Nothing Was the Same Nothing Was the Same

by Kay Redfield Jamison

  “Sad?” asked the poet Douglas Dunn about the last days he had with his wife. “Yes. But it was beautiful also. / There was a stillness in the world. Time was out.”

  As we did every year, we drove through the neighborhood to look at Christmas lights, and on Christmas night we watched, as we always did, The Bishop’s Wife. Richard nibbled on plum pudding and provided his usual running commentary on why Loretta Young should have run off with Cary Grant instead of staying with David Niven. Each year, I would say, “You’re much more like Cary Grant than David Niven.” And, because it was true for me, I would say, “Cary Grant wouldn’t have had a chance next to you. You’re the best-looking man I know.”

  This Christmas, Richard was frighteningly thin, and he looked his age, which he had never done. His hair was no longer thick or raven black. I leaned over and kissed him and said, “You’re still the best-looking man I know.”

  He smiled at me, but I saw tears in his eyes.

  “Really?” he asked.

  “By far,” I said. “By far.”

  We settled into our days. The first snow of the season came thick, soft, and gorgeous in mid-January, filling the park and covering our trees and garden. Richard was sleeping more now and eating less, but as long as I was near him when he slept I felt that our small part of the world was good. Richard’s two-month evaluation at Hopkins came and went. There was a slight new infiltrate in his left lung, but this did not seem to bother Ettinger. It didn’t sound good to me, but I wasn’t an oncologist. Ettinger declared Richard’s disease “stable” and recommended that his treatment remain the same. Ambinder came into Ettinger’s office to visit us, clearly happy to see Richard looking at least reasonably well. Richard said, “You always seem surprised that I’m still alive.” Ambinder smiled and didn’t deny it.

  Richard took me to our neighborhood Italian restaurant for dinner on Valentine’s Day. It was a serious and sad evening. It was the only time we discussed what would happen to me after he died, and it was obvious that he had given a great deal of thought to what he would say. He started by telling me how much he loved me and how happy I had made him. He said he wished he could say that he would be keeping an eye out for me once he was gone but, as I knew, he didn’t believe in such things. He did believe in the lasting influence of love. You have good friends, family, and colleagues, he said. You have a good doctor and work that is important. You will have to take care of yourself. You will have to take your medication and get your sleep. No one will be around to remind you. It was as though he had rehearsed the speech and did not know what to say next.

  “But what will I do without you?” I asked him. “What will I do?”

  Richard came over to my side of the table and put his arms around me. “I don’t know,” he said. “But you will be all right.”

  I had not cried in front of Richard since he had been diagnosed with lymphoma nearly three years earlier, but now the tears were streaming down my face. Richard pulled out his Valentine’s gifts for me, hoping, I suppose, that what he had gotten for me might help. The first present was an NIH file folder, which had a stylized glass beaker on the front; he had decorated the folder with large red and pink hearts. It looked ridiculous, and I loved it. Inside the folder were two sheets of paper. The first was the dedication page for his manuscript Cancer Tales. It was straightforward and very Richard. “To Kay,” it read. “Without whom I would not be.”

  Richard’s second gift was a copy of a letter he had written to me more than fifteen years earlier. I was living in London at the time and was in the midst of a deep and unshakable depression. He had called me one night from Washington and been unnerved by the depth of my despair. He wanted to know what he could do to help when I felt so at the end of the world and beyond hope. He said he knew depression clinically but not personally and he was frightened.

  I reread his letter, written so long ago now, and thought how far we had come in our understanding of one another, how lucky we had been to have each other, and how his misspellings could still make me smile. “I like your spelling of ‘flare’ better than the correct one,” I told him through my snufflings. He looked at the letter and said, “Well, it looks correct to me.” A lifetime of dyslexia had not altered his confidence in how certain words should look.

  11/28/85 Thu

  Dr, Kay R. Jamison

  34 Beaufort Gardens

  London S.W.3

  England

  Dearest K,

  I have seen the green ice and the ten

  minute retreats, but last night I heard

  total blackness. When I was twelve we

  visited Mammoth Cave in Kentucky The

  guide said that it was twenty decrees

  darker than total darkness, a statement

  I have never understood. I still do not

  understand it scientifically. I have

  now/however, felt it. It is like a

  black hole drawing all light into it.

  On the phone I felt life being sucked

  out of me threw the wires; gladly

  given. Unfortunately, there was no

  conservation of matter and what left me

  was not to be found in the receptacle.

  on the other end. It was as if there

  was a total annihilation of substance

  and energy. It brought back memories of

  my most primitive childhood nightmare.

  Being with you seemed like the only

  answer, Then I could see it, throw a

  blanket over it, put a glass of water

  by the bed, find its lithium, thyroid

  and if necessary get help. I need some

  guidelines on the later, I need to know

  when to worry. Is length of depression

  or depth the crucial issue or some

  combination? If I ask you are you

  taking your medicines, how specific do

  I need to be? If I ask you are you

  eating and drinking do I need to ask

  you calorie by calorie and glass by

  glass? What will tell me that you are

  toxic? In Los Angeles I can call Dan

  Auerbach, Who do I call in London;

  Anthony storr, the Darlingtons?

  I ara not glad the black hole Is there

  but I am glad I have seen it. When you

  fall in love with a star you accept

  solar flairs, black holes and all.

  Love,

  R

  He had always thought of me as an intense star, he said, alluding to the last paragraph. He brought out a small box and gave it to me. “This is for your solar flares and the black holes. And for our shooting stars over Washington.” Inside was a gold ring with sixteen small stars on it. He dipped it in my wine and put it on my finger, next to my wedding ring and the gold ring he had given me in Rome.

  “To stars,” he said.

  I reminded him of the quotation from Byron’s Don Juan that I had used in dedicating one of my books to him: “To those who, by the dint of glass and vapour, / Discover stars, and sail in the wind’s eye.”

  “To you,” I said. “To safe sailing.”

  When I look back on it now, my Valentine’s gift to Richard was an absurdly optimistic one. I had made reservations for us to spend a week in Big Sur in early April. We had not been there together and it was something we had always wanted to do. It was improbable, but not impossible, to do it now. The trip would be long but manageable; once in Big Sur, we could read and drive along the coast and mull and enjoy ourselves. We could relax; we could stop time again. Richard expressed concerns about the practicalities but was enthusiastic. When we got home, he sat down with my maps of Big Sur and I watched him with delight. Our trip was something to reach for, a race of hope against death.

  Within the month, we knew that we would not go to Big Sur together. Richard was too sick. I told him I planned to cancel my lecture at the University of California at Davis, as well as the
trip to Big Sur, but he was vehement that I not do this. “You’re exhausted,” he said, “and we have a difficult time ahead.” I argued that I didn’t want to go anywhere without him, but he insisted, and he was right. I was exhausted, physically and mentally. For three years I had been taking him to appointments at Hopkins and visiting him when he was in the hospital, sometimes driving from Washington to Baltimore and back twice a day; waiting with him for the results of scans and blood tests, meeting with doctors, requesting consultations, getting prescriptions filled; reading up on his illnesses and treatments; fixing meals and looking after the house. I was hopelessly behind in my work, struggling to maintain my psychological bearings, and trying to keep up his spirits and those of our friends and colleagues. Above all, I was worried sick about him.

  We compromised. I would go to Davis for a day to give my talk, and then drive down to Big Sur for two or three days. My mother said she would come to Washington to help look after Richard while I was gone; she also said she strongly agreed with him that I needed a few days off. She told me that I sounded exhausted and that she was worried about me. She felt, like Richard, that Big Sur was exactly what I needed. I felt guilty about leaving and was fearful that Richard would get worse. Terrible things could happen quickly.

  Richard and my mother were right. I needed Big Sur. I needed to stand at the edge of the ocean and see the Big Sur coast and the mountains and renew some of what was broken inside of me. Even if that renewal lasted only as long as it would take to get me through Richard’s death, it would be an essential thing. Big Sur gave me back some of my spirit, and that, in turn, I gave back to Richard.

  I went to Pfeiffer Beach shortly after I got to Big Sur and read the note Richard had given to me before I left Washington. “We wanted to do this for so long and didn’t,” he had written in his childlike scrawl. “We have done other things. It will not happen in this lifetime and, as you know, I do not believe there is another. But you will know that I am with you in Big Sur. Love, R.”

  I walked on the beach and read and slept in the sun. And then I slept some more. Only after the first day did I realize how bone-weary I really was. Richard and I spoke every hour or so, and as he said he was feeling better, I felt somewhat less guilty than when I had left Washington. I reread one of my favorite books, The Once and Future King, and was struck by King Arthur’s resolution and tempered optimism in the face of tragedy. I understood better this time, in the reading and from knowing Richard, the rarity of that kind of strength.

  The weather was glorious, which is not usually the case in Big Sur. I ate California artichokes and figs and apricots and walnuts. I filled myself with the sun and the breeze and the ocean and the great tall trees. I looked to the sea and I lifted my eyes to the hills, from which, with the Psalmist, I drew my strength. It passed through my mind that I would not be able to be in Big Sur with anyone other than Richard.

  When I returned to Washington, Richard was worse. Within two weeks, he was shorter of breath than he had ever been and he had lost nearly ten pounds. He caught pneumonia. He ate next to nothing and slept more; I watched him lose a bit of his life each day. The intimacy in being together during the approach of death is unimaginable. We knew that what he was going through was final. We lay so close to each other in our bed that we were aware of everything that went on in the other’s body. It was a long and private farewell.

  In mid-April, Ettinger told us that Richard’s disease had “progressed.” The way in which he said this gave us no hope. Bob Gallo made arrangements for Richard to enroll in an experimental drug trial at George Washington University Hospital and sent his medical records and scans to a gene therapist at Vanderbilt. Richard was enrolled to participate in the NIH vaccine protocol in the fall, but it seemed unlikely that he would live that long.

  He started on Iressa as part of an experimental trial to test the drug’s efficacy in patients with lung cancer. It had “shown promise,” a phrase we had come to doubt, but there were not many options left. His energy was deteriorating, he spent less time at his computer, and it was only infrequently and with great difficulty that he was able to get up and down the stairs. Friends visited more often now, but their visits were shorter.

  We had quiet evenings and somewhat disjointed days from that point on. We waited. We hoped against the reality that we knew. Richard slept more, and I lay next to him and didn’t sleep. I read to him for hours a day, although he often fell asleep, and friends and colleagues continued to stream in. At the end of April, Richard and I decided we should have a dinner party for our closest friends to thank them for their friendship and for their extraordinary efforts in trying to save his life. It was our last dinner party, but it was wonderful. I set the table with masses of candles of different heights and azaleas from the garden and made a dinner of papaya with lime and crystallized ginger and figs and salmon and champagne. Everything was alight and beautiful, and the evening was warm with friends who knew exactly what was what.

  The next day, I went to Rock Creek Cemetery to pick out a burial plot for Richard and myself. Richard was too ill to come, but he knew the cemetery because we had been there on several occasions to visit the Saint-Gaudens memorial for Clover Adams. It was the last day of April and there were great blossoming trees everywhere. I called Richard from my cell phone at different sites to describe them to him and to ask which he preferred. We agreed on a place in one of the older parts of the cemetery, near clusters of old trees and within sight of a lily pond. Richard loved the idea of our being near a lily pond in perpetuity and suggested, with a laugh, that I could drop an occasional goldfish into the pond when I came to visit him. It was a sad business.

  I did not leave the house unless I absolutely had to. If I was not with Richard, I was distractible and anxious. The only thing that helped was to be with him. In early May, Bob Gallo recommended to Ettinger that Richard try an additional drug, one he had been working on in his laboratory and that had shown antitumor activity. Richard took Gallo’s drug along with the Iressa and the Folkman regimen, nibbled at his cottage cheese and canned peaches, and remained in unflappably good spirits. He did not complain. He worked on writing up scientific papers when he had the energy and asked me to read to him when he did not.

  There were terrible things to do. Some were small—I bought a black hat with a veil from a saleswoman who was kind enough to match my silence with hers—and others were not. I went to a funeral home to make arrangements and was assisted by a very nice man who asked me if my husband knew I was there. I was surprised by the question, and said, “Yes, of course.”

  “You would be surprised how many wives don’t tell their husbands they are coming here,” he said.

  Not for the first time or the last, I was grateful to Richard for his directness in dealing with death and his incapacity to deny the inevitable. I picked out a simple birch casket and explained to the funeral director that Richard would just as soon be thrown to the fishes but that I wanted his physical presence for myself, and for how others would remember him. I told him that Richard was a doctor and a scientist who had saved many lives and that I loved him beyond reckoning. I told this man more than I needed to tell him, but then I am sure I was not the first to do this.

  In May, Richard and I continued the discussion of funeral plans that we had started in California. Only now we were not on a bench under the sun and we knew that time had run out. Richard was propped up against pillows at the head of our bed and I sat up against the footboard. We discussed friends he wanted to serve as pallbearers and ushers and who should give the eulogies, who should do the readings. A friend of ours, John Harper, who had been the rector of St. John’s Church on Lafayette Square, where I had been a parishioner before switching to Christ Church in Georgetown, had been by to visit Richard on several occasions during his illness. He gave Richard tapes of hymns, and indicated to him the ones most often used in funeral services. Richard asked if there was any way he could have all Christmas carols, but the priest suggest
ed this was probably not going to be acceptable. Richard and I just laughed; he was a thorough nonbeliever, but he loved Christmas carols even more than I did.

  Richard asked me to read to him the funeral service in The Book of Common Prayer, and then asked if there were any biblical passages about medicine or science. I said I did not know, but spoke later with Stuart Ken-worthy, the rector of my church, who suggested a reading from the Gospel of Luke. Then we turned to hymns. Richard knew unequivocally that he wanted “Amazing Grace,” and had picked out two others he liked from the music John Harper had given him. He asked me what my favorites were so that he would include one that I particularly liked. We lay in bed and listened to the three hymns I suggested and he gave his reactions.

  Under the circumstances, he said wryly, he thought he would pass on “How Great Thou Art.” He neither liked nor disliked my favorite, “Lead, Kindly Light,” so he said he thought he would pass on that one as well. He asked to listen to “Immortal, Invisible, God Only Wise” again and then said, with the honesty of a dyslexic who had engaged in a lifetime war with poetry, “I have no idea what the words mean, but I like the music.” So he chose a hymn he knew I loved and one that he did not understand. As he pointed out, he didn’t really have to understand it.

  We did a run-through of the funeral program. I read from the copy of The Book of Common Prayer that we had used in the blessing of our marriage in Los Angeles, and we played the hymns in the order of the program that they would occur. I got out Jessye Norman’s recording of “Amazing Grace,” which Richard loved, and we listened to it. When it had finished, I looked at Richard, who had a slight smile on his face. “Sounds great!” he said. “Let’s do it!” He laughed easily, I less so.