Losing Mum and Pup

by Christopher Buckley

  Once he was in bed, I stroked his forehead and spoke soothingly of the dinner we would absolutely, definitely have just as soon as the doctors figured out the kidney situation. He was babbling now, incoherent. When a Hispanic nurse came to take his vitals, he sang to her in fluent Spanish, which surprised and charmed her. Otherwise, the most articulate man in America was speaking gibberish.

  Gavin said he’d give him something “to moderate the agitation level.” The nurses injected Ativan (an agitation level moderator) into his IV drip. Gavin and I huddled in the hallway. Pup had come back from the award ceremony trip badly sick; had for several days thrown up, becoming dehydrated, which in turn distressed his kidneys, which in turn took it out on the brain and the heart. I arranged for a cot.

  It was a long night, after a long day, which had started in Geneva many time zones away. I did what I could to calm him down, but despite the Ativan he was feverishly agitated and desperate to leave the hospital. He had to catch a train. Had to get on the boat. He was now very late for an important meeting. When are we leaving? I had to restrain him physically every five minutes. After the fifteenth or twentieth time, one’s patience begins to wear. Pup, I finally said, my tone stern: We’re staying here, okay?

  No, I’m leaving. Would you get my clothes?

  He tried again to get out of bed, a complicated maneuver given the half dozen tubes and monitor wires, to say nothing of the catheter, which if yanked out would have caused excruciating pain and God knows what kind of plumbing damage. I had to wrestle him back into bed, at which point he began to projectile vom—Well, as I said, it was a long night. I pleaded with the nurses for more Ativan, a drug I would come to revere over the next fortnight. Finally, near delirium myself, I sang an Irish song to him that I had heard on my first visit there:

  If you ever go across the sea to Ireland,

  Be it only at the closing of your days,

  You can sit and watch the moon rise over Claddagh,

  And see the sun go down on Galway Bay.

  It’s a sweet, slightly sad melody. He quieted as I sang.

  That’s beautiful, Christo.

  Yes, Pup, it is. I first heard it in—

  Where are my clothes?

  Why do you need your clothes, Pup?

  We have to go.

  Pup—

  We’re terribly late as it is.

  THE NEXT MORNING, early, I was sitting on a stone wall outside the main entrance to Stamford Hospital, bleary-eyed, texting Lucy.

  Handsome, dapper Joe D’Amico, Mum’s orthopedist (She’s already in heaven), walked out briskly and, glancing sideways at me, did a double take.

  Chris? What are you—Aw, shit. Bill?

  I told him Pup was in room 4109. He said, Let me see what I can find out. He came back fifteen minutes later.

  I’m not a urologist, but from the numbers, I think he may be on the verge of renal failure.

  “Renal failure” is not a phrase to lift the spirits. Joe went off to tend to his patients. I texted: “Poss. Kidney failure.” I looked at the words on the little screen and pressed send and realized that I was crying. (Yet again, at Stamford Hospital.)

  Pup was a prominent man, and word was soon out that he was in the hospital. The calls started coming in. They were all well-meaning and large-hearted and sincere, but it is exhausting. The consoler is himself seeking to be consoled. By the second day, I was overwhelmed and began sending out daily bulletins by e-mail. If they sound delirious themselves, my defense is that they were written early in the morning, after generally unrestful nights.

  For Family and Friends Only, Please

  WFB Jr. Medical Bulletin

  June 20, 8 am

  He has something called “acute tubular necrosis,” which sounds pretty dreadful, but there’s also good news.

  ATN is basically kidney damage caused by, in his case, extreme dehydration and decreased blood flow to the kidneys caused by a drop in heart rate. (His heart rate is now back to normal.)

  Basically, his kidneys are damaged and need to get better. The good news is that they regenerate on their own. This can take 1–3 days, or 10 days.

  Within a day or two his doctor, a pro’s pro named William Hines with a lovely bedside manner, will decide whether to recommend dialysis—as a temporary measure—to stimulate regeneration.

  So there we are. We’re here at Stamford Hospital for the duration.

  He’s resting. He wakes up every hour to declare loudly to everyone that he can’t sleep and needs “a much stronger Ambien.” I take this as a good sign that he’s quite himself.

  I’ll keep you all posted.

  Love from Hospital World,

  Christo

  June 21, 7:30 am

  From the WFB Medical Desk, this just in….

  Today’s med bulletin: heart rate 120. He’s atrial-fibrillating. Heart rate was 40 Monday. Normal is 60. They’re treating it.

  His creatonin level (sp?—a kidney chemical thing) is 5.8. Normal is 1.5. At 6, they start considering dialysis.

  At this point he has less than 10% of his kidney function. But there are a few small encouraging signs that his kidneys are starting slowly to regenerate, having to do with details that I think I’ll spare you.

  He’s very, very weak, not terribly coherent. Every other time he speaks it’s to say, “I have to get my train ticket.” I’m trying to figure out where it is he wants to go. (Don’t ask.)

  Will keep you posted.

  Much love,

  Friday, June 22, 2007

  9 am

  WFB Medical Bulletin

  So his kidneys are trying to regenerate. There are good indications and some less good. For those of you who hang on my creatinine level reports (I must really learn how to spell it), it’s now 6.3. You’ll remember from my much-praised Bulletin #1 that normal is 1.5. The attentive among you will remember from yesterday’s bulletin that it was 5.8. The good part is that the rate of increase has slowed. You will be responsible for this on the final exam. The urine report I will keep to myself, if you don’t mind, but I will say this much: he is a river to his people.

  In other WFB Organ News, he’s still “fibbing.” Nothing to do with mendacity, but rather the term us medical-types use for “fibrillating.” His heart rate is in the 100 range. Normal is about 60. Monday his was 40—definitely not good, so you can see he is making excellent progress there.

  No appetite, I regret to say, but I am feeding him little delicious bits of Julian’s snacks. *

  Mental alertness–wise we are sort of in and out. He’s not conversational, though he can be toward the end of the day when the meds lie quieter in his blood. At which point he reverts to his default imperious position. Last night at 7 he instructed me that he wanted a Macintosh laptop computer, “Right now,” so that he could write a column “at two am, in case I wake up.” He was not impressed by my pleas that I would not be able, at this late hour of the day, to a) supply him with a wireless-enabled computer and an operating system alien to him, and to b) train him on said computer in “less than an hour,” to quote his demand verbatim. Doubtless this evening he will stir and castigate me for my delinquency, to say nothing of my obtuseness. But then I have never masqueraded as a perfect son.

  Dialysis-wise, we’re at the let’s-give-it-another-day stage. I can’t emphasize what superb care he is getting at the Stamford Hospital. Was I surprised to learn that Dr. Hines, his kidney doctor, turns out to be a Yale man? Not one bit. I had been a bit worried that he was Harvard, but am now at peace on that score.

  He is doing his best and sends you his best love, as do I.

  WFB Medical Bulletin

  June 23

  Arrived at the hospital at 7 this morning, bearing 50 “munchkin” donuts from Dunkin’ Donuts with which to jolly the (truly lovely) nursing staff. WFB greeted me stony-faced and furious: “WHY HAVEN’T THEY OFFERED US A COCKTAIL?”

  I had no good answer to this. He thereupon said, leaving no doubt as to the urgency,
“I need a Stilnox. Now.” (Stilnox, those of you familiar with the WFB Pharmacological Encyclopedia—Vol. XXVI—will recognize as his “definitive” Swiss sleeping pills.) While I stammered fecklessly that perhaps we might wait until the doctors had made their rounds before we rendered him comatose, he fell immediately asleep.

  Urine-wise, until now I have endeavored to spare you details about this aspect. But the high volume of reader mail suggests that you will not be denied every detail. Have it your way.

  Until now, I had never imagined that my happiness could be contingent on the color of my father’s urine. (My life used to be more exciting, really.)

  Today’s is… how do I describe today’s? I would describe it as the color of a fine Riesling: umber, full-bodied, with hints of creatinine and red blood cells with a nice finish. This is a vast improvement over the Coca-Cola hue of 48 hours ago. Volume-wise, I repeat yesterday’s med bulletin: He is a river to his people.

  He wants to go home. Every other sentence he utters is about that. I want that too for him. Very much. But we’re not there yet. My mantra, with which he is out of patience—and I don’t blame him—is: “Let’s just take it day by day. And see.”

  He sends his best love, as do I.

  WFB Medical Bulletin

  Sunday, June 24

  The daily creatinine report: 6.4. Those of you who made it through yesterday’s WFB Medical Bulletin will recall that it was at 6.5. So this is simply splendid news.

  But wait, there’s more. Since yesterday afternoon, he has been “back on sinus rhythm.” It means, to put it in terms you simple (and, I am sure, decent and good) folk can understand: we are no longer “fibbing.” (As in “defibrillating.”)

  Are we out of the woods? No. Are we going home today? No—a point I spend perhaps 90% of my conversational time with him having to reiterate. (It’s like being on Firing Line, on acid.)

  “Have you packed my things?”

  “Em, well, uh, no, Pup, not precisely. I…”

  “Why?”

  “Well, em, there’s the matter of, em, the fact that your kidneys aren’t functioning, plus you can’t breathe or move. Apart from that—”

  “I can breathe at home.”

  “Yes. Yes, certainly. You’ve—ha—got me there. Ha ha. Yup. Will you have another sip of the milkshake for me? They say it’s got all the essential—”

  “What time is our reservation on the train?”

  “The train. Yes. I’m working on that. But it seems the, um, bridge is washed out north of Bridgeport, so, you know, a few… problems.”

  “We’ll need music.”

  “Absolutely.”

  Tomorrow his regular doctors will return from their weekend frolics—no weekend frolics for this correspondent, whose motto continues to be “Tomorrow Is Another Day.”

  He sends his best love, as do I.

  WFB Medical Bulletin

  June 26

  Today’s new term is “effective urine.”

  What—pray—is “effective urine”? I myself did not, until several hours ago, know this phrase. Essentially, it is that which carries with it out of the body things like creatinine—a chemical the very name of which I am beginning heartily to loathe. What we seek, what we pray for, what we want even more than our own front teeth this Christmas this year is—effective urine. Is this really too much to ask for?

  In other news:

  We have a drip in our arm to keep us hydrated.

  Spirits: let’s face it, ten days in hospital, however nice the hospital, and this place is very good indeed, are not fun, especially if you are the author of books like Cruising Speed and Airborne. *

  He wants to go home.

  He wants to have dinner tonight at Paone’s.

  He wants me to call his barber to make an appointment.

  He wants to write his column.

  He wants to work on his (excellent) Goldwater book.

  He wants to go sailing with Van and Alistair.

  He wants me to get him his Ritalin. He decided yesterday to start calling it “Rossignol,” making for an interesting conversation.

  He wants not to hear me say, “Now, Pup, I think maybe we ought to leave the catheter in just one more day.” (Let me point out that I do not say this to him, 20 times a day, because I have nothing else to do.)

  He wants a chocolate milkshake. (Which I have been smuggling in to him. I did this after taking one small taste of the “hi-protein” milkshake provided by the hospital.)

  He does not want visitors, but he loves you all very much.

  He wants to be well.

  He wants not to hear the words “urine” or “creatinine” or “blood work.” Doubtless, he would prefer not to hear the word “kidneys,” though we—that is, I—are very much wanting these organs to get with the program and heal themselves.

  At any rate, we (Stockholm syndrome first person plural) are neither better nor worse. But we remain confident that the kidneys will, recognizing their role in amongst the other organs of a great and beloved man, soon get with the program and repair themselves tout court.

  Meantime we send you all our best love. I fully expect tomorrow’s WFB Medical Bulletin to begin with “Hosanna!”

  WFB Medical Bulletin

  July 1, 2007 (Mum’s birthday)

  Pup came home on Friday. He is, I can say as his spokesperson, “resting comfortably.”

  Urine Report: There will be no further urine reports. I know this will come as a terrible shock to many of you. Sorry, but you’re on your own. If you want a urine report, just look down next time you go to the loo.

  CHAPTER 9

  I Miss My Urine Report

  He arrived home by ambulance, and was carried upstairs to his room by two beefy young men. On their way out, one of them said to me in a lowered voice, “He’s DNR, right?” I started a bit but, recovering, said, “Yeah.” DNR means Do Not Resuscitate. If those are your wishes, you apply to your doctor and are given a letter from the state of Connecticut, signed by the doctor, instructing emergency medical technicians not to bring you back from the brink. Such were indeed Pup’s wishes. Along with the form comes a red plastic bracelet. The young man said, “If something happens, make sure he’s wearing the bracelet.” I nodded and pressed beer money on them.

  Pup was home, but he was very, very ill. His bedroom, looking out on Long Island Sound, was now cluttered with noisy machines to help him breathe.

  I’d arranged for day and night nurses. I specified that they must be… well, Pup was not one to suffer chatterboxes. One of Mum’s nurses had been on the talkative side. She was an Italian-Polish lady (her surname, with lots of z’s and k’s and g’s, would have won a Scrabble tournament). She was built like a bomb shelter and had interesting flame red and purple hair. She would talk indefatigably throughout her six-hour, $465 shifts. If she left the room, Mum would groan, “She is driving me to drink.” But she was a good lady with a warm heart, and in the final battle with Mum, she didn’t yield an inch. And believe me, the wrath of Pat Buckley could instill fear in an advancing column of mechanized infantry.

  In the hospital two days before she died, Mum had demanded that she give her her own sleeping pills. As you can see, self-medication was a theme with my parents.

  “No, ma’am,” she replied coolly. “We’re in the hospital. In the critical care unit.”

  “I am well aware of where I am. Just give. Me. My. Pills.”

  “No, ma’am. I can’t give you pills.”

  “Just. Give. Them. To. Me.”

  “No, ma’am.”

  At this, Mum’s lower mandible protruded like that thing in the movie Alien, just before swallowing an astronaut whole. “Just… give… them… to me.”

  “No, ma’am. I will give them to your hospital nurse here, and she can give them to you if the doctor says it’s all right.”

  This was the last conversation I heard my mother have.

  As for Pup, I felt, pharmacology-wise, that the ideal nurses fo
r him would be, say, sight-impaired deaf-mutes. Pup’s daily intake of pills would be enough to give Hunter Thompson pause. But there was hardly any point in turning his sickroom into a home rehab.

  The third afternoon in the hospital, after Pup had rallied somewhat, he demanded that I give him an after-lunch Ritalin from his private stash. Inasmuch as I had spent the previous three nights wide awake and physically restraining him from ripping tubes out of his arms and trying to flee the hospital, I was of the opinion that Ritalin might not—as we medical types put it—be indicated, and I refused to give him one.

  “Just give it to me,” he growled.

  “I am not going to give you a Ritalin. For heaven’s sake, Pup—you’re fibrillating.”

  “Just give it to me.”

  “No.” Moment of truth.

  “You’re fired,” he said.

  “Fine!” I said. “I didn’t ask for this job in the first place.”

  We agreed on a compromise. If Gavin said he could have one, fine, party down. He phoned Gavin, who I imagine rolled his eyes and okayed a minimal Ritalin. I spent the afternoon catering to the myriad whims of my suddenly very peppy father.

  Desperate times call for desperate measures. I entered into a conspiracy with the nurses. We worked out a Kabuki dance whereby Pup would ask for his Ritalin, and they’d give him a similar-looking Ativan pill, placing it directly on his tongue before he could inspect it.

  “I don’t understand why I’m sleeping so much,” he would say to me, rousing hours later from a narcoleptic slumber.

  “Well, Pup,” I said, avoiding eye contact, “you know, these kidney things, they, uh, do take it out of you.”

  Henry Kissinger called. “I miss your urine reports,” he said in his rumbly Teutonic baritone. I told him this was surely the first time he had uttered those words.

  Pup and Henry went back a long way: to the mid-1950s, when Henry was a young history professor at Harvard. He’d asked Pup, then the fresh prince of belles-lettres conservatism, to come speak to his students. A friendship formed and, over the years, deepened. In 1968, with Vietnam raging and a bitter presidential campaign going on, Henry, now an adviser to Nelson Rockefeller, had called Pup and said to him, Get this message through to Nixon: If Vietnam falls, word will go out that while it may be dangerous to be America’s enemy, it is fatal to be her friend. Pup called it in to John Mitchell. After the election, Mitchell summoned Henry to Nixon’s transition headquarters at the Pierre Hotel in Manhattan. The rest, you know.