism, and nationalism.”
Her attitude might be different from Barclay Reed’s, but her aggressive manner of speaking was similar enough that I smiled. “What is your field?”
“Gender studies. My focus is the link between patriarchy and violence.” At last she half-turned in her seat, though still not far enough to face me. “And what are you, some kind of glorified candy-striper?”
I let the insult stand without a reply. That felt better than defending myself, stronger. It was as though a little chemical reaction hung in the air between us, the electrons of her aggression attempting to interact with the neutrality of my decision not to engage.
“Excuse me a moment, please,” I said.
And I went to check on her father.
HE LAY IN THE BED LIKE A LUMPY RUG,
visibly flattened by fatigue. But he was awake, and I leaned in over him. “How are you doing today, Professor?”
He gazed directly at me, his eyes the dark brown of tree bark. It felt like the first time our eyes had actually met. “Has she come to watch me die?”
“More likely she has business with you that she needs to finish.”
“Our business, such as it was, ended years ago.”
“Well, you and I have business to discuss, anyway.”
He shrugged. “Do your worst.”
This was not the manner of a killer, no defensiveness or paranoia. D’s claim was ridiculous. Besides, we had a more immediate issue. “In your initial patient workup, and repeatedly since then, why have you said you had no surviving family members?”
With what seemed like great effort, Barclay Reed thumbed the button that lifted the upper half of his hospital bed. “You may feel misled, Nurse Birch, but the situation is not as it seems.”
“Maybe so, but there are implications for your care.”
“Can it wait, please? I am bone tired.”
“Yes. But we’ll need to discuss it later.”
“Agreed.” He set the bed controller aside. “The woman is strategic, I’ll grant her that. I sent word of my illness in March. She deliberately waited till I was too tired to match wits with her.”
I checked the water level in his bedside cup. There was no visible difference from two hours earlier. I set it on the rolling table, which I swung over his lap. “Maybe we can figure out a way for you to give D what she needs without sacrificing too much of yourself.”
“Maybe piglets will flap their little wings and lift off the ground.”
“Just in case they do, let’s try to get some breakfast in you. It may boost your energy. I’d like you stronger right now, if possible.”
He sighed. “I hereby temporarily submit to your culinary dictatorship.”
“I’ll alert the media.” I countered, starting for the door. But he took in a breath as if to speak, and I turned. “You need something first, Professor?”
“Blast it all.”
“What’s the matter?”
He tugged at his tuft of hair. “I have come to a realization that I am reluctant to admit.”
“I’m listening.”
Barclay Reed focused away across the room and spoke in a low voice. “I am glad that you are here.”
D WAS NOT THE WORST OFFSPRING
I had encountered. Adult children can be astonishingly selfish when a parent is nearing the end.
I have seen families demand that clinical teams do more to prolong their loved one’s life when the poor patient is so battered by interventions, anything more would be cruelty. I wait for the right moment, then suggest that sometimes the most loving thing we can do is to stop trying to cure what cannot be cured.
I have seen people tell patients to keep fighting—typically sons speaking to fathers—when clearly all the exhausted patriarch wants to do is rest. I bide my time, then point out how hard the patient has fought already, and ask them to consider giving him permission to go.
Sometimes the people listen, and the patient dies at peace. Sometimes they don’t listen, and the patient dies anyway. Nature will have her way.
But the winner of tough family members would have to be Kevin. His mother Dana was a lovely retired attorney who’d had a series of heart attacks. I met Dana during inpatient training, when the illness was well advanced and she had already told everyone, “Enough.” She seemed at peace. Under her orders, a surgeon switched off her pacemaker, I arranged for clergy to visit; family members made the trek and said their good-byes.
But not Kevin. He refused to come. He lived only ten miles away, but days passed and he did not show. Dana asked me to call him.
“I can’t get there,” he said. “Business is crazy right now.”
Dana’s daughter Felicia, who lived two hours south, came every night after work, missed her daughter’s school play, and told her husband she would make it up to him when it was all over. She called Kevin too, but he evaded her.
When Felicia finally reached him, one night when I happened to be standing with her in the ICU waiting room, she put him on speaker.
“Don’t worry,” Kevin said. “I might not be able to make it to the hospital, but everything else is taken care of. It’s all set.”
Felicia bugged her eyes at me, as if to say,
can you believe this
? “I’m right here with Mom. What else on earth is there to take care of?”
“The logistics,” Kevin said. “I’m on top of all of it.”
And then, unexpectedly, Dana rallied. I’ve seen it happen once or twice with congestive heart failure—if the situation involves excess body fluid due to low urine output from failing kidneys. The patient stops eating and drinking, preparing to die, but that brings the fluids gradually into balance, and three days later she’s better. A week after everyone told Dana good-bye, we rode a medical transport to take her home. It was my first transition of that kind, which is why I didn’t know better about checking the apartment beforehand.
When we opened the door, we learned what logistics Kevin had been talking about. The apartment was empty. Not a stick of furniture, no art on the walls, no rugs underfoot. Felicia checked, and the fridge was cleaned out. In fact, the whole place smelled of fresh paint.
I found Dana standing at the bedroom door, arms limp at her sides, and over her shoulder I saw the only thing Kevin had overlooked: one wire hanger on the closet floor.
D was prickly, no question. The murder accusation made her a contender. But she would have to get far nastier before she outdid Kevin. A woman that bitter would have minimal openness to a support group, I suspected, or bereavement services. But would she turn down a therapeutic massage?
“NOT INTERESTED,” D
said that afternoon, back at the kitchen table, eyes on a book. “I am extremely particular about who I permit to touch me.”
“A sensible policy,” I said. Barclay Reed was asleep again, which meant I had some time. My next move, because this work is so often about courage, was to pull back the chair beside her and sit.
D did not raise her head, the book in front of her like a little fortification. Sighing, she slipped a bit of paper in to hold her place. “Has he told you about losing his post at the university?”
“On my third day here.”
“Whatever his explanation was, don’t believe it. He is the most expert liar that ever lived.”
“I believe he has been generally honest with me.”
She snorted. “Has he read to you from his so-called unfinished book?”
“Actually, I have been reading it to him.”
“Perfect,” D said, throwing her hands up as if to say it was all just too incredible. “Classic Barclay. Vanity right to the end. All for a pack of lies.”
I could not resist asking. “
The Sword
is not true?”
“It’s complete nonsense, which is why no publisher would touch it.”
“Your father thought that was due to the scandal.”
As she spoke, D addressed the book on the table rather than me. It reminded me of the Professor’s impromptu lectures.
“My father has hobbled together a mishmash of unrelated facts and speculation,” D said, “presented in a context that never existed except in his imagination. The heartwarming story of an apologetic warrior? It is a concoction to salve American guilt about the ruthless obliteration of two Japanese cities. A fabrication to sugarcoat the extermination of hundreds of thousands of innocent civilians. It is a fairy tale.”
“Wow.” I had nothing else to say.
“And while we’re chatting,” she was talking louder now, and faster, “the reason he didn’t fight the plagiarism charges—I’m certain he has propagandized about that fiasco too—is that he was caught red-handed. Richard Blount, that brilliant young scholar? Now he’s a department chair at Columbia, a serious and respected intellect, but that scandal nearly killed his career in the cradle. Barclay pretends that he chose not to defend himself out of nobility and restraint. Actually, he was guilty as hell. His conduct was indefensible.”
With the
s
in her last word, a fleck of spittle flew out and vanished on the rug. It was a giveaway. D’s excess passion made her argument weaker.
So, just like when she’d insulted me earlier, I let her assertions breathe. Maybe there was some kernel of truth in them, too. Portland State would not remove the Professor’s books from the library if everything were as he’d described.
But
The Sword?
I wanted that to be true. I wanted it for Barclay Reed’s sake because he needed so badly to be believed. I wanted it for Michael’s sake as well: If Ichiro Soga could change from a warrior into a man of peace, it might be possible for my husband too.
D was staring at me, and I realized she was waiting for an answer of some kind. “I promised your father I would read the whole thing before I decided whether or not it was true.”