Ouch. But I nodded. “So you would think.”
“That change is quite articulate about your overall situation.”
I didn’t answer.
“Yes. Diminished intimacy. Reduced contact. Perhaps loneliness.”
I sat there, thinking: See if I ever lower my guard with you again, mister.
The Professor cleared his throat. “Do something with me, Nurse Birch.”
“Excuse me?”
“Anything. I have missed an entire morning and some of the afternoon, out of the frustratingly small supply remaining to me. I’m desperate to do something so the day is not an entire waste.”
I roused myself. This patient had just caused me pain, speaking about Michael with such accuracy. But the situation in this house was not about me; providing hospice care was always about the patient. Also I happened to know exactly where we could go.
IT TOOK EFFORT TO PILOT HIS WHEELCHAIR through the garden without bogging down or harming the plants. He raised a hand to stop me when we reached the azaleas, which were at their peak: abundant, pink, and fragrant.
The Professor scowled. “Don’t you find them shameful?”
“Should I?”
“They are so flagrant. So unapologetic.”
“That’s how they attract bees, though. They have to be showy to survive.”
“If only there were an analogous opportunity for me,” he said. “I would willingly perfume myself and wear pink if that would prolong my life.”
I chuckled. “Actually, a few things could make a difference. In how long you live and how well you live. If you want, I can tell you about them.”
“If I want.” He folded his hands in his lap. I was standing behind him, holding the wheelchair handles, so I could not see his face. “What I want, Nurse Birch, is to know what will occur. Likely you know as much about death as I do about the Pacific Theater in 1942.”
“I doubt that, Professor Reed.”
“Don’t patronize me. I am asking for something important.” He pointed at a little wrought-iron bench in the garden. “Sit there, please, and tell me in plain language.”
The bench was painted dark glossy green. I sat leaning forward, forearms on my thighs, putting our faces on the same level. “Ask away.”
He cleared his throat. “My prognosis, please. The unvarnished truth.”
Barclay Reed had gone to that place right away. I read it to mean that he was prepared to hear everything. “You have kidney cancer with multiple metastases. The five-year survival rate is five percent.”
“I presume the process is irreversible?”
“Yes.”
I expected a reaction, but the Professor only nodded. “Continue.”
“Well. You may experience more pain, worse than last night, because there are bones involved.” I slowed because I was nearing the crux. “Last night you declined help for your symptoms, which is your prerogative. But I urge you to reconsider.” I stood, stepping toward him. “For many patients—”
“Halt right there. No drama, Nurse Birch. Just give me the prognosis.”
“All right.” I went back to the bench. The stones beneath were coated with moss. I looked at his profile, the large old man’s nose, his stubborn jaw. “What else would you like to know?”
“A great deal.” The Professor bent forward, his face inches from the pink blossoms. He took a noisy sniff. “For now, tell me this: What goes last?”
“What do you mean?”
He blew on the petals, which fluttered from his breath. I thought, what ideal circumstances for this conversation. When it is time to hear some of life’s hardest news, who would not want his face surrounded by flowers?
“At present, I am enjoying a floral scent. My sense of smell and my appreciation of it prove that I remain a sentient being. At some point I will cease to be sentient. What will be the last part of Barclay Reed to go?”
“Oh, I see. The ears go last. Research indicates that hearing functions till the very end. Which creates an important opportunity, actually. If there is something you’d like to be hearing, a favorite piece of music, or—”
“Ha.” He sat back. “I know precisely what I would like to hear at the end.”
“What is it? I can make sure that happens for you.”
He scoffed. “Impossible.”
“It’s not, though. I’ve done that many times. Especially with music.”
“I said it is impossible.”
I knew better than to push. Another day.
Meanwhile the Professor ran his hands up and down the chair arms. “How long will all of this take?”
I dug my thumbnail into the bench’s metal scrollwork. “It’s hard to predict.”
“Nurse Birch, you are weakest when you are evasive.”
“I’m not evading anything. Each person is different.”
“Your best estimate, then.”
“Anywhere from four weeks to ten.”
“What? The oncologist told me six months at a minimum.”
“Oncologists know lots of things that I don’t,” I said. “But they are notoriously over-optimistic. Maybe he wanted to give you hope.”
“Hope?” The Professor sneered. “To a dying man, hope is a cruel lie.”
“No sir,” I said. “There are many kinds of hope. You can hope to live longer. You can hope to complete unfinished business, professional or financial. Or spiritual.”
His frown was instantaneous. “Oh please.”
“Well,” I persisted. “You can hope to minimize your suffering.”
“You keep bringing that up,” he said, leaning into the azaleas again. “Why?”
“I want you to consider preemptive analgesia.”
“Continue.”
“If a nerve gets energized, it takes more medicine to quiet it. But if you act before the problem starts, it requires less dosage. You can still function.”
Now his face was immersed, petals against his newly smooth cheeks. “At this point in my life, I do not desire to become addicted to anything.”
“Addiction? I’m describing how to avoid suffering. Last night—”
“Enough, Nurse Birch.” He sat back, fingers still holding a blossom. “Apart from evangelizing on doping me, this conversation has been illuminating.”
“Is that how you would describe it?”
“Is any question more fundamental than what the extent of our existence will be? Now I know: four to ten weeks. If you are in error, we may stipulate that it is not a matter of four to ten years, or four to ten months.”
“I would like to help you keep that time as fulfilling as possible.”
“What makes you think my life was fulfilling before I became ill?”
I pointed. “The flowers in your hand.”
The Professor jerked back as if the plant had stung him. He drew himself upright, wheelchair seat creaking. “Thank you for bringing me here. Now”—he waved a hand at the front door—“I don’t want to miss the news.”
BARCLAY REED DID FINE for most of the day, but at about four he started shivering. I turned off his AC, piled blankets on the bed, and brought him warm tea. But he shook in every limb. I placed a hand on his forehead and there was no fever. He had just taken a chill.
Melissa arrived, eager as ever. But when I went into his room to say good-bye, he looked miserable.
“Professor Reed,” I said. “I don’t want to leave you in this condition.”
“Come, Nurse Birch. Worried about a bad grade on your job evaluation?”
“I hate to see a person suffer, especially when it is preventable.”
A shudder passed through his whole frame, his jaw rattling. “Blast you.”
“I am not the disease,” I told him.
“Nor are you the cure.”
> “Why won’t you let me help you?”
The Professor sniffed. “I have my reasons.”
“You think this is stoicism but actually it is pride.”
His eyes flashed. “You dare to lecture me about stoicism? Have you ever read the Stoics?”
“I don’t even know who they are.”
He threw his hands up, as if to say how could anyone converse with such a know-nothing.
“Forgive me then, Professor Reed.” I stood and gathered my things. “I will go look up who the Stoics were. But I have no interest in standing by while you refuse to use your own powers of reason.”
I suppose I knew just where to dig at him. I had just reached the door when he called out.
“Wait.”
“Yes, Professor?”
He wrestled with himself, trying not to shiver. It lasted a few seconds, then his body was shaking again. “What did you call it? Preemptive?”
“Analgesia. Yes, sir.”
He thrust his jaw forward as if he was furious with me. “This once.”
I gave him a smaller dose than Cheryl had, in a time-release formulary so it would not knock him out. Then I sat in his kitchen and wrote a pain management plan for Melissa and whoever followed. By the time I left, the Professor was watching the BBC world report. All was calm.
“Have a good night,” I called from the doorway.
He pointed a remote at me. “Don’t you gloat.”
ONE CHALLENGE HOSPICE WORKERS FACE is that our jobs are so intense, returning to the normal world can cause emotional whiplash. When you spend the day facing death, ordinary life can seem petty. Often, people who can’t find a reliable re-entry routine just burn out.
I was lucky with Michael, and I remember the day I realized it. My patient at the time was a legitimately tough guy, Cleon, the longtime bus driver and all around strong-arm of a halfway house for troubled boys. A tall, dignified man, he had the nastiest case of Crohn’s disease I’d ever seen: mouth sores, skin pustules, plus the usual digestive misery. Cleon quit his Marlboros when the illness put him to bed, but he still had a masterpiece hack of a cough. He was strong though, like a bulldozer, and so committed to his quiet wife and to helping those misdirected boys, he would not die.
Every day was worse, weight loss and complications, but Cleon refused to let go. I helped with symptoms the best I could, but there was little mercy for him, and the hours stretched long. The man was suffering.
One evening I stopped in the supermarket on the way home, and found myself waiting at the dairy case while a woman was choosing which eggs to buy. For some reason the shelves were not as full as usual. She opened carton after carton, finding a broken egg in each one. I stood there, not saying a thing, while the woman tried one after another.
“Can you believe it?” she said to me finally, holding the latest carton open so I could see that one egg was cracked. Her mouth was pursed as if she were preparing to spit. “Some idiot must have dropped the whole pallet of them. These people have the gall to charge two dollars and twenty-nine cents, but they don’t have one decent dozen. This is a disgrace.”
I turned and left the store at once. That’s how badly I wanted to slap her.
The people in traffic had a similar effect, their hurry the utmost in triviality. I wanted to shout at them, “I have spent all day with a man who is suffering like a gladiator fighting lions, and you want to cut me off so you can sit at that red light one car sooner?”
When I reached home, I went in the back door. I leaned against the kitchen wall with my eyes closed. Michael came into the room. I opened my eyes and saw that he had halted in the middle of the kitchen. He was looking me over, and for a moment I was afraid he was in the mood for sex. Instead he took my hands and led me to the table. He pulled out a chair and waited till I sat.
“I drove an amazing car today,” he said, moving to the refrigerator. “One of those new RS-Series Audis. Man, what a rig.”
Michael didn’t care that most of his customers were rich. The cars were what interested him and kept his mechanics motivated. He opened the fridge and reached in with both hands. “The guy’s son banged into a curb and bent the control arm. For which I hope he gave the kid’s neck a proper wringing, by the way.”
In his right hand, Michael held up a jug of iced tea. In his left, a bottle of Pinot Gris from McMinnville, a vineyard we’d visited once, an hour’s drive away. I pointed at his left.
“It’s a simple fix,” he continued. “Though Audi parts are pricey, times three. Afterward I took the thing out for a test rip.”
He popped the cork and set the corkscrew aside. Taking a wine glass from the cabinet, he filled it generously. “I have never felt such compression before. Like the engine did not care what the load was.”
He handed me the glass and pulled up his own chair. “You know that long hill, up to the campus of Lewis and Clark? Sixty miles an hour and the car never downshifted. Like the hill wasn’t even there.”
I held the glass to my nose and smelled peaches. I took a mouthful. Despite my eyes’ best effort, a single tear spilled out. While I drank good cold wine, Cleon was still suffering.
Michael took my hand again. “Should I . . . um . . .” He kissed my knuckles. “Would you like to hear about the MG we had in today, too?”
I wiped my cheek and nodded.
“A beauty, Deb. Racing green with tan interior, chrome spoke wheels. A guy brought it in because of a wobble at high speeds, so I put it up on the lift. And man, the classic rack-and-pinion steering. Simple and tight.”
He was holding my hand, running his thumb over my knuckles. I took a good gulp of wine. “Any others?”
“Late in the day there was a Jag XKE. A 1965 model, with the 3.8 engine. But a disaster. Came in on a flatbed.” He bent toward me. “This college guy inherited it from his grandfather, who’d left it in a barn for thirty years, and he wants us to get it running again. Gary stood there, not saying a word while I went over the car, but I swear I could hear him calculating.”
I leaned my head against my big man, melting, letting go. “Keep going, Michael. What else?”
There were times, too, when I needed to do all the talking. Details of what I’d experienced would only leave me in peace if I described them fully and put them out into the air. When that happened, Michael was reliable about listening, even if it took from the moment I arrived home to the second I fell asleep. He enabled me to work in hospice because every day I had a loving detox.
I remember his buddy Brian hosting a Super Bowl party one year, and I overheard him giving Michael a hard time.
“You are the worst snake I have ever seen, man,” Brian said, bumping shoulders with him.
“What are you talking about?” Michael asked.
“Listening. I’ve seen you, giving Deb the Big Ear. I’m sure it gets you plenty of action. But man, don’t you know that makes all us regular self-absorbed guys look really bad? You need to cut that shit out.”
Michael laughed. “Go get me a beer.”
But the next time I unloaded on him, standing at the sink and describing Charles—a forty-three-year-old guy with a brutally slow case of Lou Gehrig’s disease, which was torturing his wife and breaking his daughters’ hearts—Michael came up and hugged me from behind. “Sometimes I think you have the saddest job on earth.”
“The opposite,” I said, leaning back on him, “Actually hospice is the most enriching job on earth, because a person who is dying savors everything, takes nothing for granted, and that is contagious. When I’ve seen a man give what may be his last hug, the one you give me when I get home is even better. When a woman can no longer taste her usual evening bourbon cocktail, I savor our wine that night more deeply. Sounds crazy, I know, but dying people have taught me how to live.”
He squeezed my hand and sat back. �
��Unbelievable.”
And I counted my blessings once again.
I HAD TO LET ALL OF THAT GO after the last deployment. As the blogger Michael was reading had advised, I needed to set lower expectations.
That proved hardest when he came home the third time. I thought after that tour of duty, which was also his longest, he would be desperate for me. Special meals. Nights with friends. Ardent lovemaking. I was game, though, if it would bring him back to himself and draw him close to me again.
We were now well into our sixth month of re-entry, and none of those expectations had come true. Touching Michael was like running my fingers along a plank, he was so unresponsive. One night I made the curry-cilantro chicken he’d always loved. He scraped the sauce off and picked at the bare meat before hiding it under his knife and fork.
As for friends, he’d been unable to conceal his impatience with their lives, the frivolity of their daily concerns. Sometimes I sympathized. I imagined he was probably feeling something like my recovery times from work: How could he enthuse genuinely over Brian’s new grill when he was walking around with memories of being in battle? His school buddy would be carrying on about smoked chicken to a man whose memory probably included smoked villages.
As for lovemaking, which I thought he’d be craving? Not once, nor even close. I kissed him the way he used to like, on the edge of his mouth, but he barely tolerated it. I touched him during the night, and he rolled onto his stomach. I surprised him in the shower, and he turned the water cold. Nice metaphor, honey.
Some days I lived in a fog of longing. I could not see any way back to what we’d once enjoyed effortlessly. When I hugged Michael, his back stiffened. He’d push my hands away and say, “I know. I’m sorry. I know.”
I talked it through on the phone with my sister Robin many times. She convinced me that passive silence was a mistake. Any reply was a good reply, if it started a dialogue.
The next time he pushed me away, we were in the bathroom. I stepped between him and the door. “If you are really sorry, Michael, quit saying that you know. You don’t know.” He glanced past me into the hallway, but I blocked his exit. “Promise me you will start seeing a counselor. So that you really do know. Promise me.”
The Hummingbird Page 7
