The Breaking Point: A Body Farm Novel

by Jefferson Bass

  “I’m not at all surprised by any of those things,” he said.

  “Why not?” I asked him. “What do they mean?”

  “The bloating is ascites,” he said. The word—it rhymed, in some slantwise, cruelly ironic way with the festive-sounding “invitees”—was familiar to me. A few years before, I’d witnessed a murder victim’s autopsy—an alcoholic who would have soon died of liver disease, if his son hadn’t crushed his skull with a cinder block first. That man’s belly had been grotesquely distended, as if he were eight months pregnant. “The peritoneal cavity—that’s the abdominal cavity, but you probably know that . . . ?”

  “I do,” I said.

  “In advanced leiomyosarcoma,” he resumed, “the peritoneal cavity fills with cancerous fluid.” I looked at Kathleen in alarm, but she was looking out the window, carefully avoiding eye contact with me. “Kathleen, you might want to consider having that drained,” Spitzer added. “It won’t change the course of your disease, but it might make you more comfortable.”

  “Would I have to be at Vanderbilt for that?”

  “Oh, certainly not,” he said. “It’s an outpatient procedure. You could have it done in Knoxville. Think about it, and let me know if you want a referral.”

  “I will,” she said. “Thank you.”

  “What about the shortness of breath, Dr. Spitzer?” I asked. “Is that also caused by the fluid? Pressure on the diaphragm or lungs?”

  “No, I’m afraid not,” he answered. “What it means is that the tumors in the lungs are blocking or crushing the bronchii. Closing off the airway. Kathleen, are you coughing up any blood?” I stared at her, horrified.

  “A little,” she said. “Is that going to get worse?”

  “It’s possible. You could start to hemorrhage,” he said. “Or you could throw a clot.”

  “Jesus,” I said. “What do we do, if one of those things happens?”

  “Frankly? Unfortunately, Dr. Brockton, there’s not much that can be done, if that happens. As I’m sure Kathleen has told you, her disease is quite advanced, and it’s not amenable to treatment.”

  I stared across the room at her, her face in profile and silhouetted against the window, and said, “How the hell did this get so far before we found it?” I wasn’t sure which of them I was asking—both, perhaps—and the question sounded almost like an accusation. But if either of them took offense, they did a good job of masking it.

  “Thing about the uterus,” said Spitzer, “is that you don’t need it to live.” I was puzzled by the statement. “It’s not essential to staying alive,” he explained. “Not like the heart or the brain or the lungs. The only time it’s essential is during pregnancy, right?”

  “Right,” I said, suddenly struck by how ironic it was that Kathleen’s uterus—the organ whose sole purpose was to nurture life—had become the agent and angel of her death. “But I’m not sure I’m following you.”

  “Well, because it’s not essential,” he went on, “it’s not immediately apparent when something’s going wrong. Women tend to overlook things like bloating or unusual bleeding. Some of that just goes with the territory.” After thirty years of Kathleen’s monthly cycles, I recognized the truth of that. “Even if the bloating is fairly severe,” he said, “they might think they’re just gaining weight. Also, uterine leiomyosarcoma is pretty rare. Some ob-gyns never see a single case. I’ve seen a lot, but that’s because patients get referred to me from all over the country.”

  “Dr. Spitzer,” I asked, “are you married?” For the first time, Kathleen turned toward me, looking startled and possibly angered by the question.

  “I am,” he said. “I’ve been married to a lovely woman for thirty-two years.”

  “If your wife got this diagnosis, what would you do? What kind of treatment would you want her to get?”

  He thought for a moment. “The best treatment I could give her,” he said. “I’d make sure she knew how much I loved her. I’d make the most of whatever time we had together. And I’d get ready to grieve like hell.”

  “YOU CAN’T JUST SIT AROUND AND WAIT FOR ME TO die,” Kathleen said finally. We were still sitting in the living room long after the call had ended. She had been looking out the window, into the fading light; I had been looking at her, watching as her features softened and grew less distinct in the gloom. “I need you not to hover,” she went on. “Hovering over me—tiptoeing around, watching me like a hawk for any little signs and symptoms? That would drive me crazy. It’d be the worst thing you could do for me.”

  The comment stung, and I started to object, but Kathleen knew me too well—it would be my way to hover. “Okay,” I said, “I’ll try not to.”

  “Thank you.”

  “It won’t be easy for me, Kath.”

  “It won’t be easy,” she agreed. “But it’ll be important.” After a moment, she added, “Don’t shut down after I’m gone. You’ll probably want to, but you can’t. Or shouldn’t, anyhow. And don’t pull away from Jeff and Jenny and the boys. You’ll need them.”

  “I need you,” I told her. “You’re the one I need.”

  “Well, we can’t help that,” she said. “You’ll need to keep busy, too.” I started to protest, but she held up a hand to keep me from interrupting. “Don’t get discouraged about these setbacks you’ve had lately. The politics. The grandstanding and game-playing. Stand up for yourself. Stand up for your work. Stand up for the Body Farm.”

  “They can have the damn Body Farm if they want it, Kathleen.”

  She shook her head. “You don’t mean that. You’d better not mean it. You’ve put too much into that place. And so have I.”

  I didn’t quite follow that last bit. “I’m not . . . How do you mean?”

  She turned, and even in the dim light, I could see the impatience in her eyes. “All those nights and weekends you spent working—at the Body Farm and in the morgue—instead of home with me? You think those didn’t cost me anything?” The words felt like a knife in my chest, but she waved her hand to shoo away my guilt. “I’m not trying to make you feel bad, honey. I know I wasn’t always gracious and generous about it, but I tried, because I knew it mattered so much to you. It must’ve mattered to me, too, or I wouldn’t have put up with it. So don’t you dare give up on it. If you do, I swear I’ll come back and haunt you.”

  She forced a smile, and I tried to laugh at the brave joke, but the laugh got tangled up somewhere between my heart and my throat.

  “One more thing, while we’re on the subject,” she said. “I see how miserable this Richard Janus thing has made you. You’ve had this cringing, hangdog look ever since the FBI and Fox News made it sound like you’d screwed up. Get over it, Bill. That, or get back into it.”

  “I can’t get back into it,” I said. “They’ve shut me out.” I held out my hands, palms up, and gave a shrug.

  “See?” The sharpness of her tone startled me. “That’s exactly what I’m talking about. What on earth has happened to your backbone?”

  In spite of myself—in spite of wanting to be so kind and loving that I could somehow magically keep Kathleen alive and well—I felt a flash of anger. “Gee, I don’t know,” I said. “Maybe I lost my backbone out there on that mountainside. Or maybe it’s tied to the whipping post.”

  “Well, untie it, then,” she snapped. “Or go find it. Or grow another one, if you have to. ’Cause being without it sure doesn’t become you. I’m the one who’s dying, Bill. Quit acting like it’s you that’s nailed to the cross.” I drew back, stunned, but then she reached over and squeezed my hand. “You’ve always made me so proud, Bill. Don’t stop now. Don’t stop when I’m gone. That would just make it sadder, don’t you see?”

  We sat a while longer; by now the room was growing dark around us, but something had shifted—eased, at least for a moment—and we sat in a sort of companionable isolation, each absorbed in our own thoughts and feelings.

  When the streetlights outside came on, Kathleen leaned over to the
end table between us, took a box of matches from the drawer, and lit the thick white candle—her wine-drinking candle, she sometimes called it. “One more thing,” she said. I braced myself for more scolding, but she smiled, her face glowing in the warm light of the flame. “I wouldn’t consider it hovering if you brought me a glass of wine.”

  IT WASN’T EASY, TAKING MY MIND OFF KATHLEEN and refocusing it on my work. But she was right, and I owed it to her—and to my own sanity—to try.

  I’d been taken off the Janus case by Prescott, cut off from everyone in the FBI’s San Diego field office. It was possible, though, that Mac McCready would still talk to me. I dialed his Quantico number, and he answered on the third ring. “McCready here.”

  “Mac, it’s Bill Brockton, in Knoxville. Are you still speaking to me, or is the entire Bureau shunning me?”

  “Still speaking, but I’m not sure I’m much of an asset to you. I’m not exactly the golden boy around here, either. Prescott’s pretty pissed at me, too. Hard to blame him—he’s been getting chewed up pretty bad himself, by big dogs with sharp teeth.”

  I hadn’t taken time to consider the awkwardness of Prescott’s position—he was, after all, the public face of the troubled case—but whatever compassion I felt for him was offset by my slight resentment of the time pressure he’d applied . . . and by the powerful sting of feeling like the scapegoat. “Not fun for any of us,” was the best I could muster. “Listen, Mac, I’m still trying to figure out who told Prescott about the teeth. Do you know?”

  “It was that reporter. Malloy. Guy’s a prick, but you gotta hand it to him—he was a giant step ahead of us.”

  “But how’d he get there, Mac? Who told Malloy the teeth had been pulled? Who knew? I sure didn’t. Not till I cleaned ’em off the other day—after Prescott called to fire me.”

  “Had to’ve been somebody who was in on it,” McCready mused. “Maybe it was the guy with the pliers. Hell, maybe it was Janus himself.”

  “Why? Why would whoever faked the death—Janus or his DIY dentist—put a bug in a reporter’s ear?”

  “Good question, Doc. Figure that one out, and you’re nearly there.”

  “You think Janus wanted to embarrass the Bureau?” As soon as I said it, I decided it was highly unlikely, given that the Bureau wouldn’t just be embarrassed; the Bureau would be gunning for vengeance. “Nah, not that,” I said. “Janus would know that the FBI would move heaven and earth to catch him if he’s humiliated y’all. Maybe he promised the dental assistant a big payoff, but stiffed the guy instead.”

  “That could work,” he agreed. “Listen, I gotta go—I’m teaching a fresh batch of recruits at the Academy about one of your favorite topics today: bugs. ‘Trust the bugs,’ right? Keep the faith, Doc. It’ll get better.”

  As I hung up, I couldn’t help wondering, Will it? How? And when?

  AMONG THE MANY MEAN SURPRISES THAT ACCOMPANIED the Ultimate Mean Surprise—Kathleen’s death-sentence surprise—was the secretarial surprise: the mountain of insurance forms, financial forms, legal forms, and other forms of forms to be scaled. In a perverse corner of my mind, I imagined the grim reaper, twenty-first-century style, no longer mowing down mortals with a scythe, but simply burying them alive beneath truckloads of paper.

  In the seven days since our telephone conference with Dr. Spitzer, Kathleen and I had come to an unspoken agreement, an uneasy détente. We distracted ourselves from the bigger issues of mortality and grief by focusing on what we began calling “the business of death and dying.” We dealt with the business—the bureaucracy—at the kitchen table, sorting papers into stacks and categories that sometimes covered every square inch, despite the fact that we’d added a leaf to the table. There was a certain amount of apt irony, Kathleen noted early on, in dealing with death at the kitchen table, where she had almost perished at the hands of Nick Satterfield years before. “Not with a bang, and not with a whimper,” she’d joked, “but with a notarized signature in triplicate.” At moments like that—moments of understated heroism—I admired the hell out of her and wondered how on earth I’d be able to bear losing her.

  I was doing a surprisingly good job of not falling apart—even Kathleen commented on it—until she slid me an official-looking form headed with the logo of the Tennessee Department of Health and Environment. “What’s this?” I asked.

  “An advance directive. It’s the state’s new version of a living will.” I felt a jolt of fear shoot through me as I scanned down the page. Near the top, directly beneath her own name, Kathleen had designated me as her “Agent”—the person authorized to make health-care decisions for her—but in a series of boxes beneath my name, she had systematically tied my hands, checking the “No” box beside every possible treatment option: No cardiopulmonary resuscitation. No defibrillation. No life support. No surgery, antibiotics, or transfusions. No tube feeding or IV fluids.

  I stared at the form—its grim specifics, the litany of life-extending options she was refusing—and then looked up. She was watching me closely; it was all I could do to meet her gaze. “Looks like you’ve got your mind made up,” I said, trying to keep the pain—sadness and also self-pity—out of my voice. “Nothing here for me to do.”

  “Yes, there is,” she said. “You make damn sure they abide by this. I’ve heard of too many cases where hospitals ignored these things—jump-starting people’s hearts, putting people on respirators or feeding tubes—even when the patients had living wills on file. If anything like that starts to happen, you fight tooth and nail to stop it, you hear me?” I nodded. “I need you to say it. Out loud. Promise me you won’t let them keep me alive.”

  I felt tears running down my cheeks. “God, Kathleen.”

  “Promise me.” Her voice was like steel.

  “All right, dammit. I promise.” It was all I could do to choke out the words.

  “Thank you.” She pulled a handful of paper napkins from the holder and passed them across to me.

  I wiped my eyes and blew my nose, with a wet, honking blast.

  “Nice,” she said. “It’s your table manners I’ll miss most in the afterlife.”

  “Something to look forward to, while you’re waiting for me.” I gave another Gabriel-worthy trumpet blast, then flipped to the form’s second page. “So I just sign down here, as a witness?”

  She shook her head. “You can’t.” She reached across and pointed at a block of fine print that excluded relatives, by blood or marriage, as witnesses. “I guess the powers that be want to make sure you’re not trying to get rid of me.”

  “Good for them,” I said. I glanced up at the organ-donation section of the form and saw that she had specified only her corneas. I glanced up at her.

  “My organs can’t be used,” she said. “They might give cancer to somebody else. The corneas are safe, though.”

  I nodded. “Well, I know that’s important. Be a shame if you couldn’t donate those, after all your work to help people’s vision.”

  “I’m glad you brought that up,” she said. “I want to do more, if you’re willing.”

  “Like what?”

  “Well, it looks like we’re in pretty good financial shape, right?”

  “I wouldn’t exactly call us rich, but yeah, looks like we’re not in any danger of going belly-up. Especially since you’re refusing expensive treatments like Band-Aids and aspirin.”

  “Don’t be a smart-ass,” she said, but I caught a twinkle in her eye, and I managed a half smile. “That life-insurance policy we took out on me years ago, when Jeff was a baby?”

  “Yeah?”

  “Well, he’s still listed as the beneficiary,” she went on. “Seems like he doesn’t need it now. His accounting practice is growing like crazy.”

  “You want to change it so the boys are the beneficiaries? Set up college funds for them?”

  “I want them to get half of it,” she said. “Twenty-five thousand apiece. Enough to help, but not enough to make them lazy.”

  “Seems
Solomonic of you,” I said. “What about the rest?”

  “I want to give it away, Bill. To charity. Do a little good on my way out.” She reached across and took my hand. “I want to give twenty-five thousand to my foundation, to hire a part-time director and fund-raiser. So Food for Sight can keep going—and start growing—instead of just limping along, or dying with me.”

  Her generosity touched me; her foresight astonished me. I rubbed my thumb across the back of her hand. “Do you have any idea how much I admire you?”

  “You’ve mentioned it once or twice.” She gave my hand another squeeze.

  “That leaves another twenty-five thousand,” I said. “Who’s that for? UT?” She shook her head, so I guessed again, mentally reviewing her list of favorite causes. “League of Women Voters?” Another head shake. “Doctors Without Borders?”

  “No. Airlift Relief International.”

  I blinked. “Airlift Relief? Janus’s thing?”

  “Yes.”

  “But . . .”

  “But what, Bill?”

  “Well, for starters, he’s dead.”

  “So? I hope people keep giving to my ‘thing’ after I’m dead.”

  “But you’re not a drug trafficker, Kathleen.”

  “Neither was he. I don’t believe it, Bill. I think he was set up.”

  “You think he was framed? By the FBI? Come on, Kathleen.”

  “Maybe not the FBI. Maybe somebody else—some other agency, or the real drug traffickers. I don’t know who. But I do know that a lot of poor people in Central and South America will die in disasters if people don’t step up and keep that outfit going.”

  “I think we need to think about this some more,” I said.