(Part 2, Lay Me Down Tomorrow)
To move wild laughter in the throat of death!
It cannot be; it is impossible:
Mirth cannot move a soul in agony.
LLL Wm Sh.
In room 425-L, on the oncology wing of the medical center, the TV was mounted up on the wall near the door. Patients could see the TV and anything coming in the door at the same time. As I walked in she was lying on her side in the hospital bed, her head half-covered in that stiff terry-cloth stuff they use for blankets. “Katy Sandoval?” I asked. She looked at me with the eye that wasn’t covered by the blanket, and then back to the TV, as if to say “I’ve had enough talk for now.” She had had visitors in the morning and kept up a cheerful attitude for them, but she was tired and had reached the end of cheerful.
“Miss Sandoval, do you remember me? We talked a couple of weeks ago, about your health, about mobility and fatigue, and strength?” There were new flowers on the windowsill, and the bulletin board, already two layers deep with cards pinned to the cork, had added another layer. There were one or two ‘get well soon’ cards but most were greetings and good wishes.
“Are you checking on memory this time?” She said after a moment. Her voice was soft but clear, considering.
“Um, no, not memory. But how about standing, or short walks? Say about 30 feet at a time?”
Katy was still watching the TV and hadn’t moved. I heard recorded laughter from the show on TV above me. She breathed deeply and then turned her eye to me. “The attending oncologist says that I have limited and declining ambulatory capacity, and that the cachexia – she means wasting away – will lead to more severe restrictions,” she said in a neutral tone without a trace of irony. “However, my scheduled transfer to another facility – she means a hospice – can still be effected without the use of a stretcher and ambulance. The doctor is concerned about my depression and being easily overwhelmed emotionally. She is considering additional treatment even if the pain is mitigated through the PCA. She means the morphine pump.” She moved her thin arm from beneath the blanket and held up the button, still watching me, and gave herself a morphine hit.
She’s getting there, I thought. “Treatment,” I asked, “like Zoloft, for the depression?”
She looked at me closely and then shrugged without moving. “Zoloft needs a few weeks to take effect.”
Just then there was a single knock on the door followed by a housekeeper calling out “Room cleaning.” She came in with the cleaning cart. “Please come back in a little while,” I said to her.
“Yes, Doctor,” she replied and left.
I turned back to Katy. “And is the morphine alleviating the pain?” One convenient aspect about hospitals is that patients get used to answering questions. You can ask quite a lot. And you can ask the staff just about anything, if you look like a doctor.
She looked back at the TV and said slowly, “The thing about this morphine is that it slows things down. It is a trade-off, do you understand? Yes, the pain is alleviated, but there are side effects. This talk with you, for example, is taking forever.” She paused for a moment, thinking this conversation was taking an unusual turn. “I do remember you. Are you from the hospice?”
I shook my head. “No, I’m not from hospice. We’re just doing a periodic check, to see if there is anything that we can do.”
She started to answer and I knew she was going to ask me what “we” meant, but then her eye narrowed a bit and she said, her head still half-buried in the stiff terry cloth, “I hear that a lot, you know? ‘If there is anything.’”
She paused and then said “One floor down, there is a woman with a leg fracture, and one of you ‘anything’ people will go in and smile and say ‘Is there anything I can do for you?” and the woman will smile and say “Oh, gosh, maybe you can bring me a good novel, or maybe a deck of cards, or how about a dark chocolate bar, that sounds great’, and the anything person will smile even bigger, because they can do that. That’s a good anything. Then they might go to the next room and ask the man with the kidney stones, ‘Can I do anything?’ and he will act grumpy and make a remark about peeing, but it will be good-natured and light-hearted because he will be gone in a day. He will say “I am supposed to drink a lot, can you can get me a six pack?’ and they will laugh together and say ‘Sure, a six pack of cranberry juice.’”
She stopped and took a breath.
“Then the anything person, like you, will come in this room. And I feel bad for them. They smile and start out the same, ‘Is there anything …’ and the smile gets a little strained, and the voice gets just a little soft, because what would anything be? It’s discouraging for them, you know?
“But I say ‘Oh, can you get me some Jell-o or a magazine’. I don’t want them to feel bad.” She raised her head a little and looked at me with both eyes. “But today, no Jell-o, no magazines, Anything Man. Not today. But I would love to hear about anything else that you have in mind. Really, I would.” Her head sank back to the terry cloth and she was tired from the speech, but she was still watching me, with a little glitter in her eye.
Yeah, she’s close, I thought. I should charge the hospital for counseling.
“It looks like you’re getting a lot of anything here already,” I said, moving over to the IV stand next to her bed. “Hmm. Megestrol acetate, Procrit, Oxandralone. And then your morphine gun. So anything else might not be more medication.” She got that ‘what the hell?’ look in her eye, and I said, “Did you ever get to make a wish, you know, with the wish people?”
She gave me a thin smile with that one. “I don’t think Disneyworld will happen,” she said. “Or swimming with dolphins. Anyway, that’s for the children.” She was still a little interested in the conversation. She had had enough of the strained happy talk with friends and family, where everyone was trying to say something normal but worried that they might bring up a bad subject. And she had had enough of the bad news from the staff, relentless and direct.
“Yes, most of the programs are kids only. But there are agencies for the grown-ups.”
“Oh? What do adults wish for?” she wondered aloud.
“What do adults wish for? Disneyland, yes, that’s popular even for big kids. But getting together with the family comes up a lot, maybe taking an RV trip with them. Going to rock concerts. Driving Herbie the Love Bug. Meeting celebrities. Meeting Ellen DeGeneres, that comes up.”
She raised her head off the pillow. “She would come here?” she asked, a little more animated.
“No, you have to make an appointment, go to wherever she is. Same with Rickie Fowler. Golfing patients have asked to meet him. Then there are patients that ask for trips to Hawaii, or Mexico. Or to get a tattoo in Daytona Beach.”
“Yep. You never know.”
Another thin smile. “I might have been able to do that a few weeks ago.”
I nodded. “Sure. It depends on how you feel. If you are having a good day. But, to be honest, a lot of the wish things – they are just so passive, you know? You are taken somewhere to see something. You see it and then you are taken back. Probably in your wheelchair the whole time. Aren’t things passive enough?”
She raised herself on her elbow. “What else can you do? You are mostly wheelchair bound. You are weak and past tired.”
“Yes, one is not feeling well. But still, those wish things aren’t about you. They are for you, but not about you. And the care here is for your body and maybe a little for your emotional state, which is fine, but it’s not concerned about your volition, about you.
“For patients presenting like this,” I said and instantly regretted it, “volition means controlling nausea and vomiting, or what to eat. Not much more than that.”
She considered it. “Actually, that can be satisfying, to control the nausea and not throw up on somebody. It can be quite an accomplishment.
“But go on,” she said, though she glanced briefly at the nurse call button.
I am too goddamn preachy, I thought. “I’ve got a tape here I’d like to play for you,” I said, bringing a small recorder out of my pocket. “Listen to this.” I started the recorder and the famous voice began, weak and hoarse, but unmistakable. She stared at recorder and recognized the speaker, and then sat up on the bed and listened intently.
“After I knew that I wouldn’t get better, sitting around and waiting was intolerable. I had to do something, anything. I was weak and feeling terrible but it was impossible to just wait for more of the same. I was just watching the clock tick.
“Then I got involved in something, something a little crazy. And that stopped the clock for a little while. A little while.” There was a pause with labored breathing. “I hadn’t forgotten the clock. It was still there. I was just apart from it. And maybe I can do it again…or at least remember it.
“This is going to sound insane, I know. But don’t just linger.”
I stopped the recorder and looked at her. She was still sitting up, bewildered and uncomprehending, looking back and forth to me and the recorder. “That was …” she trailed off.
“Yes, the newscaster. “
“He died…he died a few months ago. Lung cancer.”
“Yes, he did. He made this recording before he died. He said what I wanted to say to you – that there are things you can still do, that you don’t have to just sit here.”
She stared at me. She was simply astonished and hadn’t felt that way in a long time. For the last few weeks she had had two kinds of news. The first kind was friend and family happenings that she pretended to be interested in, because she was a nice person and wanted to keep her friends and family from feeling uncomfortable. Her friend Ashley got her degree. Cousin Jared was going to Edmonton for the summer. The ad agency where she had worked was sold to a London firm that wanted to add staff here in New York City. Her visitors brought her these tidings out of politeness and because they didn’t know what else to say, and she politely showed interest.
The second kind of news was from the doctors and it was always bad and it was always worse than expected. The metastasizing hadn’t been controlled; it was spreading faster than ever. The chemo therapy wasn’t just not working, but had also damaged her liver. And, the time frame that the doctors had given her a few months ago – that had to be revised. So any conversation with any medical person, anytime she saw a doctor coming toward her with a tablet or clipboard, anytime there were lab values or images involved … it was bad.
Just being astonished, and not hearing immediately bad news from a doctor (at least she thought I was a doctor), was a powerful stimulant and took her a little out of herself. Of course, the cocktail of cocaine/ synthetic endorphins/ dexamphetamine that I had put in her IV, when I looked at her meds, was also working pretty well. The dose was tricky, though. Too little and she tells me to get lost and calls the nurse. Too much and she starts shrieking. But for the moment it looked like the juice was keeping her attentive and focused.
She kept looking at me and I could see color coming back to her face. She had been a good looking girl, and even now with her scraggly hair and thin face you could appreciate the high cheekbones and the well-defined jawline. But she still didn’t say anything, and I was remembering where the nearest exit was when she finally looked down and said sadly “Like what? What can I do?”
“I was thinking about a job, a brief one, just for a half day.” That got her attention and perked her up again. She looked back up at me and tried to sort things out. She pulled the morphine button from under the blanket and looked at it, maybe wondering if she had pressed it one too many times, or not enough.
“Yes, it sounds crazy. But it is something that you can do, it’s not that physical, and you should enjoy it. A lot. Wait, let me finish. You know the “Next Girl” agency? On 53rd? You auditioned there a couple of years ago.”
“Eighteen months,”, she said. “Before I got sick. So?” She was suspicious and wary again. “I know the place. What is this? Is this a joke?” Her eyes narrowed and she frowned, which for a moment was a frightening look, and very much unlike her normal calm expression.
“Katy, I am d — absolutely serious.” Watch those adjectives. “Stay with me for a minute. That agency. They brought you in for an audition, is what I hear. I heard it was an uncomfortable experience. No, I heard it was a rotten day for you,” I revised.
“How do you know this? Why are you talking about this? You are not a doctor.”
“I was told that you got singled out, sort of, in front of the other models.”
She shook her head from side to side, as if trying to sort out the memories that were coming back from the bizarre conversation. The memories won out. “Yes, it was a bad day,” she said. “They just kept at me, they wouldn’t let it go, they had to pick at everything.”
“The two agency heads?”
“Yes. Are they sisters?”
“They act like it. They wouldn’t let up on me. BMI too high. Face too round. Legs too short. How old was I. Why was I applying?”
“Well, why did you apply?”
“To see what would happen. Why do you think? I had been doing some part-time modelling. I looked okay then, you know? I wasn’t wasting their time. God, I know they get a lot of women applying, but they called me in. They saw my head shots and called me in.”
“What did you expect?”
“Nothing, they called me.”
“Were you excited?” I wanted her to recall that day, the details.
“Of course I was excited. It’s a prominent and influential agency.” She shook her head again, struggling with the memories and the drugs and the strange conversation.
“They were so awful to me,” she continued in a low voice, “I guess I am thin enough now. She stood up shakily and looked down at herself, her hospital robe and thin legs.
I took out an 8 by 10 from under papers on my clipboard and showed her a picture. “Do you think they would use this model?”
She looked at the picture and shrugged. “I don’t know. She has nice eyes. A lot of make-up. Maybe. Who is this?”
“But you think this face would work for them?”
She was confused but stayed with it. “God, I don’t know. I guess… it’s what they said they wanted, I don’t know… good structure, eyes wide apart, dark looks. Straight nose, they didn’t want a button nose, I remember that …they did pick on another girl with a button nose. Thin, of course, this girl is very thin…” It was a picture of a dark-haired, good looking woman looking up at someone, with a unique expression, a calm gaze that didn’t penetrate so much as absorb and assess that other person. An expression that said: “You don’t have what I need. But it’s okay. It’s all right.”
She looked at me and wavered a little and then slumped back on the bed. “This is me. I mean, that’s a picture of me. With hair. Make up. How — when was that…how could that be me? Where was this taken?”
“Yes, it’s you. It’s touched up a little and you got more hair.” More than a little. A hell of a lot of touching up and single-image morphing. “But it’s you. When you had visitors last week, someone was taking group photographs, do you remember? There were a couple of close-ups of you.”
She took the 8 by 10 and stared at it, trying to understand. Trembling and breathing rapidly. I guess I was trembling a little myself, wondering if this would work.
“They’d think I was thin enough now. My hips wouldn’t be too big. They’d like my face now, wouldn’t they.” She looked at me. “Oh God, that’s what you are doing. Oh God. That’s grotesque. That’s so awful. How can you do this?” She started to cry softly but then paused and took a breath, trying to get control. She slowly reached over and picked up the call button. “How could you do this?” she said as she wept. “Why would you?”
I waited on that one, letting her emotions slug it out among themselves. Resignation and a quiet bitterness had wrapped around her without opposition for months. Now there was something else…something small, pushing back. I wasn’t sure if it would get through.
But she wiped her eyes and shook her head. “No, no. It’s wrong. You are taking advantage of me.”
“Katy, it’s you that would be taking advantage. Taking control of something. You would act, not be acted upon.
“At that marketing firm you probably did a lot of creative exhibitions,” I added. Well, I know she did, but it wasn’t the time to be specific. Katy had worked for a few months at a small firm which specialized in public promotional events, or as the city attorney put it, “malicious mischief”. The company had attracted a lot of attention but had also violated a number of city regulations and eventually shut down. For one promotion, Katy and a few others had camouflaged themselves with body paint and other props to blend into the background near a construction site for a community hospital. The Mayor himself was cutting the ribbon. As he did Katy and the others neatly crept out of position and surrounded him before the security team protecting the Mayor could react. Katy handed to the highly surprised Hizzoner a business card from their client, a private security company.
I did want to bring up one particular event. “And what about that episode with the journalism professor, the Carrie Johnson thing, at the university?” She looked up at me sharply and got that scary frown again, though she didn’t seem displeased. “How did you know about that?”
“From a friend of mine at the university. Great story. But you didn’t follow up at all, with any of the players that I know of. I thought that was interesting.”
She thought about it for a minute, remembering how it felt at the time. Before all this. She said, “It was better not to follow up, to leave it like that. And we were graduating, getting out of there.”
She looked over to the bulletin board and all the cards. “You heard about that, huh?”
“It was truly inspired.”
After a minute she looked up at me again, more calmly, and took another deep breath. She had that glitter in her eye. “I see. I get it. Jesus, it’s awful. Can it work? Could I do it?”
“It can and you could. We’ve got a make-up truck parked outside.”
“Now?” She said incredulously. “You mean now?” Another emotion, complete surprise, which she hadn’t felt for a long time. Put more color in her cheeks.
“Yes, now. Do you think we should make an appointment for next month?” I let that sink in. “Besides, the shoot is scheduled for… “ I looked at my watch “ …about three hours from now. For the Next Girl agency. They are expecting you. We’ll do the preliminary make up and dress on the way.”
She shook her head slowly, still looking at the picture.
“It’s an upper body shoot, for jewelry.” I said.
She didn’t reply.
“Mostly sitting shots, no walking around. And it’s a paying job.”
“We unplug you from the IV tree for a few hours at most. You’ll be back here before dinner.”
She said slowly “Dinner.” She was thinking that dinner would be mostly through her IV. The chemo had been stopped but her nausea was still bad.
“C’mon, we’ll hear the rest of the tape.”
She put the picture down. “Tell me why you are doing this,” she said softly, but with more command, more control, than she had had in months.
“Hmm… the short answer is that you will get a big charge out of this. You’ll get out of here, and it will be an extreme change of scenery for you, and it should be fun. Tiring but fun. We’ll manage the pain.”
“What’s the long answer?”
“We can talk about it on the way, but it has to do with volition, I guess. With will. With having an impact.”
She took that one and seemed to put it on the shelf for later. “Why are you doing this?”
I shrugged. “Do you ask the Make-a-Wish people why?”
She looked at me with that same calm gaze. “Will they be there?” She said. “Will the two sisters be there?”
“Yes, they’ll be there. They aren’t sisters.”
“What do you have against them? Is this a plot to steal the what – the jewelry?”
Now I was surprised. “Oh, God no. I have nothing against them in particular. And the jewelry in these shoots are often replicas.”
She looked at the picture again. She was more alert and focused now. “Can you make me look like this? Like the picture, but for real?”
“Better. I’ve got a make-up artist waiting now.”
Another deep breath. Then she shook her head slightly, thinking about it. “No, no, I can’t do it. You want to take me away, but I can’t. I am sick. I am … ugly. I can’t even walk far. It will take too much out of me. It would take days away from me…” she trailed off and closed her eyes. “It would take away days…” She looked at me, questioning.
“Katy, this will give you a day.” I looked around at her hospital walls, at the small window which looked out at another side of the building. “You don’t have a day here, you have duration.” I looked at the clock on the wall. “You see the clock tick. You know what will happen here for the rest of this day, and tomorrow, and the next day. You know who will come in and you know what they will say. When Doctor Venugopal comes in with his tablet you will already know what’s on the screen. That is what this day holds for you, here.”
She looked down and gripped the bedcovers with her hands, squeezing and squeezing the rough terry cloth. Then after a minute she straightened up a little and slowly stood up, wavering. Without looking at me she took hold of the IV pole and shuffled over to the wall, to the bulletin board. She put her palm gently on one of the greeting cards as she thought it over, thought about what it meant to leave the hospital for this.
She nodded to herself, and then shook her head, and then nodded again. “I’ll try it,” she said. “I want to try,” she added.
“Just one thing – “ she paused and looked me in the eye. “I’ll need another shot of whatever it was you gave me earlier.”
“All right, Katy. All right. Let’s get started.”