by Deirdre Bair
Once again he was on the telephone, first to Aldo, until he realized how upsetting his unfocused ramblings were, then to Sandy Frazier in Montana. “Strange how the letters and telephone don’t mix,” he wrote. “Will I tell you the same things when I’ll talk to you? Will I worry?” Frazier was indeed worried, for Steinberg asked him to buy a gun, specifically a .38-caliber Smith & Wesson revolver that he was familiar with from his time in the navy. Frazier tried to talk him out of it: “I took it as something crazy and said no, I wouldn’t do it. All I could think of was that he would shoot himself in New York City with a gun that was registered to me in Montana. I told him I thought it was a crazy thing to do.” Steinberg accepted Frazier’s refusal and dismissed the subject by saying he wished he were Swiss, because all Swiss men had to serve in the army and “everybody there has a bazooka under the bed.” Next he asked Prudence to buy him a gun, and she too refused. Shortly after, he decided that as nothing else was working, he would have electroshock therapy.
STEINBERG WAS “TIRED OF WAITING FOR SANITY TO RETURN,” an expression he had used many years earlier when he made his return pilgrimage to Tortoreto in search of he knew not what. He knew he had to do something drastic, because panic and anxiety left him frightened to the point of paralysis most of the time, and depending on where he was, he was afraid to leave his house or apartment. When he could not avoid being with people, he had to make a superhuman effort to pretend that everything was normal, and when others treated him as if everything was as it always had been, he was both upset and amazed that no one could sense his despair or realize how troubled he was. His night fears were overwhelming, so he took Ambien to help him sleep. Sometimes it made him wake up happy, but the feeling never lasted for long.
By early December 1998 he feared that his depression was intractable and that he could do nothing to cure it, either alone or with the help of doctors and psychiatrists. Dr. Jerome Groopman had just become a staff writer on medical subjects for The New Yorker; he recommended that Steinberg consult his psychiatrist brother, Dr. Leonard Groopman, who was the first to suggest that Steinberg might benefit from electroshock therapy. When Arne Glimcher learned of Dr. Leonard Groopman’s suggestion, he referred Steinberg to the psychiatrist Dr. Frank Miller, who agreed that it could be beneficial and then became the doctor who authorized the treatment. At first Steinberg dismissed the idea out of hand, but eventually he decided that he had no other option.
Prudence was so alarmed when he told her that he would have the treatment that she went to a medical bookstore and bought and read the only book in stock on the subject. The book’s introduction gave the history of all the past horrors of shock treatment, but the text described the latest progress, explaining how treatments were much shorter and more controlled than they had been and were surprisingly effective for curing depression in older people. She was unexpectedly reassured by what she read and felt it made her better equipped at Steinberg’s next appointment with Dr. Miller, to be “a less naive advocate, since Saul wasn’t the type to do research or grill doctors.”
The original plan was for Steinberg to have ten or twelve treatments, and originally he did not want anyone but Prudence to know. He changed his mind and told Aldo in a telephone call, but instead of calling Hedda directly, he asked Prudence to go to her house and tell her in person that she was not to worry. His internist, Dr. Tepler, and the psychiatrist, Dr. Miller, both told Steinberg that he would suffer a cumulative loss of short-term memory but would regain it entirely within six to eight weeks. Originally he was to go to the Payne Whitney clinic’s psychiatric facility, perhaps as an outpatient, but someone, Prudence remembered, probably one of his doctors, thought he would need greater privacy to be amenable to the treatment and he was admitted to the Greenberg Pavilion at New York–Presbyterian Hospital.
He was treated every other day from December 16 to December 24, 1998, and was discharged for a short break on Christmas Day. He began a second round of treatments as an outpatient on December 31 but was rehospitalized for further treatments every other day from January 4 to January 13, 1999. He was discharged again on January 15, and by that time, as Prudence remembered, “he was getting a little scrambled (not unpleasantly so) and they didn’t want to push him into flat-out incoherence, is how I recall their putting it.” She also remembered that Steinberg was “never not himself,” and although he did not see anyone but her during the treatment, she did not think any of his close friends would have been able to tell that anything untoward had happened to him.
Prudence was waiting when he was brought back to his room after the first treatment. She was terrified to go in despite hearing from the nurse that he was fine, but the moment she saw him, she was astonished at the change in his expression. “I didn’t know then the term ‘mask of depression,’ but it was simply gone. He fell immediately into easy banter and said he had to call Hedda immediately. And I knew just from the tender way he drew out Hed-da-a-a, as if it were the first word he’d ever learned to say and was savoring the syllables, that she would be instantly reassured. She told me later—I’m sure I would have gone there afterward so we could kvell together—that she hadn’t heard his voice sound like that in ten years.”
Almost immediately he felt so much better that he was able to joke. He was allowed day passes, and just before Prudence collected him to go to lunch in a nearby Turkish restaurant that he liked because the cuisine reminded him of Romania, the nurse took his temperature with a sonar instrument. Prudence had never seen one before and asked what she was measuring; without missing a beat, Saul replied, “Ego.” He joked that even with no memory he could still make a bon mot. Dr. Torsten Wiesel came to visit, and the ever-courteous Saul said, “This is Prudence, and this is”—forgetting Torsten’s name—“Virtue.”
Prudence assumed that because Saul was never bedridden, he had been hospitalized both as a safety precaution because of his age and to make sure he stuck with the treatment long enough for it to be effective. He liked to go for walks around the neighborhood, noticing with pleasure that his physical vitality had returned. He looked at the street scenes with such expectation, as if he were plotting new pictures, and he was so joyful that it gave her joy to see him that way. As his treatments wound down and because it was January and bitterly cold and snowy, Dr. Miller thought it would be a good idea for him to go somewhere where he could move around easily and consolidate the psychic and physical gains he had made. Prudence was surprised when Saul said he wanted to go to St. Bart’s, for he had not been back there since the time Sigrid had had such a serious breakdown that she had to be airlifted back to New York under heavy sedation. She could only guess that he might be testing himself to see if he really had overcome the many emotions connected with Sigrid’s suicide, but he may also have chosen St. Bart’s because “it was warm, he knew the hotel and could predict the kind of anonymity he would enjoy. And maybe they’d been happy there the time before [her breakdown].” Just before they left, he wrote to Henri Cartier-Bresson, telling him that he thought he would never recover from Sigrid’s death but (without mentioning the electroshock treatments) that he was slowly and timidly coming back to life. As he reread what he had written to his old friend, he was convinced that the worst was over.
THEY LEFT FOR ST. BART’S ON MARCH 7, and Steinberg was happy to be back in the same hotel in the same rooms, sitting on the same balcony and looking out at the beach. He sent Sandy Frazier a postcard praising the weather’s “many degrees of perfection” and told him how much he was enjoying reading Lytton Strachey’s Elizabeth and Essex. He particularly relished that she was seventy and Essex thirty-four when she had him decapitated. He was also reading G. M. Trevelyan’s History of England, pleased with and sharing Trevelyan’s liberal political interpretations.
They were there a week when the effects of the electroshock therapy began to wear off. He began to make notations about himself in his datebook on the day they arrived, and on the day after, March 8, he wrote, “Lost memory of p
art of life made of quarrel [sic] tears, pacify, forgive, no speak. Then again offense, etc.” After that, his daily notations were about how his moods varied; how pleasure came from glancing through Prudence’s copy of Moby Dick and rereading Solzhenitsyn, taking long walks on the beach, and enjoying the local food, but how easily pleasure was replaced by concern. He was carefully calculating his worrisome weight loss in both pounds and kilos and calling Hedda every day, more because he needed her to reassure him that he would stay well than because he simply wanted to talk to her. At the end of March, he was back in New York and summed up the vacation as leaving him “tired and disappointed.”
As April began he made a careful note in his datebook about the times and quantities of the medications Ritalin, Dexedrine, and Adderall that he was supposed to take each day but did not. At the same time, Dr. Miller’s office was telephoning to implore him to schedule a follow‑up appointment and he was stalling. On April 11, Dr. Miller sent a letter urging him to come to the office for an evaluation: “It is my opinion based on twenty-seven years of work that you will relapse within the year if you do not have either outpatient ECT or attempt to reintroduce an antidepressant.” Dr. Miller put the risk of relapse within the year at 65 percent and within eighteen months at 85 percent, saying, “Obviously, this is a serious but avoidable prognosis. You may not appreciate fully the work and effort that went into your diagnosis and I don’t want it wasted.”
Still Steinberg did nothing. He blamed his increasing lethargy on his loss of appetite and the steady weight loss that resulted. During the last week of April 1999 he had lost so much weight that he consulted his internist, Dr. Tepler, who had him check into the hospital for several days of tests beginning on April 28. Prudence Crowther was at work on April 30, when Steinberg telephoned to say he was putting Dr. Tepler on the line. Dr. Tepler told her that Saul Steinberg had been diagnosed with pancreatic cancer and there was nothing to be done.
“And then I went to the hospital,” Prudence recalled. “I don’t know if Saul ever actually told anyone else, including Hedda.” Although there was the possibility that one of his doctors told Hedda at an appropriate moment that the disease was fatal, Prudence thought it more likely that “maybe we just figured she’d realize soon enough what was happening.”
CHAPTER 47
THE ANNUS MIRABILIS OF 1999
The annus mirabilis of 1999. The year of my death—I would guess, calmly.
While he was in the hospital, Steinberg signed a second advance health-care directive naming Prudence Crowther as the person authorized to make decisions about his care and treatment if he became unable to do so himself. Nothing was necessary, as he was in full cognizance, but she organized all the details of his release and contacted the people she thought should know that his pancreatic cancer was so advanced that he would go home to hospice care for what might be a matter of days, a week at the most. By the time he was back in his apartment, Aldo Buzzi and Sandy Frazier were on their way to New York to help Prudence through the final vigil, or, more accurately, to help Prudence help Saul and Hedda get through it.
Sandy slept at a friend’s apartment but spent long days at Saul’s, while Aldo stayed full-time. He arrived on May 6 and went directly up to Saul’s bedroom on the second floor of the apartment, leaving Prudence downstairs in the living area to hear something she had not heard for a very long time: Saul’s deep and resonant laughter, a laugh that surely only a friend of such long standing as Aldo could have elicited. Aldo worked hard to make their meeting a joyous reunion, and his effort set much of the tone for how the people who loved Saul would behave as his last days unfolded.
When it came to stoicism, Prudence believed that Aldo could have given Marcus Aurelius lessons. By his own choice, he slept on the living room sofa, rising early to make his bed and clear away the evidence of his habitation and get things ready for the friends who came throughout the day. The apartment was perfectly constructed to hold a vigil for the dying, as Saul’s bedroom was quiet, tranquil, and secluded on the upper floor, while his friends downstairs could cook, talk, laugh, and sometimes cry without disturbing him. There were often many people floating about in the kitchen and dining room, as each of Saul’s friends had an orbit of their own friends who wanted to make sure their needs were met while they ministered to his. Vita Peterson was there for Hedda, and among the others was an Italian-speaking friend of Prudence’s whom she invited to give Aldo a respite from having to speak English all the time. In an effort to instill levity into the sadness of what was essentially a death watch, Prudence and Aldo agreed that living in a duplex was the best way to ensure a good end.
For the several days before the hospice attendants began their daily visits, Prudence and Aldo took care of Saul, doing everything from helping him sit up in bed to escorting him to the bathroom. Saul was resigned to his end, medications kept him relatively comfortable, and he relaxed in Aldo’s care, reassured that Aldo knew what to do because he had had years of experience caring for his terminally ill mother.
On the afternoon of May 8, Prudence recorded in her datebook that the doctors had decided morphine was no longer necessary; she followed this with Aldo’s observation that Saul no longer felt pain but his despair had returned. She also recorded some of Saul’s remarks to her: “I’m dying, I can feel it—and of something so stupid. And I don’t know what I’m dying for.” Later that same day, he said, “I’m glad I don’t have parents.” And even later, when he was drifting in and out of sleep, he said something for which he seemed to want an answer: “a.m. Send everybody home.” Prudence asked what about Hedda—should she still be allowed to come every day, and if not, what should she tell her? Saul said, “Tell her to stay home.” Sometime later he said, “I want a Parisian doctor to tell me what I have.” When he had periods of delirium, he sometimes talked to Sandy in Italian, a language Sandy did not speak; to Hedda in Romanian; once or twice to Aldo, whose mother was German, in what might have been garbled German but was more probably Yiddish. At other times he spoke coherently in English to Prudence.
No one who observed them could forget how tenderly Aldo cared for his dearest friend, particularly Prudence, who thought Aldo may have been suffering greatly inside but admired the way he could still be witty for Saul and enchanting to others. Aldo’s demeanor helped to keep everyone on an even keel, and they were all grateful to him. During the week he was there, the only problem for Prudence and Sandy was the delicate one of how to ensure that Aldo and Hedda would be in each other’s company only briefly and in passing, for in all the years they had known each other, they had never forged a friendship of their own and maintained cordiality only out of consideration for Saul.
Aldo had to return to Italy on May 10, and in their last encounter, Saul bid his old friend addio, an expression he did not use with anyone else, in the most moving and meaningful way. After Aldo was gone, Sandy and Prudence set up a schedule of shifts to make sure that someone would always be with Saul and so that Hedda could be alone with him whenever she wanted. Hedda always went to her own house to sleep, but during the day she stayed close to Saul, either watching him from the staircase while he was being attended medically or sitting at his bedside. Despite the anti-anxiety medications he still took, Hedda was convinced that Saul’s sleep had been restless and fitful until Aldo was gone and she began to stay with him; as if sensing her presence, he slept quietly and deeply. But there was something puzzling about Hedda’s behavior, as she gave an impression of growing anxiety to the others. At first Sandy and Prudence thought it had to do with Aldo’s being there, but when her nervousness continued after he left, they were unsure about what to do until Vita Peterson told them why Hedda was so jittery and uncomfortable.
Saul had long before made Hedda promise that she would be holding his hands when he died, and Hedda had willingly agreed, but now the prospect terrified her, for several reasons: first because she was afraid that he would die at night when she was not there, and then because she feared she mig
ht break down in front of him and ruin his last moments of life. Her first fear was soothed soon after Saul was brought back to the apartment, when his doctors realized that the quick end they had envisioned was not going to happen as swiftly as they had predicted and that his death would probably happen in a matter of weeks instead of a few days. Although Prudence would have found a way to make private sleeping quarters for Hedda if she had wanted to move in, Hedda never asked, deciding on her own initiative to sleep at home and spend her waking hours at Saul’s. Vita Peterson was the devoted friend who usually accompanied Hedda back and forth, and after Hedda broke down and confided her fears, Vita thought Prudence and Sandy needed to know so they could try to resolve Hedda’s uneasiness. From then on, Prudence and Sandy worked out a sensitive and discreet collusion to ensure that someone would be downstairs and ready to run up to assist Hedda in any way she needed.
The last days unfolded with a certain structure imposed by the team of hospice personnel from Mount Sinai Hospital. Early each morning a nurse examined Saul and assessed his condition. Afterward, Prudence telephoned Hedda to give her the report and tell her to come whenever she wanted. Despite the inevitable recitations of daily decline, which were so sad for Hedda to hear, knowing how she would find him before she got there made it easier for her to assume the bedside vigils. She broke down only once, but gained control over herself and recovered quickly. It happened when Dr. Tepler came to examine Saul while Hedda waited outside on the staircase; when he was finished, he assured her that Saul was not suffering and that he would have all the medication he needed to relieve his pain. She accepted what he said and seemed fine until shortly after, when the retired Dr. Fisch arrived out of friendship to pay his final farewell, at which time she burst into tears. She was more difficult to comfort and calm that time, until Dr. Fisch told her to take one half of one of Saul’s anti-anxiety pills when she went home that night. She did, and slept for the first time in a very long time, and when she went back the next day there was a marked change in her ability to cope.