by Fred Galvin
“Nothing that needs my attention more than you do.”
I took a couple of deep breaths and found that pushing the following words out was the most difficult thing I’ve done in my life.
“Okay. This morning Ken called me.” I paused.
Jen didn’t flinch. She showed no emotion. The only indication that she had any idea about what was coming was a slight squeeze of my hands and a stiffening of her back. She just waited for me to speak in my own time. I fought very hard to keep from breaking down completely.
“He wanted to discuss the results of the tests from your appointment.” I felt I couldn’t go on but I knew I had to. My amazing wife could sense my difficulty and paved the road for me.
“And Ken gave you some bad news. Now take your time and just tell me what he said. And, Dan—it’s okay.” She squeezed my hands tighter. “Whatever it is, we’ll handle it. And don’t worry, I don’t have a gun close enough at hand to shoot the messenger.” She smiled reassuringly. Can you believe that? She knew she was about to get very bad news, maybe even a death sentence, and she was soothing me and trying to make it as easy as possible for me with a joke.
I managed a weak smile. “Right. Okay … ”
She sat patiently while I went on to regurgitate everything Ken had told me. One thing I have always had which has done me in good stead in my profession was a very clear and sharp memory. I can remember even the most minor case details, which constantly amazed Ronnie. So I took my time and related the conversation Ken and I had and I did it almost verbatim. When I was done I was spent.
Jen didn’t start crying. She wasn’t shaking, wringing her hands, or noticeably perspiring and she didn’t show a deer-in-the-headlights expression, all of which I surely would have done given a role reversal.
She asked, “Is that all of it?”
I sighed heavily. “Yes. All of it. Precisely.”
She stood up and took me by both elbows to stand me up with her. She looked up at me directly and intensely. “Okay then. Tomorrow morning at ten we’ll go see Ken and figure out our next moves. But as soon as we’re done with Ken there’s one thing I want to do before we come home.”
“Sure. Anything.”
“I want to take the ferry out to see Libby.”
Chapter 8: Seven words
After a sleepless night, we went to our ten o’clock appointment with Ken Garner, not without any hope, but certainly not with the expectation of his greeting us with a smile and saying something along the lines of “and upon further review, it seems we were wrong about the aggressive nature of the tumor. It’s actually only at Stage 1 and should be treatable with surgery followed up with targeted radiation. You should expect a full recovery after surgery and chemo.”
We knew that wasn’t going to happen. Our best hope was that treatment would slow the tumor’s growth and possibly buy Jen a few years during which the medical technology may make sufficient strides to save her life before time ran out. Statistics over the past few decades show Big C’s winning percentage had been reduced but it’s still batting about .500 and knocking the ball out of the park frequently.
As it turned out, even our best hopes weren’t even close to the reality of the situation.
When Ken greeted us I knew immediately where we stood. We had known each other most of our lives and when you are that close to a friend, well, you just know. He came out of his office to greet us in the reception area which, true to his word, was vacant of any patients. His shoulders were slumped, contrary to the confident demeanor I was used to seeing. He looked somehow smaller than his six-foot frame. His lab coat seemed to hang on him. His handshake was still firm but lacked its usual vitality. His hug of Jen was held for a few beats longer than usual.
I have often wondered how doctors like Ken can deliver life-altering news without seemingly being affected. But Ken had always told me that the short answer is, they can’t. At least he can’t. It was never easy.
We’ve all seen films and TV shows where a doctor unemotionally tells a patient that he or she has six months to live, accompanied by a chilly, and apparently insincere “I’m sorry.” Sure, one can rationalize by saying it’s the job and it comes with the territory. But in reality, any worthwhile and compassionate physician will have some degree of difficulty in conveying a prognosis which spells the impending end of a patient’s life.
We went into Ken’s office and, as was his style, he dispensed with small talk and got right to the point at hand. He was clearly anguishing over having to have this discussion with Jen and me but he was both a professional and a personal friend of us both. He picked up a paper from his desktop, clearly a summary of the test and biopsy results, and started to read. His hands shook to the point where he just put the sheet down, folded his hands, and looked at Jen and me.
“Shit. There’s no need for me to read you the technicalities.” Then, he held Jen’s eyes. “Jen, I’m sure Dan has shared with you the details of our conversation yesterday. I know how his recall of minutiae is total and that he didn’t miss a detail. So I will summarize, then I will answer every question either of you has. There’s no rush. My appointment calendar is clear until later this afternoon.”
Jen nodded. “Yes, he told me everything.”
The irony of the words “there’s no rush” hit me. I wanted to scream back at him “Of course there’s a rush now! Every moment left to us is precious! We have to squeeze the twenty-plus years that we would have had in retirement into what? Nine months? Six? Three? Less?”
But I knew saying that wouldn’t be fair and would have done no good.
So I choked out the questions that the six-hundred-pound gorilla in the room was sitting on. “Okay, Ken. I guess the main things we want to know are first, what exactly is the prognosis? Second, what are the treatment options and their expected results? Third—” I paused as my throat constricted. We all knew the gorilla was still stinking up the office and that he wasn’t going to leave until all his questions were asked and answered. Ken waited, knowing what was coming. My heart raced and I choked back my emotions as best I could. I opened my mouth to speak but all that came out was a croak.
Jen took my hands and squeezed. She bent toward me and kissed my cheek. “It’s okay my love. I’ve got this.”
Then she turned to Ken. “I think the third and fourth questions my husband was trying to ask are how long do I have and what will it be like?” The six-hundred-pound gorilla got up and left, shoulders slumped, knuckles dragging, his work done.
~~~
Jen had always told me that when I discussed a homicide case Ronnie and I were working with her, even if it was over a meal or maybe a drink, that I would frequently change from Dan-the-husband into Dan-the-cop who had those “cop eyes.” That’s when she knew I had retreated into my casework mode.
Now I knew exactly what she meant when I saw my childhood mate Ken-the-friend become Ken-the-medical-professional as he discussed the prognosis and anticipated treatment options and their effects on the quality of Jen’s life. I had lost all track of time but my watch later told me we spent at least an hour there.
We learned that Stage 3 and 4A cervical tumors are treated by chemo radiotherapy, which is a combination of chemo and radiation therapies. While some chemo drugs cause fewer side effects, and sometimes none at all, Ken warned us that the strength of the drugs Jen’s treatment required would indeed cause her great discomfort.
Cancer cells tend to grow fast, and chemo drugs kill fast-growing cells. But because these drugs travel throughout the body they can also affect normal, healthy fast-growing cells. Damage to these healthy cells causes side effects which include, but are not limited to, fatigue, hair loss, easy bleeding and bruising, infection, anemia, nausea and vomiting, appetite changes, constipation, diarrhea (both?), weight changes, mood changes—the lovely list goes on and on. If those aren’t enough, some chemo drugs can also damage cells in the heart, kidneys, bladder, lungs, and nervous system.
Surgical opti
ons include a simple hysterectomy to remove the uterus (but not the structures next to the uterus) or a radical hysterectomy to remove the uterus and surrounding tissues. Some pelvic lymph nodes may also be removed depending on the extent of the tumor’s spread.
Ken suggested Jen’s condition would require the most intense chemo radiotherapy due to its aggressive nature. A radical hysterectomy may be proposed initially as a precaution. He had a consultation scheduled with a senior oncology colleague the next day to review Jen’s case in detail during which a decision on surgery would be reached. Ken’s opinion was that, while the surgery could have some benefit, the trauma and postoperative discomfort to which Jen would be subjected would probably be greater than the benefit derived.
Regarding those dreaded third and fourth questions, how long do we have and ongoing quality of life during that time frame, Ken was direct. He simply said, “The short answers to your last two questions about how much time left and how the side effects will be are”—he paused and took a long deep breath—“six to nine months and very difficult.”
Direct and to the point. Those seven words had just defined the remainder of our lives together.
Six to nine months and very difficult.
About 180 to 270 days of deteriorating health and accelerating discomfort, pain, physical and emotional anguish, culminating in the termination of Jennifer Unger-Deckler as a living being. Simple as that. Seven words uttered by my friend Ken Garner in his office on the Lower East Side of Manhattan Island on an appropriately dreary and dank rainy day.
Take it from me, you cannot possibly anticipate your reaction to hearing those words, whether they pertain to you or someone close to you. The previous night, and the morning of our meeting with Ken, I had steeled myself as best I could to the possibility of hearing those or similar words.
The Death Sentence.
But when Ken said them, I experienced sensations I never expected. Initially I just stared at him, or rather, through him. Then a series of emotions consumed me. A shiver went through me like an electric shock. My spine involuntarily straightened. I flushed and began to hyperventilate. My temples pulsated. Sweat suddenly covered my forehead and my palms. I had to work to keep from evacuating my bladder.
All that within seconds of hearing The Death Sentence. I honestly thought I was going to have a heart attack or a stroke. I reached for Jen’s hand and it was there, as it always had been whenever I had reached for it. I turned to her and through my welled-up eyes my vision beheld an amazing sight. My beautiful bride was looking at me and smiling. Yes, she was smiling. I wouldn’t say she was beaming as though she had heard we had won the Powerball drawing but she was smiling nevertheless. It was more of a smile which said Well, now we know and I’m okay with it. Let’s move on.
I managed to croak, “You’re smiling? How can you be smiling?”
My bride squeezed my hand. “Now we know. I’m okay and we’ll be okay. Let’s move on.”
Then she turned to Ken. “Ken, thank you for being direct and compassionate. Can we meet again in a few days after you have finished your consultations to discuss in detail the specifics of possible treatments and how they will affect me day to day? Right now, Dan and I have to go see a lady.”
Ken just blinked a couple of times trying to grasp how this woman, who was just told she has less than a year to live and that the time she had left was not going to be much fun, could be smiling and calm.
“Sure, Jen. I’ll clear Monday morning at ten if that works for you. A lady? You have to go see a lady? May I ask what lady?”
I got it. I was suddenly okay too. I cleared my throat.
“Libby, Ken. We’re going to take a cab to The Battery and get on the ferry to go out to see the Statue of Liberty, you know, Libby. In all the years we’ve lived here can you believe we’ve never been out to see her? Well, we’re going out there today regardless of the weather.”
Chapter 9: Bookies For Dummies
Now that he was a Made Man, Frankie Finacci was initially assigned to work in the Family’s Lower East Side bookie operations as a “persuader” for three section underbosses. He learned the ropes of being a mob bookie and he learned quickly. As you may suspect, a persuader’s job is to “persuade” delinquent bookie clients to pay up their gambling debts. Frankie was given latitude to define “persuasion” as he saw fit just as long as he made the collections. As an incentive, he was allocated a commission of ten percent of what he collected.
Frankie’s version of persuasion took several forms depending on the situation. First-time offenders who weren’t seriously delinquent (as in not over one day) were persuaded to pay up with a “late charge” within twenty-four hours. The late charge could be a flat fee or a percentage of the delinquent amount, again at Frankie’s whim. The initial persuasion generally came in the form of a phone call from Frankie or a visit from one of his goons suggesting prompt payment. The obvious implication was that the next contact would be Frankie in person and only one of them would walk away from the meeting on two good knees. It was obviously understood which one would be that person.
For more chronic delinquents, or “stiffs,” the initial phone contact was skipped and the personal contact indeed resulted in a cracked kneecap, broken nose, or finger or two. As the degree of the delinquency offense rose on the “stiff” scale, the persuasion escalated proportionally. Pain, coupled with intimidation, can be a great motivator. You get the picture.
Frankie had no reservations about applying whatever persuasive techniques were necessary. It mattered little that a stiff may have had a spotless record previously. If a stiff said something like, “Come on Frankie. I’ve never missed before. How about a break?” Frankie would most likely reply, “Okay, sure. Here’s your break.” This was followed by the cracking of the stiff’s thumb or index finger, which was followed by Frankie getting in the stiff’s face with, “Yesterday is yesterday. Today is now. Get me?”
Profoundly elegant? No.
Profoundly effective? Yes.
Frankie Finacci learned the bookie business very quickly. So quickly, in fact, that he was promoted to bookie status much sooner than the average “persuader.” Thus, he became Fast Frankie Finacci because of his fast rise in the organization. He was proud of his moniker and would sometimes even introduce himself in that manner.
~~~
This is a good time to have a brief lesson in bookie basics. Let’s call it “Bookies For Dummies.” Now, don’t take offense at the implication. Every detective had to take this course in one form or another, mostly through OJT; that is, on-the-job training.
Betting on sports is only legal in very few states. The rest of the country has to make its bets illegally, through bookies. As with any enterprise that holds the promise of easy money, there’s never a shortage of hungry gamblers looking to make a few dollars.
A simple analogy is this: The bookie borrows money from you. The collateral is the bet. If the collateral appreciates in value (you win the bet) then you get your money back with interest, determined by the odds of the bet. If the collateral goes bust (you lose the bet) then you don’t get paid anything. In fact, you probably end up owing money which, if unpaid for very long, could result in broken kneecaps or worse.
Let’s say you are a Yankees fan and the Yanks are playing the hated Boston Red Sox tomorrow night at The Big Ballpark in the Bronx (Yankee Stadium for the uninitiated, and shame be upon you if you did not know that). You have faith that your team will prevail. In fact, your faith is so strong that you wish to profit from said faith, but not with just some pissant ten- or twenty-dollar bet with a drinking buddy who is an insufferable Red Sox fan or an even more insufferable perennial Yankees hater. You want to do significantly better. So you discreetly ask around your workplace or in your neighborhood tavern and are given a name and contact information of someone who “handles wagers professionally.” That’s where Frankie Finacci and his cronies would enter the picture. He would be your bookie.
“
Bookie” is a slang term for “bookmaker.” Bookies do not usually make their money by placing bets themselves, but by charging a transaction fee on their customers’ bets known as the vigorish, also known as the vig, juice, margin, or the overround. Bookies may also lend money to bettors and are not shy about doing so, being confident in their abilities to collect (see “persuasion” above). And, like any lending transaction, the loan is neither free nor is it bound by usury regulations. You won’t be seeing an annual percentage rate prominently disclosed on your lending agreement. First of all, it’s more like a daily percentage rate and secondly, well, there ain’t no stinking lending agreement, is there? That last was not really a question.
While some bookies are involved in organized crime, others operate independently, simply taking bets for a few friends, family members, and/or colleagues. You won’t see any of these operating anywhere near Fast Frankie’s turf.
