Knocking on Heaven's Door: The Path to a Better Way of Death (5 page)

He told me about shooting a coiled, hissing, poisonous snake

called a puff adder in the rocky foothills, about putting a loud

but harmless homemade bomb on the Cradock railroad tracks,

about breaking both arms slipping from a homemade trapeze

that his father, who ran the town’s struggling daily newspaper,

hung from a backyard pear tree. He bought me
Oliver Twist
and

the African adventure novels of H. Rider Haggard.

He gave me the Christmas presents he’d yearned for as the

youngest of five children growing up in the Depression: a Lionel

train set, a working model steam engine, and a tiny airplane with

a high-pitched motor that flew on a wire The love he showed me

settled deep in my heart and marrow, in a place far below thought.

In the evenings we would lie on the carpet before the fire,

and I would touch the scars on his cheek, his calf, the back of

his hand—his body a map that I loved to make him explain.

KnockingHeaven_ARC.indd 19

1/31/13 12:27 PM

20

katy butler

“Tell me the story,” I’d say, “how you lost your arm.”

During the Second World War in Italy, he’d volunteered for

armed reconnaissance, seeking out and destroying small pock-

ets of retreating Germans as the Allies fought their way up the

Italian boot. A shell burst over his foxhole in the mountains near

Siena. Shrapnel hit his head and both hands, and his left arm

was shredded. After he came to—and here my father would

raise his one hand, his fingers splayed out in the firelight—the

first thing he did was reach for his gun.

“It was then,” he would say, “that I knew I was a man.”

In a field hospital set up in an Italian farmhouse with a red

canvas cross on the roof, my father’s left arm turned black with

gangrene. They weren’t sure he’d live through the night. A mor-

tar hit the roof. Before he passed out, a shower of white dust fell

from the rafters onto his face.

Doctors amputated his left arm at the shoulder and saved

his life.

To fight the infections coursing through his bloodstream, they

shot him full of a miraculous new drug first discovered in London

in the 1920s but not widely deployed until the Second World

War, when American and British scientists and military person-

nel teamed up to manufacture it on a mass scale, using a hardy

“mother” mold discovered on a rotting melon in a market in Peo-

ria, Illinois. I never heard my father thank God for his miraculous

survival. He thanked Sir Alexander Fleming and penicillin.

Now we were thousands of miles and decades away from South

Africa, England, and Italy. The medical advances that saved

him as a twenty-one-year-old had once again been deployed.

But how far could miracles reach? The man who taught me how

to take a bath would never again take one on his own. The man

who taught me to revel in words and stories could not speak.

KnockingHeaven_ARC.indd 20

1/31/13 12:27 PM

knocking on heaven’s door

21

An orderly walked into the room: a short, squat man in his

fifties with longish hair, a belly pushing against his green V-neck

hospital scrubs, and a blurred blue anchor on his right bicep. He

carried a can of foam, a plastic bowl half full of warm water, a

disposable razor, and a hand towel. After nodding to my mother

and me, he sat down on a plastic chair, perpendicular to my

father’s wheelchair, and looked at his face.

He did not banter, talk down, or coo. He pressed white

lather into the palm of one hand and softly daubed my father’s

ruddy cheek. He held my father’s chin and stroked his razor up

that cheek with tenderness. He took all the time in the world.

He paid close attention to what he was doing and invested the

moment, the room, with a presence I can only call sacred.

The hospital may well have saved my father’s life with thou-

sands of dollars’ worth of oxygen, liquid nourishment, saline,

X-rays, intravenous lines, feeding tubes, barium-swallowing tests,

catheters, and other sophisticated treatments and diagnostics.

Now I watched someone tenderly touch him.

Fearful of the notorious impersonality of modern hospitals,

I’d taped family photographs above my father’s bed to make

sure nurses knew we cared what happened to him. My South

African mother told everyone who entered the room that her

husband lost his arm in the Second World War—“fighting for

Demaacracy,” she’d say ironically, in a broad American accent,

as she was fighting for his dignity now. But the orderly did not

need family photographs or a war history to treat my father with

reverence. We were in an oasis of caring, everything the modern

hospital aspires to be and rarely is. And I was learning, from a

fat man with a tattoo whose name I didn’t know, how to love my

helpless, broken, and infinitely slowly dying father.

My mother twisted her hands in her lap and sat, uncharac-

teristically quiet. Among the photographs I’d stuck above the

bed was a family favorite, taken in 1946, of her and my father

KnockingHeaven_ARC.indd 21

1/31/13 12:27 PM

22

katy butler

on a playing field at Rhodes University in South Africa’s Eastern

Cape. She was twenty-two in the photograph, and he was twenty-

four. It was taken only a few months before they walked out of

the Grahamstown church together, all dressed up and grinning,

with her white veil thrown back and his black hair flecked with

confetti and rice. Two years before they sailed away to England

with me in a bassinet, and more than a decade before they sailed

the Atlantic, this time towing three young kids, relying mainly on

each other and their own guts to build a successful, even elegant,

American émigré life. In the photo, they were both buttoned into

my father’s army overcoat, as though he were the mother kanga-

roo and she the baby. They had not yet bickered and shouted and

taken each other for granted and quietly contemplated divorce

and seen each other through disappointments and softened and

reconciled. They were laughing. My mother was barefoot. She

had just won a footrace, and it was starting to rain.

The orderly dipped his razor into the water.

In the early 1970s, after graduating from Wesleyan, I’d given up

my shared rented apartment and driven cross-country to Cali-

fornia, part of the great baby-boom diaspora from small towns

to cities on the coasts. I was doing what generations of middle-

class children have done since the Industrial Revolution: going

off to seek my fortune, forgetting that blood is thicker than

water, and not looking back. By then, my father and I had long

been estranged, our easy early intimacy lost to years of fights

over my undone homework and messy bedroom and his bad

temper and expectations, never met, that I get straight A’s.

Desperate to become a writer, I landed in San Francisco

chasing the success I secretly hoped would make him proud

and that I was sure would elude me as long as I remained within

the force field of his baleful doomsaying. I wrote for an alterna-

KnockingHeaven_ARC.indd 22

1/31/13 12:27 PM

knocking on heaven’s door

23

tive weekly and then for the
San Francisco Chronicle,
the big

morning daily. Twelve years later I quit to freelance for maga-

zines. I married and divorced. I made my own life. I visited my

parents once a year, and sometimes not even that often.

Of course we kept in touch. When I was still in my twenties, my

father wrote me a remorseful letter acknowledging that not long

after we‘d come to America, he’d “become insanely ambitious for

you and let all the love go out of the relationship.” Our edges soft-

ened. He lent me half the down payment for my first San Francisco

house. On my birthday, he would write me tender, formal, almost

Victorian letters. Several times a year, I would send him articles I’d

written, like a teenager still yearning for Daddy’s approval.

Every March, after teaching a writing workshop in Washing-

ton DC, I would take the Amtrak Acela north and be picked up

by my parents in New Haven. When it was warm enough, my

father and I would linger over breakfast on the deck beneath a

lattice of pale green, unfurling Dutchman’s pipe vines, parrying

happily over something in that morning’s
New York Times
while

my mother washed the dishes
.
We’d duck and dart behind walls

of words. Often I wasn’t sure what he really thought.

The rest of the time, I was comfortable loving my parents from

a distance.

The orderly asked my father to turn his cheek.

As my father turned his head, his eyes caught the glossy

stitching of the red chenille sweater I was wearing, bought at

a secondhand store. It was the kind of visual detail he’d rarely

noticed when his powerful, professorial left brain was intact.

The stroke had stripped away our shared vocabulary of

oblique love along with his capacity to speak. In the years to

come, I would express my love for him less in words than in

acts. And as my father cast off the husks of his old life, I found

KnockingHeaven_ARC.indd 23

1/31/13 12:27 PM

24

katy butler

myself overwhelmed by a deep underwater love rising from

depths I was just beginning to plumb.

Finding the right word for one of the first times since the

stroke, he said, “Beautiful.”

Later that day, or early the next—I don’t remember—the hos-

pital’s “discharge planner” told us that my father had to be

transferred to a center for neurological rehabilitation at once.

Only later would I understand the rush: the hospital was los-

ing money on him with every passing day. Out of $20,228 in

services performed and billed, Medicare would reimburse Mid-

dlesex Memorial only $6,559, a lump sum based on the sever-

ity of my father’s stroke diagnosis. (Such losses are absorbed

by charitable donations and, in what is known as cost-shifting,

revenue from more profitable departments and better-insured

patients.) This lump-sum system, known as the DRG (for diag-

nosis-related group) was instituted in the 1980s during a period

of rapid medical inflation to force hospitals to control costs. But

it also incentivized rapid discharges, turned patients into items

on conveyor belts, and eroded the hospital’s traditional role as a

place for nursing, convalescence, and healing.

I drove my mother to the closest place with an available bed,

a high-rise rehab center in the poor city of New Britain. In a

panicked rush, she accepted it—the first but not the last snap

decision she would make in her new role as my father’s medical

guardian. We followed my father’s ambulance there and ner-

vously watched the orderlies unload him. I was terrified he’d

somehow shatter, like a cracked glass.

The place had been recommended by Dr. Fales, my parents’

internist. The TV blared in the day room all day, there was no

access to the natural world, and my father, who was spontane-

ously recovering some speech, strung together enough words to

KnockingHeaven_ARC.indd 24

1/31/13 12:27 PM

knocking on heaven’s door

25

tell my mother vehemently, “Get me the
hell
out of here.” She and I drove south to Gaylord Rehabilitation Institute in rural Walling-ford, and my hopes lifted when we toured its leafy campus, with

its Disney-like indoor “Main Street” where the brain-damaged

could practice buying apples or toothpaste or simply walking in a

straightish line holding onto a rail. In 1989, six months of intense

rehabilitation at Gaylord had helped a young Salomon Brothers

investment banker, whom the newspapers called the Central

Park Jogger, learn to walk and speak again after her skull was

bashed in with a brick.

Perhaps my father, too, could be fixed.

I was thinking in confused ways then. First I’d fantasize

about sending for Berlitz language-immersion tapes and drilling

my father until he could speak and understand English again.

Then I’d hope he’d have another stroke and die. The one sce-

nario I didn’t consider was the likely one, spelled out for us in a

brochure from Gaylord: stroke victims tend to improve rapidly

for about a year and then the gains taper off. They live, on aver-

age, with varying degrees of disability, for another seven.

Gaylord had no empty bed.

I sprang into action like the reporter I was, like the man my

father had been, and like the substitute husband my mother now

needed. I spun her Rolodex. I negotiated with a social worker at

the New Britain rehab. My mother called a friend whose former

husband was on the Gaylord board and whose daughter was

a doctor. I called the daughter. We begged. We waited. I said

we’d cover whatever charges Medicare wouldn’t pay. It gave us

something to do. We thought we were making a difference. It

was just about the only way we could show our love.