Life became easier with the passing of Mrs. Umlauf, and Berta was allowed to bring down her son, who had been looking after the Umlauf lumbering empire, and his high-spirited wife and son to spend long vacations in the near-empty house. But Ludwig’s behavior began to change, and Berta saw clearly that her husband was beginning to recapitulate the steady decline of his mother. He became forgetful of even the simplest details. He was increasingly irritable. He lost interest in things and would sit for long periods out on the enclosed porch staring at the waterway but finding no pleasure in it. What really surprised Berta was that he turned over the financial management of his mother’s estate to the accountants in Marquette, so that Berta lived in a kind of shapeless world, which distressed her.
Two aspects of his behavior caused her serious apprehension. He loved to drive but became increasingly unable to do so and refused to turn in his driver’s license. When Berta suggested he do so, he shouted at her that he could still drive as well as ever. This first problem was solved by Dr. Farquhar, who refused to certify his eligibility for a renewal, and because the situation was acute, he arranged for a policeman to come to the house and ask for the canceled license. With a concession that surprised everyone, Ludwig turned over the precious document and allowed Berta to drive him, even thanking her when she did.
The other problem was never solved. From time to time Berta would enter a room to speak with him only to find that he had vanished, disappeared without any warning that he was going to be out taking a walk. Frightened at what might have happened to him, she would run about the neighborhood, over the bridges that joined the islands, and find him often a far distance from home, striding along happily, unaware of where he was or by what route he might be able to return home. But he was always glad to see his wife and did allow her to lead him back.
After the fourth or fifth such episode she consulted Dr. Farquhar, who listened, then said: ‘Berta, the doctors at the top of our profession have recently defined what appears to be an old disease with a new name. We’ve always had cases like your mother-in-law’s and Ludwig’s, senility we called it. But now they’ve identified a special type of senility, Alzheimer’s disease, named for the doctor who described it. He was a German at the beginning of the century—it’s taken all that time for his discovery to be accepted. I think Ludwig has Alzheimer’s.
‘The basic thing you must understand is that it’s like no other disease we know. A doctor cannot say for sure that a patient has it. No measurable or testable symptoms, no specific cause.’
‘Then how do you know?’
‘When the patient dies, an autopsy of the brain shows that radical changes had taken place. The brain cells had died. A large proportion of the connections that control memory, reasoning, the ability to recognize old friends or family members, they’d been destroyed. And that visual inspection of the dead brain during an autopsy is the only sure proof.’
‘Then how can you say that Ludwig might have this disease?’
‘Sounds silly but what I’m about to say is true. We investigate and dismiss one possibility after another. Ordinary brain damage? Not that. Malfunctioning of the carotid arteries that carry blood and oxygen to the brain? Not that. Standard decline into senility with weakening of the entire body? Not that. When we’ve thrown out all the logical possibilities, what we have left has to be Alzheimer’s.’
‘Will you please start the testing on Ludwig? I want him given every chance of a decent life.’
‘We’ve already done most of the tests—that is, you have.’
‘Me?’
‘Yes, you’re surprisingly well informed on these matters. Comes from what you’ve told me about the deaths of your in-laws. You tell me that Ludwig cannot remember what happened a few days ago but he rambles on about events that happened decades ago. You say that sometimes he looks at you and cannot remember who you are. And most important, that he seems to be in good health because he takes long walks but never knows where he winds up or how to get back. Classic descriptions, Berta.’
‘And what other tests?’
‘Blood tests, but I’ve already done them. And that leaves the two new ones. A check of the carotid arteries that run up the neck—that’s the easy one. And the very new CAT scan, a remarkable instrument that can see through bone and into the brain. Will you inform your husband about the necessity—’
‘Ludwig’s afraid of everything. And he’s never listened to me. You tell him, he trusts you.’
The carotid test, which involved ultrasensitive tracking of the behavior of the great neck arteries, created no problems for Ludwig, but the CAT scan was another matter, for it not only came on a bad day when his mind was severely unfocused, but it also involved his being stretched out flat on his back, his hands strapped to his sides because he was fractious, and his head and torso being moved slowly into a dark tunnel whose curved top came down a few inches from his face. For an ordinary patient it would have been frightening; for Ludwig it was terrifying, and despite his hands being immobilized, his strength enabled him to throw himself off the movable stretcher on which he had been placed.
The three nurses who operated the device plus the able doctor in charge were powerless to get him back on the stretcher that would carry him into the machine, but as he struggled, Berta whispered into his ear as the nurses held his head: ‘Your mother wanted this done, Ludwig. She said it was no big thing.’
‘Did she have it too?’
‘She did.’ Comforted by that mendacious reassurance and a momentary return of normal thought, he said suddenly: ‘You can take off these things,’ and when the straps binding his hands were removed, he climbed onto the stretcher and lay back like a satisfied child as he was slowly moved into the dark cave of the machine.
As Dr. Farquhar had supposed, all tests were negative, so that he could tell Berta with some reassurance: ‘We’ve excluded everything. What’s left has to be Alzheimer’s.’
‘But we’ll never be sure until he’s dead and you can look directly into his brain?’
‘That’s right,’ and he gave her two books dealing with this dreadful disease, plus the fearful summary: ‘There’s no cure. There is no remission. Soon he will not even know who you are. But as his brain dies, his body will seem to grow stronger. You must have heavy locks on the doors or he will wander off and you might not be able to find him.’
‘Would having Lucy Canfield in to help give me the assistance I’ll need?’
‘You’ll need two Lucys, one night, one day. Can you afford that?’
‘Yes.’
‘But the more sensible solution, and I’ve watched this in several cases, would be to find a good nursing home, and they do exist, you know, and—’
‘No!’ Then, because her dismissal had been so instantaneous and fierce, she explained: ‘After the rather painful deaths of his father and mother, Ludwig took down our family Bible, made me place my right hand on it and swear that I would allow him to die in our home and that I would never under any circumstances put him in a nursing home.’
‘He could not foresee the circumstances.’
‘But I took an oath. More important, when I promised I saw the terrible fear in his eyes. I have to live with that.’
Lucy Canfield had a black friend almost as reliable as she, and the two helped Berta maintain a comfortable home for this giant of a man, a former football player of some skill, who had to be watched twenty-four hours a day. His decline was swift, remorseless, terrifying and repulsive. When strangers saw her leading her husband by the hand, they smiled, and children who became familiar with the sight sometimes said cruel things: ‘Look at that little lady guiding that big, dumb-looking hulk.’ Ruefully she thought: He wasn’t always a hulk. In high school, he was everybody’s idol.
As older residents on the island became aware of his illness, they would telephone Berta when they saw him wandering and she would rush out to rescue him, driving the tormenting children away and taking his hand. One such escape was
more serious; Lucy had placed him on the porch where he enjoyed watching the waterway, even though he could not distinguish the boats or the lovely Washingtonia palms. On this occasion, when the urgent desire to go walking seized him he simply strode through the screen, tearing it apart with his powerful hands, and headed off in a new direction.
Because residents on the other islands were not acquainted with his wanderings or the family to which he belonged, they ignored him, so he walked happily across several of them until he reached the footbridge leading to Island 11, which was slippery, and he fell into the water. When the police found him hip-deep in soft mud, splashing his hands and chuckling, they pulled him back to land, and recognizing him as ‘that walking fellow from Island 5,’ drove him home. Berta, frantic on seeing him wet and covered with mud, thought for a moment that he might be dead. Realizing how stupid that was, since he was walking toward the house, she burst into laughter at herself. The officers were amazed that she should be laughing at such a moment, but were reassured by her rushing to Ludwig and embracing him, mud and all. She cried: ‘Thank God you found him. Oh, thank you so much.’ When the men saw the screen Ludwig had torn apart they laconically remarked: ‘Better not put him on the porch anymore.’
More difficult to deal with was his failure to recognize the three women who cared for him, or even to know that they were women. Nor could he differentiate between the two black women and his white wife, and when his faculties deteriorated so far that he became abusive, he would curse them, convinced that they had stolen the funds he kept in Marquette.
The inevitable decline to the point at which he could not attend to his bodily functions resulted in one of the more distasteful routines for the women. Either Berta or one of his nurses would have to unzip his trousers and encourage him to urinate properly, or lower his pants completely and place him on the bathroom commode, followed by the necessity of wiping his bottom. Once, after such a performance, Lucy brought the other nurse with her to face Berta: ‘We can’t go on like this. It ain’t human. Over there is that building they call the Palms, they have a fine hospital area, I work there sometimes. You could drive Mr. Ludwig there in ten minutes, and they got ways of handlin’ a case like this. I’ve seen it.’
Without telling the women of her oath, Berta said stubbornly: ‘I cannot take my husband to such a place—’
‘It’s not a livin’ hell,’ Lucy exploded. ‘It’s better for him than here,’ and when Berta remained obdurate, the women delivered the speech they had agreed on: ‘Mrs. Umlauf, we can’t work here anymore.’
‘Oh my God!’ Berta cried. ‘You can’t leave me alone.’
‘Rachel, she has a cousin, a strong man, cares for people like this. He has a man friend who helps at night. We’ll bring them to see you tonight after they get off work. You can trust them, but they cost more money than you’ve been payin’ us.’
‘If it’s money you want—’
‘We want out. We’ll bring the men tonight.’
When Berta saw them she realized how shattered her world had become, for the two men were rough types she would never have allowed near her house under ordinary circumstances. Now she must invite them in and live with them, the cousin during the day, the stranger at night. But she saw that they were big enough to manage Ludwig, and she gave thanks for that.
The two men moved into the house, and they brought stern discipline to Ludwig. He would do as they said, and if he tried to go his stubborn way, they were capable of knocking him about until he behaved. They were not tender-loving-care nurses but they were effective. However, after they had dealt with Ludwig for two weeks, they, like their cousin and Lucy, wanted to speak with Berta: ‘Miz Berta, him and me works part time at the Palms over there. You never saw a better place. Clean. People who knows what they’re doin’. Real professional. They can do the job much better than us, and you got to see it.’ Timothy, the bigger of the two men, insisted that Berta drive over to the Palms right then, and when he led her to the second floor where he had worked with Alzheimer’s patients, everyone knew him and said a warm hello.
Under his guidance, and with assistance from Ken Krenek, Berta had as favorable an introduction to Assisted Living as possible, and when Krenek learned where she lived and what her problem was, he said enthusiastically: ‘Mrs. Umlauf, it’s simple. You let us care for your husband, we’re good at that. And you remain in your home and drive over here as often as you wish—even take your meals here, that could be arranged.’ Then he added: ‘It’s the orderly way to handle it,’ but at that moment she was powerless to accept: ‘I shall remember what you said, Mr. Krenek. It makes great sense.’ As she left Assisted Living, she stopped at the exit, turned wistfully to look at the attractive complex of buildings and burst into tears to think that she must forgo such an eminently suitable place.
Ludwig’s death did not come quickly. The black men labored with him for half a year, wondering between them when the old man would have the decency to die. The accountants in Marquette wanted to know whether Berta was really paying out such huge sums for house care when public services must surely be available. They even flew one of their team down to see whether the widow Umlauf, as she was referred to on their books, was being bilked by Florida sharpies. At the end of one day’s inspection the man said: ‘Mrs. Umlauf, this arrangement is ridiculous. I was at that fine place just across the bridge and their staff can take the matter off your hands for less than you’re paying now. Please, in the name of common sense, consider such a solution.’
When Berta heard these words pronounced with an accent that made her think she was back in Marquette, the bitterness with which she remembered that unkindly place overcame her: ‘What would the people in Marquette say if they learned that I had placed my husband in a nursing home?’ and the man said: ‘Yes, that would be a consideration. But I believe we could arrange it so they’d never know. He’d still get his mail at this address.’
Ludwig Umlauf finally died because his tangled brain could no longer send protective messages to the vital parts of his body. Brain, lungs, kidneys, respiratory system all seemed to collapse at the same time and he died not knowing where he was or who was tending him. He could not even differentiate his wife from the big black men who took care of him. Even his legacy of more than six million dollars presented problems, for he had never bothered to write a will.
On the day after his estate was finally settled, Berta met with her son, his wife and their son in the library of her home on Island 5: ‘My beloved children, these years have not been easy. I wish you could have lived here with us as I had intended. But in these harsh times I’ve learned several lessons that will determine the rest of my life and influence yours when I’m gone.’ At this point her son moved his chair closer to hers and tenderly touched her arm.
Noel had acquired his un-German name in a curious way. His grandfather, gruff old Otto Umlauf, had insisted that when a grandson came along, he must be named Otto, to preserve the family tradition, and he was so christened. But the registry book also showed something the older Umlaufs never discovered: Berta, acting on her own, had slipped in a middle name that she had always intended for a son, if she had one, so the young man now sitting beside her carried the legal name Otto Noel Umlauf. On the day he went off to school he took with him a note to hand the teacher: ‘My name is Noel Umlauf,’ and so he became a tiny testament to the romanticism and independence of spirit that Berta Krause had nurtured as a girl.
She said: ‘As you know, I have been deeply and tragically involved with three deaths in this family. Your grandfather Otto, your grandmother Ingrid, and your father, Ludwig. I better than anyone living can tell you that each of them approached death with no inner courage to make it a natural part of life, and no concern for those they would leave behind. I can only say that they died miserably and in ways that terrified both them and me.
‘Well, I do not intend to die the way they did, and I want each of you to remember what I’m about to say. And for the lov
e of God, keep in a safe place the documents I’m going to give you. Listen carefully.
‘As I grow older and fall into the decline that overtakes all of us, do not, I pray, do not take me into your homes to be a burden, an expense and a shadow over your normal lives. You, Noel, do not allow false family pride to keep your wife from putting me in a nursing center of good reputation where I can die in peace and with dignity. You, Victor, never say: “Isn’t it awful that Grandmother has to be in a nursing home when she could have remained in her own home?” To all of you, do not give a damn about what the neighbors in Marquette or anywhere else say about how you handle this problem. Think only of your own welfare and mine and do the right thing, the Christian thing, and help me to die properly.’
Everyone began talking animatedly, but no one in the room was uncertain as to what Berta had said with such dignity and force. She resumed speaking: ‘I have prepared, with the assistance of an excellent book, what lawyers now call a living will. I need two witnesses who can attest to my soundness of mind to sign it. Noel and Victor, would you please come here?’ From her desk drawer she removed two copies of her will and a pen.
‘As you can read for yourself, it says that when I reach the point at which I am brain-dead, I do not want to be kept alive as a vegetable by the latest miracles of medicine. I want to be allowed to die simply and honorably. And the will states specifically: “I do not want cardiac resuscitation, mechanical respiration, tube feeding or antibiotics to keep me alive physically when I am already dead mentally and spiritually.” ’ She looked intently into the faces of her son and grandson. ‘These are my wishes and I can tell you that I’m thinking more clearly at this moment than I ever have in my life. Please sign.’
Respecting Berta’s deep feelings on the subject, both Noel and Victor signed the will on the lines provided for witnesses. Then Berta handed Noel one copy of her will. ‘I give you this paper as a sacred trust. Please be guided by it.’
Recessional: A Novel Page 28
