by Claire Adams
That may very well be the first time I’ve used the words “I promise” outside the phrase “We’re going to do everything that we can.”
I know she’s scared, but I really believe this is her best shot. I don’t just want her to live for another 10 or 12 years, I want her to have a full life.
“Okay,” she says. “There’s someone else out there; do you have to see them before we go?”
“Yeah,” I tell her. “If you want to, you can wait out there with Yuri while I finish up and I’ll walk you down and introduce you to Dr. Willis. She’ll be the one in charge of the trial.”
“Okay,” Grace says, but hesitates. She quickly makes her way over to me and gives me a quick kiss on the cheek before she turns and walks out of the office.
“Yuri?” I call out.
She comes to the door, saying, “You know, we do have an intercom.”
“Yeah,” I answer. “Would you send in Mrs. Probst?”
“Sure thing, boss,” Yuri answers, and leaves the room again.
Mrs. Probst has stage four small cell lung cancer. She doesn’t have much time left, and there’s not a whole lot that I can do for her.
We’re past the point of treatment now and we both know it. Today’s appointment is to discuss how best to make her comfortable over the remaining week or so that she has left.
The hard part with Mrs. Probst is that she refuses to be admitted to the hospital, though by all rights she should have been in a bed here weeks ago.
Her son, Brian, wheels her into the office and guides her to the far side of my desk before taking a seat next to her.
“How are you doing, Brian?” I ask.
“I’m doing,” he says. “I think it’s time we get Mom to come to the hospital, though. I don’t know how much longer she’s got, and I don’t want her to have to spend her last days in so much pain.”
I turn to Renee. “How are you feeling?”
It’s a stupid question, but one that still needs asking.
Right now, Renee is in a great deal of pain. I’ve given her prescriptions for painkillers, but she refuses to take them. Every breath for her is a struggle, and it’s one that she never fully wins.
With a heavy wheeze, she lifts her oxygen mask enough to say, “I don’t want to be admitted. If I’m going to die, I want to die in the house my husband built.”
“Mom, you’re in pain,” Brian says.
“That’s life, dear,” she says, and puts her oxygen mask back over her mouth and nose.
“It is her decision,” I tell Brian and then turn to Renee, “although there is a lot that we can do to make you more comfortable, even if you choose not to stay in the hospital.”
She shakes her head slowly.
She’s already resigned.
In my business, in her progressed stage of small cell, resignation isn’t necessarily a bad thing. The five-year survival rate is about two percent, and unfortunately, everyone sitting in this room right now knows that’s not going to be her.
Still, there’s no reason she should suffer any more than she has to.
“Would you consider a morphine drip?” I ask. “We have buttons that you can use to give yourself a dose, within limits, of course. That way, you can still be in control of-”
“I’m not...” she wheezes, lifting her oxygen mask slightly, “in control…of anything… anymore…”
“This can give you control over your pain,” I tell her. “There’s always going to be some discomfort, but you might be surprised how much a little relief can help.”
This 75-year-old woman is, without a doubt, the toughest person I’ve ever met in my life.
For an oncologist, that’s a hell of a statement.
The fact that she’s even sitting up in her power chair is a small miracle. She shouldn’t even be out of bed right now, and it’s astonishing that she’s capable of doing it. I’m not exaggerating when I say that I’ve never seen anything like it.
Renee just says it’s the only excuse for her to leave the house that anyone will accept anymore.
For her, as painful and exhausting as it must be, this is the closest thing to a vacation she’s likely to know from here on out.
“No,” she says, not bothering to lift her mask this time. “I’m tired…I’m weak…I’m ready…”
“You’ve got to talk to her,” Brian says. “There’s got to be something you can do.”
“There’s nothing more we can do at this point,” I tell him. “Other than manage her pain and try to make her as comfortable as possible…” I sigh. “There’s just nothing else for us to do.”
“Why isn’t she on the transplant list?” he shouts, startling me and his mother.
“Her cancer’s metastasized,” I tell him. “There’s nothing more we can do. I advocated getting her on the list, but the transplant committee denied it. I’m sorry.”
Brian turns to his mother, tears in his eyes. He’s young. He can’t be more than 35.
“You’ve got to do something,” he says.
“I’m ready,” Mrs. Probst breathes, and with that, her head droops forward.
I’m on the other side of the desk and crouched down next to Mrs. Probst in a second, feeling her neck for a pulse.
“What’s happening?” Brian asks.
Shit.
“I’m sorry,” I tell him.
I’m not feeling a pulse and she’s DNR. I try to find a pulse in her wrist, but there’s nothing.
“You’re sorry?” he shouts. “Why the hell are you sorry?”
I look at my watch. “Time of death, 11:47,” I pronounce.
“What?” he cries. “No, you can bring her back. You’ve got to bring her back.”
“She signed a do not resuscitate order,” I tell him.
“I don’t give a fuck what she signed!” Brian yells in my ear. “You need to give her CPR.”
“I can’t,” I tell him. “Legally, I can’t.”
“She’s dying!” he yells, and the door to my office opens.
Yuri’s in the doorway, waiting for some kind of instruction from me, but I really don’t think now is the time for me to tell her to call the morgue.
“I’m going to need a little help in here,” I tell her. “Mrs. Probst just passed away.”
“Why aren’t you doing anything?!” Brian screams at me.
“Mr. Probst,” Yuri says. “You need to come with me.”
“Fuck you!” he shouts. “I’m not going anywhere. This is my mother, and you’re just letting her die!”
“Brian,” I say in as calm a voice as I can muster given the situation, “you need to come with me.”
“You’re just going to leave her here?” he asks, his anger turning to grief and confusion.
“No,” I tell him. “A couple of doctors are going to come in here and help me move her to a gurney, all right? I’m sorry, but this is what she wanted.”
Brian’s in tears now, clutching his mother’s hand.
I’ve had patients die before. I’ve been in the room when it’s happened, but it’s never happened in my office.
After a few minutes, a couple other doctors and a few nurses are in my office and we’re lifting her as carefully as we can onto the gurney. Brian’s just standing off in the corner of the room now, watching us in silence.
For now, we leave the gurney where it is. I’m not about to tell Brian that he has to leave his mother’s side.
“If you want,” I tell Brian, “we can give you a few minutes with her.”
He’s wiping his nose with his sleeve and doesn’t say anything.
“We’ll just be right outside whenever you’re ready to come out,” I tell him.
With that, the other doctors, nurses, and I exit the office, and I close the door behind us.
Most of the nurses leave, and all but one of the doctors go, as well.
Yuri’s sitting at her desk, looking at the grain of the wood in front of her.
“Are you all right?” I as
k. “That was pretty hard in there.”
“It’s okay,” she says. “I’d probably be doing the same thing in his shoes.”
“Okay,” I tell her. “Let me know if you need anything, will you?”
This isn’t what I expected of today, but something like that is never out of the realm of possibility.
I look back over the waiting room, but immediately turn back to Yuri.
“Where’s Grace?” I ask.
“She left when Brian started screaming,” she answers.
“Do me a favor and see if you can get her on the phone, will you?” I ask. “I’ve got to stay here until-”
“Yeah,” Yuri says. “I’ll call her.” She picks up the phone and dials the number.
Brian comes out of the office, his eyes red from crying.
“I’m very sorry, Brian,” I tell him, but he just walks past me and out the door.
Mr. Probst died a few years ago, so Brian’s the next of kin. There are some things he needs to sign, but I feel okay giving him some time.
“Boss?”
“Yeah?” I respond, turning back to Yuri.
“She’s not answering her phone,” she says. “I can keep trying.”
“Please do,” I tell her, and look to the doctor and nurses still in the waiting room with me. “We should get her down to the morgue,” I tell them, and that’s what we do.
It’s about 20 minutes before I’m back in my office, and Yuri’s quick to tell me that she still hasn’t been able to reach Grace.
I have another appointment in about 10 minutes. I’d planned to use my lunch break to take Grace down for her first day in the trial, but with the situation being what it is, that’s just not going to happen.
“Has anyone been in to take the chair?” I ask Yuri.
“It’s still in there,” she says. “Do you want me to call someone?”
“Yeah,” I tell her. “Let’s see if we can get it out of here before my next appointment comes in.”
“Sure thing,” she says, and picks up the phone.
“Are you sure you’re all right?” I ask.
“Yeah,” she says. “I’ll be fine. I’m just a little shaken, I guess.”
“Okay. When you’re done, you can take a break if you need it.”
“That’s okay,” Yuri says. “I’ll stay.”
“All right. I’ll be in my office. Let me know if someone can get up here in the next few minutes.”
The sheer impracticality of getting the electric wheelchair out of my office without climbing in and driving it — more than a little insensitive, I think — is something I’m going to have to deal with if Yuri can’t get someone to come in and take care of it.
I’ve never given much thought to that sort of thing, but it can’t be a new situation to the hospital.
I pull out my phone and dial Grace’s number. It rings a couple of times and then goes to voicemail. She’s ignoring my call.
If I knew she was still in the building, I’d risk being a little late for my next appointment to talk to her.
There’s no telling where she is, though.
After something like that, she might already be in for her first day of the trial, or she might have left the hospital entirely.
Yuri pops her head into the room and says, “Nurse Travis is on her way.”
“Thanks, Yuri,” I say. “Let me know when Mr. Farrer gets here. And if Brian Probst comes back in, let him know where Nurse Travis took the chair and call Benedict so Brian can fill out the paperwork.”
“Okay,” she says, and leaves the room.
Nurse Travis comes in a minute later and removes the chair from the office, leaning over the back and using the joystick to propel the chair forward.
I guess I could have thought of that.
I’m still trying to get my head back together when Yuri comes back into the office.
“A couple of things,” she says. “First off, Brian Probst came back in and he’s waiting for Benedict to get here. Nurse Travis left the chair out here, so that’s all taken care of, and I don’t know if you’ve gotten ahold of her or not, but Grace still isn’t answering her phone.”
“Thanks, Yuri,” I answer, and rub my eyes.
“Oh,” she says, “and Mr. Farrer just called to cancel his appointment. I got him rescheduled for next Tuesday.”
“When’s my next appointment?”
“You’ve got about 20 minutes,” she says. “It’ll be Mrs. Frost at 12:40. After that-”
“Thanks, Yuri,” I interrupt.
After Mrs. Frost’s appointment in the office, I check up on my admitted patients. It’s a full day.
I just wish I knew where Grace is.
Chapter Thirteen
The Wrong Side of Intervention
Grace
I missed my first day with the trial, but I couldn’t stand to be in that hospital another minute.
That woman died in Jace’s office. I get that she was a lot worse off than I am now, but that hardly makes any difference.
As terrified as I’ve been, I guess I haven’t really allowed myself to let the harder truth sink in: I am going to die.
Yeah, it’s not going to happen as soon as it did with that woman earlier today, but I’ve seen the statistics. I’ll be lucky if I see 40.
Jace has been calling off and on all day, but I can’t bear to talk to him right now.
He’s an oncologist. He’s used to death. Me? I wasn’t in the room, but just hearing that man screaming at Jace to do something…
My phone rings again and I look at the number. It’s Jace again.
I could turn off my ringer, but I’m waiting to hear back from John on whether he’s going to stop being a pussy and take my plan for the Midwest to the board.
If I don’t answer the phone now, Jace is just going to keep calling.
“Hello?” I answer.
“Grace,” he says, “thank God. I’ve been worried about you. Where’d you go today?”
“I went home,” I tell him.
“Do you want me to come over?”
“I don’t know.”
“Okay,” he says. “If you want, we can talk about what happened today. I know it was a bit of a shock, but maybe I can help talk you through it.”
If anyone could, it would probably be an oncologist. Still, I’m not really in the mood to think about what happened, much less talk about it.
“I’m good,” I tell him. “I could use something to take my mind off of it, though.”
“I can come over,” he says.
I sigh.
“Or not,” he says hesitantly. “I don’t want to crowd you. I’m just trying to help.”
“I appreciate that,” I answer, deadpan.
“Are you backing out of the trial?”
“I have no idea,” I tell him. “I’d rather not talk about it right now.”
“Well, if you need anything, just let me know,” he says.
“Hold on.”
“Yeah?”
“I don’t know,” I tell him. “Could we maybe just talk for a little bit?”
“Sure,” he says. “I know that it’s hard being there when something like-”
“Yeah,” I interrupt, “still not wanting to talk about that.”
“Okay, what do you want to talk about?”
“What are you wearing?” I ask.
Yeah, it’s stupid, and right now I couldn’t be any less interested in getting laid, but it’s about the furthest thing from that other conversation I can think of at the moment.
“You know what I’m wearing,” he answers idiotically. “You just saw me a few hours ago.”
“You’re really bad at this,” I tell him.
“Oh,” he says. “Geez, uh…”
“Really bad.”
“I’m sorry. I’ve never really done this before.”
“Oh, so you’re a phone sex virgin, huh?”
“I guess you could say that,” he answers. “Maybe you cou
ld teach me a few things.”
“I’m really not in the mood to be a tutor right now,” I tell him. “If you can think of something for us to do that has no connection whatever to doctors or patients or cancer or tumors, you go ahead and give me a call back, though.”
He’s quiet.
“All right, then,” I say. “I’ll talk to you later.”
I hang up the phone and flip on the television.
There’s nothing on that’s of the slightest interest to me right now, but I keep flipping through the channels anyway. I lie down on the couch and settle on an old movie with David Bowie as a prisoner of war, and I set the remote on the coffee table.
It’s not long before my eyes close and I’m drifting off into sleep.
My dreams are a circuitous nightmare where I’m in a long, brightly-lit hallway, looking for the door I’m supposed to go through. I don’t know why I’m there or what’s on the other side of the door, I only know that I need to find it as fast as I can. The lights flicker from time to time, but it’s just a mild annoyance as I continue walking down the hallway. There are signs next to each door, just like how the hospital has the room numbers on those bluish-gray plaques, but none of them are in a language I’m remotely familiar with, much less read.
Still, I keep walking down the endless hallway.
I get that feeling there’s something behind me, but when I look back, all I see is the white, sterile passage. Maybe I’m going in the wrong direction.
I turn around and start walking the other way, but the lights flick off completely and stay that way until I turn back around once more and resume my original path. My every footstep is echoing against the walls, a quarter of a second after each foot hits the floor. Off in the distance, I can’t be sure, but it almost looks like there’s an end to the hall. I keep looking at the signs next to each door, but the language written on them is becoming less akin to writing and more like scribbles and chicken scratches.
“Hello?” I call out, but my voice doesn’t even echo.
I take a step and I hear the reverberation.
“Hello?” I call out again, but my voice is lost in the enormous tunnel.
A moderate dose of fear enters me, so I start walking again, looking behind me every once in a while to check for anyone or anything following me, but there’s just the bright, empty hall. I walk a little faster and the signs next to the door are changing color and shape before my eyes.