Mitch licked his lips. It was dry in the room. “If she’s brain dead,” he said quietly, “that means she can continue to live, I mean exist, until something else happens.”
“Yup, that’s right. Remember the Terry Schiavo case?”
Mitch nodded.
“That’s an extreme example. Your aunt could continue on in a deep coma, with a feeding tube and no responsiveness to any stimuli. For the next day or two, we’ll keep her here in ICU and watch her. I need your permission to do the MRI and some other non-invasive tests. I’ll let you know the results and then we’ll talk some more. At that point you can decide whether to do the EEG.”
“Ok,” Mitch said. “Thanks for explaining things in understandable English. Can we stay with her a little more?”
“Sure. You can stay as long as you like. There are no restrictions on visiting here. May I ask you a question Mr. Farber?” Mitch nodded.
“Does your aunt have a living will?”
“No,” Mitch said. “She was incompetent when I moved her down from New London. There was no way we could have executed one this past year.”
“Hmm,” Dr. Teitelbaum said, tapping his pen on the chart. “That’s unfortunate. If she remains in a deep coma, which I would say is more likely than not, we would discharge her from here, either back to the Nursing Home or to a hospice. Someone will have to make the decision about what kind of life support she should have. Are you her only relatives?”
“No. There’s also my sister. That’s it.”
“Well, I can only advise you medically. You might want to think about quality of life issues. Maybe discuss it with your Rabbi. In the short term, let’s see how things develop over the next few days.” He reached out and shook Mitch’s hand. “Feel free to visit her anytime and if you call, they’ll page me. Nice to have met both of you,” turning to leave. “Sorry it was under such circumstances.”
“It’s always under such circumstances for him,” Ell observed, after Dr. Teitelbaum had left.
Mitch returned to Aunt Helen’s bedside. He called her name twice but there was no response. He reached under the blanket and held her hand in his, warming it, feeling her cold boney fingers move in his palm. “Ell. She’s responding,” he said enthusiastically. “You try.” Eleanor went to the other side and took Aunt Helen’s other hand in hers.
“With me too.” She smiled across the bed at him.
“Doesn’t this mean she’s reacting to touch?” he said hopefully.
“I don’t know what it means, Mitch. Maybe she’ll be more responsive tomorrow. But don’t let’s get our hopes up.”
They stood on either side of the bed, each of them massaging one of Aunt Helen’s hands, Mitch willing his aunt to open her eyes, recognize him and speak his name. It didn’t happen. “We should go,” Ell said. “It’s been about an hour.” Mitch knew she was anxious about leaving the kids alone at home. He reluctantly let go of his aunt’s fingers. They stopped at the nurse’s station. Mitch signed the MRI authorization and made sure they had their home and cell phone numbers. He asked them to cover Aunt Helen with another blanket. No reason for her to be cold even if the room was.
They emerged from the brightly lit lobby into total darkness. The tall silver colored street lamps that lined the lane to the garage and the sidewalk to the Emergency Room were out. The only glimmer, through the octagonal cinderblock wall came from headlights of a few cars lined up to exit the garage. Eleanor stepped gingerly and took his arm for support as they walked to the garage entrance. It was pitch black beyond the last car waiting in line. He took out the remote key and pushed the yellow button. The interior lights of the Taurus beckoned to them reassuringly from the corner.
“What do you think happened?” Ell asked him.
“Probably a power failure. The hospital either isn’t affected or has an auxiliary generator. Let’s get in the car.” He backed the wagon out and pulled in behind the last car in line. None of them had moved since he and Ell had entered the garage.
“Now what,” she asked anxiously.
“I’ll take a look,” Mitch said getting out and walking down the line of idling vehicles toward the exit.
“I’m going to phone the children,” she called after him, through the open window.
When Mitch got to the cashier’s booth, the problem was obvious. The cash register and the controls to lift the exit arm were both electronically operated. The lot attendant was standing outside her booth. Her flashlight lay on the open window, its beam shining on the closed gate. She was a short woman with her hair braided in rows, in an Atlantic Garage jacket, with a plastic nameplate identifying her as Nazrit. She had called Hospital Security, she said, but there was nothing she could do until the power came back on. Some driver in line hit his horn, sounding a series of annoying long blasts.
“That’ll help a lot,” Mitch said to Nazrit who shrugged. “Do you mind if I look at the gate arm,” Mitch asked. Nazrit gave him her flashlight. Mitch walked around the arm and tried to lift it. It moved a few inches. He saw it was attached by two large bolts to a three foot high vertical metal post.
“Is it ok if we removed the arm and left without paying,” he asked her.
“I cannot keep you prisoner here,” she said. “This is the United States of America. Not Ethiopia.” She flashed him a broad smile. “The cash register is not working anyway.”
Mitch walked back down the driver side of the line of cars, explained what the problem was and asked if anyone had a wrench in their car. He knew his wrenches would only fit the Ford’s bolts and it looked like they were smaller than those on the gate arm.
“We’re going to take the gate apart,” he said to Ell. “Kids ok?”
“Yes, but it’s getting late. We need to get home,” she said nervously. “We have to.”
“Don’t get upset, Ell. It’s going to be all right,” he said calmly. “Just a question of finding the right sized wrench. I’ll be back down at the exit. Call the kids back and tell them what’s going on. If it makes you feel better, keep talking to them on your cell.” He looked at his wife, trying to hide his own concern over her behavior and puzzled by her anxiety. Usually, she was the one who was unfazed by the unexpected.
As he approached the booth, he had to laugh. In the darkness, the scene looked like a robbery in progress. There were five men, armed with flashlights, tire irons, wrenches and hammers surrounding Nazrit, as if they were about to break into the cash register and steal the day’s proceeds.
Mitch tried two of his larger wrenches. As he suspected, they were too small.
“All of us pushing on the gate could break the arm off,” one of the others suggested.
“Let’s try to unbolt it first,” Mitch replied, recognizing the man as the driver of the BMW who had been blowing his horn.
“Try this,” one of the other men said. Mitch took the adjustable wrench from him, fitted it on the bolt and pulled up on the handle. He felt the bolt loosen and then turn more easily. “It fits. Hold the arm level,” he asked as he finished with the first bolt. One more to go.
The lower bolt didn’t budge. He shone the flashlight on it. The bolt was encased in rust. They clustered around the remaining bolt, as two security guards, cruised by in a white Dodge Neon. One of the guards acknowledged them with a half wave, as they continued past and up the hill toward the main hospital building.
“I guess this is a usual occurrence for them,” one of the other drivers snorted. “Power out and a bunch of white guys trying to break out of the garage.” Someone else laughed.
“I can’t move this,” Mitch said, stepping back. “Someone else want to try?”
One of the other drivers quietly reversed the wrench so that the handle, instead of facing the booth, now pointed in the same direction as the arm. Balancing himself on the arm, the man brought his booted foot down hard on the handle. The wrench moved and the man, having loosened the bolt, continued turning it as Mitch held the gate arm level.
“Nice
thinking,” he said to the problem solver.
“It’s like using a tire iron. Sometimes your feet are better than your arms,” he replied, acknowledging Mitch’s compliment. Problem Solver helped Mitch carry the arm to the sidewalk. The others had returned to their cars, BMW impatiently gunning his engine in the third vehicle back. The woman in the passenger seat next to him was checking her appearance in the mirror on the back of the sun visor.
Eleanor was on her cell phone. “Ok, darling. Daddy’s back now. We’ll be home soon.”
“They’re ok, of course.” It was more of a statement than a question.
“I don’t know why I’m like this,” she said as Mitch drove through the now disassembled gate, waving good night to Nazrit.
“I feel that nothing bad can happen to the kids if I’m on the phone with them.”
“That’s irrational,” he said. “You’re normally not like this, Ell. So smotheringly protective. Amy’s at the stage where she wants to be in control of her own life. You can’t treat her as a little girl if you want her to become a responsible teenager.”
“You’re right. You’re right,” she said, nervously putting the cell phone in her purse. “I’m just so on edge. I was so happy to be coming home to you and the kids. I thought leaving them alone tonight, meant something bad was going to happen to them. And I know it’s not fair to you. With Aunt Helen like that. I couldn’t help myself.”
He reached over and stroked her thigh. “Want my opinion? Don’t answer that. Of course you do.” She nodded and forced a slight smile. “You’re a terrific mother, wife and professional. You’re juggling all three and when you go away on business trips, you feel guilty about leaving us.”
“No, I don’t,” she protested. “I don’t feel guilty.”
“Maybe not consciously, but subconsciously,” he insisted. “That’s just my observation. You overcompensate when you come back. You’re overly protective trying to make up for not being here as their mother.”
She was silent for a moment. “Why don’t men feel that way? You go out of town sometimes. You don’t act like this. Don’t you feel guilty? Even just a little?”
He was tempted to tell a white lie. Tell her that he regretted being away, to make her think better of herself. But he had never felt guilty about going away on his infrequent business trips.
“No, Ell, I don’t. One reason is I know you’re home with the kids. You’re a great mom. You’re going to take care of them while I’m gone. Maybe men don’t feel this way because of biology. Forget all this modern stuff about equal parenting. You carried and gave birth to Amy and Josh.” He locked his fingers in her left hand, pulled it toward him and brushed his lips across the smooth skin on the back of her hand. “And you carried the two we lost.” He couldn’t bring himself to call the miscarried fetuses, babies. God. How they had been devastated each time. “There must be a special bond between a woman and her children that a man simply can never have. First, don’t feel guilty. There’s no need. And if you have to, don’t translate it into overparenting and obsessive worrying when you come back.”
“So what can I do about it? You make it sound so easy. I have to travel for my job.”
“I’m not talking about giving up your job. You’re missing the point. It sounds harsh, and I don’t mean it that way, but the three of us do manage to survive while you’re gone. I’m a responsible father. The kids eat, do their homework, take showers, do their chores. Sure. Amy and Josh miss you.” He squeezed her fingers. “And it goes without saying that I miss you the most.”
“You can say it all you want. I like hearing that.” She held his hand in her lap.
“Look. We’re almost home. I’ll walk Oliver. Why don’t you ask Amy and Josh what happened while you were gone. Let them fill you in. They’re bursting to tell you things. Just listen and it’ll be almost as if you were here each day. And Ell, I don’t know anyone who can juggle a career with being a wife and mother as you can. You’re terrific.”
“I’m sorry I wasn’t more of a help tonight with Aunt Helen,” she said sadly.
“Hey. You’re home and went with me to the hospital, even though you didn’t want to. You’ll help me decide what to do about the Hospice. You’re there for me. I can’t ask for more than that.”
“Neither can I,” she said, her eyes brimming with tears.
He walked Oliver slowly, content to let the dog set the pace. He wanted Ell to unwind, to spend time with the kids alone, unrushed and undistracted. It also was an opportunity for him to think about Aunt Helen. Poor Aunt Helen. He had gotten used to the routine with her in the Nursing Home. He realized that, despite her age, he had expected life to go on the same way, at least for another few years. Her living at the Home and coming with them on outings, celebrating the holidays together, Aunt Helen’s crazy moments, her screwy logic, the funny things she said, even her paranoia.
Now, it was coming to an abrupt end. During the past year, at the beginning when she was more lucid, he had treasured her recollections as a window into his mother’s life as a young girl. Over the past few months she had become less coherent. Her physical condition had deteriorated to the point where she could barely stand unaided. He now realized that Dr. Teitelbaum was gently pushing them down the path of preparing for Aunt Helen’s death. Her coma was probably irreversible. Once he and Ell knew that, they had to decide whether to keep her on life support. He should call Judy. It was too late tonight. He wanted her here for moral support and to participate in the decision. She’d have to come up to D.C. of course, to see Aunt Helen for herself. Molly would also be helpful, especially since Aunt Helen did not have a living will. Did they have the right to stop feeding her without it? He didn’t know. He shuddered, thinking of his aunt, as she had been tonight, living on in that condition. Oliver looked up at him, responding to the involuntary shaking of his leash. What kind of tree to plant for Aunt Helen? And where in the yard? He was back to his thoughts of almost a year ago, when she had lived with them, before she was admitted to the Nursing Home.
Maybe a weeping cherry he thought. It would represent the bitter and the sweet of her life. He could plant the tree in front of the dining room bay window. Where they would see it when they sat down as a family for meals.
Chapter Eighteen
Mitch and his sister sat in Room 318 on the third floor of the nursing home. Two days ago, Aunt Helen had returned from Georgetown to her old room. Molly had arranged it. No sense putting her in the hospice wing where no one knew her, she had said. Besides, it was easier to keep her in familiar surroundings rather than moving her things to the other wing. A high hospital bed had been wheeled in. The appropriate monitors and life lines were attached to his aunt’s even frailer looking body; oxygen, a thin, barely noticeable feeding tube through her nose, the IV for hydration. A hospice nurse, from the wing downstairs, had been assigned to visit several times a day. Amina always seemed to be checking on her, and replacing the IV when needed. Izzy dropped by, usually around noon, more to keep Mitch company than to see Aunt Helen.
Dr. Teitelbaum had called before noon the morning after their visit. The MRI revealed blockage in the carotid artery in the lower part of the brain. Mitch had excitedly told Dr. Teitelbaum about his aunt moving her fingers the night before. The doctor didn’t doubt that it had happened. Sometimes, he explained, there is residual movement in the early stages of a stroke. Following the MRI, when he had examined her, she was definitely paralyzed, although still able to breathe regularly.
Mitch had authorized the EEG. It had shown no brain activity at all. Mitch had camped out in her room during the day, working from his laptop and using his Blackberry to stay in touch with his office. He had brought their Bose CD player from home. Amy had stayed up late two nights, burning several disks of Mozart, carefully labeling them in her neat block letters, ‘Mozart’s Greatest Hits for Aunt Helen.’ His daughter had insisted that there be a bowl of oranges in her great aunt’s room. It sat on top of the dresser, giving the
room a more cheery appearance and a hint of a citrus smell.
“Do you think she can hear us?” Judy asked. She was perched on the side of Aunt Helen’s bed. She didn’t wait for him to answer. “You know you can see the veins on her forehead. Her skin is so translucent now,” she said, peering closer as if she could see inside.
“I don’t know,” Mitch replied. He lounged in the wing backed armchair, watching the late afternoon shadows gradually engulf the back lawn. The sunlight was still on the bright patches of yellow and purple pansies in the beds encircling the crepe myrtles. The soothing sound of one of Mozart’s violin concertos was making him drowsy. He turned and watched Judy stroke Aunt Helen’s temples.
“The Hospice Social Worker said that subconsciously, she might recognize familiar voices even if she can’t comprehend the words. The same thing with music. If it’s the kind of music she liked while,” he almost said ‘alive’, “she could hear normally, somewhere it’ll strike an inner chord. Sorry, no pun intended. And be comforting to her.”
Judy ignored his comment and moved toward the end of the bed and held Aunt Helen’s foot through the blanket. “I’m glad I came, Mitch. They’ll just have to manage without me. That’s all there is to it.”
He had noticed a change in her yesterday. He had met her at the baggage claim carousel at National Airport. She looked different to him, not as severe as in April. As she walked beside him to the US Air hourly parking lot, he noticed that everything was a bit more stylish about her. Her hair was no longer parted in the middle, but was cut in a way which made her face more welcoming. She wore a three quarter length black jacket with a colorful embroidered flower pattern, over a white blouse and dark tan slacks. Her shoes, while sensible looked more comfortable than clunky. The conversation in the car on the twenty or so minute ride home, while not substantive still contained little nuggets of her changed emotional terrain. She was taking yoga, she said, not just for coordination but to attain better control over her emotions. Become more peaceful with her thoughts, was the way she had put it. Eleanor, who Mitch had never heard insincerely praise another woman’s looks to her face, complimented Judy on her clothes and haircut.
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