Green Dream

by Robert Gollagher

  “Oh, God, Ruth. Why didn’t you tell me? ”

  Ruth cried, now. Michael had never seen her cry. It disturbed him, deeply, to see the iron-strong old lady crying. He just leaned across and hugged her, the first time he had ever hugged her. He held her for a long time. “Oh, Ruth. It’s going to be okay. It’ll be okay.”

  Eventually, Ruth made him go back to his chair. “We need to talk, Mike. We need to talk, now. There’s no time left.”

  “Okay, Ruth. What? What can I do?”

  “Michael, you have to understand. I’m dying, now. I’ll never make it though another week. You know that. This is my last week.”

  “Oh, Ruth.” Michael was crying, softly. “I know. I know it.”

  “Mike, I can’t ... I can’t take the pain any more. It’s getting worse. It’s getting much worse.”

  “Oh, for God’s sake Ruth, why didn’t you tell me? I’ll get you some morphine, something, I’ll talk to Dr Cheng. Ruth ...”

  Ruth looked at him in silence. Her eyes were dull. Her face was that of a skeleton. She was a dying woman, a couple of days away from her own death. Her words chilled Michael to the bone, when she finally said, “I’m already on morphine, Mike.”

  They were just five words, but Michael knew. “You’re ... already taking it? Doesn’t it stop the pain?”

  Ruth shook her head. A tear rolled down her cheek.

  Michael couldn’t say anything. He knew what she would say.

  “The pain never stops, Michael. I can’t ... I can’t take it any longer. This isn’t the way I want to die. Not like this. So, I want you to promise me something.”

  “Anything, Ruth.”

  “When I get worse, and I will get worse, I want you to tell them to increase my morphine. They’ll say it isn’t safe. They’ll say it could stop me breathing. But you have to make them do it. Do you understand, Mike? I don’t want die slowly, like this. I don’t want any more pain.”

  Michael hugged her again, sobbing. Ruth coughed as she cried, embraced by the only person in the world who truly loved her. Finally, Michael said, “I understand, Ruth. You have my word.”

  “Thank you. Thank you, Mike.”

  “You know, I love you. You know that, Ruth, don’t you?”

  “I know, Mike.” Ruth looked terribly tired.

  Michael stayed with her, until she fell asleep.

  The next day, Ruth didn’t wake up. Not fully. Michael was there in the morning for her, but she was only half-conscious. She rolled in her bed, tossing from side to side. Her breathing was terrible. Michael could hear the crackling sound of fluid in her lungs with every breath. All the drugs in her intravenous fluid line, which flowed into the catheter in her arm, were no longer helping her. And Michael knew that even the morphine was not enough. He could hear Ruth groaning deliriously, at times when she became more conscious. The oxygen she needed to supply her failing lungs was supplied through a small plastic tube that ran under her nostrils. The nurses and young doctors came into the room frequently, to check the oxygen and the drip, but there was nothing more they could do.

  They let Michael stay all day, on that sad Tuesday.

  At three o’clock, Ruth came out of her sleep and spoke to Michael for the last time. She seemed confused.

  The young doctors had told Michael that Ruth would not live more than three days. Michael knew how long those three days would be for her, like this, how long, and how inexpressibly painful.

  Ruth suddenly saw Michael’s face come into focus. “Michael.”

  Michael tried to smile, but his smile was wet with tears.

  “Michael, I’m glad you’re here,” Ruth whispered.

  “Me too,” Michael said, stupidly.

  “Michael, I’ve left something for you. You’ll find it in my room, in the top drawer. I told Dr Cheng to tell you about it, but now I can tell you myself. I didn’t ... I didn’t know if I’d be able ...”

  “It’s okay, Ruth. I hear you. What is it?”

  “In the top drawer Michael. In the top drawer.”

  “Okay. I’ll find it. Don’t worry, I’ll find it.”

  “Michael, don’t let them keep me going like this.”

  “Ruth ...”

  “Michael, you know I have always held onto life.”

  “I know.”

  “I’ve never given up. I’ve ... never given up. I never would ...”

  “I know.”

  “But there’s too much pain. Everything is pain. Do you understand? Everything is pain. There’s no escape from it. I can’t fight it, even when I’m asleep. It’s there when I sleep.”

  “Dear God, Ruth.”

  “You promised me, Michael. You remember?”

  “I remember.” The pleading in Ruth’s eyes broke his heart.

  “Tell Dr Cheng. Tell him, Michael. You have to tell him ...” Her words crumbled into disarray as the pain took her over again. She never said another thing that Michael could understand, she just fell back into her fitful sleep, her nightmare world of confusion.

  An hour later, Michael had summoned Dr Cheng. He made the old doctor follow him to a quiet corner of the hospital, at the end of an empty seminar room where no one would hear them. He told the doctor of Ruth’s wish not to go on any longer. He told him about the pain, which the young doctors had not been able to stop. He told him that Ruth wanted the morphine dose increased, so that she would not wake up again. He told him she could not bear the pain.

  “I understand,” said the old doctor. “She has only two days, maybe three. She will pass away soon. I’m so sorry.”

  “No, no. You don’t understand, doctor. She doesn’t want to die like that. She doesn’t want to die so slowly, in so much pain. She told me that the pain never leaves her. Even when she’s asleep, the pain comes to her like a nightmare. She’s in agony.”

  “What do you want from me, Mr Andrews?”

  “I want you to grant Ruth’s last wish, what she told me to ask you. You have to increase her morphine, so she doesn’t gain consciousness again. You have to stop the pain, doctor.”

  “Mr Andrews, her morphine is already as high as we can go. If we increase the dose any further, it could be fatal.”

  Michael shook his head in exasperation. He turned away from the old doctor, then he spun around to face him again. “Fatal? For God’s sake, she’s dying! She’s dying, and she’s in pain.”

  “Yes, she is dying. We’re doing all we can.”

  “All you can? All you can? Can you save her? Can you save her life? Is there any chance that she will live?”

  “No. I can’t save her. No one can.”

  Michael raised his voice as loudly as he dared. “Then, for God’s sake, show some mercy. Don’t put her through this. Don’t make her suffer right to the last moment. Give her the morphine.”

  “You’re asking me to put my patient’s life at risk. I can’t do that, Mr Andrews. It’s against the law. It’s not my decision.”

  “Against the law? This old woman is the greatest, kindest person I’ve ever known in my life. She saved my life! I’m alive because of her. Now all she wants is to die with a shred of dignity. She just wants the pain to stop. Tell me you know that’s right, doctor. Don’t tell me about the law. Tell me what you know is right, in your heart.”

  “My heart, Mr Andrews, and the law, are two different things. I can’t break the law. If I do, and they find out, they won’t let me practise. I won’t be able to help any more patients. I can’t do it.”

  “There’s a patient, right here in this hospital, dying in agony, and she needs your help. She needs your help.” Michael could see the old doctor was unmoved. “This is my friend, dying. She’s asking for help. For God’s sake, a dog would die better than this! A dog would get more mercy. Please, doctor, please ... just help her.”

  “I’m sorry, Mr Andrews, but this conversation is over.”

  That night, Ruth’s moaning nearly drove Michael mad. He couldn’t even imagine what kind of pain she must h
ave been going through, what kind of nightmares. The nurses that came to tend to her gave Michael sideways looks of sympathy. They knew it was wrong. They knew what Ruth wanted. She had told them, too. Michael knew that Ruth must have known that Dr Cheng might not listen, otherwise she would have simply have told the doctor himself. So when one of the young doctors came, late that night, Michael decided to ask her. The doctor must have been about twenty-nine, only a few years older than Sally was when she had died. She was short, had dark, curly, brown hair and a slight build.

  The young doctor examined Ruth, frowning. She let out a heavy sigh and turned to Michael. “How long has she been like this?”

  “All day, doctor. All day.”

  “She’s sweating. Her heart rate is up. She’s not even fully unconscious. She looks like she’s in a lot of pain.”

  “She told me she was, a couple of days ago. And she was nowhere near as bad as this, then.”

  “The nurses tell me she requested more morphine. Is that correct, Mr Andrews?”

  “Yes. She didn’t want to die like this, not in this kind of pain. She told me she wanted her morphine increased, so that she wouldn’t wake up. Can’t you help her, doctor? She’s dying. Please, I’m begging you. Don’t make her die slowly, in agony, like this. Please.”

  The young doctor looked at Michael, without a word. She looked at Ruth’s pain-racked body on the bed. Then she looked closely at Ruth’s chart. “This morphine dose looks low, to me.”

  “What? Sorry, what did you say?”

  “The dose she’s been getting. It looks a little low. It’s obviously not controlling her pain.”

  “But Dr Cheng said it was a high dose.”

  The young doctor ignored him. “I think we’ll need to give her a higher dose, right away. She’s in terrible pain.”

  “You do?”

  “Now, you understand, Mr Andrews, that Ruth is dying. These are her last hours. She needs more morphine to control the pain, but there is ... some risk that the drug could be too much for her. It’s possible that it might bring on respiratory arrest faster than might occur without the drug. But it will stop the pain.”

  “You mean, she could stop breathing.”

  “She will stop breathing, Mr Andrews. It’s only a matter of time. There’s no question of that. Ruth is dying. The only difference the morphine will make, at a higher dose, is to stop the pain. As it stands, she has hours to live. With more morphine, it could be a little less.”

  Michael realised she was trying to help Ruth. “Just don’t let her die like this, doctor. She didn’t want to go in agony, like this.”

  The young doctor looked at Ruth. There was pain and anguish in Ruth’s barely conscious face, and there was no escape from the pain. “As I said, Mr Andrews, this morphine dose is a little low. We’d better give her some more.” She put her hand on Michael’s arm. “Don’t you think?”

  Michael sighed in relief. “Yes. Yes, that was her wish.”

  Mercy came, for Ruth, when the young doctor summoned one of the nurses to bring more morphine. The young doctor injected it slowly into the port of the drip set. The drug flowed down into Ruth’s arm-vein and from there to her heart and to her brain. A great relaxation came over Ruth’s restless body, she lay still, and her breathing settled down into a regular rhythm. The tensed muscles of her face, the look of pain and anguish, disappeared. Ruth’s face looked relaxed. She was very deeply sedated.

  “Thank you, doctor. Thank you,” said Michael.

  “Nothing to thank me for, Mr Andrews. I just think this is a more appropriate dose of morphine for the severity of her pain.”

  “I understand.” Michael did not say what he understood. He did not say that he knew the young doctor was speaking in riddles, letting him know that she had granted Ruth’s wish to die peacefully.

  “All right then, Mr Andrews.” And the young doctor was gone.

  Michael stayed with Ruth that night. It was four hours later, at 3:15 am, when Ruth’s regular, crackly breathing slowed down. Her heartbeat became slow and erratic, also, which triggered the alarm on the bedside monitor. Within a minute, two nurses had arrived in the room. A minute later, the young doctor had returned.

  She examined Ruth carefully, before she spoke.

  “She’s going into respiratory arrest.”

  One nurse held an oxygen mask over Ruth’s face, while the young doctor injected a respiratory stimulant into her IV line.

  Michael managed to hold Ruth’s limp hand, despite the activity of the nurses and doctor around him. As she stopped breathing completely, he bowed his head and cried.

  The other nurse grabbed an endotracheal tube, ready for the doctor to insert it into Ruth’s windpipe, so they could ventilate her lungs artificially, but the young doctor waved her away.

  “No,” said the young doctor. “She left written instructions that she was not to be revived. She didn’t want artificial ventilation.”

  The nurse nodded and put the tube down.

  “Goodbye, Ruth,” Michael whispered, close to her face, but he knew that she could not hear him. “Goodbye.”

  The young doctor looked at the heart monitor one last time, then turned off its noisy alarm. The display showed a flat line, no heartbeat at all. Ruth had passed away. Her pain had ceased four hours earlier, with the higher dose of morphine. The last four hours of her life had been peaceful sleep. She had been granted her final wish.

  Michael cried, in devastation, leaning over her body.

  Time seemed to stand still.

  He didn’t even notice the others leave.

  And then he was alone, with Ruth, and with his tears.

  Michael drove away from the hospital for the last time. The city streets were deserted and dark. When he reached Ruth’s house, he let himself in at the front door. He had to fumble with the keys in the darkness before he found the right one. He wandered through to the kitchen and looked around, trying to let it sink in that Ruth was gone, remembering the meals they had shared here together, remembering the conversations. He walked through the hallways of the house for a few minutes, then went into the library and looked at Ruth’s pictures on the mantelpiece. And then he went to his bedroom, lay down on the bed, in a state of shock and exhaustion and disbelief, and fell asleep. His sleep was deep. He did not dream.

  It was after midday when he finally woke again.

  It was hot, and it was the heat of the day which roused him.

  Michael got up, feeling like hell, and went to the small bathroom, the same one that he had always used, and showered. He ran the water cool over his body. He stood there for a long time, letting the cold water wash away the sweat from the long, hot sleep. His face was covered in rough stubble, but he didn’t bother to shave. Eating a cold breakfast at the big kitchen table, Michael remembered what Ruth had told him. He had to go to her room. There was something for him there.

  When he had finished eating, Michael went to Ruth’s room. Her bed was neatly made, the way he had made it the day after he had taken her to hospital. It seemed such a crime to Michael, that she was not here. This was her room. This was her house. It was where she lived, where she belonged. But she would never be here again. It just seemed wrong. It seemed empty.

  Michael went to the chest of drawers next to the bed. He slid open the top drawer, slowly, and looked inside. There was an envelope with his first name on it. He sat down on Ruth’s bed and turned the envelope over in his hands. He realised that Ruth must have written it before she went into hospital, days before the terrible morning when she could not get out of bed. She must have written it to be ready, to make sure she could say what she wanted to tell him. She must have known it would all happen as it did. Finally, he ripped the envelope open and read the letter.

  Thursday, 5 March, 1998

  Michael, my dear friend,

  I know this must be hard for you. But before you read on, I hope you will stop to think of the times we lived together, the things we taught each other, and how far
we have come. I hope you will stop to think about the life we shared for a while, rather than the death which has ended it. I’m an old lady, Michael, and I have lived a long and full life. Your life is just beginning. Please make that new beginning a good one. That is my dearest wish for you.

  Although I’ve only known you for a few months, you have become like a son to me, dear Michael, and I can’t tell you how much it’s meant to me, to see you get well. I’ve known bad men, and the cruel things they have done, terrible things, and I’ve known good men like you, men who have done wonderful things, things which inspire me, men who have everything good in their heart and sometimes don’t even really know it. You are a good man, Michael Andrews.

  I hope, one day, you find someone you love again, Michael, and I hope that you will have children, if that is your wish – I think it probably is – because you would make a wonderful father. I only wish that my granddaughter could have been lucky enough to have had a father like you. I am sure that if she did, she would still be here today. And I am sure that she would have been glad that you have read her diaries and that you have learned something from them, most of all that you are still here, Michael, still alive. I want you to keep those diaries. I leave them, and Sally’s memory, to you.

  Dear Michael, thank you so much for taking me flying yesterday. I haven’t felt so excited, so young, in years! You took me back half a century, Mike. You took me back to my early days with Fred. You reminded me how good it is to have someone in my life again, to have a friend like you. I only wish that I might have had a little more time to enjoy flying with you, but I thank you for taking the trouble to talk an old lady into trying something she should never have been afraid of. It was wonderful. Please promise me that you will continue to fly, because I know how much you love it, and that you will continue to show others how to fly, because you are a great teacher. And I learned something from you.

  I love you very dearly, Michael Andrews. I think you are a wonderful man. Please be happy, not sad, because happiness is what a man like you deserves. Remember that.