by Gil R. Moore
June 24
“It’s stage four, for sure, and it’s growing fast,” Rich told me. “You know what that means. Shit. I’m sorry to be telling you this.” I’ve worked with Rich a lot, and I know he’s a sweet guy, but no one seems nice when he’s pronouncing a death sentence on your wife. I wanted to hit him for a second.
“She didn’t tell you any of this?” he asked. “I went over it with her.”
No, that wife of mine really dropped me in it. Just this morning, she told me that she had seen the doctor about some problems, and she wanted me to talk to him, to help her understand. I had thought it was a backache or something like that. I finished my breakfast—scrambled egg whites and dry toast. Luisa cleared the plates away, and I asked my wife what was wrong, specifically. She said she didn’t know, she just didn’t feel right.
I went to work. I saw the patients who were on my schedule, mostly procedures in the morning, and then I stopped by Rich’s office. I lurked outside for a moment while he was in with someone else. A woman and an adolescent male came out of his office with red eyes. He was holding her hand very protectively. Rich saw me waiting. I hadn’t understood then why he gripped my hand with both of his and was so formal in the way he invited me into his office.
“No, tell me everything,” I said to Rich. “If you have the time right now.”
“Of course.” He twisted in his chair. “She presented with headache, fatigue, spots in her vision. On physical exam, I saw an obvious melanoma, on the back, just to the left of the medial line. It was about five centimeters—all of the bad signs, blackish, oddly shaped, rough surface, occasional bleeding. It must have been growing for some time.”
He paused and I knew what he was thinking. She’s my wife. I’m a doctor. Why hadn’t I seen this? She has pale skin, almost melanin-free. A mark like that would be impossible to miss. I didn’t give him an explanation.
Rich went on, “There were other, smaller spots. The tests showed, well, it’s malignant. It’s in her brain and her spine. It’s in her lungs, probably elsewhere, but we didn’t have a chance to find out more.”
“Why?”
“She said she wanted to think about what to do. I, of course, urged on her that we had to move fast—but then again I don’t honestly think we have realistic treatment options. You’ve seen this before.”
“It’s the worst,” I said. “It eats up everything.”
His office is smaller than mine and faces downtown. Mine has a river view, which everyone agrees is the prettiest side of the building. Rich started talking about treatment options, palliative treatment options. I was sure he was right, so I just nodded along. I left and promised to talk with my wife about it.
Why hadn’t I seen it, though? I knew he was still wondering that. He probably wondered if I was somehow guilty or derelict as a husband and physician. Or did he guess at something like the truth? My wife pulled away from me a long time ago. She’d moved into the spare room, which we’d once thought would be the kids’ room, a few years ago. I hadn’t seen her unclothed back in at least that long.
As I got back to my office, I reviewed my schedule for the afternoon. I had a lot more work to do; I knew I would be lucky if I got home before 6:30. Despite the fact that I wanted to finish up, so I could go home and talk to my wife about this, I kept getting distracted by thoughts about her—sentimental thoughts.
Then my afternoon appointments started coming in, and then I went out onto the floor to visit consultation patients. This made me feel better. There’s only so much variation in what I do. My patients all have problems with their hearts. I use one of three or four techniques to diagnose almost all of them. Treatment is then usually a simple decision, like an equation—here’s the diagnosis, here’s the patient’s age, lifestyle, etc., here’s the treatment. You can throw away ninety percent of what they tell you as irrelevant to the heart.
I did get out at 6:30 (about average, despite the interruptions), and I was home in fifteen minutes, with a show of grace from the traffic gods. As I drove, I wondered how much it would change my life when she was gone. Some, certainly. I can’t deny that. As strange and solitary as she has become, I am still used to seeing her and telling her about any plans I make. But the major patterns would be untouched. I would still drive to and from work. I would still ream out x number of cardiac arteries each day.
I went straight to the dining room when I got in, and she was sitting there with dinner spread on the table. I sat down at the place for me. I became hungry as I saw the food there. I could have spoken with her then, but I didn’t want to rupture our routine. We ate. I asked her what she had done that day. I don’t remember her answer.
We both finished, and she took our plates into the kitchen. After a moment alone, I followed her. I started the hard conversation. “We need to talk,” I said.
“I’ll be done with this in a minute,” she said almost as quiet as a whisper.
“Alright, come into the living room.”
I walked to that room and sat down on a couch. She keeps all of our magazine subscriptions spread on a table. I looked for a new one and began reading it from the first page. At page six she sat down in the chair across from me.
“I spoke with Rich today,” I began. “Did he explain everything to you yesterday?”
“I guess so.”
“Did you understand it?”
“Not entirely. I was waiting to hear it from you.”
“Well, this is serious. It’s very hard, but the cancer has spread around your body.” I realized I was touching different parts of my chest to illustrate—something I try not to do with patients. “It’s a kind that grows very fast, and once it’s advanced to this point there’s¾ well, there’s no way to stop it. Treatment now would be to prolong your life a little and to make you comfortable until—” She had been watching my face, but she turned her eyes aside at the last part. “Are you alright?”
“Yes.”
“I’m sorry. This is terrible to hear. But we’ll have to make some decisions about treatment, about what kinds of interventions you’re willing to try. And we should talk about how you want your… if you should get worse…”
“Tomorrow. Can we talk tomorrow?”
“Okay. But it has to be soon.”
“I’ll have to cancel my classes.”
“Keep going as long as you can. You have some time.” It was always good for patients to remain involved in their lives. She taught dance to kids from disadvantaged families, at a rec center.
I stood up and walked over to her. I put a hand on the back of her shoulder. She always sat straight in her chair, not using the support of its back.
“Can I look?” I asked. She bent forward, and I pulled her blouse out of where it was tucked into her pants. I put my fingers inside the shirt and freed it all the way around. The fabric was so thin I felt I had to be careful not to rip it. My fingers grazed the skin near her waist, and I was reminded of a period, a long time ago, when I used to still try with her. I would try to touch her skin, to entice her. Her skin now seemed so hot and strange.
I lifted the shirt along the axis of her spine. She was thin, so that her muscles showed through. I saw a few suspicious spots that I might advise a patient to have biopsied. Then I got to the obvious mark, right at the point on the back that you can’t reach yourself. It was as big as a few coins dropped on her back—like the ones you see sitting at the bottom of a wishing well. I hitched her shirt over her shoulders and placed my fingers on either side of her mark. It was mostly black, with a little pink around the edges. It had a crack in it. You couldn’t doubt for a second what it was.
I moved one finger to touch the mark itself. Its surface was rough, entirely different from her skin. I felt the border, where it converted from skin into something like a giant, deep-seated scab. I suddenly remembered a whole series of things. I don’t want to write them all here. I can’t write them all. Things like going on picnics with her when I was a medical student. After eating, I studied and she walked out to the river. I remembered how we made love when we had both wanted children. That was a long period—ten years. When I married her—it sounds stupid—but when I married her, she was more beautiful than anyone else I had seen. I pressed the mark and a drop of blood bubbled into the crack.
I dropped her blouse back over her body.
“I’m sorry. I’m very very sorry.” I walked out of the room. The nostalgia had overcome me. It was a silly scene. I’m not proud thinking of it.
I went to my room and watched the financial news for a few minutes. Then I picked up the phone and paged her through the intercom system. “I just wanted to let you know, if you need me, I’ll be in my workout room.”
“Alright. Thank you,” she said.
I changed my clothes and got on the elliptical runner I use to warm up. It was 8:30 at that point. I always try to start by 8:30, so I can be done by 10:00. Otherwise it interferes with my sleep.
August 8
It is my new routine to buy flowers every day. My wife asked me to do it. In one of those moments when I was required to ask her if there was anything I could do for her, she replied, “I would love it if you brought me flowers every day. Nothing much, just something pretty—”
Today, I forgot to time this pattern against one other habit of mine. I bought the flowers as I drove to my girlfriend’s house. I thought it would save time, because she lives between the flower shop I like and the hospital. But then we went to lunch and I insisted on driving. She opened the door to the car, and the flowers were on the front seat, as if placed there for her.
“For me?” she asked, as she picked them up and brought the bouquet to her nose.
“Of course.”
“Why didn’t you bring them to me?”
“It’s more of a surprise,” I replied. We both sat down in the car. She kept looking at the flowers and smiling. I figured I would have to go to the flower shop and get another batch.
Lunch with Carla was what I expected it to be. She’s always very appreciative of pleasures like good food. It’s one of the things that excited me when I first knew her. I suggested some dishes. We ordered more than we needed, and we both tried them all. We never spoke about my wife, but I sometimes think that Carla is excited by the change in our relationship since my wife has been ill. We are a little more open about being together, and we are spending marginally more time together. She seems to feel she can claim more of me. I never see her more than a couple times a week, but when my wife is in the hospital, we sometimes spend the night together.
The two are very different, and I don’t just mean because one is sick and one is healthy. Carla has worked her whole life. She got a bachelor’s degree from the state university, and she took night courses to get an MBA. She works in the same hospital as me, as a director of administrative services, or something like that. (I first met her when I was placing a complaint about one of my admins.) She’s only 32—she’ll rise much higher. She takes new things with the eagerness of the hungry.
My wife was privately tutored when she was a child. Her father was an ambassador. She went to Radcliffe and then was in a modern dance group. I met her at a performance. We had a friend in common, who had dragged me with her to see this Allison. Immediately I was overcome with passion when I saw how strong her body was, to discipline itself into such unnatural shapes. I always thought she could have kept dancing, professionally. But she didn’t want to once we were married.
After lunch, Carla and I went back to her apartment. It’s a simple formula most of our dates follow: do something, have sex, end. And her apartment is usually the place. I suppose it is a nice apartment. It’s clean and has everything a person needs. But everything in it looks like it came from a mall. Usually this doesn’t matter. Carla herself is quite lovely.
Today, I don’t know what it was, and this has never happened to me before (and I’m 48 years old), but I wasn’t physically interested in her. After we pressed together and took our clothes off, I didn’t feel even a spark in my groin. Carla hardly noticed, though. She’s aggressive in the boudoir. She likes my muscles. She likes to be held by me. I adequately duplicated my manhood with two fingers, to bring her to a climax. When it was time for me to leave, she didn’t want me to. She walked me out to my car wearing a bathrobe.
At the flower shop, the same salesman helped me, and I kept asking for more and more flowers, two or three at a time, until he was carrying an immense pile. If they weren’t such insubstantial things, the load would have broken his back. He took forever to wrap them up, and when I placed them in the passenger seat of the car, they jutted into my peripheral vision like another person.
I got to my wife’s room at the hospital, and Rich was there with her. He was sitting on the edge of her bed, more like a friend than a doctor. I put my immense pile of flowers on the table near my wife.
“I was just on my way out for today,” Rich said.
“It’s good of you to—” It was only half of the sentence. But in a situation we all understood so well (and understood to be hopeless), I didn’t need to speak the end. We shook hands. He stepped out of the room. I sat down where he’d been.
“Do you see these flowers?” I said to her. I held them in front of her nose. She put her hand out to touch a number of the petals, lightly pinching them between her fingers.
“So nice,” she said. She was tired from her treatments and dulled by her painkillers. She waved, instructing me to move the flowers to one side, and looked at me. We sat for a while. Neither of us wanted to do anything more.
“It’s beautiful outside today,” I said after a long time.
“Oh yes? I would like to feel the sunshine—or the rain.”
“The hospital is a hard place—it’s hard being here. I forget it sometimes.” I was inured to so much. “I was thinking of how we first met.”
She smiled. We were locked in a mutual gaze again.
I continued, “You were the most beautiful thing I had ever seen, in your dance. “
“I didn’t like you that first night,” she said.
“No? Why?”
“You seemed too strong to me. You walked right up and expected people to get out of your way. But you brought flowers to our first date. I always saw your gentler side after that.”
“Why did you go out with me?”
“Ginny wanted me to. And you were handsome.”
“I didn’t know that.”
“It’s not relevant,” she said.
I felt like something had changed between us, flipped right over, because of what she had said. She’d never told me more than that she had loved me very quickly.
Again we were silent for an unmeasured space of time. We both were content with these periods of doing nothing but sitting together. Even though her time was so limited, there was too much time to fill in the hospital.
She closed her eyes for a few minutes, then without opening them, she said, “I’ve decided that after this cycle, I’m not coming back to the hospital. I want to be in my home. I know you want me to keep going.”
“No, it’s okay.”
“Being here isn’t life.”
“It’s okay. I have trouble giving up. Another week. Another day. But if you’re done, I’ll take you home.”
I took her hand in mine. It still looked young. It was as hot as anything living still. Her face, though, had been decimated, as if the demolition crews had started there, even before the tenant had vacated the premises. I turned my body around so I wouldn’t look at her anymore. I lay with my side along her legs and my head coming to the level of her navel. I felt her beside me. We lay in the same bed. I slowly ceded control to sleep.
A nurse woke me. She had come to administer medication. For a moment, I wasn’t sure where I was. I had no idea what time it was. I had slept in the hospital so many nights. Then I remembered, and I missed not knowing. The clock said 9:42. I had been there too long.
I let the nurse finish her thing. Then I bent down and kissed my wife’s cheek. “I’ll be back tomorrow—in the morning and the evening.” I touched her cheek.
“I’ll be here.”
October 1
I’ve looked at this mole on my leg for as long as I can remember. This morning I thought it looked like it had grown. Maybe it had changed color a little, grown a black blister in its heart, crept out from its borders. I spent a long time, sitting on the edge of my bed, staring at it, prodding it, pinching it.
I can’t explain what I felt. My wife is less than two weeks in the grave. Melanoma crushed her.
I wasn’t certain my mole had grown, or changed, but I felt almost certain in my heart that there was something wrong with me. I called Rich—he took such good care of my Allison. I was almost excited. My hand trembled. I said it was urgent. I asked him to clear a few minutes on his schedule. He did. He promised to see me at 3:00.
I was still at home, because I had lightened my schedule for the last few weeks. But today I wanted to get to the hospital. I’ve been tired and lethargic, I realized. I haven’t been doing a lot of my regular activities. I should try to do the things I did before. I got dressed. I put on a suit, the same one I had worn to her funeral.
After taking her to her grave, we’d gathered here at the house. I had worn a different tie. I had wandered amidst all these people. Carla was there, but she kept a discreet distance from me. Once she cornered me near the bathroom and put her hot hand on my face and asked, “Are you alright? Are you holding up?”
“I’m fine,” I told her, and I went back to the other guests. A lot of the people I didn’t know or I had only met once or twice. Many of them I had only met in the last few weeks as they came to the house to say their farewells. There were several children, fourteen- or fifteen-year-old girls, who had been Allison’s dance students. One of them approached me. “She was the best teacher I ever had. I had her for three years because I did Advanced Dance II.”
“You should have seen her dance when she was younger,” I said somewhat nonsensically. “She could have been a professional.” I think I patted the girl’s head, as if I were some actor playing a grieving man.
The sun sheared into the windows and cracked into panels, planes, and lines around the house. The light kept growing longer and brighter as the funeral party went on, as if we were heading toward it. She had wanted the sunset view. We built the house facing west. It was about ten years ago. The same time we gave up on having children. We worked on this instead.
“You need to keep eating,” Dahlia told me. She had watched Allison in her last few weeks.
“Thank you, you’ve been too kind to us.” I included the dead woman in the same category as myself.
“Not at all.” She stood beside me for a moment, as I looked at all of the people who I barely knew around me. “I have to go now, my husband is waiting for me to drive me home.” She gave me a hug and left.
The same company that sent Dahlia also rented me the bed and the IV drip and the oxygen equipment that had kept Allison comfortable. They would pick it all up the day after the funeral. But while I stood in that “party,” I thought of the bed with the steel railings still in Allison’s room. I wanted to go lie there.
I rarely get out of the house without thinking something like this. Today was no exception, but driving to work I could mostly zone out. I was in my office an hour before the first patient was scheduled.
Ahh, more fun here. There was a large padded envelope on my desk. I saw the writing on it was Carla’s. I had broken it off with her two days ago. She had stayed over at my house a few times after my wife died. Whenever she used the bathroom or turned on the television, it made me uncomfortable. I don’t know why, but it just seemed wrong. I couldn’t stand to stay at her house. So I told her two days ago not to come over anymore, and that I just couldn’t see her for a while.
There was something slinky in the envelope. I could feel it when I picked it up. I opened it and drew out a tie, one of my Feragamos.
There was also a note in the envelope. “This is everything you left with me. Thanks for making it so easy to ‘disengage.’”
I guess I had used that word with her, “disengage.” I looked at the note for a while. Then I checked to be sure there wasn’t anything else in the envelope. Then I decided to change ties for the one I’d just gotten back. It was nicer than the one I was wearing, so why not?
Then I looked at the picture on my desk, the one picture. I’ve been doing this a lot lately. I try not to when patients are with me, but sometimes I can’t help it. The photo’s of Allison when she was about 27. She is walking toward me along a path that cuts through a field of wildflowers and waist-high grasses. She’s wearing shorts and carrying a backpack. The secret story of the picture is that we had made love about five minutes before I shot it, with the sunlight warming our skins. The blanket we’d lain on was rolled up in her backpack.
Maryanna knocked on my door to tell me that the cath lab was looking for me. I was late for my first appointment. I had to work straight through lunch, because everything seemed to take longer than I expected. As 3:00 approached, though, I worked quickly and efficiently to clear my schedule. I couldn’t be late for my appointment with Rich.
I kept touching my leg where the mole was, wondering if it was sore. Sometimes it seemed it, sometimes it didn’t.
I walked to Rich’s office through the connecting corridors and erratic levels of the hospital. I was almost tired when I got there, and I realized I had been walking fast. My heart was beating hard. It could have been fear; it felt the same as excitement. His door was open. I knocked on the frame and stepped in.
He looked up from a file. “Hey, are you alright? What’s the problem?”
“Rich, thank you for taking this time.” He stood up and we shook hands then sat in facing chairs.
“I’ve got this mark that I’m concerned about,” I said.
“Really?” He instantly sat up straighter and looked concerned.
“It’s a mole I’ve always had, but lately it looks to me like it has grown.”
“That’s not good, but hopefully it’s not anything serious.”
“Right. Hopefully.” I patted my leg. “It’s right here.”
“Okay. Let me see.”
I had to unbutton my pants to uncover the mole. I dropped them to my knees. I pointed at the mole without really looking at it myself. Rich leaned a little closer. My heart was still going at 150 beats per minute.
“You say it’s grown lately?” he asked.
“I think so.”
“That would always be a concern.” He was picking his words carefully. “But I don’t think this is anything to worry about. I’m all but positive. I’ll have a biopsy done if you think you need it, but—” I was looking at him, but for a moment I felt like I couldn’t see him. There was just a space there where he should be. I don’t understand it.
“That’s a relief,” I said, but I felt like shit. Why was the thought of being healthy so unsatisfying? It was worse than being ill. “I guess I’ve been a little off lately.”
“Have you been sleeping? Eating?”
“More or less.”
“There isn’t anything wrong with you physically,” I heard, although I wasn’t sure who was talking. “It wouldn’t be unusual for someone in your situation to feel a lot of sadness. You’ve lost so much. You’ve lost more than you knew you had.”
I didn’t say anything—just sat there with my pants around my knees—because I wasn’t sure if anyone was talking to me or if the voice was in my head. I didn’t know what to do next. Everything seemed off, and I couldn’t explain why.
