by Tracy Kidder
The three of them chatted, Joe sitting up to look at Lou now and then. Finally, sometime after Joe’s daughter left, a little before lunch, Lou’s stiffness and the wary look he’d worn since breakfast passed. And Joe lay back, relaxed.
“I don’t like to say it in front of Ruth,” Lou said to Joe, “but, you know, when it happens, I want it to happen quick.”
“You die after me,” Joe said. “Day after, you can die.”
***
That afternoon, now that Lou was feeling fine again, Joe turned to less important worries. “The Red Sox. They stink. Last night. Three men walked and two guys couldn’t bring them in. They leave men on base all the goddamn time.” He sat up. “And that’s swearing, that’s not a prayer, and you can go boo about it.”
“Okay, I forgive you for that, Joe.”
Joe lay back down. Lou suggested, “It’s those prima donna pitchers.”
“No! Hitters, too. I’d fire the manager, the general manager, and all the ball club. And I’d bring up, uh, Pawtucket manager and his whole team. Bring the whole team up. Currrist!”
Almost everything was back to normal. A few days later, Lou’s doctor visited and deemed Lou’s angina “stable.” But Joe still had some shortness of breath, and he had that cough. It wasn’t a constant thing, but it wouldn’t go away. It would start with his laughing, at a Red Sox rally or one of Lou’s stories. Once started, the cough went on for minutes, Lou gripping the arms of his chair at the sound, while Joe gasped for air between the spasms, his feet kicking his mattress.
5
Last night Joe told the nurse he needed a wheelchair for today. He knew the routines at the VA hospital. Now he sat in the borrowed wheelchair in front of the Forest View nurses’ station, fifteen minutes early, waiting for the driver to arrive. The driver wasn’t late, but already Joe had asked the charge nurse to call and make sure he was coming. Joe looked diminished in the chair. He looked up at one of the nursing supervisors, a tall woman anyway and very tall standing beside his wheelchair, and he said to her in a voice that sounded choked, “I’m afraid they’re gonna keep me.” Joe’s eyes studied the nurse’s face, to see if she was hiding something, afraid she might be.
“No they’re not,” she said. She leaned down, her face close to his, and rubbed her hand on his bald dome. He did not protest. Held in her embrace, Joe looked away and stared at nothing.
***
“Route Nine,” Joe murmured as the car turned onto the two-lane highway. Joe smiled to himself. He didn’t say much the rest of the way. He sat in the front seat and looked out the window.
They had to go only about a mile. A golf driving range went by on the right, and then a little bunch of stores, a liquor store among them. And then off to the left appeared the outer grounds of the VA Medical Center—beside the road a pretty pond and a wide, upward-sloping field, as closely mown and verdant as a fairway. The field ends at a stand of tall evergreens, framed against the sky on this blue and green and golden summer morning. Out beside the entrance there is also a garden, meant for the eyes of passersby. The garden is always immaculately tended, no matter what the state of the national economy. In the garden a cluster of pruned shrubbery spells out the initials VAMC, just above which the hospital always plants a sign. The slogan changes periodically. Sometimes the sign reads, TO CARE FOR HIM WHO SHALL HAVE BORNE THE BATTLE. Today it read, PRICE OF FREEDOM VISIBLE HERE.
Sometimes lone figures appear from among the trees at the top of the hill, old men or young, walking across the grassy hillside, down an unofficial path known locally as the Ho Chi Minh Trail. They are heading, it is generally assumed, for the liquor store across Route 9, though actually, most go to the convenience store instead. But the landscape was empty at this morning hour. Nothing besides pond and garden, field and woods, and the top of a smokestack, rising above the trees, was visible. Trees hid all the buildings of the medical center. Perhaps it was that fact, the impression that something was being hidden, which made these outer grounds seem eerie in their emptiness. Their military neatness proclaimed that this VA hospital wasn’t like some others—the filthy sties to which some veterans had returned from Vietnam. But the landscape’s prettiness and orderly solitude made contemplation of what lay behind the trees all the more appalling, like a flaming shipwreck on a calm and sunny sea. The wards of the hospital proper, the locked psychiatric wards, the drug and alcohol rehabilitation wards, the nursing home wards, in one of which Joe had lived during the longest four months of his life. To Joe, these spruce grounds were not pretty. They were dismal.
The car went up the drive on a winding way all overhung with trees, past old brick buildings and numbered parking lots, and then into a courtyard, surrounded by more brick buildings coupled together with walkways. It was an angular and complicated-looking place, worn by time and traffic. It was a place of boxes inside boxes. Joe had lived on C Ward, one of the innermost boxes, but today, he hoped, he wouldn’t go much farther than the waiting room and a doctor’s office. After the usual difficulties—swinging his feet out the door, rising slowly, his good arm quivering as he lifted himself—Joe transferred from car seat to wheelchair, was pushed on a brief passage through the summer morning, up a concrete ramp, and into the outer waiting room in front of the receptionist’s window. Joe surrendered his VA identity card. The fact that his eyes never left it would by itself have proved he was a veteran, and remembered all the many ways of getting lost in paperwork. He could hardly have forgotten. From time to time he would receive notices from here canceling cholesterol checkup appointments that he’d already kept. He put the identity card back in his pocket and started waiting.
Half a dozen men sat on vinyl chairs in the center of the room. Most of them were watching a game show, craning their necks as if looking at airplanes. The TV was mounted high up on a wall. On the walls were a few framed photographs of men in suits, depicting, as in an Army orderly room, the chain of command. Joe looked around. It was all the same. The place was clean as always. “And the nurses and aides upstairs, they’re wonderful. Just like at Linda Manor. But…” Joe’s voice trailed off, and in a moment a nurse came up and wheeled him into an office. “My blood pressure will be higher,” he told her as she put the cuff around his biceps, “because of the VA and everything.”
The nurse smiled.
“I mean it.”
But it wasn’t much higher than usual, 150 over 88.
“Is he gonna check my lungs?” Joe asked the nurse when she took off her stethoscope.
“I think so.”
“I feel all right. Except, you know, for my stroke.”
The nurse departed. Joe looked around the small gray room. He sat beside a metal desk. “Adjust. Jesus Christ. Adjust,” he said. He flexed his left arm. He growled, looking at his biceps. “But. Lou and I have adjusted.” Joe sighed. “I don’t want booze anymore, but yesterday after supper I’d have given a thousand, no, I’d have paid anything for a cigarette.”
The doctor came in a moment later, a trim, dark-haired young man in a white coat, with a pleasant smile. He sat down facing Joe, introduced himself, and asked Joe how he was.
“I feel well,” Joe said emphatically. “You know. Stroke, you know. I feel all right. So why the hell did they send me here?”
“So they didn’t tell you?” The doctor leaned toward Joe, his elbows on his knees.
“The nurse said it was to check my lungs.”
“Yes. The x-rays show an area on the right side that’s either pneumonia or a scar. I don’t know. It could be a persistent pneumonia. It could be that. Sometimes there’s a cancer or a growth. If you asked me do you have lung cancer, no, I don’t think so.”
“I don’t care,” said Joe.
The doctor blinked. “Are you coughing a lot?”
“Once in a while I cough at night.”
“Any fever or sweats?”
“No.”
“Are you losing any weight?”
Joe smiled. “No-oooh.”
/> The doctor leafed through Joe’s records, asking questions. Was Joe a smoker? Was he still a smoker? When had he quit? How many packs a day had he smoked? “If you had to average it over fifty years, would you say you were a two-pack-a-day smoker?”
“Yes. But I used to drink, you know.”
“But you gave it up,” said the doctor, looking at the records.
“Says you were in the Navy. Where?”
“South Pacific.”
“Says you were a lawyer.”
“Uh, probation officer. I practiced law on the side.”
Joe’s aphasia seemed to strike most often when he wanted most to speak his mind, and also when he was feeling nervous. “Wait a minute now,” Joe told the doctor at one point when he couldn’t get an answer out. “I got half a brain, you know.” The doctor’s questioning had turned from medicine to small talk, and Joe was uneasy without knowing exactly why.
In fact, the doctor, expecting Joe’s visit, had studied Joe’s chest x-rays and had a plan in mind. He’d arrange a battery of tests for Joe and have the resident lung specialist examine the results, all of which would mean that Joe would have to spend a few nights here in the hospital. Getting back to business, the smiling young doctor said that what he was going to do now was formally admit Joe to the hospital.
Joe’s face flushed. “Oh, bullshit!” he roared. He came halfway out of the borrowed wheelchair. It looked for a moment as if he were going to throw himself onto the doctor.
The doctor stiffened momentarily, rocking back in his chair. Then, leaning forward again, he explained that he wanted Joe to have a CAT scan and a bronchoscopy. He explained the procedures. A bronchoscopy meant putting a tube down Joe’s throat to have a look inside his lung.
Joe waved his good hand at the doctor. “The hell with it!”
“That’s up to you,” said the doctor. “None of these tests can be done at Linda Manor.”
“I don’t want to be here anymore,” said Joe, his face still flushed.
“A CAT scan test is done as an x-ray test. It’s done in Providence, and hear me out before you say ‘bullshit.’ If you have Medicare—”
“No, I don’t have Medicare.”
“Or you have a bank account.”
“No,” Joe said.
“The CAT scan will give the lung specialist an idea,” the doctor went on. “But to figure out why an old pneumonia is still there, he needs to look in your lung with the tube.”
“All right,” said Joe, “I’ll get the CAT scan. But I don’t want to be in the hospital any more.”
“You mean never, or any more than is absolutely necessary?”
“Never.” Joe’s eyes were narrowed. The doctor seemed momentarily lost. Joe, in a gentler tone, said, “Because I’m seventy-two years old, and I, uh, you know.”
“You can’t die young anymore,” said the doctor, and he smiled.
“No! I’m old.”
“And whatever happens, happens.”
“Right!” Joe said.
“All right. I can accept that.”
“I don’t want tubes in me,” Joe said.
“You want quality of life, not quantity?”
“Yup.”
“Okay,” said the doctor. “We’re on the same wavelength.”
“My wife and daughter signed, uh, the paper. At Linda Manor.”
“I think I have the beginning of the idea.” The doctor leaned again toward Joe. “But you should know some other things. If it’s pneumonia or TB, those are potentially very treatable. But there’s no way to know how to treat it if we don’t know what it is. If it’s something more serious like lung cancer, it might also be treatable, but not outside the hospital. You might say you don’t want that—”
“That’s right,” Joe interrupted.
“But I can’t know what’s there,” the doctor continued, “unless you have the CAT scan and bronchoscopy. I’m not saying that to persuade you.”
“Okay. But I don’t want to spend the night here.” Turning his face half away from the young man, Joe waved his hand again. “Lung cancer, forget it.”
“Don’t give yourself lung cancer.”
Joe looked at him and, as if explaining something obvious to a child, said, “I know I don’t have lung cancer. I know I don’t have TB.”
The doctor put on his stethoscope. He listened to Joe’s heart and lungs. “When you were in the hospital in Pittsfield, did they check your prostate gland?”
“They took it out.” Joe grinned.
“I want you to have a chest x-ray today.”
Joe smiled. “That’ll give me cancer.”
“All the x-rays?” said the doctor. “Hold on a second and I’ll address that.”
“No. Because I’m kidding.” Joe added, “You know, I don’t want a CAT scan.”
“It’s up to you,” said the doctor. “But I’d do it if I were you.”
“Okay, I’ll get the CAT scan, period,” said Joe. He looked squarely at the doctor. “But they have to take me back to Linda Manor.”
“You drive a hard bargain.”
“I’d commit suicide if I have to stay upstairs,” Joe said. “Honest to God.”
“Fair enough. You like Linda Manor.”
Joe stared at him, pausing a moment to assemble the words. “I like it better than here.”
So they struck a compromise. The doctor would have Joe x-rayed again right now, to see if anything had changed with the problem in his lung. And while Joe was getting x-rayed, the doctor would see what he could do about getting Joe a CAT scan locally, so that he wouldn’t have to spend any nights in the hospital.
Joe rode the wheelchair down several corridors, then up an elevator, down another corridor—a passage of enough turns to make a nervous person worry about ever getting out of there. But he was calm now. He got his lung x-rayed again and was rolled back to the lobby and parked beside the rows of chairs at the center of the room.
There were two rows, placed back to back. Joe sat at the end of the row that faced the television. A couple of children in the row behind him were talking about their pets. Joe listened, smiling, his eyes on the TV. Another game show was in progress. From the cluster of people waiting arose a collective odor of dried sweat. A couple of young men with packs of cigarettes rolled up in the sleeves of their T-shirts sat nearby. A woman was speaking to an unshaven elderly man in ragged-looking clothes. “Can you spare me some money for food and cigarettes?” The old man didn’t answer her. Joe had gone to the Linda Manor beauty shop for his bimonthly haircut just the other day. He’d gotten his usual close cropping, so that the haircut would last. The fringes around his bald dome were almost as short as his considerable five o’clock shadow, which appeared within hours after he shaved. All of Joe’s head looked like it needed a shave. Joe wore sweat pants and a polo shirt. He looked as if he still belonged here.
Joe stared up at the TV. His thoughts went elsewhere. “Once they get you in this place, they don’t like to let you go… What the hell. You know you’re not gonna live forever. If I were fifty, I’d do it. Most people aren’t like Lou. People don’t make ninety-two. People don’t do that often… Upstairs. There were five of us in a room. No TV. And I depend on TV. And I just lay there. I can’t read. Lou’s all right because he’s active. People keeping people alive. For God’s sake. It’s ridiculous.” Joe looked around the waiting room. “They might forget me, and I’ll sit here till tomorrow. For Christ’s sake, what’s takin’ him so long? That’s why I don’t like coming to these goddamn places.” He made a face and looked back up at the TV. “Room with five guys, and one guy I could talk to, and he used to go away. I was here four or five months… I gotta wait for him. Then I gotta wait for transportation.”
The doctor, walking briskly, stopped beside Joe and said, “I’ll be with you in five minutes.”
“Okay,” Joe called after him. The doctor disappeared into an office.
“That was nice. That was really nice. He’s the only one
ever did that.”
Joe looked back at the TV. The game show was concluding. “He didn’t win the car,” Joe murmured. Then the nurse came for him.
Joe was wheeled up to another desk, inside another gray-looking office, but in front of the same young doctor. “You know, I want to thank you,” Joe said. “You’re the only, uh, physician who ever came out and told me you’d be out in five minutes.”
The doctor grimaced. “Well, that’s something I did right. Now let me go over something I did wrong.”
He said that he’d just studied Joe’s latest x-ray, and the picture seemed to show that the irregularity in Joe’s lung, whatever it was, had diminished greatly. It wasn’t gone, but the problem seemed to have improved enough to make the doctor think that it might clear up altogether by itself. He would put the issue of the CAT scan and bronchoscopy on hold, and have Joe come back in about a month for another x-ray. “So I’ll see you in four weeks,” the doctor said.
Joe had begun to smile.
“You’re happy,” said the doctor, “but I feel like an idiot. I never saw a lung problem that went on month after month and then improved like this.”
“But I have inner strength.”
“I’m sorry to worry you,” said the doctor.
“I wasn’t worried,” said Joe, leaning toward the young man. “Because when you reach your seventies, every day is a good day.”
The doctor needed Joe’s identity card to fill out some paperwork. Joe handed it to him, saying, “But, uh, give it back.” Fifty years had passed since, administratively speaking, Joe’s identity had depended on military dog tags, but again Joe’s eyes stayed on that card for as long as the doctor had it. Joe returned the card to his pocket, and in a little while he was riding back toward Linda Manor.
“A longer stay than you anticipated, Joe,” said the driver.
“Yeah,” Joe said. “You wait, you know.”
“Well, it’s no different in the service,” said the driver.
“I know,” Joe said.
Joe meant to prevent him, but the driver had to finish the chord and utter the old military saw: “Yeah, just like in the service. Hurry up and wait.”
