What Remains (22 page)

The third round is in September and Carolyn is back, and while Anthony drifts in and out of sleep we sneak off to Wendy’s for a junk-food fix.

I order a number two—a Classic Double, no cheese. “Biggie the fries, biggie Diet Coke,” I tell the cashier, and she punches it in.

It’s a little Wendy’s in Washington Heights packed with moody teenagers and sleepy-looking residents.

Carolyn sighs dramatically after I order. “Can you please stop saying ‘biggie’ every time we come here?” She rolls her eyes at the girl behind the register and jerks her head toward me.

“No, and you want biggie fries, too.”

She rolls her eyes again.

“Say ‘biggie,’” I tease her.

“I’m not saying ‘biggie.’ I want a number two and a Frosty.”

I turn to the cashier. “One more number two with a Frosty,” I tell her, “and biggie the fries.”

If there is anything certain in our lives at this point, it is that I will biggie the fries and she will roll her eyes at me. I drag out our Wendy’s lunch as long as I can. I eat every single fry, dipping each one carefully in ketchup. I talk nonstop, pulling out every single piece of office gossip I can think of.
Don’t get up,
I am silently willing her.
I don’t want to go back.
But we do stand up, clear our table, empty our trays in the orange garbage containers, and walk back to the hospital.

Weekend chemotherapy is lonely. People have weekend plans and so won’t be stopping by. We don’t want anyone to come but can’t stand to be alone. Hospitals on the weekend are smothered with emptiness. There is no sense of movement, of change, of seasons. We start the same day over and over. The same false lighting glares down at you everywhere, no matter the time of day, and it is always cold. Somewhere in New York there are people warm and surrounded, and none of them know of this, that we are here.

Sundays are completely dead. We try to schedule the cycles to finish on Sunday, so Anthony can be at work the next day. After our first Sunday, spent searching for someone to check us out, we learned to get his discharge papers signed earlier, before his doctor leaves for the weekend.

By the fourth cycle things are going wrong, and we deal with them the best we can. Anthony can’t walk. He is leaning on me. I have to reach my arm around him and hold him up under his arm. No one remarks on this as we leave. No one says,
Hey, are you okay there? Are you sure you’re ready to go?
Had they asked, Anthony would have answered angrily, a steely
Yes!
We would still have checked out. But I would feel better if someone noticed:
Yes, you see it, too! I’m not crazy. I need help.
But no one says anything, and I begin to think I’m imagining it all. His entire body shaking, unable to walk without my help. I consider mentioning this to the resident when he hands us the discharge papers, but I know Anthony will regard it as a betrayal. I smile and take the papers.

We are referred to a neurologist, who diagnoses Anthony with polyneuropathy. Another diagnosis. They barely register now. The nerve endings in his legs are dying. There is nothing to do about it. I buy him a cane at Zitomer’s on Madison.

On a Friday in October I go to the hospital as usual after work. It’s our last cycle. The tumor hasn’t shrunk, but it hasn’t grown either, so Dr. Best of the Best has encouraged us to go ahead with the last treatment. When I walk into Anthony’s room, there is no equipment, no Med-Vac to drip the chemo. The lights are off, and Anthony is sitting hunched on the edge of the bed.

It’s six at night, and my thoughts are panicky.
Has something gone wrong? Did we forget to check in this morning?

“Where’s the doctor?” I ask him. I force myself to sound calm.

“I don’t know. I think he left.”

He is alone, thin and pale. I am struck by how helpless he looks, the empty room. I take it in cautiously. “I’m confused. Have you been sitting here all afternoon?”

“The nurses are waiting on something from the lab.” He is anxious. He tells me no one has checked on him.

“Where the hell
is
everyone?” I am trying to keep my voice steady.

“They’re waiting on my blood work.”

“When did they take it?”

“A while ago, I guess. Don’t make a scene, Carole. They’re just busy.”

I know when I hear him call me by my name to be careful. He has said this before,
Don’t make a scene.
As a patient, he does not want attention called to him. He thinks there must be patients who are worse off, and they are getting treated first. After all, he thinks, he’s going to get better, and these other sicker patients might not. But it’s no longer true. Now he is sometimes the sickest patient in the unit. I am not the sort of person to make scenes, I think, though it turns out I just need the right set of circumstances.

This is my
Terms of Endearment–
Shirley MacLaine moment. It’s in all the movies in which someone dies—the moment when you understand, when you get it. This is all just a charade. The doctors have moved on to other patients and you’re left screaming for help at the nurses’ station. Anthony is not so much a patient anymore but a guest who has overstayed his welcome.

“I just got to my husband’s room, and he’s been sitting here all day waiting for the chemo,” I say on the phone to the lab. “I left this morning, and he’s been sitting here
all day
—why is he still sitting here?” The last three words are tight, clenched.

“I’m sorry, Mrs. Radziwill. Someone should have called. We’re waiting to hear from his doctor. We need a dispensation from his doctor before we can release the drugs.”

“Why? His doctor already ordered the treatment.”

“His blood work came back, and his creatinine level is a little high.”

The creatinine level indicates how the kidneys are functioning; it is monitored closely because kidney damage is a possible side effect of ifosfamide. A healthy creatinine level is 1. One is perfect. It means you’re walking, eating, drinking, and everything is running smoothly. Ten, on the other hand, is total kidney failure.

Anthony’s creatinine level is approaching 2, they tell me, and yes, they have called Dr. Best of the Best. He has okayed the chemo but asked for a modified version: slightly reducing the ifosfamide to compensate for the kidney concern. But the lab hasn’t sent up the drugs yet. “We have another call in to the doctor. We’re waiting to hear back.”

His doctor ordered it,
I think.
If he says give it to him, then give it to him!
His creatinine level is elevated, but still it’s only at 2, and kidneys don’t fail until 10. Or so I thought.

“What is going on?” I ask the doctor when I reach him on his home phone. “Anthony’s been waiting in his room all day.”

“What are you talking about? I ordered the drugs,” he says. When I repeat what the lab has told me about the creatinine level, he answers me testily. He’s aware of the problem, he says, and has already addressed it.

Dr. Best of the Best sounds impatient. I’m sure I am not welcome, calling him here. “I ordered the fucking drugs. I told them to send up the drugs this morning. Hours ago.”

The
fucking
startles me. I have not heard a doctor curse. Best of the Best is angry with the lab.

I switch the phone to my other ear and glance at Anthony. He is staring at a wall. His arms look thin but heavy. As if they have dropped there at his sides and he can’t lift them back up. I look past him out the window at the commuters—people leaving offices to drive to houses in the suburbs. Warm food and garlic smells hugging them as they walk through familiar doors.

I don’t know whom to turn to. I need to trust the doctor, to put my faith in him completely. I’m lost if I can’t. He’s my compass. I need to trust that he is right and that the lab is responsible for the delay. A simple miscommunication. This is not the time, in the fifth round of chemo, almost at the end, that I am eager to question Anthony’s doctor.

In the early rounds I did the research. I combed the Internet for new drugs, new treatments, and studied their side effects. I brought it all to Best of the Best’s office. He listened quietly while I read from articles and
World News Tonight
transcripts and then gave me his opinion. After the third round he didn’t respond. I named the drug, and he wrote the prescription without even looking up. He gave me a triplicate prescription for Marinol, the “pot” drug, which I filled and then took myself to get to sleep. When Anthony asked how long he would live if he didn’t finish the five cycles, Best of the Best replied, without missing a beat, “Oh, I hate it when my patients ask me that.” In the beginning, yes, I would question, but now I don’t have that kind of time.

Twenty minutes after we hang up, the lab brings up the drugs.

I am pleased with myself, a little. I have taken charge and taken care of something, I think. I help Anthony get comfortable; then I find a supply room and go inside and shut the door. I sit down on a step stool, next to boxes of surgical masks and bedpans and a stack of white blankets, and cry.

He does the chemo drip for three days around the clock, and after seventy-two hours I have forgotten about the lab and the cursing. We are back on course, pushing ahead. I move it away from everything else on my mind.

It is two weeks after the fifth cycle of chemo, and Anthony has not regained his strength. Best of the Best told us it might take a little longer to recover; the last cycle is always the most difficult. He has been home but unable to go to work.

No one knows what goes on in our secret lives. We guzzle NyQuil to sleep. We get up in the night to change the sheets, which are soaked in perspiration. Anthony sleeps upright so he can breathe easier. If I hear him struggling, I nudge him to wake him up. He is always, it seems, up during the night. I take his temperature every hour. I cry in the shower so he cannot hear me.

He has had a fever for days, and we are biding it. But this night seems worse. It is four in the morning, and he is running a 103-degree fever and is filling the crescent moon–shaped bowls they gave us at the hospital with bile, so we agree on the cab.

“Columbia Presbyterian, emergency room,” I tell the driver calmly.

We are used to going to hospitals in cabs. In New York this is what you do.

There are things I know how to do, regardless of how crazy it all seems. I am serious, efficient. Following my own made-up directions. I am unable, still, to say
I can’t do this by myself
. And no one suggests that I get help. There is such a fuzzy line between sick and rush to the hospital, and we keep moving it. Hailing cabs at four in the morning.
Keep moving. It will be worse if you stop.

This is the second trip to the ER in as many weeks. But this time, before I finish checking him into the hospital the emergency room doctor says, “I think you should call his mother,” as he puts an oxygen mask on Anthony and hooks up a saline IV.

We have been in hospitals for years, but now I am worried. It is the expression on the doctor’s face. The stark change, it seems, in Anthony from the door of our apartment to here. I have a fleeting thought of him dying right here in the ER, but that can’t be possible. Can it?

The ER doctor is serious and direct. He is disheveled, sweaty, and he’s talking fast. He has no time for careful meetings. He tells me Anthony is fighting a massive infection. They won’t be sure what it is until the blood tests and cultures come back from the lab. The doctor starts an IV for Vancomycin, the antibiotic of last resort. “It’s not good,” he is saying. “His immune system is so compromised from the chemo, he’s having difficulty fighting back. There is very little we can do except wait.” I don’t respond. “The first twenty-four hours are the most important. If his condition doesn’t improve, well, that’s not good either.”
Mrs. Radziwill,
he is trying to tell me,
I think your husband is going to die.

Carolyn comes in the morning. Lee arrives with Hamilton. Herbert calls from Los Angeles. Friends start showing up in the afternoon. There are people who haven’t seen Anthony in the hospital before, who don’t know what this is like, and Carolyn won’t let me reassure them. She is worried about me. She grabs my hand in the waiting room and makes it clear she will take care of me, and the others will have to manage this on their own.

After Anthony is situated in the ICU, I book one of the McKeen Pavilion’s guest rooms, and Carolyn and I spend the night. She is afraid to leave me now. Afraid that if Anthony dies during the night, I will be here all alone. I wake up early the next morning and call the ICU.

“How is he?”

“He’s the same,” the voice says flatly. “Unchanged.” The nurse says it slowly, without inflection, like a recording.

“What does that mean?”

“We were hoping for some progress.”

Carolyn is sitting on the bed next to me, and I won’t talk to her. I put the phone down and cry. She brings me juice and a muffin and runs the shower for me. When I get out, I see that she has laid out the clothes she brought for me. I get dressed and sit down in the bathroom and she blow-dries my hair.

I suddenly realize I’m not prepared for him to die. I’m not ready for this. Not yet.

I’ll just sleep, I think. I’ll wake up and he’ll be coming out of it.
Close one,
I will tell him. He’ll smile and squeeze my hand. But I wake up and his condition is the same and I can’t look at anyone.

Carolyn and I walk silently to the ICU. John is there already. Caroline comes in with Ed, Holly with Pete and Joan. Marc and Lori are sitting in the waiting room outside. Anthony’s sister Tina, here with her boyfriend, is visibly shaken. It looks as if Anthony is hooked to every machine they have. His resistance is breaking down, his kidneys are failing, his circulation system is going, his white blood cell count is skyrocketing, his red blood count is too low, his respiratory system is shutting down—it appears to be irreversible.

John comes back late that night in his tuxedo, straight from an event. It is nearly midnight, and Carolyn and I are waiting for him. He is the one who can save us somehow. The one we count on. The one who brings magic dust and sparkle, and we hold our breath each time, hoping he can still do it. We are hoping, Carolyn and I, that he can somehow pull this off.

He kisses her, gives me a quick hug, and walks over to Anthony’s bed. We have been standing here for hours, watching him drift in and out of consciousness.

“Tonypro,” he says quietly and grabs Anthony’s hand. John’s shoes are black and shiny. His bow tie is undone. His tuxedo looks comical in the yellow lights of the ICU.

He begins humming, and then there are words. We can barely hear him, but Anthony does, and he smiles. His eyes are still closed, but they seem more relaxed when he smiles, and then his mouth starts to move along with John’s.

They sing together softly, this children’s song, with their hands clasped like little boys. They sing it over and over, John holding tightly on to Anthony’s hand. They are in a place that no one else has ever been or could ever go, singing a song that John’s mother used to sing to the two of them. The boys who laughed and played and sang silly songs are all grown up now—John in a tuxedo, Anthony in a hospital gown.

The doctors think Anthony will die tonight, and John takes him to the safest place he knows.