At 3:20 P.M., I emailed Stephen: “Any news?” At 3:38 P.M., he replied, “We are at the hospital. They are doing an EKG. Nothing new to report yet. I will keep you informed.” As it turned out, instead of taking Carol for a joyride in the wheelchair, Stephen and Lissa struggled to lift her into it as she groaned in pain. They wheeled her through the lobby, hauled her up into Stephen’s car, and drove to NYU Langone Hospital.
The details dribbled out, one phone call at a time. Carol had broken several bones in her back, her vertebrae weakened by the radiation she’d undergone to shrink the tumor on her spine. She was diagnosed with pneumonia, and the cancer had reached her lungs, which explained the cough that wouldn’t go away. Her white blood cell count had gone from 15 to 19.8 in two weeks, another bad sign, I assumed. She was on two different kinds of intravenous antibiotics.
Stephen let me know when he was about to go home to feed Teddy and take him out. In the morning, he called me again. “Lissa stayed. She told me this little group came in to report to Carol the results of the tests they did. The guy in charge was an intern … young, kind of cocky.” Stephen was indignant. “He announces that she needs major surgery, immediately, to fix the spine fractures and then two months of intense rehab. Carol looked at him like he was crazy and said, ‘I won’t be alive in two months. Didn’t you read my history?’ Lissa couldn’t believe a doctor would say that.”
I couldn’t believe it either. The cruelty of his incompetence was stunning. I said to Stephen, “I blame myself. If I hadn’t been planning to come over with the recorder, Carol wouldn’t have taken a shower and fallen.” He interrupted, “No, I was mistaken. She didn’t fall taking a shower. She was trying to go to the toilet. You had nothing to do with it.” I felt a little better.
It was the second time she’d fallen. Stephen told me about how the first time she hadn’t been able to get up until someone arrived to help her. He said that in the two weeks since I’d seen her, she’d deteriorated noticeably. One night she called and asked him to come and cook a bacon omelet for her and to bring Teddy. He bought the eggs and the bacon and drove downtown, but when he arrived, he found her in bed, retching into a bowl. “I’ve never seen her that way. She couldn’t even speak. I stayed till eleven-thirty, because I couldn’t leave. She was pitiful. She has some new cough medicine, something with codeine in it. She took it and finally fell asleep. She hadn’t slept at all the night before.”
Then Stephen told me about Bruno. I had just about forgotten about Bruno, Carol’s twenty-two-year-old cat. “Not this past Friday, a week ago, she called and told me that Bruno wouldn’t stop crying. He wasn’t keeping himself clean. He wasn’t eating. On Saturday, Lissa took him to the vet. Kidney failure.” Lissa called Carol, who told her to go ahead and have him put down. That was that.
Stephen said that when he visited Carol on Monday, she’d seemed detached, unemotional about Bruno. “When I got there, all Bruno’s things were gone, his bowls, his food, everything. Lissa probably.” I told him that Carol had always seemed unconcerned about what would happen to Bruno, almost as if she knew the situation would resolve itself. “I asked her about him several times. She would shrug or change the subject.”
Stephen sighed. “Harry is another story.”
That night, I emailed Carol a picture of Harry in my bed and the one of Harry and Minnie sleeping on the couch. In the subject box, I wrote, “H and M and I are worried about you.” A little after midnight she wrote back that in the hospital, she couldn’t open pictures and that she was worried, too.
thirteen
CATCH-22
Thank you, Joseph Heller, for giving the English language a name for idiotic, illogical, senseless bureaucratic impossibilities.
Carol was brought to the emergency room at NYU Langone Hospital that Sunday. Finally, after hours of tests, she was taken to a room. You might assume that being transferred from a gurney to an actual bed meant she had been admitted to the hospital. Wrong. She was still, technically, an emergency room patient. On Monday, she was told that since she had decided against treatment for the broken bones in her back, she could no longer remain in this jurisdictional limbo. She would not be admitted. She had to leave. She was in such pain she couldn’t stand up. She had pneumonia and was dying of cancer, but, according to Medicare regulations, the hospital was not allowed to admit her. Rules were rules. She was free to go home. Of course, she couldn’t go home without twenty-four-hour care, but, Medicare requirements again, she didn’t qualify. She could pay out of her own pocket. The only problem, she didn’t have any money because she couldn’t work.
Carol had wanted home hospice services thinking caregivers would come to her apartment, but discovered she wasn’t considered close enough to death. On that Sunday afternoon, after her fall, Lissa and Stephen tried to call her oncologist … and tried … and tried. When they finally reached him, he said to take her to NYU Langone Hospital rather than the closest emergency room since he was on staff there and could look after her. On Monday, Lissa and Stephen both tried to call him again. No reply.
Lissa and another of the Three Graces, Kate, confronted the hospital social worker. Where, they wanted to know, was Carol supposed to go if she couldn’t stay in the hospital and couldn’t go home? As the social worker hunted for a place, the rules began to bend, slightly. A reason was found to keep her at NYU, a crack she could fall through … temporarily. Her pneumonia, something about adjusting her pain medication, whatever it was, it bought her another day, long enough for arrangements to be made for her to go to the Haven, an extended-nursing-care center and hospice, operated by the Visiting Nurse Service of New York, inside Bellevue Hospital, a few blocks away.
When I got to Carol’s room on Tuesday around six P.M., Lissa was with her. “They’re about to transfer her to the Haven. Should be any minute now.” “Okay,” I said, “I’ll stay till they come. Who’s they?” “An ambulance,” Lissa replied. “When it arrives, someone will come and put her on a gurney and take her down. I’ll ride along with her.”
They seemed ready to go. Lissa gathered up Carol’s things and put them in a plastic bag, which she parked on the bed. Carol was dressed in the clothes she was wearing when she’d arrived. Her discarded hospital gown was lying on a chair, strings hanging down. She looked pale and strained, obviously still in pain, but she managed her wolf grin. “The drugs work.”
We caught up. We chatted. We looked at our watches. We asked a nurse who came in, “When are they coming?” Her answer: “They should have been here by now,” but by seven o’clock, no one had appeared. At eight o’clock, we were still waiting. Carol was getting anxious. The message from the nurses’ station was always the same: “They should have been here by now. We don’t know what the problem is.” At one point, I went to the ladies’ room. I saw two men guiding a gurney through the narrow hallway. I rushed into Carol’s room and told her. We heard it coming, getting closer, but then it didn’t stop at her door. Maybe there was a mistake and it would be back, but no. It simply went away. None of us could think of anything to say. We stared at each other. Carol’s sighs sounded like small gasps of pain.
She had a roommate, a young man, college age, from another country, although we never found out which one. He didn’t seem to be sick. We wondered why he was there. His girlfriend was with him. They played video games on an iPad, cheering, laughing, calling out, making so much noise the nurses told them several times to be quiet. With each outburst, Carol winced.
Just before nine, I realized I couldn’t wait any longer. My au pair was busy that evening, so I had to let Minnie and Harry out. Usually Minnie didn’t eat her dinner until I got home. She would be hungry. Even if the buses came quickly, I’d be an hour getting home. Lissa said she’d stay. Carol protested, but clearly she was relieved she wouldn’t have to make the move alone.
The next day, I called Lissa to find out what happened.
“We didn’t get to the Haven till ten-thirty,” she said. “It was pretty awful. The
ambulance ride over there was rough. The driver went really fast, and the ambulance sort of tilted around corners. Carol bounced around a lot. She was in agony.”
Carol agreed to go to the Haven because she was promised a single room. “Sure enough,” Lissa went on, “when we arrived, she was put in a room with a roommate, an elderly woman who moans all the time.”
The end of the excitement for one night? Hardly. No sooner had Carol been wheeled into her room than a palliative-care physician accompanied by an entourage of white-coated underlings of unknown function crowded around her bed with questions to ask and forms to fill out. All Carol wanted to do was go to sleep, but no. The questions came first. Finally they all left. Lissa started putting Carol’s things away and making plans to go home. Suddenly, an aide materialized at the door and informed Carol she was about to be given a bath.
“We couldn’t believe it. A bath? It was going on midnight,” Lissa said. “This woman wouldn’t take no for an answer. Carol kept telling her she’d already had a bath at NYU. She didn’t need two in one day. She just wanted to sleep. She was practically in tears. In the end, the woman left, but it was surreal.”
The next morning, the palliative-care doctor was back with more mystery followers trailing after her, asking more questions, filling out more forms. She had no interest in the medications the NYU doctors had prescribed. She increased Carol’s morphine dramatically, according to Lissa, turning her into a zombie.
I said I would be over after work.
If you want to find a hospital in Manhattan, go to the East Side. Hospitals line First Avenue, one after another for eighty blocks, their backs to the East River. Hulking monuments to specialization and philanthropy, with the names of their rich benefactors appearing in boldface on facades and over doors. Bellevue is toward the southern end of this crowded corridor. It’s the oldest public hospital in the United States, dating from 1736, before the American Revolution, and it’s huge.
I walked into the big glass entrance and asked how to get to the Haven. I was told, “On Seven. Down the hall. Follow the blue line on the floor.” As opposed to lines in other colors, which led to different departments. All I could think of was Hansel and Gretel sprinkling bread crumbs along their path, leaving a trail so they might find their way home. The blue line went on and on, straight, to the right, then the left, past a restaurant, alongside a collection of amazing old photographs documenting Bellevue’s history, for what must have been a quarter of a mile, until it stopped at a security desk next to an elevator bank, where I was given a visitor sticker. Over the next few weeks I would come to despise that blue line.
When I reached Carol’s room, Lissa was there. Carol was so groggy from too much medication, she couldn’t talk.
“And you know what else happened?” Lissa said after filling me in about the day. “In the middle of everything with her morphine, the 9/11 people came up to interview her. She knew it was important, but she was totally out of it.”
The agency that monitors and evaluates 9/11 survivors had offices at Bellevue. To process Carol’s claims for compensation, caseworkers needed to talk to her. For weeks they’d been trying to make an appointment, but her endless doctors’ appointments had made scheduling impossible. Now here she was, so up they came.
Lissa described the visit. A whole new set of paper pushers with a whole new set of questions and forms. Carol practically unconscious in bed. “They asked whether she had her windows open on 9/11.”
Carol emailed the following afternoon: “M—no visitors today, way too exhausted…” Then emojis: a sad face, a smiling face, a cat, lips, and a heart.
I sent new dog pictures. She replied with more emojis.
Then from Lissa, one of those which do you want to hear first, the good news or the bad news stories? How about the good news, because the bad news is so bad? The palliative-care doctor was finally working out the proper dosage for Carol’s morphine and other medications, Lissa told me. So far so good, I thought. Carol’s friend Kate, who was particularly good at confronting authorities, had managed to get Carol moved into the promised single room. Also good. “But…” Lissa got to the bad news, the unexpected bombshell. “Carol’s being told she can’t stay at the Haven. The doctor says if she can swallow pills on her own, hospice doesn’t kick in, and Medicare won’t pay.”
It was NYU all over again. Suddenly I understood why she’d been taken off the drip she’d been on at NYU and been forced to take her medications orally at the Haven. It was a test.
“So now what?” I asked. Lissa sounded frantic. She and Kate and Cecilia, the Three Graces, were trying to figure out how to raise money, either to keep Carol at the Haven or to pay for twenty-four-hour home care. “We’re trying to sell Carol’s belongings. We’re emailing all her friends about an online fund-raising campaign, too. You should have the email by now. If she has to go home, we’ve got to get rid of things, so there’s room for a hospital bed.”
Already, someone had agreed to buy her beautiful marble table. I tried to imagine her apartment without it and without all her other treasures. How would she feel if she went home and found the place pillaged, stripped of the things she loved? I reminded myself, How many thousands, how many millions, of Americans are worse off? I realized, I was missing the point, which was that three younger women who loved her were going to make sure, so help them, that Carol would get the care she needed.
“She’s really upset.” Lissa seemed pretty upset, too. “And I found out why her oncologist doesn’t call back. She’s technically on hospice now, so he’s not allowed to have anything to do with her treatment anymore. Isn’t that weird? I couldn’t believe he was just ignoring her. I went along when she had her appointments with him. He’s wonderful. I sort of had a crush on him.”
I emailed Carol. “It just seems as if there’s waaaayyy too much bureaucracy in all of this. I hate to put it this way, but your time is too valuable for all those doctors with conflicting, confusing information to steal it from you.” Her response: “AMEN!!!!”
The next time I visited, Carol was propped up in bed holding a small, kidney-shaped, stainless steel basin in both hands in front of her, as if it were an offering. She was expecting to vomit. Odds and ends of sandwiches and pastries friends had brought her sat mostly uneaten on her bedside table, getting stale in crumpled-up cellophane, alongside plastic cups with bent straws and a water pitcher.
“I can’t really eat. I’ve been getting sick to my stomach a lot,” she said. “It’s awful. Eating was always one of my favorite things.” She didn’t want to talk about what would happen if she was kicked out of the Haven. She wanted me to tell her about Harry and Minnie. Kate was there, too, regaling her with the gossip from their building, describing the doings of people I didn’t know, exaggerating just enough, I thought, to make Carol laugh. The gossip she ate up as if it were dessert. Conversation stopped when a nurse came in with little paper cups on a tray, the kind you’d fill up with ketchup or mustard at a fast food restaurant. Each one contained a pill. Kate and I watched as Carol downed them with water. The nurse left. We started talking again. A few minutes passed, and then, a small miracle happened. A big miracle. Carol began heaving and then vomiting into the kidney-shaped basin. All of the pills she had just taken were floating in the runny mess she had thrown up. We stared at them for maybe five seconds. Suddenly, Kate snatched the basin out of Carol’s hands and rushed out of the room. She took it straight to the nurses’ station. I followed.
“Look at this! See?” Kate refused to be ignored. “Carol Fertig, down the hall, can’t keep her medication down. I want to talk to her palliative-care doctor. Now! Here’s proof she can’t take pills by mouth anymore.”
Carol was allowed to stay at the Haven.
fourteen
DOMESTIC BLISS
Carol was right. Harry, left to his own devices, would indeed have slept till noon every day. Unfortunately for him, chez Teichner, lying in bed all morning wasn’t an option. At five-thirty, a
quarter to six at the latest, when I usually get up, I’d find Harry against a pillow, perpendicular to my head, snoring. I’d slip out from under the covers, brush my teeth, wash, dress. Then I would collect the bag containing scissors, first-aid supplies, and the bootie I put over his cracked pad. Most days, he never woke up. He’d just keep right on snoring as I picked up his paw. It was like holding a baby’s hand and waving goodbye. I could move it any way I wanted as I started applying antibiotic ointment and wrapping it in tape, eventually pulling on the red bootie and securing its Velcro strap. At night, after boosting Harry up onto my bed, I’d remove the bootie and cut the bandage off.
It took a while, but after considerable trial and error, I worked out a system and figured out which products worked best and how much of everything I needed to keep on hand.
I thought about what the people at my local CVS pharmacy must have thought. I would go in and buy them out of nonstick pads and the various kinds of tape I used, eight, ten, twelve rolls at a time, if they had that much, plus enough antibiotic ointment to oil an elephant. The girls at the registers always looked puzzled as I unloaded my basket. They had to recognize me, I was in there so often. Were they curious? Why those particular first-aid items over and over? What kind of injury were they for that never got better? How big was the person or thing this woman was patching up? Did she have a mummy at home?
They’d get in new stock, and suddenly, a day later, it would all be gone. Surely no other CVS store in Manhattan went through that stuff so fast. I could imagine the store manager looking at the sales figures and wondering what in the world was going on, the warehouse perplexed and possibly suspicious at the constant reordering. Every time, I’d shell out forty or fifty dollars. Harry’s foot care, I discovered, was expensive.
When Harry Met Minnie Page 13
