Stephen Dixon - Late Stories

“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?”

“All right. Now all of you leave. I want to be completely alone in my room tonight. Not with you, one of the kids or a private nurse hired for tonight. I just want to think.”

“Okay. We’ll be here, or only I will, bright and early tomorrow morning. Now will you let me kiss you good night?”

“Of course. Have a good dinner at home. Or all of you go out for dinner. There’s still time.”

Phone rang very early the next morning. It was still dark out. My first thought was that she had committed suicide, or tried to, in some way. That that was why she wanted nobody to stay overnight with her. Because I would have. I had no intentions of going home. It was the head nurse in ICU. Abby was hysterical, wanted to know where I was. Wanted to be discharged from the hospital right away. “I told her she couldn’t be discharged till much later this morning. There were forms, procedures, instructions. The people who took care of that don’t come in till nine. We almost had to keep her down with wrist restraints.”

“Are you in her room?”

“Yes.”

“Can you give her the phone receiver?”

“She doesn’t want to speak to you. ‘No more malarkey,’ is how she put it. I’ve tried to explain things to her. But she says she only wants you to get here immediately and take her home.”

“Tell her to relax. I’m coming. That I just have to wash up and dress. Did she say anything about a feeding tube?”

“That’s mainly what she’s so hysterical about. It’s a no.”

After dealing with the paperwork and instructions how to take care of her at home, we left the hospital around ten. She went home by regular ambulance this time, not the big emergency medical truck. The previous time I drove her home. She died in her hospital bed at home fifteen days later. Was conscious the first five days and then slipped into a coma she never came out of. She refused food, drink, medicine and oxygen. The visiting home hospice care nurse, who came every morning for about twenty minutes and, once Abby was comatose, resupplied me with morphine whenever I was almost out of it, was surprised Abby was still alive on the sixth or seventh day of her coma. “No medicines? Nothing to eat or drink or for her breathing since she came home? I thought she’d be gone before I got here today.” The only thing she drank the first five days other than ice chips every so often, and I suppose you can call that drinking, was a sip of champagne from a glass held up to her lips. Only foods she ate during that time was a chocolate-covered strawberry — it was around Valentine’s Day, so something the bakery at the market I go to had — and a small piece of nova on half a rice cracker that had to be placed in her mouth. Both of these and the champagne on the second day she was home, when we had a little party in her room with our daughters and her best friend and her best friend’s husband who came down from New York. She didn’t want to see anybody else. “I don’t want to scare people with how I look.” I don’t know whose idea the party was. Maybe it was mine. I remember wanting to lighten the mood in the house, and it seemed to work for an hour or so, at least for her. “My last bite,” after she ate the nova and cracker, or part she bit off. “I might throw it up, but oh, it tasted so good. This is one of the foods I’ll miss. Nova. Sturgeon. Smoked whitefish. Russian caviar. Raspberries and artichoke hearts. Quite a spread. And the champagne. Such a good one too. Everybody: eat up. So much good food I can’t touch. Finish the champagne — it can’t keep — and open another bottle for yourselves. Phil, we must have another good bottle of champagne around. What we didn’t drink but intended to last New Year’s Eve. There’s no law saying it has to be chilled.”

I haven’t got all this down exactly right. I could ask my daughters for help with some of it, but I don’t want to bring any of it up to them again. It only makes them sad and me sad and they don’t want to be. Me? I don’t mind, and the truth is, sometimes it feels good. I don’t even know if I got the order right of what happened those last fifteen to sixteen days. But I think this is how it generally went. I didn’t take notes or keep a journal. I never do about anything. It’s all memory, in my head. If it doesn’t come out when I’m thinking of it, it usually comes out sometime later. But to get back to where I started from: I’ve been wondering if she would have lived longer — and I’m not talking about a few days or weeks but months; years, even, where she still might be alive today — if she hadn’t gone to the hospital that last time. Crazy thought? You bet. But possible, I’m saying, possible. A thought just to make myself feel even worse than I already do about her? Maybe that too. But maybe she would have gotten better — recovered completely from the pneumonia, that last time — if she hadn’t gone to the hospital. No threat of a feeding tube or of being intubated again, which is the worst thing that can happen to you there, the air tube or whatever it’s called forced down your throat into your chest and kept there, with you on your back the whole time, for God knows how long. For Abby, the three times it was done to her, it was more than a week. And the fuss and discomfort and anxiety, too, of being driven to the hospital in that truck and wheeled into the emergency room and then the intensive care unit and tests and x-rays and oxygen mask and IV’s and everything else including screams all night from patients in other rooms and nurses and aides waking you up every two to three hours to take your temperature and blood pressure and draw blood and empty your urine bag and maybe change the catheter and check your IV’s and ask if you need to use the bed pan or are in pain and give you medicine in liquid or pill form. Maybe it all got too much for her, just as she might have thought it would, once she was in the hospital for a couple of days, and she gave up trying to fight the disease and complications like pneumonia that often go with it, and thought what’s the use? She’ll only be back here in a few weeks under the same if not worse conditions, the ICU doctors and palliative team giving up on her even faster than they did the last time, and got the idea, or finally settled on one she’d been thinking about awhile, to starve and dehydrate herself to death at home. So what am I getting at? I lost what I was thinking. Then what was I thinking? That maybe I shouldn’t have pressured her the way I did to go to the hospital. Not “maybe.” I shouldn’t have, period. And also not got Marion to urge her to go to the hospital too, which Abby absolutely didn’t want to do. She wanted to stay home. She might have got better. I should have done what she wanted, or at the very least thought about it more. No, done what she wanted and not just what I had it in my head she should do. Getting ganged up on the way she was and being so unhappy and frightened in the hospital, and because she’d gone through it a few times in the last two years, weakened her to the point where she couldn’t fight me or anything anymore and just wanted to die. I don’t know. But I definitely think I did something very wrong. Weeks after Abby died, or months — I forget; could even have been a year, two — Marion so much as told me so. We were having drinks in the living room of my house. Marion, just tea. Her husband was there. Actually, we were sitting in the enclosed porch off the living room, it was the last time they came to the house, alone or together, though I’d invited them for drinks a couple of times after that, and I haven’t been to their house since Abby and I had dinner there a few months before she died. I’ve no idea why. Maybe some things I say depress them, and I cried the last time they were at my house and Marion then started crying too. Or being with me reminds them of Abby and that depresses them; at least it does Marion. I’d put out a plate of different cheeses and a bowl each of hummus I made and crackers and olives and a small dish for the pits. We talked mostly about Abby. How much we all miss her. She’s not someone you can ever forget, Marion said. The last book she translated that Patrick was reading and enjoying. “It feels like I’m reading the actual Russian,” he said. “I don’t know how she did it.” That I think of her many times a day and have a dream or two that she’s in almost every night. “Sometimes she loves me in them and says so. More times, though, she hates me or is very angry at me and won’t let me make up to her.” And those last fifteen to sixteen days. How it became, Marion said, more and more difficult for her to drop by for even a few minutes to look in on Abby and listen to her lungs and take her pulse, which she wanted to do daily. “It broke my heart to see her deteriorate so quickly once she went into a coma. Though I thank God she didn’t seem to be in any pain. So thank God, also, for morphine. But I want to tell you something, Philip. To get it off my chest, so to speak, or out of it, is more like it. Patrick knows what I’m about to say. I’ve prepared him. And I don’t want to make us feel any sadder than we already do about our Abby. But okay. I’m stalling, so here it is. I think we should have, that last time, since we knew her chances of surviving another round of pneumonia were rapidly decreasing with each hospital stay and that this one could easily be her last one and she’d never come home from it—”