Barely promoted

Friday, November 26

Friday Beaker and I met, tearfully, with Dorothy-the-social-worker. She confirmed that there was no mention of any cardiac issues in Annajane's records. (We suspect the M.E.'s office just made up the artheriosclerosis. Malnutrition? Too weak to live? Was the broken clavicle her first experience of extended physical pain?) Dorothy was very careful to tell me that I'd been a good daughter. The hospital's priest came by as well. My mother abused him mercilessly every time he visited her. But he was always kind to her, and he was very kind to us. We signed for the $600 in cash that Annajane had mysteriously had when she arrived at the hospital.

We roared through a department store looking for undergarments for Annajane, cufflinks for me, a tie for Beaker. I convinced the drycleaner's next door to steam the red wool dress right then and there. "Is this for a party, dear? A wedding?" "A funeral." I didn't tell them who would be wearing it.

I dropped the clothes off at the funeral home, and wrote them a large check.

We went to look at monuments, since the V.A.-issued stone on my grandfather's grave must now be replaced. The first place we went, the guy kept telling us how to evade the cemetery's regulations on consent of deedholders: "They ask you if you got uncles, easy: you say you just got one! Don't even mention the other one!" I realized we could walk out, so we did.

We went to look at the current stone. Of course, what with the burial planned for the next morning, the grave had already been opened. I lost it, totally.

I started stims: 4 Gonal f, 2 Repronex, drop the Lupron in half.

Thursday, November 25

Thursday Nanna, Ricky, Marina, Beaker and I built Thanksgiving dinner. Nanna developed palpitations as she tried to arrange a fruit bowl (there was too much fruit). I stopped Marina from glazing the turkey with pineapple, but then she stood back as I burned it to stringiness. She boiled the potatoes whole (!) and unpeeled (!), then peeled them after they were cooked, but her new masher left them lumpy. I didn't make anything new. The last few years I've made adventurous fall soups, but only Annajane has ever liked them (and sometimes they've made Nanna, with her weak pancreas, ill).

My family is Catholic (well, perhaps only Nanna really is), so our grace at evening meals is always the same, even at holidays. Even at holidays where we're supposed to be extra thankful, or holidays where someone is suddenly (or not?) missing.

During dinner, Nanna and Ricky talked about how many clothes of Annajane's seemed to be missing; those untrustworthy people at the homes and hospitals must have stolen them! Ricky congratulated himself for managing to keep track of his own stuff, even when he was a touring musician (and a drug addict, although he didn't mention that part). I thought of how my grandparents' denial of my mother's problems had led to many, perhaps most, of my childhood mementos disappearing when she lost apartments, of how sweet and confused most of the other crazy people in all the institutions had seemed, and of the vast stupidity of my uncle, but I managed to fume silently.

After dinner we went through Annajane's clothes, looking for something to bury her in. I voted for a lamé jacket she'd sewn herself in the early seventies, but Nanna chose a red wool dress from the early sixties.

Wednesday, November 24

Wednesday Nanna and I met with the undertakers. I didn't realize until afterwards how little of the meeting Nanna had been able to hear. (She didn't realize there would be no visitation until Saturday morning.) It was clear during the meeting, though, that we disagreed on disposition of the body, and we said we'd call the funeral director later that day with a decision. (The cremation/burial conundrum was finally resolved at tolerable cost by deciding to bury Annajane in her parents' plot, purchased when my grandfather died twelve years ago; apparently it can hold three caskets.)

I picked up Annajane's belongings from Daisyfield. When I asked for boxes to put her clothes in, they produced empty adult diaper cartons, size extra large.

I called the medical exminer's office again. They hadn't actually done an autopsy. The official cause of death is listed as, "artheriosclerotic heart disease and schizoaffective disorder."

I had to make two late runs to the grocery store, one for potatoes and one for (I am not making this up) sweet potatoes.

Beaker drove out through awful weather and full pre-holiday traffic, arriving very late at night. He brought my only good suit, the deep navy one I bought seven years ago just after her first breakdown of the modern era. The one I wore for my job interviews.

Tuesday, November 23

Tuesday morning I went for my day 3 bloodwork and ultrasound. I whined to the nurses hard enough that they didn't make me pay for the cycle. Dr. Data was studiously neutral: "Some studies show stress has an effect on success rates, but others don't."

I went out to Weatherwood in the afternoon. I cried for the first time when I saw Nanna all in black, even her socks.

I spoke with two social workers and a doctor who had seen Annajane on Monday. They concurred that she had seemed to rally a bit that day: her weight was holding stable, she was holding her head up more, and she had longer coherent stretches. She ate more. That evening, she had been in bed asleep; she was fine when checked at 11:30, but not breathing at 11:45. They called an ambulance, performed CPR. They called me at about 12:45.

I called the medical examiner's office: "Look, we're really busy in here, we got five-six bodies in here today. Joe! Joe! You gonna autopsy Maple? Yeah, um, call us back later and we'll tell you the results."

After much reassurance from nurses, I decided to continue with the cycle, but hold on Lupron for three extra days.

Triple time

The next few entries will be an accelerated account of, well, some of what happened. Subject lines will be the, um, actual dates described.

As Annajane lay dying

I was flying to New York, quietly amazed that I could just stare out the window and watch the pretty lights of the city. Perhaps I am calm about the cycle, I thought. Perhpas it is good to know that it will be the last.

I was on the phone with Beaker, carping bitterly about his travel schedule. Damnit, my ovaries are more important than your conference, honey. Let me burst into a little flash of tears so you know how true that is.

I was reading Quicksilver late into the night, way too late for when I needed to wake up. I didn't like the Jack Steptoe section anywhere near as much as the Daniel Waterhouse section, but I'm never into historical battle scenes. And then my cellphone rang. A doctor with a thick European accent, just like Dr. Brash's, told me he had bad news.

They don't know what happened. She went to bed yesterday evening, and the next check found her cold. The psychiatrist who called me is not her regular doctor and didn't know whether there had been other medical complications since I last saw her.

I don't know what happens next.

Little necessities

After a migraine on (Lupron) day 8 and icky brown spotting—with extra pink streaks!—on day 9, today, day 10, the gates have opened. I'm hunting for plane tickets and packing my bags with:

• Bras in many sizes.

  

• Sweaters with loose sleeves.

  
  

• Drawstring waist pants, including pajamas. (Are all drawstring waist pants, in the end, pajamas?)

  

• The best bloat-ready jeans ever. Yes, they're being sold for their "slouchy sophistication." But, oh, the stretch, the waist adjustment tabs,

  

  and the soft fabric lining inside the waistband!

  

  (Plus they're cut way big, so I bought a size that, for me, is so four years ago.)

• Big knives.

  

  Ah, Thanksgiving with family.

Sudden overlap

So, the Chronicle has its big-wig pay issue out. Mostly about college and university presidents' salaries. (Sadly, no public links to the raw data.) However, they also include the top 5 salaries paid at each institution; I think the data comes off one of the forms they file, as non-profits, with the goverment.

Why, who's that on Cornell's list? A couple of doctors (not including Dr. Data) from the reproductive medicine unit? Each of whom makes at least five times as much as the president of Granolan?

Now, this happens at a bunch of universities that have big hospitals—although usually it's cardiac surgeons who make the list. Still, it's, um, interesting to find out the program is, um, distinguished in yet another sense. (But, should I be worried that Dr. Data's a slacker?)

Slow burn

Q. How are you doing on Lupron?

A. Aside from an occasional uterine twinge, just fine! And, I mean, I can see why the ol' uterus might be getting annoyed. First the medical instruments, then the delay in housecleaning...

Q. No, really.

A. Really, I'm fine. No headaches, no hot flashes. Actually, it's kind of nice having my hands and feet not be so cold all the time.

Q. What about the toaster oven?

A. Leaving it on all day? That was just a freak chance thing. The indicator light is invisible in the morning sun, and I always worry that I'm going to forget to turn it off—that's why I usually just unplug the damn thing.

Q. Thoughts of impending doom?

A. Look, if Beaker's presentation at a staff meeting tomorrow goes badly, we could end up starving on the street. It's not impossible. My friend who's getting Lasik could go blind. If my meeting with the dean on Thursday goes badly I could end up department chair next year, too. All these things could really happen. Don't tell me they couldn't.

Q. How many days did it take you to go buy some dishwashing detergent? After you had run out completely and dishes were piling up in the sink?

A. That's a very low blow. Three, I admit, it was three.

Q. And the naps?

A. Okay, you got me there. Yes, after every meal. Including breakfast. It makes it much harder to remember to do the dishes.

Q. Which is why you still haven't, despite having purchased the soap?

A. Um. Yeah.

Q. What about the simmer burner?

A. What simmer burner?

Q. Remember you made that pot of pasta sauce on Monday, that simmered for four hours? The one that's still soaking in the sink? Perhaps you should check the stove.

A. [...]

Hanging on

During my trip to New York, after losing a pint of blood, but before having my uterine lining scraped, I went to see Annajane. Her social worker Dorothy had called my cellphone just after I'd gotten off the plane, when I was sitting on the Q33 on the way to the subway. Apparently what little she managed to say had changed in tone: "It seemed like she might be trying to say goodbye." And Dorothy reiterated what Tim had said about her physical difficulties, how she was spending her days propped up in a geriatric chair with her head slumped over. They'd taken her over to the (regular) hospital again to see if they could find anything wrong with her neck (no), and they were worried that she might have a urinary tract infection.

The unit she's on now is not a geriatric unit. Hospital three has such a unit, but for now they think it's important to have her surrounded by familiar staff. When I got there, her geri chair was pulled up by the nurses' station; the nurse who had just changed her diapers was joking with her. They pushed the chair over to her room so that we could have some privacy. She hadn't eaten much lunch, so they asked me to help get her to drink some Ensure, which was in two styrofoam cups, each only half full. Despite her hand tremors, despite her neck pain, she could get the cup to her mouth and raise her head enough to drink—but she couldn't concentrate enough to keep doing it. They're worried she's lost weight since being admitted; I can't see how she could eat a substantial amount without being fed, and I don't know if she's being fed every meal.

It's hard to say how her condition now compares with last winter. Physically much worse, of course: the injuries, the fraility. They're making her get up to walk every two hours, to avoid pressure sores, and it's awfully scary when she is walking, even with an aide on either side. Mentally? She can enunciate more; she managed to finish sentences most of the time I was there. But she can't think about anything, anything but herself right now. Last February I could tell her stories and she would listen, even if she couldn't respond. Now her attention drifts off, and she goes straight back to her basic themes: "Only you can save me, Emmy. I'm so weak now, but you're so strong." There was a tangled set of memes around money, about various members of the hospital staff controlling the world, sort of standard paranoia. And then there was the need.

She could not let go of my hands, the entire time I was there. It was difficult to go ask the nurses questions, because I had to disentangle myself each time. I could only get her to let me leave by reiterating how I'd be back at Thanksgiving, how soon that was. "You've given me something to hope for."

When I left, it was just starting to get dark. I walked to the train station. The hospital sits in a landscaped park (for which I'm sure its suburban neighbors are grateful). The main drive, no longer open to cars, is lined with mature Japanese maples, perhaps 20 feet tall, and big dark pine trees. I'd noticed the maples last summer and been impressed only by their size; the foliage was, for the most part, plain green. But the climate there is gentler than in Ohindinois, so their fall colors were still there: tapestries of red and yellow, thrown bright against the green of the pines by the remaining light.

She's only 61. Sitting crushed on a pile of pillows in a geri chair, she looks ancient. One of her grandmothers lived to 95; the other, to 84. Her mother is 89 and going strong. I think the staff are worried that she's trying to starve herself. I can't believe she's suicidal; she never has been before. But she's also never been in protracted pain before. I don't know how much they can do for her shoulder, and I worry that it might heal crookedly, in a way that only accentuates her scoliosis. Her tiny, tiny bones, and the medication-induced tremors, are trapping her, way before her time, perhaps even way before her tired, tired mind.

While I was there, she said her shoulder hurts less when she's lying down. Nanna and Ricky went to see her this weekend and said she was in bed when they got there. I hope that's a good thing. I was worried that she'd blow my cover (my family doesn't know about the trips to Cornell), but, of course, she's not that articulate. It sounded like she was having more trouble finishing sentences when they were there. Nanna is extremely sad.