Nothing Was the Same Nothing Was the Same

by Kay Redfield Jamison

  The days and nights did not get any better for Richard. He slept more and, despite oxygen, now and again would gasp for air as a fish will when taken from the sea. He did not respond to either of the experimental drugs and, with that, a cold dread came into the house and stayed. I returned to the funeral home to talk with the man who had assisted me before. He was kind and direct and reassured me, “We will take good care of your husband.” They had taken care of Oliver Wendell Holmes and Franklin Delano Roosevelt, he said, and Thurgood Marshall and John F. Kennedy. I told him my husband would be pleased, especially about Thurgood Marshall. I turned to leave.

  “We’ll see you later,” he said.

  I tried to respond but my heart had stopped.

  It was early June 2002. The foxglove was high in our front garden, and the honeysuckle was climbing every which way over the stone walls. I picked armfuls of pink and white peonies and put them in the bedroom. Never, in seventeen summers with Richard, had I seen so many butterflies as there were now, in this early June. I tried to catch a small white one to keep Richard company, but I couldn’t keep up with it. And, as Richard said, I shouldn’t have tried. The butterfly ought to be free to fly in the garden.

  He said this without envy or regret.

  JOY BE THE STARLIGHT

  We spent most of our last day at home together reading and writing in the room across from our bedroom. Richard worked on a foreword he had agreed to do for a colleague’s book and I read. He was very tired, and fell asleep now and again, but it was a good day. A peaceful and private day. I read to him what I had written the day before for my book on exuberance, a habit we had slipped into after he first became ill with lymphoma. I had quoted Robert Louis Stevenson, and he had asked me to read to him from Stevenson’s original essay on youth and old age.

  I made us a cup of tea and began reading. “We may compare the headlong course of our years to a swift torrent in which a man is carried away,” Stevenson had written. “We have no more than glimpses and touches; we are torn away from our theories; we are spun round and round and shown this or the other view of life, until only fools or knaves can hold to their opinions. We take a sight at a condition in life, and say we have studied it; our most elaborate view is no more than an impression.”

  Richard was intrigued by Stevenson’s assertion that no matter how carefully man studied something, his understanding was incomplete, an impression only. He seemed both heartened and disconcerted by the observation, and spoke about partial, shifting knowledge in the context of his own science. The advances in the understanding of schizophrenia and the brain were rapid, but however much was being learned, relatively little was actually known. Much of what was known would not last. He talked at length about how much he regretted dying without being a part of the discoveries to come. He would never know what causes schizophrenia or how to prevent it. He did not know now, he said, most of what would be commonplace science in twenty years.

  What he said was true. Discovery is the boon and the chafe of science; much of what is learned will be supplanted by newer findings. There was no good answer to his regrets except to say that the pursuit of new knowledge is reward in its own right and that knowledge begets new knowledge. For those doing medical research, there is the reward that comes from easing pain and saving lives. I reminded him of how deeply he had loved his scientific work and being a doctor, and how much he had improved the lives of those who suffer from schizophrenia and other psychiatric illnesses. He had passed on his enthusiasm, curiosity, and intellectual rigor to the hundreds of young scientists he had trained. For them and for his colleagues, including me, he had been the best possible example of discipline, imagination, and the refusal to give up.

  “Perhaps,” he said.

  Still, he knew that what I said was true. His colleagues and those he had mentored had made clear to him their respect for his science and his character. The impending death of a colleague fosters hyperbole, but the sincerity of the tributes from his peers was obvious.

  “Perhaps,” he said. “Perhaps.”

  But he smiled, and his mood was brighter.

  Richard did not want to die, but he was not afraid to. He did not want to end his explorations of the brain, but he knew he had had a passionate run. He had used a fine brain to study the brains of those less fortunate, and he had made a difference. He was not lucky to die when he did, but he was lucky to have lived as he lived.

  That night, I lay in Richard’s arms for a long time, thinking about us, thinking about him. I was peaceful in a way I had not been for months and felt some hope that we might have longer together than we thought. When I woke up in the morning, Richard was gasping for breath.

  We drove immediately to George Washington University Hospital, where the doctor who examined him said that both of Richard’s lungs had collapsed. In all likelihood, he said, this had happened over a short period of time and, with luck, inserting a chest tube would allow him to breathe more easily. Richard underwent surgery, and I sat with him that night as long as the hospital would permit. He did not look better, however. Indeed, he looked sicker than I had ever seen him look.

  When visiting hours were over, the nurse insisted I leave his room. I was deeply unsettled by this; it was, I know now, the primitive distress of an animal being taken from its dying mate. I had worked in hospitals for nearly thirty years, however, and saw the need for rules. Rules matter, except when they should matter least.

  As I got up to leave, Richard said, “I love you, sweetheart.”

  “I love you, too,” I said. I reached over to kiss him good-night. “See you in the morning.” It was the same exchange we had had every night for nearly twenty years, but this time it was our last.

  At four o’clock the next morning, a doctor in the hospital’s intensive care unit called to tell me that Richard’s health had deteriorated and he was in grave condition.

  “I think it is important that you come to the hospital as quickly as possible, Mrs. Wyatt,” the doctor continued. “His chances are not good.”

  My drive to the hospital was a nightmare, my half-sprint to the ICU worse. When I finally found Richard’s room and saw him, I knew he was going to die. He was unconscious and connected to a tangle of tubes, monitors, and a ventilator. Although unconscious, he was struggling with the ventilator because of earlier damage caused by radiation to his esophagus.

  Richard never regained consciousness. His face swelled from the fluids he was given to fight infection and to keep his blood pressure elevated. By the second day in the ICU, he was unrecognizable. The doctors extended next to no hope for his survival. Even if he survived the wildfire sepsis, they said, it was hard to imagine, with his diseased lungs, how he could ever get off the ventilator. I watched the numbers on his monitors lurch about, and with them lurched my moods.

  Stuart Kenworthy, the rector of my church, came by the hospital to visit, and I was surprised by how much better I felt after talking with him. It was consoling in an ancient, essential way. Perhaps because priests see human life from baptism to death, they have both a more profound and a more pragmatic perspective on death than others do. He was certainly more comfortable in an ICU than I was. I found it hard to deal with the physical changes in Richard and told Stuart that I doubted I would ever be able to get rid of the images of Richard’s bloated face. It was the least of matters, but it was one that haunted me. He said that I would, in time. He suggested I put my favorite photographs of Richard around the house and that eventually I would remember him as he had been. It was good advice, practical, and it worked.

  After Stuart left, I picked up my copy of The Book of Common Prayer, looked up the Order for the Burial of the Dead, and started to read. “I am the resurrection and the life, saith the Lord,” it began, and I thought: Not yet; I will hear this soon enough. I closed the book. But then, as minds will do during such times, I suppose, I sought out the past to prepare for and provide solace for what was to come.

  Standing by Richard’s bed
side, I thumbed through the prayer book and read aloud to him one last time. It was a prayer the priest had read to us in Los Angeles. “Let their love for each other be a seal upon their hearts. Let it be a mantle about their shoulders, and a crown upon their foreheads. Bless them in their work and in their companionship; in their sleeping and in their waking; in their joys and in their sorrows; in their life and in their death.”

  The words had meant a very different thing to me when life was what we had and death was unimaginable. I had heard then love and companionship and joys. Now I heard the force of different words, sorrows and death. But I heard love as well.

  The attending physician came to me not long after and said, “Mrs. Wyatt, we need to talk about what your husband would have wanted done.” He was direct and kind; he was very professional. We went through the details of Richard’s advance directives, which were unambiguous, and decided upon the medical conditions for removing life support. I went to a hotel nearby to get a few hours of sleep, afraid to risk getting manic, desperately hoping he would live through the night so that I would be with him when he died.

  He lived through the night. The next morning, the ICU doctors asked me if I wanted to stand in with them on their rounds as they discussed Richard’s medical situation. I listened to what they said, appreciative that the clinical discussion made it clear that his death was inevitable. He had organ failure in his heart, lungs, kidneys, liver, and whatever else there was that could fail. His pupils were fixed and dilated. There was no hope for survival. We went through his advance directives again and I made the decision to have his blood pressure medications and ventilator withdrawn. The decision, which was a straightforward one, seemed anticlimactic to the preceding days of unsustainable, chaotic monitor numbers. He was, in reality, already dead. It remained for me to give sanction to it. I did this with cold fear.

  An ICU, of necessity, is a well-lit and exposed place, but the nurses did the best they could to lend privacy to Richard’s death. What they did and their way of doing it was thoughtful and habitual. They removed the trails of plastic tubing and the bleating machines, drew the curtains around his bed, and dimmed the lights. He was alive, but scarcely and not for long. I had no idea what to say to him other than to repeat, again and again, “Thank you for such happiness.”

  To myself I said, I want my husband back. It became a mantra over the weeks to come. I want my husband back.

  I looked at Richard’s body, which had been through so much for so long, and I was, by the grace of books, given the gentlest of images. I remembered Hazel, the great-hearted and open-minded leader of the band of rabbits in Watership Down, a book both Richard and I loved. When Hazel died, he simply left his body on the edge of a ditch and then ran off free of his tiredness, through the woods and into a field of primrose. Hazel’s fairness and self-assurance had always reminded me of Richard—both in how he lived and how he died—and the image of Hazel’s light taking-leave-of-life was genuinely comforting.

  It was the beginning of my true knowing of the consolation of language. I would soon learn that the images that drift in and out of one’s mind during grief are not always kind. The mind can cut both ways; it can throw up memories that disturb or delight, relieve or agitate. The mind is unpredictable. I should have known this, of course. But, whatever was to come, the image of Hazel’s release was a gift when I most needed it.

  I put my head on Richard’s shoulder and broke down completely. Then I kissed him good-bye and went into another room to complete the paperwork that goes with death.

  The rest of the day filled with the practicalities of autopsy permissions, funeral arrangements, whom to call, and what to do. Why to do it was not an option of thought. That night, the night that Richard died, my mother, my brother, and Richard’s and my close friends sat outside, on long grassy grounds in Maryland, and drank mint juleps before dinner. It was a beautiful, early June evening, and given the circumstances, we had a strangely lovely time. Despite the awfulness of it all, everyone drew together and reminisced and laughed. We were so different, Richard and I, and that made for much of the laughter. As it always had. My friend Jeremy ordered a bottle of champagne and offered a toast to Richard, and we raised our glasses: first to him, and then to Richard and me, and then to the band of friends that we were. Our friends and family had made Richard’s and my last years not just bearable but exceptional. They would continue to do so in the months to come; they would make his death endurable.

  A colleague of mine from Hopkins and his wife, good friends to both Richard and me, came down from Baltimore to have dinner the next night. They brought not only kindness and shared memories, but also sleeping medication. The latter was to avert my becoming manic during a time when I was likely to lose sleep. My colleague made it easy for me. Instead of my having to call one of my doctors and wait at a pharmacy, which I was unlikely to do, he took it into his hands to get a prescription filled. It was a small act of kindness but enormously important. I benefited from the fact that many of my friends and colleagues were not only practicing psychiatrists, but specialists in mood disorders as well. Most particularly, I benefited from their compassion. Over the coming months, they called me often to make sure I was getting enough sleep, that I was not manic, not depressed.

  There were so many things to do. Someone from the funeral home called to ask me to bring over clothes for Richard, a task I found abhorrent. I picked out a shirt I had gotten for him in London, the silk tie he had worn the day we married, and gray slacks. I could not imagine why I was picking out such uncomfortable, formal clothes for him to wear, but that seemed to be what one did. It was dreadful and pointless and I cried the entire time. Days later, when Richard’s body finally was delivered to the funeral home, I had to formally identify his body. He was scarcely recognizable to me. I signed yet another paper of death and asked them to close the casket and not allow anyone else to view his body.

  The funeral was held in St. John’s Church in Georgetown, a few blocks from my own church, which was being restored. The church was packed and the service beautiful. The soloist sang “Amazing Grace” magnificently, and I wondered how closely Richard had attended to the words. I thought I knew the hymn well, but it was only in hearing it sung on that afternoon, in that way, and for Richard, that I heard the words dangers and grace as they were meant, and that grace would lead him home. I don’t think he ever thought of himself in terms of grace, but I did. Or at least a particular kind of grace. Certainly, Richard would not have thought of “going home” in any hymnal sense, but it was a lovely rendition all the same. And it was for him.

  Bob Gallo and Jim Watson gave eulogies bearing witness to Richard as a scientist, a doctor, and a man of kindness. To my delight, Bob also recounted an evening not long before when several of us had gone out to dinner together and Richard had said to me in front of everyone and from out of nowhere, “I love you. You’re so beautiful.” Bob said then and at the funeral that Richard had a way of raising the bar for romantic behavior.

  My brother approached the pulpit slowly. I saw his eyes glance down at Richard’s coffin and then, after fingering his tie, something he often does when putting his thoughts together, he straightened his back, placed his notes on the lectern, and began his eulogy. He conveyed our family’s condolences to Richard’s children and his former wife. He thanked Richard’s doctors and colleagues. Then he talked about the photograph in the funeral program. It had been taken the day that Richard and I got married in the Shenandoah Valley, he said. He and my mother had watched Richard, who, unlike me “generally moved in a quiet and deliberate way,” literally run up the stairs of the Winchester County Court House, where he had waited, at the top of the landing, with a look of “pure delight” and impatience. It had been, my brother said, “a marvelous moment and a magical day.”

  It had been a magical day. The Shenandoah Valley town where we got married had changed sides seventy times during the Civil War, which, Richard noted, was enough to give one pause. He
and I had spent several weekends together in the Shenandoah Valley and were drawn to marry there by romantic memories and the beauty of the great oaks and birches, apple trees and hickories. When I was young, I had raced horses flat out on summer hunts in the Shenandoah Valley and taken horses swimming in the river. It was not far from Washington and, as Richard insisted, we could play Paul Robeson’s “Shenandoah” on our way there and back. Which we did, repeatedly. It was a wonderful place to marry; it was a perfect day. The four of us—my mother, my brother, Richard, and I—drove back to Washington after the ceremony was over and had champagne and a quiet dinner in Georgetown. We were impossibly happy.

  Later that night, Richard and I made love for the first time as husband and wife. Afterward, he turned to me and said gently, “Good night, Mrs. Wyatt.”

  I, lulled by sex and happiness, on the cusp of sleep, thought: How beautiful, how strange, how marvelous.

  “Good night, Dr. Wyatt,” I murmured back.

  There was a pause. Then I felt his body next to mine, shaking with laughter.

  “You can call me Richard,” he said.

  And so I had gone to sleep on my wedding night, laughing out loud and hopelessly in love. We understood that life had its bounds, but on that night we believed that time would be generous to us, as love had been.

  How odd to smile during Richard’s funeral. He was dead and I was smiling to myself. Grief does that. Laughter lies close in with despair, numbness near by acuity, and memory with forgetfulness. I would have to get used to it, but I didn’t know this at the time. All I knew, as I sat in Thomas Jefferson’s church next to Richard’s coffin, was that memory had given pleasure first, and then cracking pain.

  I turned to the back of the funeral program and read the words I had chosen for Richard. They were from “Love Song,” by the Scottish poet Joseph Macleod: