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Franny and the Angel of Death

Frances had some kind of cancer scare.  She went to what my brother Uncle Doctor Bobby Gene calls the Mayonnaise in Rochester and they cut her uterus out. A little later they put a radium implant in to make sure every thing was hunky dory. That was a little under a month ago.
The next thing I knew my father wasn't going to tell her.  It spread to her lungs and they were talking about a month or two. How the hell can you not tell some one about their own death. If they're going to work anything out, at least they should have a shot at it.
When she got the news Dad said that she took it tougher than he could have. Big surprise! She had just bought a $1500 leather coat on sale for 700. She told him to return it. That and some new shoes.
Franny and I had never been close, but my mom pushed me to go see her in the hospital. As I sat at the end of Fran's bed I watched the minutiae of their conversation. I guess, I knew it wouldn't be fun.
Fran was drugged on morphine and my father was sitting on the bed acting out the charade of trying to cheer her up.
"We had some bad times and we has some good times, " he said.
"Yes, we did."
Since I'd hardly ever seen my father and Frances express so much tenderness and emotion, I embarrassedly looked around the room from the portable toilet on wheels to the clear green plastic oxygen tube snaking from the machine standing inside the bathroom. I steeled myself to look back at Frances and noted the hospital gown with its faded laundered stains. Her thin hair dyed a brownish red looked almost clean. This wasn't the hospital room out of Farewell to Arms.
Standing on the ledge next to the window which hid a radiator were the half a dozen assorted hospital plants wrapped in pastel foil and the large porcelain statue of a Siamese cat.
. She seemed to like it that I fell by, so once I had made the trip to the hospital I found myself trying to stop in for a few minutes every day
.  One day I ran into my father in her room. Franny asked if we could find a motel and if I would drive part of the way.  I agreed. Was it starting to eat her brain or was it the morphine?
I got up and walked to her bed table to use the phone, and made several urgent calls that could have waited. I needed to remind myself who was dying.
When I hung up the phone I sat in a chair at the end of her bed.  Francis giggled and acted as if we had a secret that I was never let in on. I grinned back.
Maybe I should give them some time alone, I thought seeing some escape.
"I'm going to my house," I said giving my Dad a message.
He nodded that he understood.
I took Franny’s hand and exchanged the secret smile. Then I walked down the hall of the hospice looking into the rooms of other dying patients.  Some of them looked remarkably young and healthy.
I drove home, sat at my computer, and made more phone calls. While I was reading a story my father knocked at the door. After all these years I still haven't gotten used to his knock. It is less of a knock and more of a demand. Sometimes he'll rap on the door with a quarter. A loud, sharp, high-pitched insistent tap tap tap.  Forget whatever you're doing. "Let's Go."
We went to Jax and I had a steak. Something in his attitude seemed to say that now we could talk. He didn't have to be "on" now that we weren't at the hospital. He told me again that he had known her sixty-five years. I suppose that was his way of telling me that he doesn't know how to face the world alone.
•••
Although they call the wing that she is on a hospice it is just another unit of the hospital.  The hospice movement in England seems more in touch with the actual experience of dying. The idea there is to maximize consciousness, help people to be as lucid as possible and have NO pain. For one example, they use a heroin cocktail. To even consider such an idea is bad taste. I mean, here's a woman that's going to be dead in a month but in America the medico's have their "guidelines.”  Are they afraid that she's going to get addicted?
 And, of course no one ever thinks about any of this junk until until the last few days when you're actually faced with it. [move]
The next time I went, the whole trip was starting to get familiar. I saw two ladies that I'd seen before going up and down the hall using wheel chairs. One pushed an empty chair as a walker. The other one was sitting in the chair, dragging herself up and down, pulling herself along rails that were attached to the walls. Or, sometimes it was almost like she was paddling with her foot. No matter what time of day or night I came to visit, one of those ladies would be doing laps up and down the hall.
When I came into Franny's room she was sitting in a big easy chair while a blue jacketed aid changed the bed. The aid put several rubber pads on a rubber mattress.
"How come she keeps wetting her bed," I wanted to know.
"It's just a process of the disease. You lose the feeling of having to go.  It goes along with most of the diseases."
I looked down and saw a wide rubber strap going around the chair and around Franny's waist.
"Why is that necessary?"
"It's just a reminder for her to stay in the chair if she gets up and wonders around."
When the aid finished tucking in the sheets she helped Fran back into bed, first tying her up in a "posey jacket she's supposed to wear."
After she was tied into the  bed,  Franny looked up at me and said,
"I have a dollar in the world.
"I have one dollar and one penny
"I have one dollar and one penny
"I have one dollar and one penny"
This woman had been so sharp with the books that my father wasn't able to trace the money as it passed through his own business.
Fran and my mom didn't even like each other, but mom seemed genuinely sympathetic.
"Jesus, Mom! They tie her in a chair and they tie her in bed with a Posy Jacket so she can't get out and she's pissing on herself and they come and clean her up and then they tie her in the chair."
"Poor Franny," said my mom about the woman who had married my father. Mom had always been polite toward Fran, but the compassion looked real enough. "Poor Franny," she only said it once and it sounded like she was crying.  It still rings a little.
"Why can't they do something to stop this," I asked the question that kept  resonating whenever I talked about Franny's condition.
"When you were in the hospital after your accident some man in Florida killed his wife who had cancer" mom told me.  "She was begging him to do it, but they sent him to prison. He was about seventy five at the time and they didn't let him out until he was into his eighties. And, she was begging him to do it. Honey, there's nothing you can do."
Franny comes from a big family. Nine kids, I think. But, I never ran into anyone at hospital except my Father that once. She hasn't talked to one sister for years and another brother might come for the funeral.  People don't visit, but everyone comes to  the funeral.
Mom told me about two unrelated incidents where doctors had overdosed terminal patents who had then died. The doctors had "gotten in trouble," my mom told me, so other doctors were probably "being careful."
They probably were "being careful" because here she was dying of cancer, in pain and having trouble breathing and she wasn't even on a morphine drip. I asked the nurses if they felt that she should be on one and they thought she should be. I knew that no one was going to listen to me.  So I started making the phone calls to my brother Richard, to my mom, to my brother Uncle Doctor Bobby Gene and to his wife, Cynthia.
"Can't we do something," I kept asking.
During one of our late night Long Distance calls Richard asked, "What would you do if it was me?"
         "Put an 870  in your ear and pull the trigger.
"Who would have thought that you would have been there for her, you two were never close" said my mom, qvelling a little.
"I don't know what you mean. The hospital is between two and five minutes from my house. I stay between fifteen minutes and half an hour. It isn't that big a deal, Mom."
I called Uncle Doctor Bobby Gene and asked if she shouldn't at least be put on a morphine drip. He said that she probably should be.
I called dad and pushed him. He was waiting for the doctor to tell him what to do, or something. I told him to call the doctor's office and demand a return call the same day.
JJ called the Dr. and asked for a call back, but didn't get one for days. Doctors tend to avoid their dying patents for obvious reasons.

Nothing changed. When I went to visit her the next time she still wasn't on a morphine drip. I called Uncle Dr Bobby Gene's that night and talked to his wife, Cynthia. If Gene, the doctor said something then my father might move and put some pressure on Fran's doctor. Here I was trying to push Cynthia into activating Gene. Talk about dominoes.
We talked for a long time and Cynthia was very supportiveShe must have done something because the next morning I got woken up by a call from Uncle Doctor Bobby Gene.
It was not my little brother, but rather my brother the doctor that called explaining reality to me. 
"It's not going to be pleasant," Uncle Doctor Bobby Gene predicted. For this he had to go to call long distance?
"Why doesn't somebody just give her something"
"You mean kill her"
"Yup."
"That's murder,"
"Gene you should see her."
"I've seen people in that situation. ."
"You mean that it's better to have her go through this amount of suffering so that nobody 'murdered' her? I don't get it."
"Who can make that decision?" Uncle Doctor Bobby Gene wanted to know. "The angel of death comes when it's ready."
To talk about the angel of death is to make a decision of one kind, putting on the medicine man mask and coming out with this canned speech about the angel of death. How many times have you done this one?
And I can't tell if he's somehow mocking the doctor role that he plays all the time.  Not rigid Robert. He's probably feeding you whatever they taught him in Counseling 102 in medical school. After all, that's his power. He's not going to give that up. He's not mocking the angel of death, he's the lecturing angel.
It isn't like she's got any kind of chance, this cancer is only going to get worse and more horrible while she’s not able to breathe. Not being able to catch your breath— and it goes on and on and on and on and on and there's no relief. And you can't catch your breath but you can't think about how terrified and exhausted you are from trying to catch your breath because you can't  catch your breath . And you're so worn out from the work of trying to catch your breath but it's not just for a minute. This is life. For the rest of your life.
And while you're gasping and trying to catch your breath, but you never can catch it, the people around you are having discussions about the angel of death and murder. And you can't even catch your breath for a few seconds. And they feed you the intravenous food so you can last as long as possible. They think you have a right to each gasp and the terror.
And the nurse says they can give you a drug that will reduce the panic so you can breathe a little easier. But the drug can't take it away. You will still gasp for air and your face will show the panic  and horror until the angel of death comes.
I had gone to the hospital every day and I was exhausted by it, so I skipped a day. But, Franny couldn't skip a day, I thought, or an hour, or five minutes.
When I came into her room  again I thought that she had the hiccups. I made some joke about the hiccups when I realized that the short staccato sound was Fran gasping for air. The joke was gone and Franny was still trying to breathe.
"I told you to go see her, but you don't have to go every day," Mom told me trying to release me.
•••
My father made arrangements with the cremation society to get her cremated for around a hundred and a half. At first I was impressed with his practicality in the middle of dealing with her death. Then I realized that those details gave him a way to handle with his feelings of being lost.
After working out the deal with the cremation society they had to find a hearse to get her there from the hospital. The funeral homes tie it in to a package as opposed to a "direct cremation."  JJ called the county coroner's office who told him that transportation had to be a licensed Funeral Director and the cost was between four and fifteen hundred dollars.
"Just to drive her across town?"
"They've got it sewed up," my dad said.
You feel like you're on one of those moving sidewalks at the airport and you can't get off. They make used car salesmen look like Mother Theresa.
Uncle Doctor Bobby Gene said that the other side of that greasy coin is that you don't want people having any kind of easy access to bodies. I guess that we've all heard stories about stealing bodies for everything from necrophilia to Satan worship.
One place wanted twelve hundred dollars for the taxi ride. A couple of days later my dad made the arrangments and settled on a non-Jewish mortuary. He called it a “$675  compromise" to get the body dragged across town from the hospital to the cemetery for cremation. "We don't care who moves the body," he said.
If Fran knew what was going on, I know that  she would rather drive herself and save a buck.
•••
It was just a couple of days before Christmas and stores were jammed with shoppers and the streets and freeways were packed with honking cars. The weather had moved in a couple of weeks from what they call unseasonably warm with no snow on the ground to a forty something  below wind-chill blowing ice powder bits. And, as normal as those Antarctic temperatures and winds are in December there is the unspoken understanding that we are in the middle of a natural disaster that will pass in a few months.
I didn't want to go up and watch Franny have the hiccups again. Those short involuntary clutches for air. That's got to be about as bad as it gets.
There has to be a word between startled and scared because that's what I was when I walked into her room.
The nurse told me later that she was having a hard time dying and though I'd heard that phrase before, it had always sounded like a cliche. It never meant anything to me.  Just something people said.
She was lying on her side and there was nothing to suggest consciousness except that her eyes were wide open. The lids were red and her eyeballs like tiny upturned bowls. They stuck out so much she might have been a George Lucas monster. The pupils never moved and I didn't see her blink during the half hour that I was there. At first I didn't hear a sound, but after a while as she gasped for each [mouth thrown open]  breath.
I heard: "AhAhAHAAAhAh." It was as if it signified some kind of involuntary crying with each exhale. The mouth hung open in a shape for which there is no name. Her tongue was a pile which held her bottom cheek plastered against the sheet.
And the regular intermittent sound "aahaAAHHH...
[silence]
HAAAhAh"
For a long time I watched as she tried to breathe. I looked around the room. There was an unopened present on a bed table sitting in the middle of the room. There were stacks of Ellery Queen mysteries. Several of my cards leaned against a box of Smith Brothers Cough drops on the table next to her bed.
I needed to do something down by the desk. Talk to the nurse, that's it.
"I'm down visiting room 429. How long can this go on?" I wanted to know.
"I don't even guess any more," said the middle aged nurse wearing an oversized college sweatshirt. Her tone of voice was gentle but flat. "Are you a relative?"
I shrugged.
"She's having a hard time. It's even hard for us to watch and we see it all the time.
"I wouldn't say more than a day," she answered breaking her own rule.
I knew that I wasn't going to ask her how she got into this line of work or how long she'd been doing this, so I dragged myself back into Fran's room.
Nothing had changed in 429. Fran was still gasping to breathe. The skin hung on her frame like a ratty old blanket. Her left arm had the IV needle held in place with a two inch piece of white tape. The pile of a tongue still held her cheek against the sheet. Still she gasped to breath. "AhAhAHAAAhAh."    And the pupils were still fixed in open sockets.
"AAHAAAhAh"
silence
silence
silence
"aahaAAHHH"
I stared at her looking for resolution, but there wasn't any.