I lay still, listening — listening for a whirlwind, and a Voice within it offering eloquent answers — but all I heard were crickets and cicadas, and the waning wail of a freight train keening somewhere in the distant dark.
Chapter 31
I didn’t pressure Kathleen to drop her opposition to treatment — not overtly, at least — but I did persuade her, through a combination of cajoling and browbeating, to let me speak with Dr. Spitzer, the Vanderbilt specialist who had diagnosed her cancer. At the appointed time, we called him from our living room, sitting together but listening and talking separately, each on our own cordless phone. Kathleen spoke first, sounding oddly formal and slightly embarrassed to be imposing — or to have me imposing — on Spitzer’s time. Brushing aside her apology, he asked how she was feeling. “Pretty good, I guess, for a dying woman,” she said, and her matter-of-fact fatalism made me wince. “I get short of breath when I go up stairs. Also, I feel really bloated now, as you predicted, and I can’t eat more than a few bites before I feel stuffed.”
“I’m not at all surprised by any of those things,” he said.
“Why not?” I asked him. “What do they mean?”
“The bloating is ascites,” he said. The word — it rhymed, in some slantwise, cruelly ironic way with the festive-sounding “invitees”—was familiar to me. A few years before, I’d witnessed a murder victim’s autopsy — an alcoholic who would have soon died of liver disease, if his son hadn’t crushed his skull with a cinder block first. That man’s belly had been grotesquely distended, as if he were eight months pregnant. “The peritoneal cavity — that’s the abdominal cavity, but you probably know that…?”
“I do,” I said.
“In advanced leiomyosarcoma,” he resumed, “the peritoneal cavity fills with cancerous fluid.” I looked at Kathleen in alarm, but she was looking out the window, carefully avoiding eye contact with me. “Kathleen, you might want to consider having that drained,” Spitzer added. “It won’t change the course of your disease, but it might make you more comfortable.”
“Would I have to be at Vanderbilt for that?”
“Oh, certainly not,” he said. “It’s an outpatient procedure. You could have it done in Knoxville. Think about it, and let me know if you want a referral.”
“I will,” she said. “Thank you.”
“What about the shortness of breath, Dr. Spitzer?” I asked. “Is that also caused by the fluid? Pressure on the diaphragm or lungs?”
“No, I’m afraid not,” he answered. “What it means is that the tumors in the lungs are blocking or crushing the bronchii. Closing off the airway. Kathleen, are you coughing up any blood?” I stared at her, horrified.
“A little,” she said. “Is that going to get worse?”
“It’s possible. You could start to hemorrhage,” he said. “Or you could throw a clot.”
“Jesus,” I said. “What do we do, if one of those things happens?”
“Frankly? Unfortunately, Dr. Brockton, there’s not much that can be done, if that happens. As I’m sure Kathleen has told you, her disease is quite advanced, and it’s not amenable to treatment.”
I stared across the room at her, her face in profile and silhouetted against the window, and said, “How the hell did this get so far before we found it?” I wasn’t sure which of them I was asking — both, perhaps — and the question sounded almost like an accusation. But if either of them took offense, they did a good job of masking it.
“Thing about the uterus,” said Spitzer, “is that you don’t need it to live.” I was puzzled by the statement. “It’s not essential to staying alive,” he explained. “Not like the heart or the brain or the lungs. The only time it’s essential is during pregnancy, right?”
“Right,” I said, suddenly struck by how ironic it was that Kathleen’s uterus — the organ whose sole purpose was to nurture life — had become the agent and angel of her death. “But I’m not sure I’m following you.”
“Well, because it’s not essential,” he went on, “it’s not immediately apparent when something’s going wrong. Women tend to overlook things like bloating or unusual bleeding. Some of that just goes with the territory.” After thirty years of Kathleen’s monthly cycles, I recognized the truth of that. “Even if the bloating is fairly severe,” he said, “they might think they’re just gaining weight. Also, uterine leiomyosarcoma is pretty rare. Some ob-gyns never see a single case. I’ve seen a lot, but that’s because patients get referred to me from all over the country.”
“Dr. Spitzer,” I asked, “are you married?” For the first time, Kathleen turned toward me, looking startled and possibly angered by the question.
“I am,” he said. “I’ve been married to a lovely woman for thirty-two years.”
“If your wife got this diagnosis, what would you do? What kind of treatment would you want her to get?”
He thought for a moment. “The best treatment I could give her,” he said. “I’d make sure she knew how much I loved her. I’d make the most of whatever time we had together. And I’d get ready to grieve like hell.”
“You can’t just sit around and wait for me to die,” Kathleen said finally. We were still sitting in the living room long after the call had ended. She had been looking out the window, into the fading light; I had been looking at her, watching as her features softened and grew less distinct in the gloom. “I need you not to hover,” she went on. “Hovering over me — tiptoeing around, watching me like a hawk for any little signs and symptoms? That would drive me crazy. It’d be the worst thing you could do for me.”
The comment stung, and I started to object, but Kathleen knew me too well — it would be my way to hover. “Okay,” I said, “I’ll try not to.”
“Thank you.”
“It won’t be easy for me, Kath.”
“It won’t be easy,” she agreed. “But it’ll be important.” After a moment, she added, “Don’t shut down after I’m gone. You’ll probably want to, but you can’t. Or shouldn’t, anyhow. And don’t pull away from Jeff and Jenny and the boys. You’ll need them.”
“I need you,” I told her. “You’re the one I need.”
“Well, we can’t help that,” she said. “You’ll need to keep busy, too.” I started to protest, but she held up a hand to keep me from interrupting. “Don’t get discouraged about these setbacks you’ve had lately. The politics. The grandstanding and game-playing. Stand up for yourself. Stand up for your work. Stand up for the Body Farm.”
“They can have the damn Body Farm if they want it, Kathleen.”
She shook her head. “You don’t mean that. You’d better not mean it. You’ve put too much into that place. And so have I.”
I didn’t quite follow that last bit. “I’m not… How do you mean?”
She turned, and even in the dim light, I could see the impatience in her eyes. “All those nights and weekends you spent working — at the Body Farm and in the morgue — instead of home with me? You think those didn’t cost me anything?” The words felt like a knife in my chest, but she waved her hand to shoo away my guilt. “I’m not trying to make you feel bad, honey. I know I wasn’t always gracious and generous about it, but I tried, because I knew it mattered so much to you. It must’ve mattered to me, too, or I wouldn’t have put up with it. So don’t you dare give up on it. If you do, I swear I’ll come back and haunt you.”