Kristopher Jansma - Why We Came to the City

The next day Sara had come to William’s door with suitcases in hand. “You can go live with George if you want,” she had told him, “but either way I’m staying here.” William had not argued, smart boy, and within minutes had set up an air mattress for her in the dining nook. Sara had three weeks of unused vacation time saved up. She promised Luther that she’d edit five stories a day from home and answer the forwarded calls when the new intern was out or in meetings. She canceled appointments with caterers and bands and florists. She and George still hadn’t picked a place, much less set a date. The apartment search was likewise forgotten. But none of that mattered now. She’d stay through Christmas if she had to, no matter how much Irene hated it, filling IV bags with the Assure she’d come to Duane Reade to buy.

She scoured the shelves, looking for Double Boost, which was always in short supply, since one Double gave you twice as many vitamins and minerals as a Regular. Why did they even make the regular? Who’d rather drink two of these instead of one?

The last set of scans had come back during the second hospital stay. The tumors still weren’t shrinking. They weren’t growing either, but they soon would be, now that the chemo and radiation treatments had ended. And the doctors couldn’t just keep stepping up the treatments forever. It was time to try something experimental, like drug trials. Sara tried not to think about the estimated odds of success.

22 percent

16 percent

9.2 percent

Irene was like a child. She took every opportunity to stall in taking her medications — pretending to nap or to be busy in the bathroom. Saying, “Let’s do it in a few minutes,” when a few minutes rapidly became an hour, or two, even when these things had to be done strictly according to the color-coded Excel spreadsheet schedule that Sara had taped up in every room of the apartment.

The Prednicen-M had to be taken four times a day with an Assure. Irene had to apply a 1 percent hydrocortisone cream three times a day to the rash that was being caused by her denosumab injections. Actually, Sara had to apply the cream, because there were some spots on her middle back that Irene couldn’t quite reach. Then every morning, thirty minutes before her first meal, Irene had to have one Fosimax pill with water, after which she had to stand upright for thirty minutes to prevent heartburn. For the canker sores, Irene had to rinse with a mouthwash of milk of magnesia and Benadryl liquid five times per day, and it had to be mixed fresh each time. Four times a day she had to take amphotericin B, for thrush. Zofran as needed for nausea; Vicoprofen as needed for pain.

Because it was hard for Irene to swallow, Sara had been quartering these pills every day, then grinding the pieces up with a mortar and pestle like some sort of apothecary. After a week of this, Sara had deep-red calluses all over her palm, so George went back to Sur la Table and bought a battery-powered spice mill that worked much better.

The milkshakes had to be poured into the IV bags, which could then be hung from the standing lamp by the couch, the cabinet knobs in the kitchen, the shower rod in the bathroom, and the coat hook in the bedroom. Jacob had affixed a 3M Command utensil hook behind every chair in every room that Irene might conceivably use. The hospital had given them only two IV bags, and these had to be washed after each use or the chalky residue clogged the opening.

William was there most of the time, but he was hopelessly disappointing at these tasks. George and Jacob came by nearly every day to help out for a few hours, and this gave Sara some time to do her editing and to sleep and to take anxious walks around Madison Square Park — but there were things the boys truly couldn’t do: Irene’s urine output had to be measured, so Dr. Zarrani could be sure that she was retaining enough fluids. This involved Irene putting a plastic measuring device on the toilet seat (which she forgot if Sara didn’t remind her), peeing into it, and then calling the results out to Sara, who was keeping a record down to the milliliter. There were programmed cell phone alerts. There were laminated lists of hospital phone numbers for each of them to keep in their wallets in case there were questions. And still it felt like they were losing this fight.

Poor George had been on duty when Irene began having horrible cramps and had made a complete hash of everything while he tried to help without waking up Sara. Very sweet, but it meant three hours of agony for Irene while George tried to follow Internet instructions for a lower back massage that would ease her cramps. When Sara finally woke up, it had taken her ten minutes to get on the horn to three different people, who eventually concluded that, because of her all-liquid diet, Irene needed to have some senna tea twice a day to make sure she also had a regular bowel movement. That was another thing to log and another thing the boys didn’t keep track of, along with cleaning the area around the PEG tube carefully with antibiotics and dealing with the mess that resulted that time when the cap came off Irene’s tube in her sleep and the contents of her stomach dribbled out all over the couch.

“Why isn’t she fighting this?” Sara had cried to Dr. Zarrani.

“She may be very depressed,” Dr. Zarrani had said. “But she wants to get better.”

Sara wasn’t convinced. Irene seemed pissed off, not depressed.

“This is so goddamn demoralizing!” Irene shouted at least once a day, as if it were all Sara’s fault. She was cranky not to have time to get to the studio anymore. She sketched in bed and on the couch while they watched endless reruns of ¡Vámonos, Muchachos! , but half the time she fell asleep after drawing just a few lines. Then she’d wake up in an even fouler mood, as if she’d just been cheated out of valuable time.

“This is fucking torture!” she screamed, throwing her charcoals across the room.

Sara wanted to tell her that she’d get on the phone to the UN right away. File briefs under the Geneva Conventions. She’d throw one in for herself while she was at it. Because it was torture for Sara to see her best friend in this state. Torture to be barely sleeping, to be missing work, to hardly ever sleep in the same bed as George or have a meal that wasn’t takeout. Her only social interactions, besides complaining to the boys and yelling at her interns over the phone, were during the brief times she walked to Duane Reade.

Lately she’d begun lingering, just to have the breathing room.

Sara stared at the cardboard sleeve that held the six individual Assure bottles together. It had a nice picture of an elderly woman on it, looking full of life and ready for a hot night down at the Old Folks’ Home Ballroom, doing the Buffalo Shuffle with a nice half-blind Vietnam War veteran with some Viagra squirreled away among the cataract medications on the nightstand. Sara pushed pack after pack to the side, looking for the Double Boost, muttering to herself, Good for you, Grandma. Go down swinging. Young at heart. Golden years and all that jazz. But if you could just leave a little Double Boost for my friend here, who is young at heart and young at body, still quite squarely in her Regular years, that’d be swell.

At the pharmacy window, there was just one man in line, an older man wearing a ridiculous green spandex unitard, propping up a bicycle. Magnanimously, he gestured for Sara to go ahead of him to the counter — the pharmacist was somewhere in the back.

“She’s getting my things already,” he explained, as Sara thanked him. Setting her heavy bag down on the counter, she checked her wristwatch. Good. She would make it back by four-thirty.

“Aren’t you a little young for those things?” the man said, gesturing to the Assures. Sara looked down at Grandma Golden Years, then back up at him. He looked a little as if he’d rolled right out of an Assure commercial: Senior citizens, on the go!