When I went back in the room after Katie left, I did not tell Jim about our conversation, but a little later, back out in the hallway where I could be alone, I called Jim’s children, and mine, and then Bridget, who had become for me—though she was younger than my daughter—like a wise parent. With Bridget, I allowed myself to have the conversations I could not engage in with anyone else, about death, and dying, and after. With rare exceptions, I had virtually not allowed myself to imagine a life without Jim, but now—in the quiet of those conversations, with Bridget—I did.
Another person I called, in the aftermath of my conversation with Katie Kelley was our attorney friend Robert in Miami—part of the self-created network of pancreatic cancer survivors I had sought out early on. Robert was a virtual anomaly—the only Stage 4 patient I knew of, now that our Stage 4 friend from the breakfast group had died, who had hung on so long and well. We had never met, but his was the voice I wanted to hear on the other end of the line that night.
He was heading to a Seder, he told me, but he always made time for me. I told him about Dr. Kelley’s visit. The no-chemotherapy verdict. We’d hit the wall, I said. Or at least it was looking that way. But he was the man for whom a miracle seemed to have occurred, and some incorrigible part of me still held out for the possibility that Jim might find one too.
Robert had recently returned from a conference on advances in the treatment of late-stage pancreatic cancer. I was hoping he might have something to suggest that nobody else had come up with yet.
“Do you have anything for me?” I asked him—this man who had become, for me that year, the friend to whom I turned in my darkest hour.
He drew in his breath. Silence on the other end of the line.
“So, what are the words you’ll speak tonight at the Passover table?” I asked Robert.
Later, I would ask another Jewish friend to explain to me the meaning of what my friend told me over the phone that day. I would learn that it was a metaphor, and a statement of hope. His words expressed a wish to be in Israel, my friend explained. But Israel as a symbol for whatever it is in each of our lives that represents the promised land. Somewhere between heaven and earth, body and soul. A peaceful resting place.
“Next year in Jerusalem,” Robert said.
88.
It was the first week in March when Jim entered the hospital. It was late April when he came home. Wisteria time.
I had driven the BMW to pick him up—careful not to get the car dirty, with the knowledge that I’d be selling it at some point not so long from now. A nurse brought Jim to the curb in a wheelchair—hospital policy—while I came around with the car. When I pulled up, Jim wanted to take the wheel.
He drove more cautiously than usual, and without his usual finesse. One time on the bridge it seemed to me that he was weaving a little outside of our lane, and he almost missed our exit.
“I’ve got it, baby,” he said, observing me gripping the seat. When we reached our driveway in Hunsaker Canyon, he took it slow, just as we had the first day we’d made our way to this spot, on Jim’s motorcycle.
“We’re home,” I said. The live oaks. The fruit trees behind the house where deer liked to graze with their fawns. The hot tub where we used to sit—before the presence of those drains made this impossible—to watch the stars, or the sun coming up.
Like an astronaut emerging from the landing module after a long space flight, Jim climbed with exquisite deliberation out of the driver’s seat. He stood a moment outside the house before going in. After years of drought, the winter had brought rain, and now the field behind the house was green all the way out to the oak trees. For the first time since we moved here, the brook was running again. You could smell the jasmine, and the wisteria was in bloom, same as it had been the first time we pulled up here just two years earlier.
We made our way along the path to our front door—Jim’s gait slow but steady, mine matching his. As he placed his hand on the doorknob, Jim turned around again, his gaze taking it all in.
“This would be a good place to die,” he said. We stepped inside.
89.
Though we had not spoken of it, life at home felt different now. A team of home care nurses had set us up with a schedule—weekly deliveries of the antibiotic Jim had been receiving at the hospital that we’d infuse at home now through a PICC line in his arm at eight-hour intervals, along with all the usual drugs. This was a demanding schedule, but it allowed Jim to be home in our own bed—with Willy’s dog, Tuck, still on extended loan to us, under the covers by our feet, or in side-by-side chairs on our balcony at the end of the day, looking out over the trees of Hunsaker Canyon and listening to the birds.
The chief condition for Jim’s release from the hospital was that I administer Jim’s antibiotic infusions three times a day. The nurse had instructed me on the procedure for carrying out the infusions, and though at first the whole thing had seemed impossibly complicated and risky—particularly for a person like me who had never maintained anything close to a sanitized environment, (a person who could be counted on to have crumbs on her clothes and garden dirt under her fingernails), I knew that for Jim to stay out of the hospital, I had to get this right, with no margin for error.
I located an RN—a neighbor whose father had died of pancreatic cancer—who offered to oversee the infusions until I felt more confident about delivering them myself. I had never met Lori before, but now she arrived at our house at five in the morning for the first infusion of the day.
We performed the infusions at Jim’s precious glass table—a piece of furniture that I had once disparaged for looking too cold and sterile. Now I laid out the components for each infusion as a priest might the sacrament: Clean white towel. Saline syringe. Sterile wipes. Another saline syringe. Tubing. Tubing cap. Bolus of antibiotic (warmed to room temperature the hour before). Another syringe of saline. Syringe of antibiotic. More sterile wipes. I set the containers of medicine and saline in a row, in the order I’d administer them. First I washed my hands three times with the hottest water. If the tip of the syringe touched my hand before I got it into the PICC line, I started over with another sterile swab.
Jim, in the chair beside me, always told me what a good job I did. “You could have been a great nurse,” he told me.
Well, only to him.
He told me he wanted to play golf again. Maybe a nine-hole course. Next winter, he said, maybe we could go skiing, but gentler slopes than in the old days.
“There’s always ping-pong,” I said. No question, he could beat me at that.
One of Jim’s classmates from law school who knew about the cancer suggested a gathering in the city—nothing too elaborate, just the members of their class meeting up for drinks in the city. “It’s been too long since we all got together,” he wrote to Jim, though there was a little more to this get-together than that, as we all knew.
It had been months since Jim put on a suit, and none of them fit anymore. We cinched in his pants and kept the jacket buttoned, though that hardly concealed the truth of what had become of his body over the last year and a half. He laced his shoes, spent time considering the tie. He stood at the mirror a long time then, taking in the sight of himself in the beautiful Calvin Klein suit. Looking at him studying his reflection, I tried to imagine what it must be like to see, in the mirror, a person who no longer resembles you. More than once over the past year, on the rare occasions when we’d gone out in the city—to the symphony one time, and once to the ballet—we had run into some old friend who no longer recognized Jim. His physical appearance had altered that much.
Now, as he suited up for the law school reunion like a knight preparing for battle, I studied his thin, pale body with a rush of protectiveness as well as love.
“You are such a handsome man,” I told him. In spite of everything, this was still true, though he looked like David Byrne in his big suit in that Talking Heads video of our youth.
Jim drove us into the city, and—slowly, as we did everything now—we
made our way from the parking garage to the lobby of the high-rise where Jim’s old friend Phil had his offices, and up the elevator to the swank conference room where the evening’s gathering was taking place. Platters of fruit and cheese had been laid out for us, along with drinks.
This was a good-bye, of course, a send-off. But the Hastings Law School Class of ’77 greeted each other with lawyerly restraint. Most of them were still practicing law, many having come straight from work to attend the gathering. Their talk was of cases, the Warriors basketball team heading into the playoffs. The California primary.
Everyone seemed to have a trip coming up: One of them was marking his upcoming retirement by embarking on a yearlong sailing adventure; someone else had recently walked the Camino de Santiago. One woman had taken up dressage riding.
Mostly they reminisced about the old days: Jim, a law review editor back in the day, was always the one you could count on for the wittiest comeback, the most fun, the biggest laugh. One of the group—who evidently hadn’t heard the news and seemed not to have noticed that Jim had probably dropped forty pounds since the last time they’d had drinks—inquired where Jim was practicing these days.
“I’ve had to scale back for the moment,” Jim said. “I’ve got some chemotherapy coming up.”
The conversation shifted swiftly then, back to other topics. Grandchildren. Wine.
In the car on the way home I kept my arm around Jim’s shoulders as he drove. We were giving one of his old colleagues a ride home, so the banter continued. After we dropped her off, we didn’t say much for a while.
“You were my favorite lawyer tonight,” I told him. “You are always my favorite.”
He didn’t look the part of the Super Lawyer anymore, that guy with the number 10 Avvo-rating score, one of those debonair man-about-town types—the swinging dicks, he called them—who played golf at the Olympic Club and drank whiskey shots at Tadich’s. The man who used to take curves fast on the Pacific Coast Highway had taken his leave. The closet full of good shirts, miles too big for him now, had been donated to Goodwill. No more small talk over cigars, discussions of some six-figure settlement fee. At heart, Jim was never really the high-roller super-lawyer type, but he had played that game well enough, for all that it mattered, which no longer seemed like much.
It came to me, driving home over the bridge that night after the gathering of lawyers, that something had shifted over the course of these terrible months.
I had admired Jim as he was the day we met, and came to love him not so long after that. I had loved dressing up for nights on the town, speeding up the highway with the top down, sitting at some bar watching my fine, handsome husband coming in the door, briefcase in hand, and knowing he was headed for my table. But the man I lived with now, as diminished as he believed himself to be—a scarecrow in a suit with enough room left over inside for another whole person—was a man in possession of more compassion and humility than the one he’d been when times were good. He had become his finest self over the course of his ordeal. Not always, but on my better days, I like to think the same was true of me.
90.
It was one of his last pleasures, having a glass of wine, and what he liked best was sitting out on our patio, wrapped in blankets now, and having one with me.
At this point over three months had passed since I’d had a drink, and I didn’t even find it so difficult anymore, doing without. But after our return from the hospital—in this new world of Stage 4 cancer, where the horizon line lay starkly in front of us, the glittering distant vistas we used to contemplate no longer within sight—I wanted to have a drink of wine at the end of the day with my husband. I also just plain wanted a drink. More vigilant than before—when we’d polished off a bottle over a single dinner—I allowed myself to do this. “I’ll probably have to give it up later,” I told myself. I did not allow myself to form a picture of what later would look like, or where I would be then.
One night over the dinner Jim could no longer eat much of—dinner, and red wine—something possessed me to lay out for us a fantasy. In the absence of real travel, I wanted to take us someplace, if only for the space of that one meal.
“Suppose there was this clinical trial,” I said. “And they accepted you.”
More than once over the four and a half years of our time together, Jim had told me he possessed no imagination. He said this as a person (me, for instance) might admit to being a bad driver, or to having no aptitude for tennis. Maybe it was more along the lines of acknowledging color blindness, this lack he admitted to—but what he had spoken of was a deficit of something so basic and crucial, in my world at least, that his words had stunned me. I could no more picture life without imagination than I could picture life without breath.
But there was a truth to what Jim said about himself. He could come up with elegant legal strategies or hundred-point Scrabble plays, but he could not dream up scenarios that differed from life as we lived it. Maybe his father had terrorized all fantasies out of him years ago.
So now I laid out a story for him—much as, long ago, I had told my children tall tales around a campfire, or sitting by their beds at night.
The story I spun out that evening was meant for me as well as for Jim—a few minutes’ reprieve from the unbearable hopelessness of his situation.
“Suppose they put you on this new drug,” I went on. Slow and quiet, my voice not so different from the one in which I had read to my children. “Some brilliant young scientist came up with this, and nobody ever tried it before, but they chose you to be the first.
“And the cancer … went away.”
I watched Jim’s face as I filled in the details—the trip to some new city for treatment (Houston maybe? Berlin? Philadelphia? Why not make it Paris?). It was as if I had offered him a ticket for the most wonderful thrill ride anywhere, the most spectacular show. Come watch this with me. I’ll buy the popcorn.
He was there.
“You’d start to feel so much stronger then,” I said. There would still be all the mess left by the Whipple procedure, of course, but I had a scenario to deal with that one too.
“And your pancreas grew back. Not all of it, but enough that you wouldn’t even need Creon anymore.
“You could eat regular meals again,” I said. “No more drains in your belly. And you wouldn’t need all those Dilaudid pills, messing up your brain.
“I’m with you,” Jim said. His voice was low, and he had set down his fork.
What then? Where would I go with my fantasy, now that I’d started to construct it? Would I put Jim in some big law office in the city with views of the bridge and giant estate battles to litigate? Would we rent a house in Provence? I could sell a book to some big movie studio and make a pile of money. Jim could have his Tesla.
I had the imagination for this. No problem there. But I felt no need for further embellishment of the dream. For us that night, it was enough to savor the picture I’d already laid out. Cancer eradicated. Pain gone. Us together in our bed. End of story.
We ate our meal in loving silence then, as we often did. As little basis in reality as my words possessed—none, actually—it had felt good just letting ourselves go to that place for the space of a few minutes (the one trip we could still take, since Italy and Croatia were out now) and to realize, as we did, that there was nothing more we would ask for beyond the restoration of Jim’s health. That alone represented the dream. All the things we’d hungered for at other stages in our lives—success, money, beauty, passion, adventure, cars, houses, guitars—were immaterial. Breathing would be enough. Getting to walk down our road together, and come in after to share a meal. That, and ending up in the same bed every night with our arms around each other. What more did two people need?
91.
Even though she’d told me that day in the hallway outside Jim’s hospital room that she could tell the cancer was back, Dr. Kelley scheduled one more scan. I had come to accept the part about the recurrence, but I allowed mys
elf the slim hope that maybe this new scan would reveal the abscesses in Jim’s liver sufficiently diminished that he’d qualify for chemotherapy after all. No longer lifesaving, only life-extending. From where we stood now, this would have qualified as great good luck.
Sitting in Dr. Kelley’s office that afternoon awaiting Jim’s results, we took our familiar positions. For months it had been the way things worked at doctor visits, that I’d answer the questions about Jim’s medical history, starting with his birthdate that I had recited so many times that I knew it better than my social security number. 061252. Moving on to his medications. I could run down the list a lot faster than Jim.
Date of diagnosis. First symptoms. Allergy to medications. Date of Whipple. Most recent bowel movement.
Then Katie asked Jim how he was feeling. I left it for him to answer that one.
“Pretty good,” he told her, though I knew he wasn’t. “I’m doing great, actually.”
I did not correct him. I knew what he was doing here: trying to put on a good enough show that his doctor would give him a shot at more chemotherapy. Maybe even—if we were really lucky—recommend him for a clinical trial.
To this it had come: concealing how rotten you felt, so you might get to have a drug that would make you feel ten times more rotten. Putting on a brave front to your own doctor. As much of his pain as I witnessed, he was probably working hard at looking strong for me, too. (Those pushups he still did every night before bed. Pushup, singular. He was down to just one.)
And still he was chasing after chemotherapy. My Eagle Scout husband had become a supplicant, lying to his own doctor in the hopes she’d agree to infuse him with the most deadly chemicals, even though as we well knew, they could no longer prevent—only postpone—his death from pancreatic cancer.
Dr. Kelley looked at Jim squarely, her voice level, with a look of deep regret. “For you to receive chemo, Jim,” she said, “we’d need to see evidence of major reduction in the infection.” This was familiar ground we were treading. We’d been here before.
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