A Schedule of Drugs in the Valley of Death

by Sarah Reith

  Agnes made a sound that might have been sympathetic but probably wasn’t. “Is Fiona keeping records?” she inquired pleasantly.

  “Yes!” I exclaimed, jubilantly casting aside a lifetime of indoctrination regarding the qualities of those who snitch. “Fiona keeps records. Right here . . .” I began to scrabble through the binder. Trained criminals are the best cooperating witnesses, because they know exactly which information is important.

  “How often is Ms. Fiona Jones administering morphine?” Agnes asked.

  She could have been filling out a form to replace a lost drivers’ license. People don’t sound that methodical when something is terribly wrong, do they?

  I focused on the large, looping handwriting. “Today is the Fourth of July.” Today is the Fourth of July, Agnes agreed. I think she would have agreed in the same soothing, neutral tone if I had said I had a dog named Spot.

  “Okay. Today. Starting at six a.m.” I scanned the columns of doses and times. It was one o’ clock in the afternoon. “She’s been giving her half a c.c. every . . . every half hour.” I owed Fiona absolutely nothing. Snitching is a breach of trust. Without trust, there is no betrayal, and therefore no snitching. I kept a careful eye on the doors.

  “I have a note here from Marissa,” Agnes said clearly. Marissa? What was I supposed to know about Marissa? “From five o’ clock this morning. Marissa, who is a highly competent, licensed professional, advised Ms. Jones to administer half a c.c every two hours. Every two hours, Ms. . . . what did you say your name was?” I whispered my name into the phone. “That’s approximately . . . let’s do the math here, shall we? Four times the amount of morphine she was advised to administer? Where did you say she was?”

  “I think she’s praying,” I said, through lips that were clumsy and numb. I don’t know why I spoke of prayer instead of meditation. I must have thought it sounded saner, though I don’t know why. “I’ll talk to her.”

  “Yes. I think that would be a good idea.” It sounded like an accusation.

  Fiona was walking almost straight when she finally came out of her room. She closed the door behind her with solemn churchly silence. She had sanctified the area with prayer and meditation, clogging it with fetishistic ritual. It takes a recklessness that borders on vandalism to overcome the power of such carefully constructed discomfort. But something about the simple variety of someone else’s voice had taken the charge out of Fiona’s proclamations. I handed her a steaming mug of Kava De-Stress tea. It was one of Caitlin’s favorites.

  “The hospice nurse called back,” I told her, in my most casual conversational tone.

  She nodded. She didn’t seem to care.

  “I had a look at the patient. So I could describe, you know, what I saw. To the nurse. She asked me to,” I added, establishing culpability. It was as good as telling her I’d entered the room from an unauthorized direction.

  “Oh. Good.” She took a sip of her mud-colored tea. “Very sweet.” She was languid and distracted.

  “Agnes,” I continued.

  “Oh, yes. I’ve spoken to Agnes.” Her lips twitched meaningfully as she nipped at her kava again.

  “Agnes seems to think that maybe Mariana might not need quite as much morphine as . . . we’ve been giving her.”

  “Yes. Well.” Fiona set her mug aside with a little sigh, as if she couldn’t imagine why she’d expected better from the likes of me. “I’ve been talking with my friend Stacey, too, Isobel. I don’t know if you know it, but I’m not doing this on my own. I’ve been consulting with Stacey, who lives at the Center. She used to run a hospice in Arizona. She’s a registered nurse, so she’s a great deal more qualified than you or I. I told her what’s been going on, and frankly, she’s horrified. She says this happens all the time, you know. She says a lot of people are quite stingy with painkillers near the end because they’re highly addictive. Well, they’re also quite spendy, aren’t they? Think about that, if you would.” She accompanied this invitation with a frantic, unfocused glare. She wasn’t really talking to me. She was giving a speech. “But her attitude is, who cares? Who cares if she gets addicted? She’s dying, Isobel. Jesus god, don’t you get it? I’ve been sitting with her for hours on end just watching her face and I tell you I see things—”

  The skin of her face was blotchy and rough. I noticed that one of her eyelids drooped a little. She had a slightly receding chin. A wave of disgusted pity surged through me, following the same path the adrenaline had taken earlier. It made me feel like I’d taken a bath in dirty water.

  “You’ve been working so hard,” I soothed. I placed a hand on her shoulder and understood immediately why she was not the hugging kind. The bones jutted out of her with no rhythm or softness, thrumming through skin so hot it was itchy to touch. Is that what it feels like to be her? I wondered. I forced my poor hand to make a few feeble circles on the unhappy bones of her suffering back.

  “Why don’t you let me handle the night shift,” I ventured, feeling my way firmly along an unseen path. Yes: I was still heading downhill. And yes: I felt the wind in my face, from going down fast. But now the breath was steady in my smokeless lungs, which made the lies come out so much more easily. “It’s really unfair, that everything’s been up to you for so long. It’s not right, that you should have to do everything all by yourself. I said I’d be here for you, Fiona,” I reminded her, which may have been true. If I hadn’t said it outright, I’d implied the hell out of it. “Well, I’m here now.” We were confederates in a matter of life and death, whispering secrets in ill-lit rooms.

  I watched myself take shape in Fiona’s private thoughts as the answer to her half-formed prayers. All I had to do now was close that blue-veined hand inside my calloused palm. I looked down and there it was, the outer knuckle of the thumb barely wider than the rawboned wrist. It was a hand for slipping handcuffs, a hand for palming keys. It was a hand for forgeries and fakes and fleeing her homeland for the salvation of her immortal soul. I left that hand alone, at the end of its ungraceful wrist.

  But she was already nodding her auburn-haired head. “It’s too much,” she whispered. “You know, this is so stupid.” She choked, and a wave of mucus receded into her throat and thickened the rest of her words. “I just wish—I wish Reuben were here, dammit. I mean, it’s his mum. If it were my mum—” She sucked a few swallows of snot back into her sinuses. “It would just be so great, wouldn’t it,” she murmured, with a weepy little hiccup. “I mean, if we had a man here. I told you it was stupid,” she reiterated, with a squelched unhappy wail.

  “Oh. Well.” I gave her shoulder a few ineffectual feminine pats. “We’ll make do. I think women are so much more sensible about these things, don’t you?”

  “You know—” Fiona lifted her head and aimed her unfocussed eyes at the space I happened to be occupying. “I know this sounds crazy—there are more things in heaven and earth, right? But I know for a fact that she’s in agony. I can’t just stand by—” She paused for a moment. It looked like a technique of self-discipline, a strategy of war. “I know I’ve told you this before. About the connection. I’ve been here for so many months, and sometimes she speaks and sometimes she doesn’t and then sometimes when she does she means something else entirely. But we understand each other. It’s a telepathic connection,” she said, all in a rush. “There it is. I know a lot of people don’t believe in that sort of thing, but, well, I know better. I’ve learned so much from her. She’s my friend, Isobel.” She succumbed to another dainty torrent of hicuppy sobs.

  I heard a hard little Agnes-like voice inside my mind. She’s not your friend, you little twerp, it said. Mariana Blanchefleur would have eaten you alive. Even in her seventies, when she was getting DUI’s from rookie cops.

  “We won’t let her be in agony. We’ll take care of her.” As soon as I said it, I thought of all those hard-faced men in Mariana’s collection of neatly labeled film noir tapes. I remembered what it means, in black and white, to take care of someone whose existenc
e has become an intractable problem.

  I CALLED IN reinforcements later that day. “I hate to ask someone to brave the holiday traffic,” I said brightly. In the slight echo on the phone line, I could hear the subtext plainly: please accept this demonstration of concern for others as evidence of my sanity. Please . . . I winced. I was crouching next the bathtub with water going full blast in the middle of summer, just in case Fiona suddenly got interested in what I was doing. In just a few months, Californians would begin to understand that a drought of possibly millennial proportions had settled on the land.

  “Have you ever been around someone who was dying before?” the nurse inquired.

  Her neutrality was so complete, it sounded like a rebuke. “Kind of,” I hedged. Who hasn’t?

  “How much longer do you think she has?” the nurse asked next, ramping up the neutrality. We were emphatically discouraged from making predictions, so this nurse, with this question, made me feel a little like I was compromising myself—on the phone, no less.

  I hesitated. “Two . . . or three days,” I heard myself say. I knew it was true, as soon as I said it.

  “I could send someone out . . .” she offered, clearly hoping I would remember how reluctant I was to have someone do such a thing.

  “Yes, please,” I said. I heard no echo on the line.

  Hospice favors a sturdy, matter-of-fact approach to death and dying, well-seasoned with an ecumenical belief or non-belief in God or the Creator and the workings of the soul. There is a strange, hard-assed compassion to the hospice way of doing things. It’s as if the Buddha were to interrupt himself during a lecture on the impermanence of all matter to say, yeah. Whatever. Just get over it, would you?

  I met the nurse in the driveway. Her name was Barbara. She was a tiny, pigeon-chested woman with a strong, straight back. She took me in with a glance and gave me a firm, warning smile.

  “Let me see the patient first,” she ordered. She moved swiftly through the front door and brushed past Fiona, who was glaring like she’d caught me masturbating in the sacristy.

  Barbara introduced herself in a way that made it very clear she was not offering her friendship. “I just thought I’d drop by to see if anybody had any questions,” she announced, as if it were possible to “drop by” a place that was purposely out of the way.

  The only thing further down the road from us was Bible camp, where smiling pastors told a tale of fire and brimstone rarely heard this far north of the Mason-Dixon Line. The road itself was darkened all day long by the shadow of very tall wooden fences.

  “Any questions?” Barbara asked, drawing out her stethoscope. She did not put on gloves.

  Fiona clutched her binder to her chest like she was clinging to an alibi.

  “We were wondering . . . about the morphine,” I piped up weakly.

  “Ah, yes. The morphine.” Barbara seized a dying eyelid and snapped it up, like a woman throwing open the blinds in full expectation of discovering squalor.

  We all caught a glimpse of the still-gleaming white, slippery as an egg in butter.

  “She’s not there,” Barbara declared, allowing the eyelid to ease back down. “Would you let someone yank on your eyelid like that? Without so much as a twitch?”

  She faced Fiona squarely. She might have been sizing her up for a few friendly rounds in a boxing ring. But Fiona was standing before us all with her eyes closed, like a true believer ready to burn.

  “Mariana!” Barbara shouted.

  Fiona flinched.

  With a flourish, the straight-backed little nurse whipped the blankets away from the patient. “She’s not in pain. Trust me. I’ve seen pain.” She sounded almost eager. “But. She has too many blankets. She can have a sheet,” she compromised, and turned to the door.

  “I’ll walk you to your car,” I offered. “Some of the dogs in the neighborhood. They know me.”

  Barbara gave a crisp little nod, like it wasn’t even worth the trouble to tell me what she’d seen of dogs.

  “So,” she said, opening the driver’s side door. She stood behind it like she was accustomed to using it as a shield. “She’s not taking it well, is she?”

  I smiled pleasantly, to indicate that I, in contrast to my colleague, had fully grasped the fact that death is natural; that we who live with it are tranquil and serene; that we do not, under any circumstances, freak out. At the very most, we might allow the natural progression of our feelings to express themselves, in clearly-defined steps as explained to us by our spiritual care advisors and the brochure that comes with the death kit. It is acceptable to grieve, normally and sometimes deeply. We do not freak out.

  “It’s freaking me out,” I admitted, instantly sacrificing any credibility I may have had. “She’s in this crazy cult—”

  “What is your definition of a cult?” Barbara interrupted. She would have been a stern professor.

  “She’s a follower of this guy over in Lake County named Ron Spence who calls himself Buddha Maitreya.” I felt myself washed in the double pleasure of presenting a well-researched fact and sharing secret gossip. “You can look him up on Guruphiliac,” I continued, savoring my betrayal. “She seriously believes that he is simultaneously the reincarnation of Jesus Christ and Buddha. Which is one hell of a split personality disorder, if you ask me.” I had been dying to say this out loud, but my timing must have been off. She didn’t even look like she was trying not to laugh. “She calls him His Holiness in casual conversation. Like it’s a term of endearment or something. She says she’s cleansing Mariana’s karma when she meditates—which I think is what she calls it when she gets high, and she thinks she’s receiving telepathic messages from her about how she’s in agony and needs four times more morphine than she’s supposed to be getting.”

  I stopped for breath. There is a reason cult members discourage communication with outsiders. Outsiders are dangerous, because they don’t give a shit about the carefully constructed context of a miniature society where everyone is tormented by poorly synchronized wavelengths. The outsider restores order, something that’s difficult to do when you live where you work and your employment is contingent upon the trust of a nutjob stoner. The relief of standing bareheaded in the sun as I shared this dangerous information was so intense, I began to see tiny orange and yellow explosions, every time I blinked.

  Barbara was watching me carefully. “And you are—? A neighbor? A relative? Friend of the family?”

  “I’m a paid caregiver,” I explained. “I live here, too.”

  Barbara nodded, like a woman whose policy about a bullshit story is to let it pass, unremarked upon but keenly noted. “Fiona Jones is the only caregiver we have on record.” She showed me her teeth in what I eventually realized was a smile. “From the family, you understand. Mariana’s son has given her permission to take whatever measures she feels are necessary. He trusts her.” She watched me intently, scanning for symptoms of taking the hint. “He feels his mother is transitioning peacefully with Fiona at the helm. And she is.” She shifted, so the sun shone off her hard-working holiday nurse’s glasses. She looked like she was examining me from behind a pair of white goggles.

  “People go crazy,” she told me with weary kindness, like she was tired of breaking the news that everyone dies. “It’s usually religion.”

  She had a long drive ahead of her, and possibly a lot more death and dying before she could go home and enjoy a few cold leftovers and maybe a lukewarm beer. Would she struggle to hear a final heartbeat over the sound of celebratory explosions? She told me an anecdote. I tasted the dust in my mouth. Wasn’t there something about dust on the way out of Paradise? I wondered, as I hauled myself into the house.

  Fiona was in a hot-eyed fury when I came back inside. I am embarrassed to say that it did not occur to me, until that moment, that she might have been skimming meds from the death kit. It can’t be the Lorazepam, I reasoned, remembering how swiftly and utterly the drug had stilled the dying woman’s convulsions. And it’s probably not
the buttplugs.

  “Isobel.” Her face was ravaged. What the hell right do you have to be ravaged? I wondered wearily. “I need to talk to you.” She spun, hitching and crabbing and reaching for counters as she hobble-stepped through her room and onto the deck. The wisteria was blooming. Mariana had told us she planned to come back as a flower.

  “Listen. I’m very upset.” Fiona took a deep breath, to show how hard she was working to control herself. “I know for a fact that I told you to be sure no one came in through that door. Mariana is working very hard to make this transition and she simply cannot have people slamming in and out of here. It is entirely too much stress for her to handle right now.”

  I noticed she was wearing a vaguely Asian-looking housecoat with wide sleeves and a sash. My mind lingered on the broad blue hems before I comprehended the fact that one of her freckled blue-veined breasts was entirely exposed. It was just lounging there, looking calm and relaxed, nestled up against her slatted breastbone.

  “I know I have very specific requirements,” she was saying, “and that’s hard for some people to take. But I know what I’m doing here. And if you can’t respect my requirements, well. Reuben has told me to do whatever I think is best for his mother at this time.” She fixed me with an accusing stare, as if she’d caught me rummaging through her jewelry box and couldn’t believe she was thinking about giving me a second chance.

  “It was the nurse—” I protested. I still catch my breath at how quick I was to blame Barbara. I needn’t have bothered, though. Fiona did not intend to be distracted by irrelevancies.

  “Yes. I’ve spoken with the nurse.” She could have been a well-schooled heretic, dismissing an illiterate peasant’s orthodoxy. “I’ve also been speaking with my friend Stacey, at the Center. You know she ran a hospice in Arizona. I think she’s a little more qualified than these country nurses out here.” She sounded pre-emptively satisfied, as if she’d put her money on a sure thing and now all she had to do was sit back and watch the horses run. “She tells me it’s always the least qualified people who sign up for the holidays. After all, who else is going to work while everyone else is having a good time?” She gave me a peevish, triumphant look as she waited for the inexorable logic of this to sink in.