Things Remembered (7 page)

“Thirty-one dollars and twenty-five cents. Every week. I got it.”

“Please don't let me down this time.”

“I won't. I promise.” Now that she'd gotten what she wanted, her voice changed to its normal, hurried cadence. “Why don't you just give me your credit card number and I'll call him for you.”

“My purse is upstairs,” Karla lied. “Besides, I should take care of it myself in case he has any questions.”

Grace laughed. “You don't trust me. But that's all right. As long as you call him as soon as we hang up, I'm satisfied.”

“I will.”

Grace gave Karla the phone number. “Let me know if there's a problem.”

“Why don't I just have the agent call you as soon as I'm finished? That way you'll know it's taken care of.”

“You're the best, Karla.” Almost as an afterthought, she breezily added, “I love you, Big Sister.”

“I love you, too,” Karla said, but Grace had already hung up.

As she passed the bathroom on her way upstairs, Karla heard Anna get out of the shower. Only then did she realize Grace hadn't asked about Anna or bothered to pass on a greeting. The omission bothered Karla more than the loan. Grace had been six years old when they came to live with Anna. She had no real memory of their mother caring for her, only Anna. Anna was Grace's mother in every way except biological. How could she forget to ask about her now?

Karla tried to remember what she'd been like at twenty-five. Had she been so caught up in her own life that she was blind to what others were going through? The comparison was useless. Even at twenty-five, Karla had been an old woman. She hadn't seen it then, but it was painfully clear now.

The bathroom door opened as Karla passed again on her way back to the kitchen to call the insurance agent.

“Did I hear the phone ring?” Anna asked.

“I thought hearing was one of the things that went when you got old.”

Anna grinned. “I'll let you know when I get there.”

“Grace called.”

“Oh, I'm sorry I missed her.”

Karla flinched at Anna's automatic assumption that Grace had called to talk to her. “She sent her love and said she'll get back to you in a week or so.”

Anna tucked her bathrobe closer. “Is she all right?”

It seemed a strange question even for Anna. “She sounded okay to me. Why do you ask?”

“Oh, nothing,” she said unconvincingly. “It's just that Grace has been so busy the past couple of years she doesn't call very often. When she does, it usually means there's a crisis brewing.”

“What you really mean is that she only calls when she wants something.”

“We can talk about this later. I'd like to leave a little early to stop by the grocery store and pick up my Lasix before we head downtown.”

Karla didn't want to talk about Grace any more than Anna did and followed her lead. “I think we can manage that.”

Anna's cardiologist's office was on the top floor of a building that overlooked the historical landmark of Sutter's Fort. Like most locals without school-age children, Karla had driven by the park for years without ever stopping. Now, she stared down at the crudely constructed shelter from the richly appointed waiting room of the man entrusted with keeping Anna alive as long as possible. She would have given the Gucci watch she'd received from Jim for her thirtieth birthday to be one of the women herding a group of five-year-olds out of a big yellow bus rather than the woman waiting to hear in clinical detail how much more her grandmother's heart had failed since she last saw her doctor.

When the nurse called Anna, Karla walked her to the door, then picked up a magazine and headed back to the chair by the window.

“I'd like you to come with me,” Anna said.

“I think it would be better if I waited here.”

“Oh, it's all right,” the nurse said. “Dr. Michaels doesn't mind if someone accompanies the patient.”

Karla didn't care about the doctor; she was thinking about herself. She no more wanted to stand around in a cramped examining room than she wanted to walk back into her house knowing Jim had been there with another woman.

“I know you have questions,” Anna said. “Now is the time to ask them.”

Reluctantly, Karla dropped the magazine on the table and followed Anna and the nurse. Curious, she tried to see the weights when Anna stepped off the scale, but the nurse swept them back to zero before she had a chance. It was the same with Anna's blood pressure: the cuff was on and off and the numbers written in the file and the file closed before Karla could make them out.

A short time later, Anna looked up expectantly when she heard her chart being removed from the wooden pocket outside the examining-room door. Several seconds passed. When the seconds became a minute, she glanced at Karla and then the door. “He probably hasn't had a chance to go over the tests he ordered last month.”

“What kind of tests?”

“Blood tests.”

“For what?”

“I don't know. He didn't say.”

The answer angered Karla. She believed medical care was a team effort, with the patient being the most important member of the team. “It's your responsibility to ask.”

“Why? What good would it do?”

Before Karla could answer, a man with a shiny bald pate opened the door. Dressed in a generic white lab coat, tailored dark brown slacks, striped shirt, and paisley silk tie, he looked like an expensive German chocolate cake with canned frosting. He was halfway into the small room before he noticed Karla pressed into the corner and held out his hand. “My nurse didn't tell me Anna had someone in here with her. I'm Mrs. Olsen's doctor—Harold Michaels.”

Karla liked the firmness of his grip. “Karla Esterbrook—Anna's granddaughter.”

“The actress?”

“The businesswoman.”

“Ah, the one with the coffee shop in Solvang.” Having categorized her, he focused on Anna. “Any new problems since you were here last?”

Anna shook her head.

“What about the breathing? Is it getting any worse?”

“It's fine.”

“No, it isn't,” Karla interrupted. Typically, Anna made light of something that was important to Karla. “You can't make it from the kitchen to your bedroom without hanging onto the wall and stopping to catch your breath.”

“Dr. Michaels already knows that,” Anna said patiently. “This has been going on for months now.”

“Does it seem to be getting any worse?” he asked Anna.

“No worse, no better. I added another pillow to my bed.”

“Did it help?”

“I don't seem to wake up as often, so I guess you could say it helped.”

Karla half listened to the rest of the conversation as she tried to absorb how easily both doctor and patient seemed to deal with Anna's terminal condition. When it was clear the exam was over, Karla motioned to stop the doctor before he had a chance to leave. “It's plain I don't know as much about what's happening to Anna as I thought I did. Since I'm going to be staying with her for the next month, I'd like to know what to watch for. Would it be possible to make an appointment to come in and talk to you about this?”

He glanced at his watch. “I have a few minutes before I'm due at the hospital. If you think that would be enough, we could talk now.”

“Now is fine.”

“I'll meet you in my office as soon as I make a phone call. It's the one at the end of the hall. The nurse will show you.”

Karla looked at Anna. “Do you want to come?”

“Lord, no. I've heard all I want or need to hear. I'll meet you in the waiting room.”

Karla had barely settled into the leather chair opposite Dr. Michaels's desk when he came in and handed her several glossy pamphlets. “These are pretty general, but they answer some of the more obvious questions about congestive heart failure.”

“Has she talked to you about dying?”

“Yes.” Instead of sitting down behind the desk, he leaned his elbow on the file cabinet, propping his head against his hand. “As a matter of fact, we've talked about it a number of times.”

For months Karla had thought about this conversation, knowing it was one she would have to have with Anna's doctors eventually, believing it would be easy because it was what Anna wanted. Still, there was a lump in her throat the size of a fist and a sadness that made the words almost impossible to speak.

“Anna has always insisted that the quality of life comes before the quantity. If it happens that a choice has to be made and Anna can't make it for herself, it will fall to me. I need to know what I'll be facing.”

“Have you talked to her about this?”

“Not yet, but it's one of the reasons I'm here.”

Again, he glanced at his watch, hesitated, then said, “I'm going to give you the basics this morning. I can guarantee you'll have questions when you've had time to think about what I've said. When that happens, call me and we'll talk again.”

For the next ten minutes Karla listened while she heard in unemotional, clinical terms how the disease that had begun years earlier without warning or symptoms would eventually take Anna's life. How in its struggle to provide needed oxygen to the body, the heart had grown larger and less efficient until finally the disease manifested itself in the outward symptoms of shortness of breath, fatigue, and swollen limbs.

“How will she die?” Karla asked, purposely keeping her questions as unemotional as his answers.

“There's no way I can predict that,” he said. “There are a dozen clinical things that can happen, but it all boils down to the fact that her heart will give out one way or another and stop beating.”

“What about between now and then?”

“In the beginning, when she reaches a crisis point, there are a lot of things we can and will do.”

It was one thing to know something—she'd come there knowing Anna was going to die—but it was another to feel it.

“What do you mean by crisis point?”

“She'll begin to swell, not just her legs, but her entire body. She won't be able to catch her breath and may even pass out.”

“What do I do if I see that happening?”

“Get her to the hospital. As soon as possible.”

What if it happened in the middle of the night? Or in the daytime when Anna was home and she was at the store? When her month was over and she was in Solvang again? Karla had stepped into a trap of her own making. No one had made her come. She could have stayed home and minded her own business, oblivious to the details of Anna's impending death, forgiven for her lack of attention by her ignorance. Now that she knew what was ahead, she'd closed that escape route and could only go forward. But what did that really mean?

She'd been there less than a day. How much deeper would she be involved in Anna's life in a month?

“What happens at the hospital?” she asked.

“Several things, depending on the severity of the episode.”

“I guess what I really want to know is how much longer she has.”

“That's impossible to say. I've had patients who are worse than Anna who have lived for years with the disease. I've had others who were not nearly as compromised and died a lot earlier than I had anticipated.”

A woman dressed in the female version of Michaels's uniform appeared at the open door. “Ready?” she said, and then noticed Karla. “I'm sorry, I didn't see that you had someone with you.”

“Hold up,” Michaels said. “I'll be through here in a second.” To Karla, he said, “Next time let the receptionist know that you'll be coming in with your grandmother and we can schedule a longer appointment for you.” He began to move toward the door. “In the meantime, if you have any questions just give me a call.”

Karla started to rise, but he was gone before she could get out of the chair. She felt a stirring of anger at his abrupt departure and contemplated letting the anger build. She needed a distraction, an outlet for what she was feeling, and anger had served her well all her life. But she instinctively knew it wouldn't work this time. No matter how explosive the temper tantrum, no matter how detailed her argument in favor of her cause, no matter how righteous her indignation, she couldn't erase the knowledge of what was ahead for Anna.

She found Anna in the waiting room calmly talking to the woman sitting next to her, as if she weren't the patient with the death sentence and all was right in her world. They rode the elevator in silence. Karla waited for Anna to ask what the doctor had said, dreading what she would tell her, wishing she'd insisted on not going in the examining room. Most of all, wishing she'd never come. What difference did it make whether Anna's estate was in order when she died? No one else seemed to care; why should she?

Karla opened the door that led to the parking garage and stood aside to let Anna through. “Wait here. I'll get the car.”

“It's not that far.” Anna tucked her hand into Karla's elbow and started up the ramp. “Besides, there's something I want to tell you, and if I wait until later, I'm afraid it will sound contrived. I really hate coming here. It reminds me that I'm dying and that there's not a damn thing I can do about it.” She paused to catch her breath. “Having you with me made it easier somehow. I just wanted you to know that.”

Of the dozen answers that came to mind, Karla was surprised at the one she chose. “Thank you for telling me. It was something I needed to hear.”

Chapter

6

W
hy don't we stop somewhere for lunch?” Karla said as they drove away from the doctor's office. She was on the ramp for the elevated freeway before Anna answered her.