by Utt, Kelly
I wonder if John Wendell arrived by ambulance. And I wonder if it will have been his last ride. Or his last time feeling the crisp, New York winter air on his face. He always loved the winter. I remember the January during my senior year in high school when it snowed so much the city came to a standstill. John Wendell didn’t mind. He and Grandma still lived out on Ellis Hollow Road then, but when the snow started coming down they drove to our house to spend the night so John Wendell could get out on the sidewalks and walk around downtown the next morning. He was in his seventies at the time, but fit as a fiddle. He went up and down the block shoveling walkways and digging out vehicles alongside people half his age.
“Looks like your mom’s car is parked right over there,” Liam says, pointing to a nearby corner of the parking lot. “John Wendell rode in an ambulance and she drove herself over. I wish she would have called me before she got in the car. I would have driven her. I intend to be here for her as she moves through this. Alec would have wanted it that way.”
“It’s not your responsibility though,” I mumble.
“Yeah, well, what kind of man would I be if I didn’t take care of my brother’s wife in her time of need?” Liam replies. “He’d be here to do it himself if he could. It’s only right that I fill in. I know he’d do the same for me if the roles were reversed.”
“You’re a good brother,” I say. “I hope my boys grow up to be half as good to each other as you and Dad were.”
“They’ll be better, George. They’re growing up with the best family any kids could ask for. Those boys are going to make you prouder than you ever dreamed possible. Just wait and see,” Liam says.
“That’s what I’m hoping for,” I say. “I wish John Wendell…” My voice trails off and I can’t finish my sentence.
“I know, George,” my uncle says, reaching over and wrapping an arm tightly around my shoulders as we walk towards the entrance.
No one likes hospitals. They’re filled with scared people who are having some of the worst days of their lives. Not to mention that the buildings always smell funny. Disinfectant, disease, burning flesh, and God knows what else make for an assault on the olfactory organs. The scent of the hand soap alone has been seared into my memory and won’t let go.
“Did anyone call Ali?” I ask.
“I don’t think so, unless your Mom called her after she talked to me.”
“Okay,” I reply. “She won’t be expecting us home for a while anyway, but I want to call her as soon as we see John Wendell and get a report from the doctor who is treating him. I hope Dr. Madera can be here since she knows his medical history and he’s comfortable with her.”
“Does Dr. Madera have hospital privileges?” Liam asks.
“I’m sure she does. She makes house calls from time to time, so I imagine she sees her patients all the way through.”
“These days, a lot of hospitals utilize staff physicians to treat a patient while they’re in the hospital so the primary care doctor doesn’t have to. I believe they’re called hospitalists. I can see how that makes sense from the administration’s point of view, too,” Liam explains.
“Yeah, well, call me old-fashioned, but I want him to have Dr. Madera. I guess we’ll find out soon enough,” I reply.
The emergency room is bustling with activity when we arrive. Liam leans down to ask a man at the reception desk where we should begin as I spot Mom sitting alone in a row of chairs towards the back of the waiting area. She looks so lonesome back there by herself. So vulnerable. She’s been on her own for decades since Dad died, but until now, I think I’ve taken for granted what a support John Wendell has been for her. I won’t soon forget what he said at Yellow Cob about me being in town and able to take care of her now.
“Breathe, George,” Liam says, placing one hand on my back. I inhale deeply. I didn’t realize I was holding my breath. “Let’s go to her. I’m right behind you.”
We weave our way around the rows of chairs and the sad visitors sitting in them, excusing ourselves as we go, until we get to the back section where Mom is waiting. She’s fumbling with her phone. It looks like she’s trying to compose a text message, but her hands are shaking too much. When she sees us, a look of relief washes over her face. She stands and hugs me tight. Mom has always been good in emergency situations with her patients, but she seems different now. Come to think of it, maybe she had already collected herself before I saw her after Dad died. She looks pretty shaken up right now.
“I just got word that he’s in a room,” she reports. “They went ahead and moved him up to the third floor where it’s quieter. All the sounds from the E.R. were agitating him. He’s in a lot of pain.”
“Okay,” I say. “Can we go up and be with him?”
“Yes, we can,” she replies. “I was waiting on your guys to get here first, but let’s go right away.”
The three of us walk briskly past the nurse’s desk, down the hall, and to the elevators in the center of the building. Mom, of course, knows her way around since she works here. Two separate staffers whizzing by in navy blue scrubs recognize her, but they must be able to tell from her demeanor she isn’t up for chatting because neither one says anything. They sort of nod gently as she passes. She’s too focused on getting upstairs to notice. When we reach John Wendell’s room, the door is closed. I feel my knees weaken as I place my hand on the lever to open it and step inside. I take a few seconds to anchor myself. Liam is here. I know he’ll support me. And Mom is here. She will take the lead with John Wendell. Together, we can do this.
“George, son, you’re here just in time!” John Wendell exclaims. I’m surprised to see him awake and alert.
“In time for what, John Wendell?” I ask as I pull a chair close beside his bed and take his hand in mine. I give my grandfather the best smile I can muster. Liam positions himself out of the way near the heating unit while Mom looks over the medical equipment in the room to find out exactly how her dad is being treated.
“Your grandma was here. My Eleanor. She’s taking me on a trip,” he explains. I look at Mom and Liam and sigh heavily. We all know what kind of trip he’s referring to.
“Oh?” I inquire. I figure I won’t say much and will let him talk as long as he wants to. He’s moving his hands around the bed a lot and fiddling with the covers. It seems like he’s looking for something he thinks is on his lap.
“Do we have our tickets, son? I’ll be leaving soon.”
“Tickets?” I ask, tears forming in my already puffy eyes. “Where are you going, John Wendell?”
“Eleanor and I are going dancing. We’re taking the train. I’ll need those tickets. And my coat. Is my coat here? Snow is on the way.”
“Your coat is here,” I say even though I’m not sure if it actually is or not. We can always go and get one of his coats from Mom’s house if necessary. It’s more important to play along right now so John Wendell knows we’re okay with what he’s telling us.
“Good. Okay,” he says. “Oh, and I need to check the train schedule. Where can I find the schedule?”
“I’ll ask around and find out,” I reply. “Don’t worry, John Wendell. Everything will be ready when it’s time to go.”
I’ve never been present for the dying process before, but I’ve heard Mom discuss it enough to understand what’s happening here. Many people talk in terms of traveling when they’re preparing to leave this world. It’s sad for those of us saying goodbye, but the dying are wrapped up in the busy preoccupation of preparing to embark on their next journey. In many cases, they’re feeling hopeful. Making plans.
My grandfather sits up as much as he can in his hospital bed and leans in close to my face, wrapping one hand around the back of my head and leaning his forehead against mine. He’s weak and frail. The bedding he’s under now is much thinner than the quilt at Mom’s was yesterday and I can tell he’s lost weight. He hasn’t been eating. “George, I’m ready,” he says. “Are you, son?”
“Yes,” I reply. “I�
�m ready. You go ahead on your trip. I’ll look out for Linette while you’re gone.” I would normally refer to her as Mom in conversation with John Wendell, but I want to be absolutely sure he gets the message.
“Good,” he says in return, sounding reassured and settling back down under the covers. “I think I’ll take a little rest now until it’s time to leave.”
He smiles at me, then falls into a deep sleep. I hope Mom doesn’t feel bad that John Wendell’s lucid conversation was focused on me instead of her. He’s her father and they’re very close. I don’t want to steal her thunder. She apparently sees the concern on my face, because she addresses what I’m thinking.
“I’m glad he was alert enough to talk to you like this, George,” Mom says. “He and I had a similar conversation earlier today.”
“Oh, good,” I reply. “I was feeling a little bad about him talking to me without a word to you.”
“No need to feel bad about that at all, dear,” she reassures. “I think he’s saying his goodbyes.”
“Yeah, I got that,” I reply, sadly.
Before we can go any further with our conversation, Dr. Madera walks in the door. Boy, am I glad to see her. Isabel Madera is originally from Puerto Rico. She came to the mainland U.S. for medical school and landed in Ithaca to do her residency. While here, she met and married a man who is a geneticist at Cornell. That marriage ended in divorce, but she liked the area and so decided to stay on. She’s been taking care of both Mom and John Wendell in her family practice for years now. I’m really glad she’s here because I want my grandfather to be around people who know and love him right now.
Ali and I met Isabel not long before Ethan was born during a visit home. It just so happened that John Wendell developed an ear infection after swimming in the lake and we took him to see Dr. Madera one day while Mom was at work. Ali and I stayed in the waiting room and didn’t expect to actually be introduced to the doctor, but we were pleasantly surprised when she came bouncing out behind John Wendell, eager to meet more members of his family. Isabel is a stunning woman. Of course, no one can compare to my wife, but even Ali says she gorgeous. Her long, dark, wavy hair and her smooth, buttery skin set the stage for big, brown eyes, round cheeks, and full lips. Her body is near perfection with ample breasts and buttocks separated by a long, trim waist. Look, I wouldn’t have noticed that level of detail about the woman if Ali hadn’t pointed it out. I tend to be surrounded by beautiful women, but I don’t think about them in a sexual way because Ali fulfills my sexual needs. Take Jen, for instance. I know she’s beautiful, but she’s like a sister to me. I only see her in the sister category. But something about Isabel Madera piqued Ali’s interest and thus mine by extension. I feel like I’ve known Isabel a lot longer than I actually have for some reason. And I feel like Ali has known her longer, too. Ali talked about Isabel for weeks after meeting her for the first time. She still mentions her every once in a while, always with a comment about how beautiful and alluring Isabel is. In fact, I think Isabel Madera might make my wife a little hot and bothered, if I’m being honest. I’m not sure how I feel about that, but the rush of warmth in my pants upon seeing Isabel again makes me think I might just be okay with it. I mean, Isabel wears curve-hugging clothes and bites her lip in a way that makes her hard to ignore. She’s a couple of years younger than Ali, single, intelligent, and her strong-willed personality is definitely a turn on. Ali especially loved it when Isabel started speaking Spanish to another patient in the waiting room the day we met. Ali speaks Spanish, too. She learned it in order to converse with the Hispanic immigrants she works with. The thought of my hot wife and Isabel Madera speaking passionate Spanish to each other and then doing, well, let’s just say other things is too much. My manhood is as hard as a rock now. I had better stay seated until it goes down. I tell myself to focus. We’re here for John Wendell, after all.
“Linette, George, how are you, folks?” Isabel says warmly while getting a pump of sanitizer from the dispenser by the door and rubbing it onto her hands. She looks over at John Wendell and smiles a sad smile when she lays eyes on him. Her concern for him is evident. She’s sincere. We can tell she hates to see him like this.
“We’re doing as well as can be expected, Dr. Madera,” Mom answers. “We’re glad you’re here.”
I simply nod and smile.
“George, I hear you and Ali have another baby on the way,” Isabel says as she looks in my direction. “I spoke with John Wendell briefly in the E.R. a little while ago and he told me the baby’s coming.”
“Well, yes, but he isn’t due until next month,” I reply. “I guess John Wendell is excited.”
“Let me introduce you to my brother-in-law,” Mom says, walking over towards where Liam is standing. “This is Alec’s younger brother. He’s in from D.C.”
“Liam Hartmann,” Uncle Liam says, reaching out to shake her hand then pulling it back when he remembers the wet sanitizer.
Isabel chuckles. “Wonderful to meet you, Liam,” she replies. “I’m sure everyone here is glad you’re in town right now. Good timing.”
Liam agrees and doesn’t offer any more information. I’m not sure if Isabel knows about the break-in at my house. She probably saw it in the news, but maybe not. I don’t feel like explaining, so I’m relieved when she doesn’t mention it.
“Will you be able to continue caring for my father while he’s hospitalized?” Mom asks. John Wendell signed over power of attorney to Mom awhile back, so the medical providers already know she has permission to make decisions on his behalf.
“I do have hospital privileges, so yes,” Isabel confirms. “There are a number of other doctors who will probably be involved though. Specialists, mainly. We’re waiting on the x-rays they took downstairs to come back from radiology and then we’ll need to consult with an orthopedic surgeon about repairing what we’re assuming is a fracture of his right hip.”
Isabel sits down in a chair next to Mom and rests quietly for a minute before saying anything else.
“Linette, is it okay to speak freely with George and Liam in the room?”
“Of course,” Mom affirms.
“We have your dad’s Do Not Resuscitate order on file,” Isabel says. “He and I have talked about it on multiple occasions. Each time, he was clear that he wants to be allowed a natural death when the time comes.”
“I understand,” Mom replies quietly. She knows these ropes. She’s seen this scene play out countless times from her position as a nurse.
“We’re faced with a pivotal decision here,” Isabel continues. “Surgery is risky. Especially for a man John Wendell’s age. Even under the best circumstances, electing to proceed with surgery on a ninety-five-year-old should not be taken lightly.”
“I understand,” Mom says again.
“In John Wendell’s specific case, the fact that he hasn’t been eating certainly gives me pause,” she continues. “And you say he’s been largely unresponsive for several days now, correct?”
“That’s right,” Mom confirms. “Ever since Sunday morning, he’s spent most of his time asleep and he doesn’t usually respond when I try to wake him.”
“Did anything precipitate this sudden decline?” Isabel asks.
“We had a big night at Yellow Cob the evening before,” Mom explains, “but otherwise, no. It came out of nowhere.”
“How about his fluid intake?” Isabel asks.
“I’ve been able to get a little in him using a foam applicator on a stick. I wet it and then dab it onto his lips. That’s all,” Mom replies reluctantly.
“And urine output?”
“Not much,” Mom answers.
Isabel reaches into the pocket of her lab coat and pulls out a little blue booklet. Mom must know exactly what it is because she begins to sob when she sees it. Isabel places her free hand on top on Mom’s and pats it gently.
“I know, Linette,” Isabel says. “I’m so sorry. This is not easy.”
Mom nods as she tries to hold back tear
s.
“What is that?” I ask.
“It’s the damn guide to understanding end-of-life signs and symptoms,” Mom says angrily. I don’t remember the last time I heard her curse. Or raise her voice, for that matter.
“Oh,” I say solemnly. “So, Dr. Madera, you don’t think we should bother with surgery?”
Isabel pauses before answering. She’s choosing her words carefully.
“That’s ultimately up to you folks to decide, based on what you think is best. However, we’d need an orthopedic surgeon to agree to perform the surgery, and that might be a challenge given John Wendell’s general health right now. A palliative care doctor will have to be consulted.”
Mom’s face repeatedly balls up as she listens. Each time, she shakes it off and collects herself for a brief moment, only to be gripped by emotion again.
“No need,” Mom finds the strength to say between waves. “No surgery.”
It’s one thing to know someone you love is nearing the end of the human lifespan. It’s another to know they’re declining steeply and seem to be ready to move on. And it’s another yet to be the one making decisions which cement the end of this life as an immutable reality. To take the booklet. To say the words. I don’t envy Mom right now.
“We can make him comfortable,” Isabel says, continuing to pat Mom’s hand gently as she speaks.
Mom nods her head in agreement.
“I’ll order hospice care,” Isabel confirms.
Again, Mom nods silently in agreement.
“There’s a small residential facility on the outskirts of town which is outstanding,” Isabel says, speaking slowly and softly and pausing before each new sentence. “It’s located on a hill overlooking the countryside and each room has floor to ceiling windows on one exterior wall for enjoying the view. I’ve always thought it’s prettiest in the winter. Their nursing staff is top notch. I took the liberty of inquiring before I came to speak with you and they do have a room available.”