by Isaac Asimov
I was able to correct the fluid retention I had incurred at Rensselaerville by the lavish use of diuretics, but the problem did not go away. Things were, in fact, hastening to a climax in 1989.
I began to have an occasional day in which I experienced what I referred to in my diary as a “wipeout.” There was one such on November 17, 1989, for instance, in which I stayed in bed most of the day. I blamed it on a succession of largely sleepless nights. Of course, that might have had something to do with it. The trouble lay not in my simply having a lazy day, but in not feeling guilty over it. In a wipeout, I felt no anger at staying in bed; rather, I liked it and actively did not want to get up.
Nevertheless, I forced myself to struggle on. I went out to Long Island to help Stan and Ruth celebrate Thanksgiving. (Of course, it snowed, the only snow of significance in all the winter.) On December 4, Janet and I dined at the Peacock Alley with Fred Pohl. Fred was writing a book on the environment and wanted me to cooperate on it. I said, gladly, that I would do so, but that was to be the last normal day I would have for half a year.
On December 6, I was slated to give a three-hour combination of talk, question-and-answer, and book signing, and I got through it only with a great deal of difficulty. It was the first time in many years that I did not enjoy my talk. When it ended, I dashed for home, bone-weary, with Janet sizzling with anger over my having committed myself to a three-hour session. And I was thinking myself that I had bitten off more than I was now able to chew.
The next day, I experienced a wipeout and, thereafter, over a period of days, it was all I could do to drag myself about. My weariness, against which I had been struggling for months, had finally become so overpowering that I was forced to mention its existence in my diary. On December 13, I wrote, “I have no energy. That is the problem.”
Actually, that was the symptom. The problem was not something I would have been ready to admit even if I had known it. For December 14, my diary entry consisted of one word only: “Sick!”
Paul actually made two house calls to check on me and I was rather touched by that. Doctors simply don’t make house calls anymore and I took it as a powerful piece of evidence that Paul considered himself my friend as well as my doctor. (As a matter of fact, Paul is utterly dedicated to his profession, as is Peter Pasternack. I am a very fortunate man to have two such physicians taking care of me, although I am careful not to let them know I feel this way, since I prefer to yell at them a lot.)
I spent three weeks in bed, neglecting my work. Of course, the neglect was not total. I managed to keep abreast of my mail, by answering only those letters it was absolutely essential to answer. I also wrote my weekly syndicated column for the Los Angeles Times. However, work on my history book stopped. Nor could I add the final touches to The Next Millennium or to the two How Did We Find Out About . . . ? books I had been working on. I wasn’t able to do the thirty-second and last item of the Gareth Stevens astronomy series at all. In fact, the dates of December 17, 18, and 19 in my diary are completely blank.
I managed to struggle to my feet now and then for special occasions. On December 20, Janet and I were taken by limousine to a midtown restaurant to have dinner with Lou Aronica of Bantam Books and a few other Doubleday people. The conversation dealt with plans by Doubleday and Bantam to put out a uniformly bound collection of all my fiction—both novels and short stories, both science fiction and mystery.
It was a wonderful idea and I was pleased and flattered—but I also had a niggling little sensation (which I didn’t express) that it was the sort of thing usually done for a writer posthumously. Were they—in the fashion of good businessmen—just looking ahead?
If they were, I couldn’t blame them, for they would have been doing no more than I was. All through that unhappy December I kept thinking, “I’m so close, so close, but I won’t make it to seventy.”
It became almost an obsession with me that month. I was dying, I thought, and, in anger, I complained bitterly to Janet at the fate that would not let me reach the magic age of seventy.
What is so magic about seventy? The trouble is that Psalm 90:10 reads: “The years of our life are threescore and ten.”
This has been taken, on biblical authority, to be the normal span of human life. Actually, it’s not so. The average life span of human beings did not reach seventy over a large section of the population till well into the twentieth century. It took modern medicine and science to see to it that seventy is really the years of our life. But the Bible says seventy, and that figure became magic.
Comparatively early in life, I managed to have it ground into my brain that there was no disgrace in dying after seventy, but that dying before seventy was “premature” and was a reflection on a person’s intelligence and character.
It was unreasonable, of course; quite irrational. Still, I had reached sixty when, after my heart attack, I thought I might not. Then I reached sixty-five when, before my triple bypass, I
thought I might not. And now seventy was within reach and I thought, “I won’t make it.” (It reminded me of the days in 1945 when I was racing to reach twenty-six before I could be drafted—and failed.)
Janet, in despair, tried to reassure me. She said, “You’ve often told me that January 2 was an artificial birth date assigned to you when you left Russia, and that you were possibly born as long as two or three months earlier. So actually, you are already over seventy.”
But I would have none of that. “My official birth date is January 2,” I said fiercely. “If I die before then, the New York Times obituary will read ‘Isaac Asimov, 69’ and that’s unacceptable. I want ‘Isaac Asimov, 70’ at the very least.”
Yet I hung on. On Christmas Day, Janet, Robyn, and I all went to Leslie Bennetts’s to celebrate the day, and to marvel over her nearly ten-month-old baby. And the next day, I went out alone for the first time in three weeks and visited Doubleday.
Nevertheless, I was dragging about and my legs were monstrously edematous. I had what was, in the old days, called “dropsy” and my legs looked like tree trunks. I could not get my shoes on and I had to walk about in slippers, and not too comfortably at that.
Robyn, on hearing all this, grew very excited and demanded that I make an appointment with a cardiologist. Working at a hospital, she was becoming medically oriented, so that now I had two of them, Robyn and Janet, constantly yapping at my heels.
But I did as Robyn asked and saw Peter Pasternack on December 27 at his University Hospital office. He listened to my heart, and said, “You have a murmur.”
“I know,” I said. “It’s probably congenital.” I told him that when I was examined for the army in 1945, forty-five years earlier, I had been told by my examining doctors that I had a murmur, but that it wasn’t sufficient to keep me out of the army.
Pasternack shook his head. “We can’t dismiss it that easily,” he said. “In view of your edema, we have to find out exactly how bad the murmur is, for that may be the root of your trouble.”
Of course, that meant the beginning of a series of tests.
January 2, 1990, finally dawned and I was seventy years old after all —officially. Janet, Robyn, and I had a celebration dinner at our Chinese restaurant and we had Peking duck. Or, at least, they had it. I ate a small quantity only, for it had salt in it, so it was not exacdy a happy birthday even though I was greatly relieved at having reached it. Nor did it make it better that I was beginning to receive cards from all over the world, uniformly wishing me “a happy and a healthy seventieth birthday.”
I was having neither, for despite a daily dose of diuretics, I was still badly edematous and Peter was intent on having me continue taking tests.
Hospital
Months before, I had agreed to go to Mohonk on the first weekend of January to give a talk to the guests. I didn’t want to go, but a promise is a promise. We asked Peter and he said I might risk it, so we talked Mohonk into sending a limousine for us and we were driven up.
I spoke at Mohonk
on the evening of January 5, 1990, and, to my intense pleasure, it went well, and I enjoyed it. It seemed a definite indication that though I might be ill, I wasn’t dead. We were home on the seventh and I got right into bed—worn out.
On January 9, I made my publishers rounds and also chaired the Dutch Treat meeting for the first time in a month. However, I was so visibly ill, so clearly exhausted, that I badly frightened Jill at Double-day and Sheila at the magazine. My Dutch Treat comrades were clearly concerned too.
But I refused to take any more medical tests and I had come to a momentous decision.
On January 11, 1990, I went to see Paul Esserman at my own request. There, almost in tears, I made a rather long and eloquent speech, the tenor of which was that I didn’t want to take tests, I didn’t want hospitalization, I didn’t want anything. I just wanted to be allowed to die in peace, and not be made a football to be bounced from doctor to doctor to doctor while all of them experimented with me
and began to employ more and more heroic measures to keep me alive.
I had reached seventy, I said, and it was no longer a disgrace to die. I had squirreled away a sizable estate for which I had no personal use, but which was intended to support my wife and children after I was gone, and I didn’t want to waste any of it merely for the privilege of maintaining a maimed existence. I ended by saying that I depended on Paul to see that all this was done.
Paul listened to me very carefully and without comment. When I was done, he called University Hospital and got me a private room in the Co-op Care section of the hospital, and by dinnertime that was where I was.
I asked him, in later days, how he had come to do that when I had just spent an arduous half hour telling him not to do it. And he said, “Well, you might have been ready to die, but I wasn’t ready to let you.”
The first task at the hospital (where Janet and Robyn took turns staying with me) was to get rid of the edema, and that meant the intravenous injection of a diuretic. I was fitted with something called a “heplock,” which opened a passage into a vein in my arm so that material could be injected into my bloodstream at will.
I was pessimistic. It would do no good, I muttered. I was condemned to death and they were merely prolonging my misery.
But I was wrong. The intravenous diuretic did the job beautifully. During my hospital stay, I lost seventeen pounds of fluid and my legs returned to normal. I had been staring at tree trunks so long that I found it unbelievable that they now looked like sticks. I almost thought they wouldn’t be strong enough to support my weight.
While tJiere, my left leg (from which a vein had been taken on the occasion of my bypass operation, and which was more susceptible to infection as a result) developed cellulitis, a bacterial inflammation of the skin, which was more likely to happen when that skin was stretched by edema. I had to keep my left leg elevated as much as possible, while I took antibiotics to fight the infection. That was defeated too.
My big problem came on January 16, which was the sixth day of my hospital stay. For months, Doubleday had been planning a party on that day to celebrate both my seventieth birthday and the fortieth anniversary of my first book, Pebble in the Sky. It was to be held at Tavern on the Green and it was, to my horror, to be black tie. I insisted that everyone be told that black tie was optional but, of course, I would have to get into my tuxedo.
Yet when the day came, there I was in the hospital. I simply couldn’t disappoint hundreds of people, however, so I got Paul to conspire with me. He agreed not to tell anyone about the matter and to attend the party so he could keep an eye on me. Janet then “borrowed” a wheelchair and wheeled me out of the hospital at 3 P.M. when no one was looking. Doubleday had sent a limousine, which took us to the apartment. I struggled into my tuxedo and the limousine then drove us around the block to Tavern on the Green, where all my buddies from various publishing houses, all my pals from the Dutch Treat Club and the Trap Door Spiders, all my friends and neighbors, near and far, were waiting.
There was a reception. I greeted everyone happily, from my wheelchair, with my left leg on a stool in front of me. I refused all the dainties everyone was eating (too salty) and made do with orange juice. Nancy Evans, then president of Doubleday, gave me an absolute sweetheart of an introduction and I launched into my talk.
I discussed my earlier near-scrapes with death, going into full detail about my fantasy involving the Baker Street Irregulars at the time of my bypass and what a flash of disappointment I experienced on realizing that I had survived and would not get the applause a dead man would have gotten.
There was wild laughter and applause from everyone, of course, and the only negative comment I got was from Robyn, who was dripping tears, and who came up to complain bitterly to me over my speech. I said, “But, Robbie, it was funny. Everyone laughed.”
She said, “I didn’t. You may think it’s funny to talk about dying, because you’re crazy, but /don’t think it is.” Well, everyone else laughed!
By 9 P.M., I was back in my room, feeling I had handled everything perfectly and no one in the hospital would know.
However, the New York Times knew about the party. It appeared in the paper the next day and everyone in the hospital apparently read it, so that I was lectured by the nurses. Lester del Rey (whose own condi tion wouldn’t allow him to attend) called up and raved at me for doing it and endangering my life. All I could say was “Lester! I didn’t know you cared!” and that didn’t seem to soothe him. What bothered me most, though, was a matter involving my syndicated column. It was time to do it and the only way I could manage it was to choose a topic that required no reference material, write it out longhand, and then call the Los Angeles Times and read it into their recording machine.
I did exactly that, but when I called I got a young woman at the paper who said to me, as soon as I announced my name, “Oh, you bad boy! Why did you sneak out of the hospital?”
It just about broke my heart. I couldn’t even carry out an innocent little deception without the whole world knowing.
It meant I couldn’t do it twice. A few days later, Analog celebrated its sixtieth anniversary, since the magazine, originally called Astounding Stories of Superscience, had first come out in early 1930. I had agreed to attend and to give the major talk—and I could not do it. I spent a rather sad lunch hour on the day of the celebration and railed at fate.
Meanwhile I had finally been diagnosed. I was catheterized and CAT-scanned and ultrasounded virtually to death, and it turned out that the murmur, which was probably due to a congenital weakness of the mitral valve in the heart, had gotten worse in 1989. The valve had given way and sprung a leak. As a result, the blood didn’t travel efficiently from the right auricle to the right ventricle, but regurgitated somewhat. This cut down the efficiency of the circulation to the lungs, so that I easily got out of breath. What’s more, the heart could not work at sufficient efficiency to help my imperfect kidneys expel fluids from my body.
There was, furthermore, a possibility that the mitral valve was infected and that that was what accounted for its failure. In that case, it would have to be replaced. That would mean that I would have to have my chest opened again, precisely as at the bypass, and be subjected to the heart-lung machine. It was a simple operation, they assured me. (Bob Zicklin, my lawyer and good friend, had had a valve replacement operation three times, the first time under fairly primitive conditions, and had survived all three handily.)
I was finally released from the hospital on January 26, 1990, fifteen days after I had entered. They told me, however, that I would have to undergo tests to determine whether mitral valve infection really existed. On February 2, I got a call from Peter. Even though the tests for bacterial infection were all negative, they weren’t going to take any chances. I would have to return to the hospital the next day and undergo a series of intravenous antibiotic treatments.
On February 3, then, I was back in the hospital, this time in the hospital proper in a private room, and I spe
nt four weeks there. In other words, the entire winter of 1989-90 was spent either in the hospital or in bed at home or creeping about my business feeling very ill.
It was one miserable winter. They had to continue the intravenous drip for four weeks. Twice each day, material was dribbled through a heplock into my veins for an hour or two at a time.
Then, on February 15, the doctors came to me with further news. In view of the fact that no infection could be found, they did not think it wise to subject me to the operation and take a chance on further kidney damage with the heart-lung machine. Therefore, I would not have the operation to replace the leaking mitral valve. They said I could live with mitral regurgitation, that there was no chance that it would suddenly give way and kill me. At the most it would weaken further, my symptoms would get worse, and they would bring me in again for surgery.
On March 3, then, I was back at home and ready to renew my life— with a leaking valve and faulty kidneys. The doctors warned me against involvement in anything beyond my strength, but they agreed that writing (even to the extent that I wrote) was not physically strenuous and that I could continue.
New Autobiography
My winter of illness had produced many unwanted complications in my life. My mail was a disaster. Janet brought in important letters daily while I was in the hospital and I dealt with a few items there.
Most things had to await my return, when my entire two-room section of the apartment seemed crammed with envelopes and packages. Little by little, I took care of everything.
I even rewrote an article on automobiles of the future. A small revision had been plaintively asked for, but it was something I could not do in the hospital.
Fortunately, I routinely kept so far ahead of deadlines in the case of the F&SF essays and of the editorials in my magazine that even three months of inaction did not create problems. I was still comfortably ahead when the devastating winter was over and I soon brought myself back to my earlier position of being far in advance.