Rules Get Broken

by John Herbert

The chemotherapy was brutal. Day after day the IV tube dripped poison into Peg’s body; poison intended to kill her cancerous bone marrow—hopefully at a faster rate than the poison was killing her. It penetrated every cell in her body and killed not only cancer cells, but also good, healthy cells, including white blood cells, the cells that defend us from attacks by bacteria, mold spores, fungus spores and all sorts of other invaders. With fewer and fewer white cells in her blood to ward off these attacks, Peg became increasingly vulnerable to the infectious agents that surround each of us every day.

  As a result, Peg developed fungal infections, which in less than two hours progressed from a single black spot on her tongue or roof of her mouth to a growth large enough to cause her difficulty speaking or swallowing. She developed bacterial urinary tract infections so painful she was barely able to urinate without crying out in pain, and vaginal fungal infections—each in turn or simultaneously appearing as if from nowhere and rapidly blossoming into full-scale attacks.

  The bacterial infections brought fevers. In less than thirty minutes, Peg’s temperature would soar from normal to over one hundred two and a half as the bacterial attack of the moment progressed, unchallenged by defending white blood cells. As soon as her temperature began to rise, an antibiotic drip was added to the chemo drip. Sometimes the antibiotics worked rapidly, and within twenty or thirty minutes Peg’s temperature would start to drop. Sometimes the antibiotics worked more slowly, and the fever would persist for several hours. And sometimes they didn’t seem to work at all—capable of holding the offending bacteria at bay but incapable of overcoming them—and the fever would remain, unabated.

  Whenever this happened, if the attending physician decided the fever couldn’t be allowed to remain at its current level any longer, Peg was placed on a chill blanket, a contraption that matched the barbarity of chemotherapy, but mechanically rather than chemically. The chill blanket was basically a rubber pad interlaced with tubing through which water ran, refrigerated by a stand-alone chilling unit brought into the patient’s room. The patient was placed on this ice cold rubber pad, usually naked, in the hope that mechanical refrigeration would accomplish what antibiotics could not—reduction of the fever.

  The good news was that it worked. The bad news, judging from Peg’s convulsive shivering and the look of outright agony on her face, was that it was a brutally painful treatment for a patient already weakened by sickness and burning with fever.

  Thankfully, I only saw Peg on the chill blanket once—although she was placed on it several times—and I could do little to ease her suffering that afternoon other than rub her hands and feet to stimulate circulation and take her mind off the pain of the cold.

  But the nausea was the worst. The chemicals that dripped into her arm stimulated the portion of her brain responsible for nausea and vomiting, and as long as the chemotherapy continued, so did the nausea and the vomiting—long after her stomach was empty.

  For the most part I could do little to help Peg win her battle. The doctors, the nurses and the drugs were her allies, while I was relegated to being an observer. But the nausea let me be a part of the effort, although a small one. Each afternoon, sometimes for hours on end, Peg would retch again and again into the white enamel pan that I held under her chin. When she thought she might not throw up for a few minutes, I emptied and washed the pan in her bathroom sink and then returned to my post as the retching started again.

  At one point Peg stopped eating, her logic being that if she had nothing in her stomach, she would have nothing to throw up. Human physiology, however, is not so easily thwarted. She continued to retch convulsively, dry heaves the nurses called them, and quickly realized having something to bring up was better than the alternative. She decided to resume eating. But deciding to eat was easier than finding the will to eat. So I assumed the roles of cheerleader and coach when dinner came, coaxing her, convincing her she had to eat to stay strong; and she had to stay strong to get through the chemotherapy.

  And so it went. When she wasn’t throwing up or racked with fever or convulsively shivering from having been on the chill blanket, she was lying in bed either asleep or trying to sleep, summoning up enough energy to fight for another day.

  The days passed, and Peg’s chemotherapy continued. The “bad cells” continued to die. Unfortunately, but unavoidably, so did the “good cells.”

  Twenty-Five

  Even though I visited Peg every day, I didn’t see Dr. Werner as frequently as I had hoped. It always seemed that he had either just seen her moments before I arrived or stopped in moments after I left. So each day, within minutes of my arrival, I asked Peg for a recap of whatever he had said and tried to track her progress on the basis of her reports.

  But a few times luck was on my side, and Dr. Werner was either with Peg when I arrived or came in to see her during my visit. Each time this happened, I took the opportunity to ask him how she was doing, what we could expect over the coming days, and what her long-term prognosis was. And each time his report was short and devoid of any of the details that give one a true sense of how things really are. As a result, he generally failed to give me a clear picture of where we were. But still, my sense each time was that Peg was fighting a good fight and had more than a reasonable chance of winning it.

  Our exchange on Tuesday, August 12th, was typical.

  “So how’s our patient doing, doctor?” I asked.

  He had just finished taking Peg’s blood pressure and was now reviewing her chart on the clipboard that hung at the foot of her bed. “She’s doing well,” he replied without looking up.

  “How well is well?”

  “As well as can be expected.”

  “Meaning?”

  He hung the clipboard back on the hook at the foot of the bed, slowly, deliberately, and looked at me as if he were trying to decide if I were challenging what he understood to be his absolute authority within the hospital. “Meaning her white cell count is coming down as it should. She’s tolerating the chemo as well as can be expected. And her fevers are no worse than expected.”

  His tone was flat; his delivery robotic. I knew it was intentional, and I knew it was meant to convey some sort of message to me, but I pressed on.

  “This is good?”

  “Yes. She’s progressing according to plan.”

  “Anything we need to be concerned about over the next few days?”

  “Nothing other than what we’ve been concerned about all along. And that’s infection and Peggy’s reaction to the chemotherapy. Those are our two main concerns.”

  “Any idea yet as to when she’ll be able to come home?”

  “No.”

  “Are we winning?”

  “Winning?”

  “Are we winning the fight? Against her leukemia?”

  “We’re not losing.”

  “So we’re winning.”

  Dr. Werner sighed loudly, making it clear he was trying to be patient with me.

  “Mr. Herbert, a lot can happen between now and the day Peggy goes home. So I’m happy just to be able to say we’re not losing. I’ll see you tomorrow morning, Peggy. Good night, Mr. Herbert.”

  He turned and left the room. The question and answer period was over, and I had been suitably chastised.

  Twenty-Six

  Peg slept through many of my visits—sometimes because of medication, and sometimes because sleep had been impossible earlier in the day because of nausea or a fever.

  Some nights, however, she was able to stay awake, at least for a little while. But even on these nights I did most of the talking, because she didn’t have the energy to do much more than ask simple questions. So Peg would ask her three- or four- or five-word questions, and I would try to tell her through my answers what was happening in the world she had left behind.

  “How are my babies?”

  “They’re okay. They miss you terribly, of course. Especially Jennie. But they’re doing fine. Mom doesn’t go into the office anymore, so she’s hom
e with the kids all day. And Dad leaves the office for home around the time I leave to come here. To give her a little help. Jennie’s in the pool every day, learning how to swim, and Dad bought John little arm floats that you blow up and attach to each arm. So now even he’s in the water, happy as a pig in mud. But most important, they’re having fun, and they’re okay. The folks are taking great care of them. That’s one thing you don’t have to worry about.”

  “Does Jennie ask about me?”

  “Every night when I come home and every morning before I leave for work. ‘When is Mommy coming home?’ ‘Is Mommy feeling better, Daddy?’ ‘If she’s feeling better, why isn’t she coming home?’ ‘Will you bring Mommy home with you tonight?’ ‘Won’t Mommy be surprised to see how I swim?’ ‘Does Mommy miss me, Daddy?’ ‘Tell Mommy I miss her.’ ‘I love Mommy a whole lot. Do you love Mommy a whole lot too, Daddy?’ Does that answer your question? Yeah, Jennie asks about you. All the time.”

  “Is she frightened?”

  “Most of the time, no. But sometimes…yeah, I think she gets scared. Like last night. Mom was putting her to bed just as I came home from here, and Dad told me the two of them were just about to say prayers. So I go down the hall to the kids’ room and there’s John in his crib, fast asleep, and there’s Mom and Jen on their knees next to Jennie’s bed saying the Our Father. And when they’re finished, Jennie says ‘And God, please bless Mommy, and please let her come home.’ And when I heard that…I started to come apart at the seams. So Jennie sees me standing at the door, wiping my eyes and blowing my nose, realizes I’m crying, and the next thing I know she’s crying and asking Mom why I’m crying. Guess daddies aren’t supposed to cry, huh? Anyway, I don’t think she’s frightened unless I give her reason to be. So I’ve really got to work on that.”

  “And how’s my little guy?”

  “Probably five pounds heavier than when you last saw him. No, not really, but seriously, he’s great. He’s happy. He smiles all the time, and when he’s not smiling, he’s giggling. And Mom is loving him to death. Frankly, I think he’s doing better than the rest of us combined.”

  “Can I see them?”

  “Who? The kids?”

  “Who else?”

  “I’ve asked, sweetheart, but children under twelve aren’t allowed on the adult cancer floors. Not even to visit parents. I called one of the administrators yesterday to see if there was any way they could make an exception for us. But she said if they make an exception for us, they’ll have to do the same for anyone else who asks, and they can’t do that. So for now, I’m afraid we’re stuck. But I brought some pictures Mom took of the kids in the pool. I’ll show them to you later. Okay?”

  “Did you water my roses?”

  “No, I didn’t. I’m sorry, but I haven’t been to the house since Saturday, and then only for a few minutes to pick up some clothes. But I’ll call Dave tonight and ask him if maybe he can set up the sprinkler over the weekend.”

  “How is Dave? And Beth?”

  “They’re good. Dave said they’re going to try to come in next Saturday to see you, but that’ll depend on how Beth’s feeling. She’s due in a couple of weeks, so Dave’s a little uncomfortable about making the trip into the city with her. But they’re going to try.”

  “How’s your father?”

  “Not good, hon. He’s taking all of this really hard. Harder than I ever would have thought. He just can’t believe his ‘sweet patooty’ is sick. So no, he’s not doing too well.”

  “How about your mother?”

  “Well, you know Mom. She’s tough. And she keeps her thoughts pretty much to herself, so it’s hard to tell how she’s doing. But she’s determined to make life as good as she can for the kids while you’re here. Sometimes I think she’s afraid you’re going to grade her or something when you get home. But really, I think she’s all right. The kids keep her mind off you, and that’s a good thing, I guess.”

  “How’s work?”

  “Well, it’s a little crazy. I’m obviously not putting in the hours that I should be, so I’m behind on just about everything. But people understand. They really do. I’ve told a lot of our customers what’s happening, and after they wish us luck, they tell me to take care of you and not worry about them. And they mean it. Kind of nice. And everyone at the company obviously knows what’s going on, and they’re all doing whatever they can to be of help. So work’s okay.”

  “And how are you?”

  “Me?”

  “Yes, you.”

  “I miss you…so much. You have no idea how much I miss you. In the morning. In the evening. In the middle of the night. And when I think of you and all you’re going through…it tears me apart, Peg. I…to be honest…I try not to think about you during the day, because it hurts too much when I do. And then I can’t work. Can’t focus. Can’t function. And I keep asking myself why. Why has this happened? And I keep coming up empty. But I’m getting through it. God knows, if you can get through your end, I can get through mine. But I do miss you, and I love you. More now than ever before.”

  But one night, Wednesday, August 13th, Peg was wide awake, alert, almost vivacious. Our conversation that night was anything but one-sided and focused on a time before Dr. Werner and New York Hospital and chemotherapy and cancer. Instead, our conversation centered on memories—good memories—memories that we shared and which had come to define us.

  “Do you remember the first time we made love?” I asked that night.

  Peg smiled.

  “When was it? March? April?” I asked.

  “April,” Peg answered without any need for reflection. “The first Sunday in April, to be exact. Sunday afternoon. Anne Baker and Jane Goldberg had gone somewhere for the weekend, and Sarah and Jerry had gone out to the Island. And we had the apartment to ourselves.”

  “I guess you do remember.”

  Again Peg smiled. “Do you remember what happened afterwards?” she asked. “Do you remember what we did?”

  “I sure do. We got dressed, and we went for a walk. West up 67th Street to Madison Avenue and then north up Madison. I don’t remember how far. But I do remember that I was flying. I mean I felt great. And more in love than I ever thought possible. And I remember that as we walked along, we wondered if we looked any different to the other people on the street. We wondered if they could tell what had happened just by looking at us.” I shook my head in amazement at the clarity of the memory and looked over at Peg.

  “And I remember,” she added softly, “that at one point during that afternoon, you were so deliriously happy you threatened to stand in the middle of the sidewalk and shout the news to everyone around us.” She paused for a second and looked over at me, her eyes sparkling like they used to. “I’m kind of glad you didn’t do that,” she said with a little giggle.

  And before we knew it, we were laughing. At each other and at the silly things people in love do.

  When the laughter subsided, we both fell silent and looked out the window, watching the shadows of the buildings on the east side of Manhattan slowly stretch across the East River as the sun moved lower in the western sky.

  “Do you remember Dr. Amann?” I asked, turning away from the window to face Peg again. “Dr. Richard Amann?”

  “I remember,” she replied. “The male fertility specialist.”

  “He’s the one.”

  Peg rolled her eyes. “I also remember his waiting room,” she said, “and how tiny it was. And how embarrassing it was for you to be sitting there, holding your semen sample in a test tube, with all those other people who were just as embarrassed as you because they were there for the same reason. And I remember all those letters and baby pictures from patients who had babies after seeing him, all over the walls of the waiting room and on both sides of the hall leading down to his office. Yes, I remember Dr. Amann.”

  “Do you remember what he said after he examined the sample we brought in?” I asked. “After he had spent probably ten minutes telling us all ab
out sperm counts and maturation stages and motility levels? When I asked him if I was sterile?”

  Peg shook her head no.

  “He said, and I quote, ‘Well, let’s put it this way. In the eyes of the law, no, you’re not sterile. But, practically speaking, if you ever spent an evening in the back seat of a car and worried about it the next morning, you didn’t have to.’ “

  Again we laughed. Not just at the recollection of Dr. Amann’s words, but also at the thought of where we had been, faced with the possibility of never being able to have children, and where we had ended up, with not one but two beautiful, healthy children.

  “Do you remember the sign outside that church on the way back to our car after we saw Dr. Amann?”

  “I do,” Peg replied thoughtfully. “I’ve thought of what that sign said many times in other situations. ‘God’s delays are not necessarily God’s denials.’ Right?”

  “That’s right. And that was true, wasn’t it? A little surgical help from Dr. Amann…what was it called? A varicocoelectomy? Yeah, that was it. And here we are, five years later, with Jennie and John.”

  Peg gave a tired little chuckle. “I remember when it looked like we’d never have any children even after Dr. Amann,” she said quietly. “After your operation. Months and months after when I still wasn’t pregnant. I remember us deciding that if we weren’t going to have children, we could still have fun. So we booked our trip to France on the QE 2.”

  She looked over at me with a sad smile. “God, that was a great trip. Remember? A week on board ship and then two weeks in France. One week in Normandy and the Loire valley and the second week in Paris. I remember we couldn’t afford the trip, but we figured we’d have the rest of our lives to pay for it. Then we came home; and three, four months later, I’m pregnant with Jennie.”

  “Four months later,” I said. “We came home from France near the end of July, and you went to the doctor the Wednesday afternoon before Thanksgiving. I remember that because they said you wouldn’t have the test results until Friday since the next day was Thanksgiving. And I was pissed. I wanted to know so badly.”