“All right. If you say so. The two of you. You broke my defense. But when I say I want to come home, I’m coming home, even if it’s today.”
“That’s okay with me,” I said. “I want you home. And you’re speaking so clearly. Great.” I stood up and kissed her forehead. She looked away when I did it. “Okay with you too, Marion?”
“I think it’s going to work out. I won’t even go with you, and I’ll probably see Abby here tomorrow.”
“Oh. You’re both such fibbers. Anything to get rid of me.”
I called 911. The EMR truck, or whatever it’s called, was at our house in a few minutes. We heard the siren from far off—“I wonder if it’s for us,” I said — and then it was turned off when they pulled into our driveway. The paramedics examined her quickly. One said she should be taken to Emergency. “Her lungs sound congested.” They got her on a gurney and into the back of the truck. This time they said I couldn’t ride with them in the front passenger seat. Some new rules. There was an accident. “We’ll see you in the Emergency wing of the new hospital. GBMC good for you? I called in and they have room, not too jammed.”
“That’s where we’ve gone before, every single time. It’s the closest and I guess as good as any.”
Marion said she’d call me tonight. “Or you call me if you’ve time. I’ll be at the hospital first thing tomorrow morning. And you better call your girls. I’d do it for you, but I’m sure they’d rather hear it from you.”
“What do you think? She’ll make it?”
“Sure she will. She’s so strong. Look at those last times. They gave her a one-to-three-percent chance of surviving, and she fooled the experts.”
She was in the intensive care unit for five days. Every day she said she wanted to come home and I always said “Give it one more day. The antibiotics haven’t kicked in yet.”
“They’ll never kick in. You’ve gone from being a bad fibber to an even worse liar. You know it’s hopeless. They didn’t even put me on a respirator. No need to, thank God. I’m finished. They’ve given up on me. One thing, though. If by some miracle I come out of this, I’ll never let you drag me into a hospital again.”
The doctors in ICU said she needed to have a feeding tube put in. It’s a simple operation, they said, and the only way she’d get nourishment. She said “No feeding tube. That would be the end of living for me. One tube, the trach, isn’t enough? I was told it’d only be a month or two and it’s been a year and we all know it’s never coming out while I’m alive. And then those other tubes around my waist inside to my back for my baclofen pump. Did I need that too? The MS specialists said I did, but I now think the baclofen pills I was taking would have been enough. Everyone’s lied to me. Everyone’s a liar except my daughters. And the doctors are the worst liars. Or should I say ‘husbands too’?”
“Mommy,” one of our daughters said. “Dad’s doing the best he can.”
“You don’t think I know that? Everyone is. What a joke.”
The hospital’s palliative team is asked by the ICU doctors to examine her. After the exam, what seemed like the head of the team signaled my daughters and me to step outside the room. With the three other members of the team standing around her but not saying anything, she said “We hate to break this to you, but the hospital can no longer help your wife and mother. Nothing more can be done for her, other than making her as comfortable as she can be, and she now needs a different and much less aggressive kind of care.”
“Wait a minute. Slow down. She’s dying? Nothing more can be done? Everything’s been tried? This time, unlike the last four times she was here, the antibiotics failed and the pneumonia can’t be cured and you’ve no other medications or antibiotics or any other means to help her, and you’ve determined this in just four to five days?”
“That’s precisely what we’re saying. There’s been irreparable damage done to her lungs the last few years. If she goes home now, she’ll be back here in a week or two, or even less, and in much worse condition and probably in great pain and discomfort, and again there’d be nothing we could do to reverse it. Everything possible has been tried. What hasn’t been tried are medications we know won’t help her. As doctors, this isn’t easy for us to accept and is very difficult for us to tell the patient’s loved ones, but there it is.”
“So what now?”
“There’s an excellent hospice care facility not too far from here. Gilchrist. Maybe you’ve seen the entrance to it on Towsontown Boulevard. You should pay it a visit. Just go right in. You don’t need an appointment. Tell them you’re scouting it out for your wife and mother. And take your time in all this. We’re not rushing her out. Make your decision in the next couple of days. I’ve spoken by phone to her general physician — filled him in — and he agrees that this is the course she should take. If Gilchrist doesn’t appeal to you, we’ll give you the names of others. They’re all much the same, you’ll find. The one advantage of Gilchrist, though, isn’t only its proximity to the hospital and your home. Mrs. Berman spoke with great delight of her love for your cat. Streak is her name?”
“His. Close. What are you getting at?”
“It permits patients there to bring their pets with them. Just one, or one at a time, and to keep it there so long as the door remains closed. That can be an added asset in keeping the patient’s spirits up. Another advantage, although I believe they all do this, is that you and your daughters can stay in her room overnight and they’ll provide the cots.”
“I’m sure my wife wouldn’t like being in a hospice — I know her. But we’ll visit the one you said, just to have something to report back to her and to give her the final choice.” And we did — took a tour, as the woman at the hospice’s front desk called it — and told Abby about where we’d been the last hour.
“Even if the one you saw were like an Arabian palace and they’d wait on me hand and foot as I slowly expire, I’m not going to it. It sounds like a death camp. The hearses are probably flying out of there several times a day. I also wouldn’t want Sleek to experience it, my poor dear cat. Listen, you’re wasting what precious little time I have left. Besides making me even more miserable with this repulsive talk. While you were out I came to a decision, and you can’t stop me from going ahead with it. I’m coming home. Today, not tomorrow. In the next hour, if it’s possible. Don’t argue with me about it or I’ll scream, I swear it, I’ll scream and cry and make you feel even worse than you already do. And once home — and listen carefully; this is part of my decision — I’m not going to eat, drink or take oxygen anymore. And no medications, either, except what you give me to keep away the pain before I fall into a coma. And then when I’m in one if I show pain. Morphine. Make sure there’s plenty of it around and you don’t run out. They’ll give it to you if you’re taking care of me at home. Home hospice care will. I’ve heard. But I want to die at home in my own bed even if it has to be the hospital one at home. Now what do you say? Today!”
“I want you to first let them put in a feeding tube. You have to try it. It’s a painless procedure and they say you need it to live. The food will give you strength.”
“You awful person. I wanted to say much worse. Why are you acting so despicably to me?”
“Mommy, don’t be so hard on Daddy. You know how he feels. And Daddy, you have to do what Mommy wants.”
“I don’t have to. I want to help her.”
“You do have to. And you’re hurting her with your demands.”
“Let’s give it one more day. Please, my darling Abby. If you haven’t changed your mind about the feeding tube—”
“I won’t.”
“I know. But if you haven’t by tomorrow morning, we’ll take you home. Is that fair? Is that fair?”