There Was an Old Woman

by Hallie Ephron

  “What we can do is keep her calm and comfortable. That’s what we’re doing now. She’s taking medication for anxiety and delirium. There’s more we can give her as the disease progresses.” Dr. Foran put her hand on Evie’s arm. “But you know of course, no one survives without a functioning liver. The damage is irreversible.”

  Irreversible. Evie wrote the word down. Read it. And even though it was what she’d expected to hear, she felt as if she’d been sucker-punched.

  “Does she know?”

  “It’s difficult to tell what your mother”—Dr. Foran drew quote marks in the air—“knows. I’ve scheduled a brain scan for tomorrow. I’m guessing that will show that she’s already suffered significant brain damage.”

  “Significant brain damage,” Evie murmured. She couldn’t bring herself to write down those words.

  “The problem is that we have no baseline to compare. Your mother hasn’t been seeing a physician regularly. But a decline like this is generally gradual. Up to a point.”

  Since when had her mother been beyond that point? Evie wondered. Years ago when she’d shown up drunk at Ginger’s wedding? Or ten years before that when she’d fallen down the stairs? Or what about when she’d run the family station wagon into a tree?

  No one had put a gun to her mother’s head and forced her to drink. At first it had to have been a choice. At some point, though, Evie knew it hadn’t been.

  “How long does she have?”

  “You’d think with all the cases like this that we handle, we’d know the answer. But it’s surprisingly variable. Maybe a few months. Maybe weeks. What often happens is that the kidneys fail and the patient falls into a hepatic coma. After that, it’s usually a matter of days, depending on whether the patient wants us to use extreme measures to prolong life.”

  “Extreme measures?” Evie’s voice was barely a whisper.

  Dr. Foran shook her head and pursed her lips. “There’s no easy way to say this. There’s a good chance that she’ll linger. Possibly for weeks. It will be up to you and your sister to determine the course of treatment at that point.” She handed Evie some stapled pages. COMPASSION AND TREATMENT CHOICES was printed on the cover sheet.

  Evie tried to swallow the lump in her throat. She’d known that this moment was coming, but now that it was here, she wasn’t ready for it. “What should we do?”

  “Get her affairs in order. Be here for her. Watch and wait. She may surprise us all and rebound. But you need to prepare yourselves. Now is the time for you and your sister to talk to your mother about what will happen when she can no longer tell us what she wants. And this is important. Write down exactly what she says. It will make it easier for you later to respect her wishes.”

  After Dr. Foran left, Evie stood at the window of the lounge, alone with her thoughts. As fat raindrops pelted the glass, the doctor’s words sank in. She and Ginger were not going to be able to prop their mother up on her pins this time. There’d be no miracle cure. No liver transplant. Not even a temporary reprieve until the next emergency, drop-everything-right-now phone call.

  She called Ginger.

  “So you talked to Dr. Foran?” was the first thing Ginger said.

  “Yes, Ginger, I talked to Dr. Foran.” The words came out sharp. “I’m sorry. Yes. Just now. She says—” Evie’s insides wrenched, and a sob escaped from nowhere.

  “Evie? Honey?”

  “Hang on.” Evie put the phone down for a few moments until she could breathe again. Then she started over. “It’s not good.” She told Ginger what Dr. Foran had said, glad that she had taken notes.

  “Significant brain damage,” Ginger said. “But I thought you said she recognized you?”

  “Yesterday she did.”

  “So how can they tell? I mean, they’ve got her on all kinds of drugs. And she’s in withdrawal. She’s got the DTs. How can they be sure that whatever this is isn’t temporary?”

  “They’re giving her a brain scan.”

  “When?”

  “Tomorrow.”

  “And what if—”

  “Ginger, she’s dying. And Dr. Foran says it could be soon.”

  “Oh, God. How soon?”

  Evie stared at her notes, the words swimming on the page. “Weeks. Maybe only days.”

  “Days? I don’t believe it.”

  “Ginger—”

  “Oh, God. We should have done something. Dragged her to AA meetings. Gotten her a sponsor.”

  “You know it doesn’t work like that.”

  “Insisted that she see a therapist, then. I don’t know. Done something.” Ginger paused, then added, “And maybe, just maybe if you hadn’t checked out months ago—”

  “Stop right there,” Evie said, suddenly furious. “And maybe if her father hadn’t been such a shithead. Maybe if her mother hadn’t been depressed. Maybe if Daddy hadn’t died. And you’re right. Maybe if I’d been a better daughter.” She stopped and took a deep breath, counted to five, then added, “Do you really think anything either of us could have done would have made a difference? She’d have had to want to stop drinking.”

  Ginger didn’t say anything, but Evie could hear her raspy breathing.

  “Ginger?”

  “You’re right. I’m sorry. Of course it’s not your fault.”

  “It’s not yours, either.” Evie stared out the rain-streaked window. Cars were still going up and down the street. The red light on the corner turned green. As if nothing had changed.

  “And I’m sorry, too,” Evie said. “Even if I couldn’t be there for her, I should have been there for you.”

  Ginger sniffed. “Yeah, you should have been.”

  “All right already, I get it, Gingey Wingey.”

  “Sticks and stones, Fungus Face.”

  “Oh, very original.”

  “Brat,” Ginger shot right back.

  “I’m rubber, you’re glue.” Evie tried to laugh, but she just couldn’t make it happen.

  “So,” Ginger said, taking a long, audible inhale, “moving forward.”

  “Moving forward,” Evie repeated. “We need to talk to her. Both of us. Together. And find out what she wants. For now. For later. The doctor said we shouldn’t put it off for even another day.”

  After a long silence, Ginger said, “I wish Daddy were here.”

  “Me, too.”

  “I’ll be there as soon as I can.”

  Chapter Twenty-eight

  When Evie got back to the hospital room, her mother was staring off into space. She looked small and frail lying there in the big hospital bed. A lunch tray that had been left for her was untouched. Evie hadn’t eaten anything since the jelly doughnut this morning, and it was well past two. She should have been hungry, but the sight of food turned her stomach.

  “Mom?” Evie touched her mother’s cheek. “Mom?”

  Her mother gave her a tight smile. “Ginger?”

  Evie didn’t know whether she was asking where Ginger was or thought Evie was Ginger. “I talked to Ginger. She’s on her way over.”

  Her mother blinked, taking that in.

  “How are you feeling?” Evie asked. “Can I get you anything?”

  “Water.” The word came out a whisper. Her mother licked her chapped lips.

  Evie gave her a drink from a glass of water on the table by the bed. Sandra took a few sips from the straw and gave a weak cough. When Evie dabbed at her chin with a Kleenex, her mother winced.

  “Mom, I need to ask you something.”

  Her mother gave a vague nod.

  “I found checks and a lot of cash just lying around.”

  Her mother gave a faint smile.

  “The cash. Where’s it from?” Evie asked.

  “My—” Her mother mumbled something.

  “Your what?”

  Her mother’s hand tightened on the sheets. “Safety net.”

  That made Evie sad. As if a few envelopes of cash were all it took to make her mother safe. “Where is all that money coming f
rom?”

  “A friend.”

  “What friend?”

  Her mother pinched her lips shut. Evie knew that expression. It said, None of your business. Fair enough.

  “There’s also some uncashed checks. Mom, I need to use some of that money to repair the house and pay your bills. Okay?”

  Her mother’s brow wrinkled, and she stared off into the space between them. Evie touched her arm and she snapped back.

  Evie tried again. “I want your permission to use that money to pay your bills. And repair the car. And the roof—there are shingles all over the lawn. And you need a new upstairs window.”

  “Window?” Her mother was staring hard at Evie, like she was trying to penetrate a dense fog.

  Exasperated, Evie said, “I don’t want to spend your money without your permission. Can I use the money to pay the bills and repair the house?”

  Her mother nodded, not so much yes as whatever.

  “Okay. So I brought the checks with me.” Evie pulled them and a pen from her purse. “Can you endorse them to me so I can deposit them? Do you feel up to that?”

  Her mother pushed herself up and took the pen. Evie moved her mother’s lunch aside to clear a space on the tray.

  Her mother began endorsing checks, signing each one over to Evie without a pause. Each signature was a little more shaky and illegible than the last. When she’d signed the last one, she collapsed against the pillow, as if the effort had exhausted her.

  Evie was putting the checks into her bag when her mother said, “Ginger?”

  Evie turned back, thinking her mother was mistaking her for Ginger again. But when Evie followed her gaze to the doorway, Ginger really was there.

  “Hi, Mom,” Ginger said. She had a long cardigan sweater wrapped around her. Her dark hair was loosely anchored with a banana clip. Their father used to say that Ginger had the face of an angel, and she still had big lash-fringed eyes and pale skin that almost seemed to glow.

  Ginger came into the room and gave Evie a hug. She smelled of rose water. “I got this off the Internet from the IRS,” she said under her breath, handing her a two-page printed form that said POWER OF ATTORNEY, before sitting on the edge of the bed. Evie stood next to her.

  “My baby girls.” Their mother looked back and forth from Evie to Ginger. “I’m so happy to see you.” Her eyes welled with tears.

  Evie bit her lip to keep from crying, too.

  Ginger leaned forward and kissed her mother’s cheek. “So how’s your shoulder?”

  “My . . . ?” Their mother looked down at her swaddled shoulder, as if seeing it for the first time. “It’s nothing. Just a nuisance. I’ll be fine.” She gave a tight smile that didn’t reach her eyes. “Everything will be fine.”

  “Of course it will,” Ginger said.

  Evie nudged her with her knee.

  “Mom—” Ginger started.

  “I know,” their mother said, her voice barely a whisper. She closed her eyes, and a tear squeezed out and ran down her cheek. She opened her eyes. “I know it’s not going to be fine.”

  “No,” Evie said, handing her mother a tissue.

  “Not this time,” Ginger said with a sob, taking a tissue for herself.

  They hung there for a few moments. Finally Evie broke the silence. “The doctor says that the prognosis isn’t good. And that we should talk to you so we’ll know what you want if we have to . . .” It was so hard to put this into words. “ . . . make choices for you. It’s hard to even think about. But Dr. Foran said we shouldn’t put it off.”

  Her mother swallowed and grimaced.

  Evie took out the pages about treatment choices that Dr. Foran had given her. She turned to the end, where there was a list. “Your doctor gave me this to help us talk about what you want and what you don’t want.”

  Ginger picked up the thread. “If there are choices. You know? And you can’t communicate what you want.” She leaned forward. “Please, please, tell us what you’re thinking.”

  “No . . . transplant.” Their mother’s voice was clear, even if it was barely a whisper.

  “No transplant,” Evie said, writing it down. She was relieved that she didn’t have to tell her mother that a transplant was probably not an option.

  “If we have choices, where do you want to go if they release you from the hospital?” Evie said, reading off the first item on the list.

  “Home.” Her mother sounded so definite. As Evie wrote it down, she had to wonder if her mother had even the slightest idea what a mess home had become or how complicated it would be to honor that simple request.

  “Okay. Pain medication?” Evie said. Her mother’s gaze drifted to the ceiling. “Mom? Can I say that you want the doctors to do whatever it takes to keep you comfortable? Are you okay with that?”

  Her mother nodded.

  Evie went on, asking her about sedation, hydration, a feeding tube, and on through the endless-seeming list. In response to each, her mother managed to say a few words, or just nod or shake her head.

  Finally, the hardest question. “Mom, if you crash, do you want the doctors to try to resuscitate you?”

  Her mother shook her head.

  “Do you want to be kept on life support?” As she said the words, Evie winced. It sounded so cold and brutal.

  Her mother’s “no” was barely a whisper. Then she turned to Evie. “Write it down.”

  Evie did. “And what about after?”

  “Cremated,” she said.

  “Of course. Like Daddy?”

  Her mother smiled.

  Evie remembered the windy day she and Ginger and their mother powered up the motorboat that her father kept moored at the scruffy Point Yacht Club, driven it a mile or so out, and scattered his ashes on the swells of the Sound.

  Evie read the checklist back, item by item, and at the end her mother signed it. Finally Ginger took over, explaining the document she’d brought in, power of attorney, and how it would allow her and Evie to take over their mother’s finances and later her estate. Ginger held the paper while their mother signed without a murmur. Then she let the pen drop onto the bed. She whispered something that Evie didn’t catch.

  “Not afraid of what?” Ginger asked.

  “Dying,” their mother said. The tension lines in her forehead deepened. “But the house . . .”

  Ginger said, “Is there something you want us to do with the house?”

  Their mother gave a weak wave and muttered something that sounded like I’m sorry. The tension lines faded. Then, “It’s too late.”

  After that, her mother sank back again into the pillows, and she turned her head away from Ginger and Evie. Minutes later she was asleep.

  Evie followed Ginger out into the hall.

  “That was so hard,” Ginger said. She looked pale and drawn. “But not as hard as I thought it would be. And I’m glad we didn’t wait.” She glanced back toward the room. “I can’t believe it’s happening so fast. I wish there was something—”

  “I know,” Evie said. “You’re so used to fixing things, but this isn’t something that can be fixed.”

  Ginger sighed and bit her lip. Her eyes welled up again with tears. Evie put her arms around her, thinking how glad she was that she didn’t have to go through this alone.

  “I’m sorry, excuse me.” It was a nurse pushing a medication cart. Evie and Ginger stepped aside so she could take it into their mother’s room.

  Ginger wiped her eyes with the side of her hand. “Her insurance is kicking in. I called to check. So that’s okay for now.”

  “And just like she said, it turns out there really is money to fix the house.”

  “Really?”

  “I found months of uncashed pension checks that I got her to endorse. And envelopes of cash.”

  “What?”

  “Five of them. Like this.” Evie pulled one of the envelopes from her purse. Ginger took it and riffled through the hundred-dollar bills. She whistled. “What on earth?”

&nb
sp; “I have no idea. And here’s the other weird thing. I went through all of her papers. Her credit card? In March she owed eight thousand dollars. In April? Zero. Paid in full.”

  “But how—?”

  “That’s what I’d like to know. She’s not writing checks. She’s not depositing or withdrawing money. So how’s her credit card bill getting paid off? And who paid for her new HDTV?”

  Before she left the hospital, Evie made a copy of the signed checklist with her mother’s wishes and left it for the doctor. The rain let up long enough for Evie to sprint through the parking lot to where she’d parked Mrs. Yetner’s car without getting soaked. But as soon as she got in, a brilliant flash of lightning and a clap of thunder made the steering wheel vibrate. Raindrops came down like ball bearings.

  Ginger had invited her to come home with her and stay overnight in Connecticut, and Evie wished she could have accepted. It had been a long, hard day, and she really didn’t want to be alone. But Mrs. Yetner was expecting her car back, and there was so much to do at the house.

  Evie turned on the car and cranked up the defrost. The wipers, thunking back and forth at top speed, could barely keep up with the rain sheeting down the windshield. Carefully she backed out of the space and pulled out of the parking lot.

  She had to concentrate to keep the car on her side of the road. The white lines that divided the lanes were nearly invisible on the wet pavement. Ordinarily she would have pulled over and waited out the storm, but today it was good to have something other than her roiling insides to focus on. Fortunately, Sunday traffic was light, and it took only a bit longer than the usual ten minutes to drive back to Higgs Point.

  After she’d backed the car into Mrs. Yetner’s garage, unclenched her hands from the steering wheel, turned off the ignition, and set the emergency brake, Evie sat there in the dark, keys in her lap, listening to the engine tick. She could have closed her eyes and gone to sleep right there. Instead, she got out, locked the car, and hurried through the rain to Mrs. Yetner’s door. Rain dripped down the back of her neck as she stood under the porch overhang, ringing the bell. A pungent, sweet, burning smell hung in the air. Like someone was barbecuing. In the rain? Not likely.