Recessional: A Novel (7 page)

“I thought the idea was that anyone in the main building who became ill could be transferred automatically to this building.”

“Only under doctor’s orders—an outside doctor.”

Zorn considered this for some moments, then said: “So our advertising stressing complete health care—”

“Is false.”

Again Zorn fell into silent thought: “Ironclad rules?”

“Yes. To protect the local medical men.” Having said this, Krenek quickly added: “And also to protect us from lawsuits if our personnel were to give improper diagnosis or medication. The law safeguards us as much as it aids the local doctors.”

“Why don’t we make that clear in our advertising?”

“Because people coming in like to feel they’re safe for the remainder of their lives. They are, of course, but under a rather different set of rules from what they imagined.”

“But isn’t that a fraud?”

“An amiable one—does no harm to anyone.”

“Except in the pocketbook.”

“Nothing in this life that’s worth a damn is inexpensive. Especially the American health system.” Before Andy could break in, Krenek added: “Living in the Palms is not cheap, Doctor. Our residents can afford medical care, and we assure them the best.”

“On our terms?”

“The state’s. Health services for older people are big business in Florida, and everyone is careful to protect his share of the economic pie.”

When Krenek was called away to handle a phone call, Andy contemplated his surprising situation: “Here I sit, a certified doctor with these handsome facilities at hand, and I’m forbidden to use either my own skills or these wonderful lifesaving machines. I’ve thrown myself into a weird world.”

But when Ken returned to resume their trip through the Assisted Living facilities, Andy noted with growing approval the neatness of the place, the attractiveness of the individual rooms, the warmth of the public areas and the exceptional congeniality of the small, well-decorated
dining room. It was, he judged, a part of the larger building in which one could reside in comfort and care as one recovered from an operation or a broken limb. “It’s not a permanent residence, you understand,” Krenek said. “In and out’s the motto here, with an emphasis on rehabilitation. But we spend great effort to make patients comfortable and happy while they’re on the mend.”

The conviction in these words was somewhat dampened when one of the doors leading to a private room on the second floor was banged open by a handsome woman in her seventies who rushed out into the hall. Her slim, well-groomed appearance bespoke years of careful attention to good health habits and the free expenditure of money for clothes. But dominating all else was a face of exquisite porcelain beauty, with the classic lines of some Greek sculpture and framed by silvery hair. Slightly taller than the average woman but much slimmer, she looked as if she should always be dressed in flowing garments of a romantic past and sitting beside a glowing fireplace in the great hall of some castle as evening shadows settled. She looked to be the kind of woman Zorn had not often encountered while performing his medical duties in Chicago.

Incongruously, this delicate beauty began to assault Krenek with the utmost fury. In the shrill voice of a streetcorner harridan she accused him of snooping on her, of incessantly abusing her, and of trying in every devious way to steal her money. These were devastating charges to lodge against a man whose job it was to make life easy and safe for her, and Zorn was amazed that such charges had been allowed to accumulate without attracting the attention of someone with enough authority to correct them. Before he could intervene to ask the distraught woman for details, especially about the theft of the money, he was surprised to see Krenek face his accuser calmly and say in a quiet voice: “I know, Mrs. Duggan, these things must distress you, but I’m having a meeting this afternoon with Scotland Yard, and they’ve promised to look into this sorry affair. Now, if you’ll wait in your room till after lunch—”

“Thank you, Dr. Penobscott. I can always rely on you for help.” Then suddenly she turned to Zorn: “But you, damn you, you’ll be hanged when your behavior is exposed,” and she was so wild-eyed with fury that Andy fell back lest she attack him with her long, pale pink fingernails.

She fell silent, not because of anything that Krenek did but because
of something she saw over Zorn’s shoulder. From the elevator that brought visitors to Assisted Living came a man in his mid-seventies who looked out of place in the posh surroundings; his misshapen nose, broken often by fists, gave him the appearance of a stumblebum pugilist who moved about alleys and barrooms shadowboxing with imaginary foes. Shorter than the elegant woman he approached, he had thin, wispy hair and watery eyes but an aggressive manner. Elbowing his way past Zorn and nodding to Krenek, he moved directly to the woman, took her hand and said in a voice as soft and gentle as his whiskey-roughened throat would allow: “It’s all right, darling. I’ve come to take you to lunch.”

With a grace acquired from attending the grand balls of New York society, she accepted his arm, smiled at the two men she had been abusing, and allowed the tough-mannered little man to lead her toward the open elevator doors, but as she neared the entrance she stopped, whirled around and screamed at the man: “Damn you! You stole all my money. And when Scotland Yard gets here, you’re going to hang.” She pushed him aside and entered the elevator, still heaping abuse on the man beside her.

When the couple were gone, Krenek said quietly: “That’s Marjorie Duggan. As Marjorie Bates Lambert she reigned as a queen of Manhattan society. Her husband owned four major department stores along the East Coast. After he died people have told me all New York was amazed when she married Muley Duggan, the man you just saw. He’d been head of a trucking company Mr. Lambert had used to service his stores. She must have appreciated Muley’s rough-and-tumble ways after the stiff high-society propriety of Mr. Lambert and his side of the family. Anyway, she married Muley and I believe they were very happy, with lots of money and a lively way of spending it.”

“And then?”

“Alzheimer’s.”

“You must see a lot of that in a place like this. In my practice I saw none.”

“Constantly. And sometimes it almost breaks your heart. People that you know were wonderful. Lively, bright, concerned, totally in charge of their lives. And suddenly the lights dim. They flicker. They go out. The brain almost vanishes, but the body goes on, sometimes seeming even better than before because it’s no longer under any tension.”

“That must produce bizarre conditions.”

“It does. When we receive an Alzheimer’s case off the street, never been with us in the other building, we often think: ‘This poor woman ought to go straight to the third floor. She can’t survive very long.’ But she comes to this floor, good care, good food, pleasant surroundings, and she appears to flourish for a while. As her mind disappears her body remains relatively strong, and we realize that she could be here for years, mind fading constantly, body failing more slowly but death refusing to knock on her door.”

“More women than men?”

“Fifty-fifty.”

Krenek said that the Palms had three families with Alzheimer’s in which the victim lived in Assisted Living while the healthy spouse continued in Gateways. “Two of the cases, it’s the wife who’s over here.”

“How does it end?”

“It’s not uncommon for the healthy partner to die first, worn out by the strain of incessant caring for the stricken partner. It’s as if the sane person surrenders: I cannot bear this terrible burden any longer. Life on these terms has no meaning.”

“What happens to the Alzheimer’s patient?”

“At our level, I mean our economic one, the sane spouse has usually made full arrangements for extended care for his or her partner. So the loved one who has died without dying lives on and on, knowing nothing, not even aware that her husband is gone. Then one day, far down the road, she quietly dies, having known nothing for many years.” He paused, looked out the window, and said: “When you work with Alzheimer families you learn what love is, what terror can be, and what nothingness in life in certain forms can mean.”

“The people involved must from time to time think of euthanasia.”

“Not in this establishment. It’s a forbidden word.” His voice became stern: “You must understand, Doctor, that the Alzheimer folks are still alive. There’s no reason why their life should be terminated simply because they no longer have a functioning brain. Do you exterminate a diabetic because he’s lost a leg? Or even two legs?”

At the mention of lost legs, Zorn suddenly felt faint, overwhelmed by the memory of a bloody scene and of himself kneeling down to recover the legs of the stricken girl who would never use those legs
again. Hastily putting out his hand to steady himself, he looked out the window as Krenek asked: “Are you all right, Doctor?”

“Yes….I was wondering what you call those red bushes we saw as we came along the drive. The ones down there.”

“I’ve been told half a dozen times, but I forget—we should have asked Ms. Oliphant. I’m going to call her now and write down what she tells me. Visitors often ask.” He placed the call from a phone near the entrance to the dining room: “Laura, I should have asked when we were with you. What’s the name again of that red-budded bush along our entrance? Yes, I knew it was Brazilian something. Brazilian pepper tree, and you say it’s a pest? Outlawed by the state? You cannot plant it in your garden or any public place. On our land it looks great.”

When he hung up he said: “Well, you heard. It’s the Brazilian pepper tree,” but Zorn had not heard, nor did he hear now. Painfully, he was remembering a beautiful girl in her early twenties who had fainted in his arms, and he felt a tremendous desire to fly back to Chattanooga to see how she was progressing. Thinking of Dr. Zembright’s wise counsel about staying clear lest lawsuits by initiated, he banished the fleeting thought, but he did offer a fervent prayer: “God, give her the courage to battle it through,” and he wondered if she’d be able to use the amazingly effective modern prosthetics.

As they left Assisted Living to walk up to the top floor, Krenek said: “New staff frequently make the joke: ‘Second floor’s Assisted Living, third floor’s Assisted Dying,’ but we forbid such levity. We don’t allow the word
hospice
, either.”

“Yes,” Zorn replied. “I know it’s called Extended Care. But extended to the point of death?”

“Yes.” As they came into the sunny and immaculate hall with its colorful wallpaper, comfortable chairs, and little enclaves by picture windows, Krenek said: “Americans are uneasy about dying. The entire nation all the way to the Supreme Court is scared to death about the simple act of dying. We can’t define it. We can’t provide for it. We can give family members no guidance as to how to respond to it. Up here we mask it with the euphemism Extended Care as if it were hanging on to life that mattered, not the orderly passage on to death.”

“You cover a long span of human experience here in the Palms, don’t you? Full mental capacity in a person’s sixties to little or none in his or her nineties?”

“It does seem to work out that way, but some of our ninety-year-olds are still in full control.” He led the way to a broad window from which in their last days the patients could see a handsome spread of nature: “The row of palm trees that impressed you so much, the channel with the lively boats passing back and forth and that magnificent stretch of savanna. You could be at an oasis in Africa.”

“Savanna?”

“Yes. I believe that’s the scientific name for extended grassland that contains a scattering of low trees. Anyway, that’s what somebody called it before we got here, and we like it.”

“Am I free to walk through it?”

“Oh yes! It’s one of the features our residents appreciate most. There’s a footpath beside the channel. It’s marked by the palm trees, and you can walk for maybe a mile. Some do.”

“Do we own it?”

“A decent portion, but most is owned by a church. It’s not worth much as land, farming and the like, but it does face the water, so it’s really invaluable. Our adventurous residents consider it one of the most valuable features of the Palms.”

“Could you show me how to reach the footpath?”

“Walk to the far end of the main building, go out the door and turn left. You’ll enjoy it.”

When Zorn left Gateways and headed south toward the savanna, he saw instantly what a remarkable place the Palms was, for to his left—that is, to the east—lay the swimming pool while to the west stood that row of glorious palms, eighty and ninety feet high. In the open space between the trunks he had a fine view of the channel and its rich bird life. He could see pelicans dive for fish or long-legged birds he could not name, some black, some white, that seemed also to be fishing but in their own motionless way, waiting for the fish to come to them. Nature surrounded him and he felt at ease.

He had proceeded about two hundred yards from the Palms when he came upon an elderly black man perched on a four-legged stool and maneuvering a long fishing pole whose baited hook he kept far out in the water. “Any luck?” Andy asked, and the man turned on his stool. “About like always. I usually get one or two small ones.”

“What do you do with them. Fry them?”

“Oh no! I live at the Palms back there. Their cooks wouldn’t know what to do with fish that wasn’t frozen. All meat and potatoes is their specialty.”

“I’m going to be at the Palms too. New member of the staff. Name’s Andy Zorn.”

The fisherman propped his rod with the aid of two big stones, rose and extended his hand: “I’m Lincoln Noble, federal judge from the St. Louis district, retired of course.”

As he spoke, four of the long-legged birds Andy had passed flew boldly in to cluster about the old gentleman. They had learned he was their friend and that when he ended his day of fishing he would throw his catch, one by one, to them. He was their supply ship along the channel and they now jockeyed for favorable positions, two very tall blackish birds and two reasonably tall slender birds with snow-white feathers. “Those are my herons,” he said of the first pair. “Victor and Victoria. And the white ones, the egrets, I call my princesses. Are they not exquisite?” When Zorn studied the birds more closely he noted their incredibly thin legs, long as reeds in a windy marsh, their lovely feathers and their graceful necks that seemed three feet long and realized that he had not fully appreciated their beauty when he first saw them.