33
LAST ACT
Shortly after Christmas 1987, Robert and Ginny were listening to KGO Talk Radio, an airwave institution in Northern California, when Dr. Dean Edell’s regular medical advice program came on. This time, he had a report on a new surgery that could relieve emphysema. Heinlein’s ears perked up immediately: He had been having more trouble breathing than usual since the move. This operation removed the small glands—the carotid bodies—on either side of the neck that control the breathing mechanism and caused panting. The breathing function was then taken over by another area of the brain.
This was not a cure: Nothing could repair the damage the lungs had already sustained—but it could greatly improve the quality of his life.
This was not precisely an “experimental” surgery; it was done frequently and even “routinely” in Japan—but it was controversial in the United States, almost certainly due to medical politics. There was just one doctor in the entire country performing this operation, Dr. Benjamin Winter at Doctors Hospital in Los Angeles. Heinlein called Doctors Hospital and got instructions for arranging this surgery. Ginny recalled: “And he said we’re going to do it. And I said, ‘Have you spoken to your doctor about it?’ He said ‘No. And I’m not going to. I’m just going to do it.’”1 He probably didn’t want to invest the energy in the argument that would inevitably ensue with his new doctor.
Since moving to Carmel, Heinlein had to find a new general practice physician, and he selected Dr. Lola Steinbaum—a graduate of Harvard who trained at Stanford Medical School.2 The first time they saw “Dr. Lola” she asked if he was the Robert Heinlein who had written Stranger in a Strange Land—and then went to fetch her husband, Dr. Erickson, who was in practice with her in the same facility.
Heinlein had taken risks with surgeries before—wagering everything on one turn of the cards—and it had worked out well for him so far. “I tried not to interfere too much with what he wanted to do,” Ginny later explained. “Which was only good sense. You have to rely on the other person’s good sense.”3 He had to decide how to manage his own risks, and she would support his decisions. He typed up the instructions Doctors Hospital gave him, with side comments for Ginny about timing and arrangements.4
New Year’s was on Saturday that year. They rose at six o’clock on the morning of January 4, 1988, and had a taxi take them to the San Jose Airport, thirty miles away, for an anticipated stay of four days—not long at all for a surgery, but the doctor said he had his patients up and exercising the day after the surgery.
In addition to the traveler’s checks they usually carried on trips, Ginny had gotten two cashier’s checks to pay for the surgery. They had medical insurance, but the hemorrhages had run their insurance claims over $50,000, and they were reaching their claim limit.
Ginny was very uneasy about that prospect. Her careful planning and estate management could go up like paper in a flame—and it would, because she would liquidate every asset they had accumulated if it would keep him alive.
The next morning (January 5), Heinlein had the operation—under local anesthetic in theory, but he felt everything: The anesthetic, he later said, might as well have been normal saline. As soon as the first carotid body was removed, he felt some relief in his breathing: The sensation that he could not catch his breath lessened.5
Following the operation he seemed alert and cheerful. The next day the doctor had him walk briskly up and down the hospital corridor. He usually had his patients run a little, but Heinlein’s ongoing problems with balance made that impossible.
The next step, if he wanted to take the next step, was one of the new heart-lung transplants, since the damage to his lungs could not be repaired, surgically or otherwise. But he did not want to take up that option. “One to a customer,” he quipped.6
It was raining the day they were scheduled to return to the airport. They got Robert into the van while Ginny took care of the discharge papers. Hurrying to catch up, she slipped on the slick pavement, falling flat on her back, head bouncing on the curb.7 She scrambled back up immediately, bruised and shaky, but insisted they continue on to the airport; they had a driver meeting them in San Jose, so she wouldn’t have to face any demanding tasks.
Robert was exhausted—but that was normal for him following any surgery. Ginny got him into bed and when he was down took time to realize how much pain she was in. She remembered that she had some codeine tablets left over from her last prescription and took enough of those to give her some relief. She put herself to bed and found herself taking codeine for the pain that woke her every now and again.
Three days later her head cleared and she found she could move again—with considerable pain, still, and extreme effort. She hadn’t eaten or even gotten out of bed in that time. God only knows what Robert had done for himself.8 She was instantly consumed with guilt: What had she done!
Fortunately, she had dodged a bullet: He seemed normal for him, at this stage of surgical recuperation, except for diarrhea. She tried to put her anxiety out of her mind and cut back on the codeine.
Mary Jean and Andy Lermer wanted to help, and Ginny gratefully accepted assistance with the shopping and so forth.9 Ten days or so later, she was more or less back on her feet and able to get out and around: They had been living on microwaved TV dinners, supplemented with a little cooking of breakfasts and lunches, so first priority was to replenish the larder. “We’re leading a very healthy life now—” Ginny wrote, “early to bed and up early too. I expect within a month or so we will forget that we’ve had our current problems.”10
Leon Stover’s book on Robert was released by Twayne as part of its United States Author Series, with a photograph of a young Heinlein taken by Bill Corson almost fifty years earlier. The book immediately began selling briskly—for Twayne: 759 copies in the first two months.11 This is a number that would be a dismal failure for any of Heinlein’s works of fiction, but this was a scholarly series that sold almost exclusively to libraries, and their usual sale was a thousand copies in toto.12
Three weeks after the operation, Heinlein was still bedridden, still diarrhetic, and obviously sinking. Alarmed, Ginny overrode his protests and got him dressed for the first time since the operation and over to Dr. Lola’s office on February 1.
Dr. Steinbaum was shocked and horrified.13 She immediately put Heinlein into intensive care at the hospital for a week, as he was showing signs of congestive heart failure—fluid filling the membrane that surrounds the heart. She wanted to put Ginny in the hospital, too: Robert’s uncounseled surgery was bad enough, but she scolded Ginny particularly for neglecting to take care of a back injury that could be permanently crippling.
At the very least, she lectured Ginny, she should not keep trying to do everything herself. Ginny arranged through a nursing agency for an LVN (Visiting Nurse) to help out since they would have to maintain a hospital routine even after Robert went home from his second hospitalization in the first month of the year.14
Robert continued bedridden and listless, though he could be coaxed out to take the amount of exercise the doctor recommended—and no more.15 Ginny continued exhausted and overwhelmed. She feared her neglect when they came back from Los Angeles might have killed him … 16
At first they had two shifts of nurses, but the second shift had virtually nothing to do, so Ginny cut back to one. That help, though, was a lifesaver, as it was often difficult to get help on the weekends.17 They had family visitors occasionally—Kathleen (Rex’s widow) came down from Palo Alto and Lynnie Ayers, their niece. Ten days later, February 16, 1988, Robert developed flulike symptoms, and it was back to the hospital for another week—the third time this year. And counting.
There was a new round of medications—and they hadn’t gotten the last round balanced yet. The “hospital routine” they maintained at home intensified:
Robert was on oxygen all the time, and the equipment kept breaking down, needing to be repaired, etc. The nurse fed Robert—he couldn’t eat by himself
—he did not sit up in bed, just lay there.
I think that his vision was going bad—cataracts, possibly, because he did not read; I was busy with all the other things, and couldn’t read to him. No time … I had my hands full.18
By the beginning of March, he began to sit up and take notice, which made things a little easier for Ginny, as she had some feedback to work with. She made an apple pie according to his strict diet, to tempt his palate, which seemed to work, as she was able to bribe him with it, to eat the entree. They watched some of the Winter Olympics ice-skating competition together on television.
He was still very weak; Ginny called Dr. Steinbaum on March 3 to say he could not make his scheduled follow-up appointment. Dr. Lola was going off on a trip for ten days and did not want to put off the examination. She made an unprecedented house call, and seemed satisfied with his progress.
The next morning, Robert hemorrhaged again. Dr. Lola’s relief, Dr. Farrow, told Ginny to get him to the ER—a much quicker, much less stressful trip this time. The bleeding stopped of its own accord, but the hospital put him in the Intensive Care Unit for safety’s sake. This was his fourth hospitalization in three months.
And the new heart specialist changed his meds again (the diarrhea he had been suffering from for months had apparently been caused by one of the medications). This time, Ginny was able to sleep at home, only a ten-minute drive from the hospital, instead of finding a nearby hotel.
At eight o’clock on the morning of March 12, Dr. Farrow’s substitute, Dr. Grant (which made him Dr. Lola’s substitute’s substitute) called from the hospital: Robert had hemorrhaged from the nose again, and they had put him back in the ICU overnight, with a new transfusion. Robert was doing better now and would probably be moved back to the general population the next day—but Dr. Grant asked her about heroic measures.
They had talked about this, during the times when Robert could work up interest in anything. He did not want to live surrounded by life-support equipment, kept alive by main force. Fortunately, nothing “heroic” was needed this time.
Somehow Robert had picked up a bruise on his shoulder in addition to the other problems. It took major effort on Ginny’s part, but she managed to get him to sit up some—it was bad for his lungs to lie down all the time—and even to walk a little, twice a day as the doctor prescribed. It was like pushing a dead weight, but that was her job, and gradually she could see improvement:
This morning when I was in, Robert appeared more cheerful and more like himself than he had for a long time. For weeks, he’d been what I called withdrawn, but his doctor calls it apathetic. He even managed to eat some applesauce for me, and even asked for a piece of chocolate! I suppose things are looking up.19
By March 18, they were able to send him home again, though with a new battery of monitors to go along with the new regimen of meds. And he got out of bed by himself—the first time he had really walked in a long time. Ginny was working in her office. He got to her doorway and collapsed.
The nurse helped get him in the car and back to the hospital, where he was met by a CPR team. Fortunately, this was a false alarm. He was at home when Catherine Crook de Camp called, and they had a long, reminiscent talk, recapping, as she remembered, forty years of loving friendship.20
As the bills started coming in, Ginny really began to be afraid: One of the monitors he was on—and would be on for months, probably—rented for the staggering cost of $750 per day! And the nursing fees were not inconsiderable, either. It was an unpleasant fact, but it was inevitable: When their insurance ran out, they would be pauperized. She began planning what assets she could liquidate.
It was sheer good luck they had those assets in the first place—Robert’s popularity well beyond the publishing enclave of science fiction—and careful management, learning over the years from her mistakes, that preserved it for just this time of need.21
In April, Robert was back in the hospital—though this was more like a “normal” hospitalization for him. His listlessness and depression were gone (Denis Paradis had gently suggested some of that depression might be caused by anxiety for her—not something she would have thought of, herself).22 Much of his previous listlessness and apathy, it turned out, was caused by an undetected low-level urinary tract infection. Once that was taken care of, he was much more active. In this, his fifth hospitalization of the year, he had his own walker to help getting up and around—and even his physical therapist remarked on how talkative he was this time. He sat up for meals in his chair, at the room’s deal desk. George Warren, a writer colleague who had become a close and sympathetic friend of both Robert and Ginny over the last nine years,23 visited with them shortly before Ginny’s seventy-second birthday.
… I went to see him in the hospital a fortnight before his death. He was dying of emphysema and had tubes in his nose and he was below 100 lbs, and he was so weak I worried about him.
So what did he do with his failing strength? He gave me a pep talk. I was changing markets, as he’d had to do when he moved from pulp paper to slick paper in the 1940’s; he remembered how tough it had been. “Hang in there!” he said. “Outlast the SOBs!” He went on a bit in this vein, weak as he was. Heart the bolder, spirit the greater.…
The advice he gave me cashed every bit as well as the check, too. “Treat people magnanimously if you can,” he said, “It’ll make you feel better. Expect nothing and you won’t be disappointed. Do the decent thing if you can, but for its own sake.”24
If Heinlein had to choose one capsule message to deliver, that would probably be it—the same message he had packaged for children in the 1950s and repackaged for the grown-ups those children had become in the 1960s, and repackaged again for the adults those children’s children would hopefully one day become in the 1980s.
Ginny discussed his care with his doctor: The care he could get at home would be more than they could do for him at this stage. He was able to go home on April 21—by ambulance this time, so that he could be carried in, too weak to walk.
On April 25, Clifford Simak passed away.
Heinlein did continue to improve. Ginny made him a jelly omelette one morning for breakfast, trying to tempt his palate and get him interested in food. Normally, their “routine” was for him to call her in during meals, from another part of the house, and they would negotiate how much more he must eat at this meal. This time, he ate every bit of it and even asked for more. He was so lively that he played ironic word games with Spider Robinson. “I’d heard that reading had become a chore,” Robinson remembered:
I offered to read onto cassette some excerpts from the novel I’m working on, and when he heard it was about a whorehouse he expressed comically keen interest. I don’t know whether he ever played the tapes. I hope so, but I don’t mind if he didn’t.25
But the improvement was short-lived. Soon his energy began to drop, and his labored breathing became more and more an effort. He was going downhill rapidly, and they went back to two shifts of nursing care. Gradually he became aware that it was time for his last acts as an adult.
“About two weeks before he actually died, he said to me when we were alone, ‘I’m dying.’”26 He seemed surprised to Ginny. “‘Yes. I know,’” she said gently. “‘And all I can do is make you comfortable.’27 So I got all the information I needed about what he would like. I threw away the diet that had been prescribed for him, and he ate whatever he liked. Including a blueberry pie I made for him.”28
He gave Ginny his last wishes—not a burial; cremation. No memorial service, but a scattering of his ashes at sea—with military honors if possible. They subscribed to a burying service that would take care of the details.
There was more to say to each other, but they were both acutely aware they could not ever get any real alone-time together. “I kept a baby-tender by his bedside,” Ginny wrote a friend,
so that he could call someone at any time, and have someone come to him immediately. And there were things we never got around to sayin
g to each other for lack of privacy. Oh, it was possible to turn off the speaking end in the bedroom, but I seldom did, because it caused the other end to howl. I was always conscious of the fact that someone else would be listening in to anything I said, and I think he was too.29
Sunday, May 8, was Mother’s Day in 1988—a holiday that no longer had any personal meaning for either of them. Robert finished his breakfast and said he felt a little tired: He was going to take a nap—attended by the nurse on duty this morning. Ginny had her usual backlog of correspondence to do, so went to work at her office desk, answering fan mail.
After some time, the nurse came into the office and attracted her attention. “Mr. Heinlein doesn’t respond.” Robert had passed away during his morning nap—peacefully … but she had not been by his side when it happened, holding his hand.
Later, according to his wishes, she scattered his ashes into the Pacific Ocean from the deck of a U.S. naval vessel, with full military honors. Later still, she would join him on this final voyage, when her own ashes were spread upon the same waters.
Death closes all; but something ere the end,
Some work of noble note, may yet be done,
Not unbecoming men that strove with Gods …
Come, my friends,
’Tis not too late to seek a newer world.
Push off, and sitting well in order smite
The sounding furrows …
APPENDIX 1
AFTER
It may be we shall touch the Happy Isles,
And see the great Achilles, whom we knew.
Tho’ much is taken, much abides; and tho’
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.
Alfred Lord Tennyson, “Ulysses”
Robert A. Heinlein, In Dialogue with His Century, Volume 2 Page 60
