by Barbara Ebel
Gloria took a step back. “Will that be soon, Mr. Hogan?”
His face soured. “I’m taking one step forward and two steps back.” He pushed forward like he was going to tell her a secret. “The only reason I want to live right now is to take care of my will and go through small assets at home. If I can’t go home, I don’t want to waste oxygen. I want to meet my maker because my ticker is pumping inadequately … way below normal. It’s so bad, I’m not even a candidate for a heart transplant.”
“You sound pretty sure of yourself.”
“I’ve lived a good life and was fortunate to make the right decisions most of the time. Like the woman I married. There’s nothing wrong with me wanting to join her.”
CHAPTER 22
The students sat as far back in the lecture hall as possible. Grand rounds brought students, residents, and attendings from their hospital as well as the one downtown. She sat between Bob, Jordan, and Stuart while the resident on stage readied his power point presentation of “An Overview of Antibiotics.”
Annabel looked to her right while putting a few index cards on the pull-down desk top in front of her to jot down notes.
“Either of you want to go out for an early dinner on Saturday?” she asked Jordan and Stuart. “My sister’s coming to town. Bob’s joining us.”
“Why not?” Jordan said.
“I’m game,” Stuart said.
“Super. Let’s meet at five thirty.”
A stout chief resident began his presentation. Annabel knew Donn was holding down the fort for their team on call. She hoped admissions hadn’t started this early as she began selectively adding antibiotic information to her cards. They would be handy study material for their test.
Next to her, Jordan put his elbow on the desk top, half covered his face in his hand, and then all at once became interested in what she was doing. “Smart,” he whispered and proceeded to do the same thing with his own index cards. Bob slouched and put his head back but payed strict attention. Annabel’s thoughts drifted to Robby Burk, but she quickly replaced him with curiosity about the Secret Service agent she was yet to meet.
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Gloria owned nothing more than an antiquated cell phone. For a long time, when she would try to install some new app, her phone would warn her that she had an old operating system that could not download the software. Yet she couldn’t update her operating system because the phone was too old. The phone, however, had the basics, which was all she needed. She could retrieve email, text, take pictures, and surf the web to a limited extent if she had lots of time. The phone came along with her to work and was snug in one of her blue pockets. She realized she couldn’t brazenly use it while working, but she could and would take any short call from her home aide.
Sure enough, the phone buzzed early in the afternoon and the caller ID registered the call made from home.
“You know I wouldn’t be bothering you at work,” Marabeth said, “but I don’t want ya having any surprises when you get back.”
Gloria stood behind her cart and against the wall in the hallway. “What is it?”
“Your mother,” she said with concern, “she threw up twice and is quite droopy, with no energy to spare.”
“Poor Mama. Do you think she has a fever?”
“No, dearie. She hasn’t picked up a fever.”
“Do you think a hot cup of tea or two antacids will help settle her stomach?”
“I’ll try that. If she’ll keep them down.”
“Okay, then. Thank you, Marabeth, for letting me know. Tell Mama I’ll be home in a couple of hours.”
Gloria ended the call and slid the phone back into her pocket. Before she started rolling her cart again, she took a deep breath and said a little prayer that the nausea and vomiting were not much of an issue. She had picked her plan with thoughtfulness and understanding and wanted her mother to pass like Dr. Kevorkian had helped out himself. She wanted her mother to die by her hands … not with the ideas about death that they practiced in the Dark Ages.
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On the drive back to the hospital, Stuart announced that Dr. Berg and Dr. Schott already had an admission and he needed to show up in the ER as soon as he arrived. The students peeled out of Bob’s car in the parking lot and hurried for their afternoon patient care. Annabel checked on May Oliver, hoping her patient had made it out of the ICU. She found May’s chart on the west wing of the medical floor and flipped open each section.
She was encouraged to find the pathologist’s report from her patient’s lobectomy already on the chart. She read through every word. The area of the lobe which had the adenocarcinoma was larger than they previously thought. Reading the description of the cancerous alveoli and its invasion into the terminal bronchioles made her shudder. After all, it was the only organ and tissue responsible for taking oxygen out of the air necessary to sustain life. The only good thing about May Oliver’s case, she had heard Dr. Schott say, was that she was young and not an old smoker, which meant she had no underlying cardiopulmonary disease.
That was all well and good. However, the evil cells had invaded other organ systems and that was what May Oliver had going against her. Annabel walked into her room, trying hard to bring along a sunny attitude. Louise and Ken clung to either side of May’s bed, fussing at her while May slumped like a rag doll against the pillow as if the transfer had drained her of every last ounce of purpose.
Annabel greeted the couple and stood at the foot of the bed. “May, having read your chart, it’s official. Your chemotherapy starts tomorrow morning.”
May’s eyes wandered down to Annabel and she took her mother’s hand. “All right,” she said and tried to clear her throat. “I’ll give it a shot and see where it takes me.”
Louise grasped her daughter’s hand in the air. “Of course you’ll give it a shot. We won’t have it any other way.”
Annabel took a step to leave and Ken locked his eyes on her. He frowned and tossed his head back and forth to the side in a small gesture to keep from his wife and daughter. She frowned back at him as well, worried that chemotherapy might be nothing more than a butterfly Band-Aid.
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Gloria rattled her cart around the corner and wheeled it into the supply room, where she figured the next shift worker would retrieve it. She massaged her hands and left the hospital with a new sense of vigor and purpose. Now she had quite a repertoire of sick patients besides her mother to oversee and, unlike her mother, she could engage in meaningful discussions with them. At least for the allotted amount of time she spent in their rooms.
The bakery downtown would be closed, she realized as she climbed into her car and started the engine. She drove to a supermarket near the house, went in, and stared at the case in the bakery section. There was no shortage of a selection for layer cakes or sheet cakes. She chose a small square vanilla cake with buttercream frosting and asked the aproned woman behind the counter to write “Happy Birthday Gloria” on it.
She left carrying the confection in a box, a delicious symbol of all that was presently festive in her life. Her birthday, her new job, and granting her mother her wish to die under the present circumstances. She would continue to miss their old times together after she was gone, but she didn’t mind because what was about to transpire made more sense than her mother hanging on to a meaningless and terminal life. It was like a mountain climber at ten thousand feet holding onto a crevice with his fingertips while an avalanche approached from above, his necessary backpack descended to the earth below, and he dangled with two broken legs, unable to mount further.
Gloria parked behind Marabeth’s car and scurried to the front step carrying her things. She unlocked the door and walked into the main room. The heat was up too high and she smelled an odor of sickness as she went straight to the counter to put down the cake.
Marabeth sat flush up against Darlene’s bed. “She’s looking worse than I’ve seen her,” she said. “But she hasn’t vomited again, thank the Lord.”
Gloria slithered out of her jacket as she went to the other side of the bed. “Mama, I’m home. Let’s hope you feel better and can taste the birthday cake I brought home.”
“Is it your birthday?” Marabeth asked as she got up.
“It is. Whenever Mama and I were able, we celebrated each other’s special day with a cake. I bought her favorite flavors.”
“I’ll leave you, then. She’s cleaned up for now and I’ll be back in two days.”
“Thanks for taking excellent care of her today. Maybe she just had a stomach bug that is already out of her system.”
“No problem. I hope you enjoyed your first day at a new place.” She left expeditiously without looking back.
Darlene was in a different floral pajama set than when Gloria had left and her eyes stayed focused on the bed sheet tossed lightly up to her abdomen. Gloria scanned around. An emesis basin was on the nightstand as well as the cup she’d used in the morning.
Gloria couldn’t waste much more time. She stepped across to the kitchen and squirted sanitizer into her hands, rubbed a little, and went under the sink to her container and unscrewed the cap. Then she opened the cabinet and pulled out a vanilla meal substitute. She mixed them both in a cup but used less of the real drink this time and put the first bottle back.
She cut a sample piece of cake and went over to the bed with the plate and fork and Darlene’s drink. “Mama, your baby girl’s birthday is today and I got us a cake to celebrate. We’ll pretend about blowing out the candles, but my wish is that you rest in the hereafter with pure serenity. I’m sorry you got Parkinson’s disease, but we won’t let it cause you any more pain. For my birthday, I’m granting you your wish and not one for me.”
Gloria sat on the edge of the bed and worried that her mother wouldn’t drink. But the drink was so tasty and tempting that Darlene slowly took the necessary swallows. Gloria stopped for a half minute and ate a forkful of cake.
“This is scrumptious, Mama.” She put a small forkful to Darlene’s lips and her mother only managed to lick the icing. Her hand slowed down in the middle of a tremor and she seemed to want more vanilla shake. Gloria obliged and sighed with ease that the liquid had reached its target.
Gloria bused the cup to the counter and, having sampled the cake, she cut a normal size piece and went back over. “Mama, I have to tell you thanks for being so strict with me about doing homework when I was little. And thanks a lot for helping to teach me to drive.”
Gloria laid down a towel on the top of Darlene’s pajamas. In an hour, her mother upchucked very little stomach contents and it broke Gloria’s heart to see her wrench forward with such weakness. She replaced the dirty towel and threw the soiled one into a bucket in the laundry room, went back, and cleaned off her mother’s mouth and chin. She took breaks between sitting alongside her to disinfect her hands and once use the bathroom. But the vomiting stopped.
After another two hours, Gloria turned up the lamp switch to increase the brightness in the room. She searched her mind for more things to tell her mother. There were so many things and, yet, nothing more really needed to be said, except for those four timeless words which she’d uttered a hundred times in the previous weeks. Having her mother leave this world while hearing those special words, she imagined, was better than the icing Gloria had given her from the cake.
“I love you, Mama,” Gloria said again before midnight.
Darlene’s eyes barely stayed open now as her face registered peace and contentment. Her last breath was but a puff, a morsel of air with oxygen, and the last one of her seventy years.
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Stuart and Jordan had both acquired new patients in the afternoon. Annabel and Bob were up next and, within minutes of each other, they received pages from their residents in the ER.
“Students are the only people ever in this stairwell,” Bob said as the two of them descended the stairs on their way to the ground floor.
“It’s quicker than the elevator and better for our waistlines.”
“You have a gorgeous waistline without ever using the stairs.”
“Thanks. I think that’s the first direct remark you’ve ever made about my figure.”
“I practice restraint every day. It’s not easy, you know, side-by-side with you every day. Plus, you’re smart.”
They reached the first floor and Annabel put her hand on the doorknob as Bob went to do the same. She chuckled at their attempt at the same time, but she knew he was being his usual gentlemanly self and trying to open the door for her.
As she stopped giggling, she glanced up at his face - his tapered blonde hair and round face with the cheerful expression he almost always wore. His eyes searched hers. She absorbed his countenance with clarity; his admiration for her, his fondness for her, and his loyal friendship. In the dim light, she realized for the first time how blue and rich his eyes were. Like beacons of a lighthouse on a rough shore.
Bob retracted his hand away from the doorknob and, for another second, their eyes held. Astonished at the moment, Annabel deliberately blinked to shake the sense of attraction she felt and she quickly jerked the door open. She felt so uneasy, she couldn’t bear to glance at him again as they walked to the ER.
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“Hurry up and get over there,” Dr. Schott said upon seeing Annabel and Bob walk into the ER. They both looked a bit dazed.
“Bob,” said Dr. Schott, “go see Dr. Watts. She’s working up a COPD patient who needs admitting. And Annabel, you’re with Dr. Burg. Go try your first intubation with your new patient, a twenty-nine-year-old who tried to do himself in with a tricyclic-antidepressant overdose. Put that breathing tube in like you’ve done it a hundred times and decide with your resident what proper settings to use for him on the ventilator.”
Annabel inhaled deeply. Was Dr. Schott ramping up her responsibility like she was a seasoned resident? She wanted so much to intubate someone, especially after the extra attention she’d paid the anesthesiologists during her surgery rotation. They were the ultimate airway experts and she wanted to learn that skill as best she could … no matter what field she went into. But for Dr. Schott to allow her, a medical student, to do it was a thrill.
Thoughts of her encounter with Bob in the stairwell drifted to the back of her mind as she leaned over her new obtunded patient, Mick Rhoden. With the ER doctor and Dr. Burg on either side of her, she opened his mouth with a laryngoscope and slid in a #8 endotracheal tube between his vocal cords.
CHAPTER 23
Gloria leaned against the bed and kissed her mother’s forehead.
“Rest in peace, Mama,” she said softly. She sat in silence for several minutes and then stumbled to the kitchen, wiped her eyes with a tissue, and absent-mindedly sanitized her hands. Back at the nightstand, she picked up the phone and dialed 911.
“Hello,” Gloria said. “My elderly, sick mother just passed away at our house. Her death was expected, but I’ll need help with what I’m supposed to do.”
“What is your address, Ma’am?”
After the exchange of more information, Gloria hung up and waited. Her sole goal was to remain calm, focused, and sad because of her mother’s departure. Remaining calm was easy. The execution of her plan had worked like magic; her mother would be proud of her. She managed to suppress the elated joy she felt because Darlene was finally sprung from a life of imprisonment with Parkinson’s disease. Her mother was in a better place and she was the one responsible for the brave and kindhearted gesture to move her along on her path to freedom.
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It happened without much fanfare. A police car and EMS parked out front almost simultaneously. No blaring sirens from either one of them. It was after midnight and Gloria didn’t think one household in the neighborhood could tell that emergency vehicles were on their block.
The two officers, Dustin Lowe and Edgar Banks, were partners through thick and thin and were working the graveyard shift for the week. Of the two, Dustin was younger and sported a di
mple in his chin, which bemused most women. He beat his partner and the paramedics to the front porch and Gloria opened the door.
“You all were fast getting here,” Gloria said and pointed. “My mother is over here in her bed.”
The male paramedic went over and began checking vital signs while the woman asked what happened.
Gloria shook her head with despair and wiped away moisture in her eyes. “She’s had Parkinson’s disease for years and I take care of her here at home. Her stomach turned a bit sour today. I work outside the home very little compared to how much I take care of her, but the homecare lady who helped out today said my mother had some vomiting. It seemed to have mostly passed by tonight because she only upchucked once. Like I said, her Parkinson’s was really bad and her mind didn’t understand what transpired around her.”
The paramedics kept Gloria engaged with questions and they kept looking over Darlene while the two officers strutted around eyeballing the hospital-like environment Gloria had provided. Dustin Lowe wasn’t fond of corpses, so he only listened to the conversation taking place and began poking at things like he sometimes did. Encountering dead people in his profession, he always pretended he could make a case out of a situation that appeared as innocent as a baby sleeping.
Officer Lowe took a bird’s eye view of the kitchen island. The lid of a small sheet cake was open and one used plate sat next to it as well as one red plastic cup. His eye caught a shimmering to part of its surface and he looked closer at a thin substance which looked gooey, but had dried. Inside the cup, he detected a trace amount of a whitish drink. He hunched over and sniffed it. Distinctly sweet. His eyes roamed the rest of the counter and around the room and he saw another cup like it on the nightstand. He walked over in no hurry, picked it up, and wondered if it had the same glaze on the outside; he was sure it had the same sweet odor as the first one but not as strong.
