From Here to Home

by Marie Bostwick

  There was a knock on the door and Cady’s voice said, “Aunt Mary Dell? Are you in there? It’s time for the cake.”

  “Be right there, baby girl!”

  The pastry chef, Vivian, had outdone herself, baking two beautifully decorated triple-layer cakes; chocolate with hazelnut filling for Rob Lee and lemon with raspberry filling for Howard. Waiters wheeled both cakes, topped with thirty blazing candles, out onto the roof deck and placed them in front of the guests of honor while everyone sang “Happy Birthday.”

  At the end of the song, everybody clapped, and Mary Dell, who was standing off to one side with Hub-Jay’s arm around her waist, called out, “Make a wish, boys!”

  Rob Lee glanced quickly to his left, where Holly was standing, grinned, and blew out the blaze in one big breath. Howard took a breath at the same time but managed to blow out only a third of his candles. Mary Dell, still smiling but concerned, moved to his side.

  “Here, baby. You want some help? Let’s do it together.” On a count of three, mother and son took in a big breath and, together, extinguished the remaining candles.

  Ten seconds after that, while the guests were still applauding, Howard’s eyes rolled to the back of his head and he passed out cold.

  CHAPTER 37

  After he’d regained consciousness, which occurred even before the ambulance arrived, Howard seemed more or less back to normal. He complained of fatigue and a headache but didn’t seem to be in any significant pain. Even so, Mary Dell was happy when the emergency room doctor decided to admit him for observation and testing.

  Three days in, however, Howard was irritated that he was missing class and Mary Dell was anxious for answers. Dr. Ted Brewer, the hospital nephrologist, a middle-aged man of middling height with heavy black eyebrows and a serious demeanor, came into Howard’s room late on Tuesday to introduce himself and give them a surprising diagnosis—Howard was in end-stage renal failure.

  That word, “end-stage,” struck fear into Mary Dell’s heart, but she held her emotions in check. She had to, for Howard’s sake.

  “Don’t worry. Howard is in no immediate danger, but he is suffering from autosomal dominant polycystic kidney disease,” the doctor said by way of explanation, even though the string of multisyllabic words meant nothing to Howard or Mary Dell. “Basically, it’s an inherited type of kidney disease.”

  “Inherited?” Mary Dell frowned. “From who?”

  “Either you or your husband.”

  “It can’t be me. I feel fine.”

  “A person can be a carrier, or even have a mild form of the disease, without ever displaying any significant symptoms. We’ll want to schedule you and your husband for testing as soon as possible.”

  “My dad left when I was a baby,” Howard said matter-of-factly from his hospital bed. “We don’t know where he is.”

  “All right. Then we’ll start with you, Mrs. Templeton. If your results don’t show ADPKD—that’s the shorthand term for this type of kidney disease—then we’ll know that Howard’s father was the carrier.”

  Mary Dell screwed her eyes shut and lifted her hand, feeling overwhelmed and wanting to get back to what really mattered.

  “What does this mean for Howard? Are there medications or treatments that can help him?”

  “In the earlier stages of the disease, yes. But ADPKD can be very hard to detect early in its progression. Many patients, like Howard, don’t display any significant symptoms until reaching a fairly advanced stage. The good news is that, aside from a slightly elevated blood pressure, which we’re going to treat with diet and medication, Howard is in fairly good health. His heart looks fine. The bad news is that Howard’s kidney function is at twenty-seven percent and it will continue to decrease. When it falls below twenty percent, he’ll have to go on dialysis.”

  “What’s dialysis?” Howard asked, repeating the word slowly.

  Dr. Brewer looked at Mary Dell and lifted his brows, as if asking for her permission or guidance on how to proceed.

  “Howard’s an adult,” she said, slightly irritated that she even had to point this out. “He has a right to understand what is happening to his own body.”

  The doctor nodded and, in relatively uncomplicated language, went on to explain what dialysis was, how it was necessary to clean waste and impurities from the blood that Howard’s kidneys were no longer able to filter, that Howard would have to go for dialysis treatment three times a week, for three to four hours each time, and that, given his age and general state of health, there was every reason to think he could continue to live a long time on dialysis.

  “These days, with the advances in technology, it isn’t uncommon for people to survive twenty or thirty years on dialysis.”

  Howard’s eyes went wide. “Thirty years! I just started college. Someday, I’m going to have my own fabric company. I don’t have time to go to the doctor three times a week forever. I already missed my art class this week. That was bad enough!”

  The doctor smiled sympathetically. “I understand your feelings, Howard. You’re not at the point of needing dialysis yet, and it could be a long time before that happens. But when we get to that point, it will likely be the only means we have of keeping you alive.”

  Howard went a bit white and Mary Dell grabbed his hand.

  “I assure you,” the doctor went on, “people can live long and productive lives while on dialysis. We can try to schedule your dialysis sessions around your other activities. In certain situations, dialysis can even be performed in the home. After some intensive training, your mother could learn to—”

  “I don’t live with my mother,” Howard said, his voice uncharacteristically testy. “I have my own apartment. I like it and that’s where I want to stay.”

  “Ah. I see.” Dr. Brewer shrugged helplessly and looked at Mary Dell. “As I said, we’ll do our best to work the appointments around Howard’s schedule.”

  “What about a transplant?” Mary Dell asked.

  “Yes,” the doctor said slowly, in a way that made Mary Dell think he was somewhat reluctant to answer. “That is sometimes an option. But there are a number of factors that we have to take into consideration before we decide if a person would be a good candidate for a kidney transplant—age, general health . . .”

  “Howard is young, and you already said that his health was good.”

  Dr. Brewer nodded empathetically and, once again, answered slowly. “That’s true. But we would also need to take into consideration the patient’s ability to follow through with the required medical protocols. Transplant patients have to follow very strict dietary and lifestyle guidelines—no soft cheeses or deli meats, no sushi, no eating at buffets or salad bars, fresh vegetables must either be avoided or carefully washed, no use of hot tubs or steam rooms. That’s just a partial list. The biggest issues post-transplant would center on medications. Patients take a variety of medications, upward of a dozen pills per day at twice-daily intervals. Forgetting to take those medications can put the transplanted kidney at serious risk of rejection.”

  The doctor was quiet. Mary Dell sat there for a moment, waiting for him to go on.

  When he didn’t, she said, “So are you trying to say that someone with Down syndrome isn’t capable of following the doctor’s orders or taking medication on time?”

  “I am saying,” he replied in a measured and careful manner, “that kidney transplants are expensive and complicated and that to be a good candidate for a transplant, we would need to be certain that the patient had the intellectual and emotional capacity to follow all the protocols.”

  “I see.” Mary Dell set her lips, her gaze all but boring a hole through the good doctor, before turning toward Howard, who was observing this exchange from his hospital bed.

  “Howard, explain to Dr. Brewer what your schedule is like.”

  “On what day? My art class is on Monday, Wednesday, and Friday. But I go to my old program at the Down syndrome center on Tuesday and Thursday. And on Sunday I go to chu
rch and volunteer in the nursery during Sunday school. But on Saturday I just hang out with my friends.”

  “Oh, you don’t need to explain all of them,” she replied. “How about just the days you go to college?”

  Howard complied, explaining his routine for rising at six-thirty, cooking breakfast, cleaning his apartment, and doing a load of laundry before catching the bus, which involved one transfer, to get to the campus of his community college, then taking his class, perhaps spending time in the art studio or meeting with his adviser before making the return trip, stopping at the transfer point, which was close to a shopping center, to buy any groceries or anything else he needed, before heading home for the evening, eating dinner with the Morris family, and then either watching television, talking with his mother on the telephone, spending time with his girlfriend, or working on a sewing project.

  “Thank you, baby. Now tell Dr. Brewer all about your plans for your fabric company,” she said, sounding more than a little smug, “and your pillow business.”

  “The pillows are just kind of a hobby,” Howard said, then launched into a description of where he liked to buy his fabric, how much he needed for each pillow, and what fabrics worked best.

  That was as far as he got before Dr. Brewer, who had been listening carefully, smiled and lifted a hand. “Thanks, Howard. I get the general idea.”

  He turned to Mary Dell. “Your point is well taken, Mrs. Templeton. Howard is obviously a high-functioning and capable young man. If you could arrange to be in the area on a regular basis during the early phase, just in the first few months of recovery, and to be sure that the medication routines were well established, I’d have no problem recommending Howard as a transplant candidate.”

  “Thank you,” Mary Dell said, her words clipped but her expression pleased.

  “Even so, I have to point out that the waiting list for donor kidneys is years long and that patients whose lives are in immediate danger have highest priority. Any way you look at it, Howard will probably have to go on dialysis for some length of time before he would be eligible to receive a donor kidney.”

  “He can have one of mine,” Mary Dell said without a moment of hesitation. “A person only needs one kidney to live; isn’t that right?”

  “Yes,” the doctor confirmed. “But your kidney would have to be a good match for Howard’s, and while close relatives are usually the best candidates—for example, a parent has a fifty percent chance of being a good match—in your case, Mrs. Templeton, we’d have to rule out any possibility of kidney disease in your own body before considering you as a potential live donor.”

  “Fine. Let’s do it.”

  “All right. I’ll order the tests tonight and we can start in the morning. We’ll need blood work, urinalysis, and a CAT scan to begin with. If those are clear and there’s no sign of ADPKD, I’ll order more tests to see if your kidney is a good match.”

  “Thank you, Dr. Brewer.”

  The doctor rose from his chair, said he’d see them both the next day, and headed off to check on his other patients.

  “Oh, Howard,” he said, pausing at the door. “Those pillows you make. Do you think I could order two for my wife? Her birthday is coming up.”

  “Well,” Howard said seriously, “I can’t until you let me out of the hospital, and I do have another order ahead of yours. Would the middle of March be soon enough?”

  “Perfect. I’ll ask Karen what colors she likes and tell you tomorrow.”

  The deal having been made, Dr. Brewer said farewell again and left the room. Mary Dell got up from her seat to rearrange the blankets on Howard’s bed.

  “I’m okay, Momma. I’m not cold.”

  “I know,” she said. “But it gives me something to do. Makes me feel needed.”

  Howard reached for her hand. “I always need you, Momma. You know that. But are you really sure you want to give me your kidney?”

  “Baby, I’d not only give you my kidney, I’d give you my heart.” She smiled. “That is, if you didn’t already have it.”

  She squeezed his hand. Howard frowned curiously, then twisted her right hand so it was facing palm up. His eyes bulged wide.

  “Momma! Where’d you get that diamond? It’s humongous!”

  Mary Dell blushed, took the ring from her finger, and slipped it into her pocket.

  “It’s not important,” she said, and tucked in his sheet. “The only thing that matters to me right now is helping you get better.”

  CHAPTER 38

  Rachel sat drinking unsweetened iced tea at an aged and slightly gouged wooden table that Holly, trying to keep herself busy in Mary Dell’s absence, had sanded and painted a light aqua color earlier in the week.

  “So you don’t know when she’ll be back?” Rachel asked. “Or if she’ll be back?”

  “Not exactly. But Howard is out of the hospital now. I’m sure she’ll be back as soon as she can.”

  “Yeah, but how many weeks are you behind with filming—two? Maybe they need to look for a replacement. Or,” Rachel said in a considering tone, before taking another sip of tea, “maybe they should just let you take over the whole thing.”

  Holly barked out a laugh at the very idea.

  “First off, nobody can replace Mary Dell. She’s one of a kind—a complete original. Second, even if there was somebody who could step into her shoes, it’s definitely not me. I don’t suck at quilting anymore. In fact I’m actually starting to enjoy it. But that doesn’t mean I’m ready to carry the whole show on my own. Mary Dell will be back as soon as she can. We’ve got plenty of time to catch up on filming.”

  Rachel opened her mouth to speak and Holly held her hand out, traffic-cop flat, in front of her mother’s face.

  “No. Don’t even start.”

  Rachel shrugged. “Fine. Guess I’m not exactly in a position to offer career advice.”

  Holly, who was standing at the kitchen counter, making their lunch, dipped her head, feeling guilty for being hard on her mother. Rachel had had a rotten year, as rough as any in her career, which was saying a lot.

  The tabloid furor over Rachel’s “nosedive” had died down considerably in recent days. Maureen Gilronan, an actress whose star had reached its zenith in the early 1960s and who was penniless after years without work and because of exploitation at the hands of unscrupulous managers, had been found dead in her small apartment in one of Hollywood’s more unsavory neighborhoods. Now the tabloid and entertainment news was all Maureen Gilronan, all the time. No detail of the woman’s private life was too ghoulish to be shared, including the fact that her refrigerator was empty of all food, aside from a jar of expired pimentos, that she had supposedly been found lying next to an open scrapbook of her old press clippings, and that no one had seen her for more than a week before thinking of knocking on the door to see if she was okay.

  The coverage was macabre and revolting and sad, but Holly couldn’t pretend she wasn’t relieved that the stories about Rachel, though they hadn’t disappeared completely, had migrated to the back pages.

  Holly finished slicing a ripe nectarine and tossed it into the salad bowl together with some spring greens, goat cheese, and slivered almonds.

  “Now that the cruise gig is done, are you going to start looking for a new agent?” Holly was working hard to sound more nonchalant than she felt. She knew that Rachel’s finances were a mess and that, so far at least, no one had made an offer on her condo. “You know, if you need some money, I’ve got—”

  Rachel’s laugh stopped her from finishing the sentence.

  “Oh, honey. You’re sweet, but don’t think of lending me money, seriously. History has proven that I am a very bad investment indeed. You’ve always been so good with the financial stuff, never lived beyond your means, putting part of every paycheck into savings. In other words, doing exactly the opposite of everything I ever did. Can’t imagine where you got it from; your dad wasn’t any better at handling money than me.”

  Holly didn’t point out t
hat the reason she was so careful about money was precisely because Rachel wasn’t and that this particular quality, along with a few others, came as a result not of following her mother’s example but of looking at Rachel’s life and figuring out exactly what she didn’t want to be when she grew up. Still, Rachel had done the best she knew how. She wasn’t a conventional mother, but she was a good one, and without her, Holly wouldn’t be who she was.

  “I appreciate your concern, honey. But, seriously, save your money. Besides,” Rachel said, getting to her feet and pulling two plates out of Holly’s cupboard, “things are looking up. I’ve got a new gig starting next week. That’s why I have to leave in the morning.”

  “Really? Where? Doing what?” Holly was smiling as she gave the white balsamic vinegar and oil dressing another quick whisk and poured it over the salad.

  “You won’t believe it.” Rachel chuckled. “It’s actually kind of embarrassing. But, hey, a girl has to work, right? I called up Mikey.”

  “Mikey Grainger? That Mikey?” Holly’s brows shot up; she really didn’t believe it. For years now, she’d heard the story of how her ex-stepfather, Mikey, had “insulted” Rachel by booking her into the casino lounge instead of the big room.

  “That Mikey,” Rachel confirmed. “Honestly, I wasn’t sure he’d take my call. But he did and signed me to a three-month contract. And, before you even ask—yes, I’ll be performing in the lounge.”

  “Oh. That’s really . . .”

  Holly wanted to say that it was great, but, given Rachel’s history with Mikey, she wasn’t sure if this was the correct response.

  “It’s a good thing,” Rachel said as Holly placed a generous serving of salad onto each plate. “I’ll have a very nice suite in the hotel, seven hundred square feet, which sounds like the Taj Mahal after living in that closet of a stateroom they gave me on the boat. The money is better than the boat too. I’ll be able to pay my bills, as well as some of the money I owe the IRS.”