He concluded gloomily: ‘So Mr. Reed knows he’s dying, and may even want to get it over with, but he has no assurance of how or when or in how much final pain. One of my patients, a fellow named Saul—I liked him tremendously—had an ingrown toenail that got infected in spite of all I could do. I had to amputate his leg, which allowed him to live three months longer. Had to clean the stump of the leg three times a week—his immune system provided none of the curative power that would normally enable a stump like that to harden in three weeks.’ Grimly he said: ‘It was one hell of a way to die—an ingrown toenail …’
As an afterthought Leitonen added a macabre anecdote: ‘This Saul I spoke of had a friend named Christopher, who faithfully tended him until he died. Not surprisingly, Chris began to fear he might have contracted AIDS from his contact with Saul. So I ran a series of tests, and when I showed the data to Chris he sighed with relief: “Thank God it’s only cancer. For that we have cures.” And there you have it, Zorn, AIDS is what makes cancer seem benign.’
As he hurried off to make his rounds, the feisty little doctor promised: ‘I’ll visit Reed again at eleven tomorrow. I’d like to have you there so you can make your own judgment as to how we should treat this brave young man.’ As he reached the door he turned to say: ‘Not many doctors, when they make their rounds, know that every patient they see will soon be dead. Other doctors sometimes cure their patients. I never do.’
The next day Zorn hurried to the Angelottis’ where Dr. Leitonen had told him he would be waiting but the busy doctor had phoned to say he’d be a few minutes late. As Mrs. Angelotti delivered the message Zorn caught a fleeting glimpse of a man furtively descending the stairway behind her, a tall man dressed in black and wearing a Borsalino with the brim pulled down to mask his face and eyes. Zorn thought he looked like Zorro in a Grade B movie and wanted to ask Mrs. Angelotti who the man was, but his shifty manner indicated that he had hoped to slip out before anyone could question him, so Zorn assumed that he was simply a shady intruder.
While awaiting Dr. Leitonen, Zorn sat in the reception area, where two emaciated men were playing chess without speaking, as if they had to conserve all their strength for the demands of the game. They were so thin and their faces so distorted that it was impossible to guess their ages; they could have been in their forties or, perhaps more likely, in their twenties. They moved their hands with extraordinary slowness, as if the task of getting an arm in motion was so difficult that one had to allow it to take its own leisurely course. Another peculiarity was that the two men moved no parts of their bodies below the shoulders: trunk, legs, feet remained immobile, and even their heads, once set carefully in a certain position, remained stationary; they did not turn even slightly to notice his intrusion into their space. But despite their physical immobility he had the strong impression that they played their game at a high level of intellectual intensity; mercifully, their brains were not as depleted as their bodies. For Andy the scene was a caricature of AIDS: two ghastly figures playing chess with neither caring who wins because it doesn’t matter.
When Leitonen arrived he apologized for his tardiness: ‘More patients every day. We need a lot of doctors like me, but we don’t have them.’ He corrected himself: ‘Some of the older doctors are terrified of AIDS. Will have nothing to do with it, but more of the younger men understand, and some of them volunteer to help. And then something like Dr. Weatherby’s case comes along, and we’re back to square one.’
‘What happened to him?’ Andy asked, and Leitonen explained: ‘While treating a patient, he noticed a pustule on the man’s arm and told him: “That could prove fatal if it’s not treated,” but when he lanced it he nicked himself, and he became the fatality.’
When they ascended to the second floor, Zorn observed that Leitonen was so busy he could not waste time on niceties, regardless of the severity of the patient’s illness. At first, he seemed unusually brusque as he plunged directly to the purpose of his visit and asked: ‘Mr. Reed, do you really want to know everything I’ve found out about your condition? No punches pulled?’
‘Yes.’
Bluntly Leitonen rattled off his findings: ‘Blood tests show red count way down—the left lung quite filled. Doesn’t look good—everything is in about what we would expect at your stage.’
‘So?’
‘You fall into the basic patterns of this disease.’
‘What stage am I in?’
Firmly, but with gentleness, Leitonen laid out the facts: ‘The rate at which your weight has declined parallels the other cases, no worse, no better. Your susceptibility to minor afflictions, about the same. Like the others, you seem particularly susceptible to some threatening weakness. For others it may be the liver, may be bleeding ulcers; for you, pulmonary weakness—that hacking cough. So you must be considered quite normal.’
‘On the big roller coaster straight to hell?’
Andy now witnessed a prime example of what his medical school instructors call ‘the bedside manner,’ because Leitonen became infinitely gentle: ‘Mr. Reed, I’m not a theologian. I can’t answer some of your biggest fears, but I am a doctor with broad experience and I sincerely want to help you. As I told you yesterday, you could have many months before your body has to give up—or, on the other hand, you could go suddenly if that cough worsens.’
‘I see no purpose in hanging on. I’d like to get this over with.’
Placing his gloved hand on the sick man’s arm, Leitonen said softly: ‘Mr. Reed, I understand how difficult this is for you.…’
‘Does everyone have to put on gloves to touch me? Am I something set apart, behind a wall of rubber gloves?’
‘Mr. Reed,’ Leitonen said, ‘a doctor friend of mine didn’t wear his gloves, got infected and died. Doctors are needed—you should know—’
The room was silent, then Reed said: ‘I apologize,’ and Leitonen replied: ‘I apologize to you for speaking so bluntly, but my obligation is to keep you alive. I’m not only sworn to do so, I’m legally bound. But I’m also driven by the absolute belief that one of these days there’ll be a breakthrough. Our geniuses in the laboratories are going to lick this plague, and you could be one of the first to profit from what they discover. I live on hope and so should you.’
‘Then you won’t help me to end my misery?’
‘I will not. But I will ease your passage. There are ways, you know.’
‘Please don’t use them on me, because I lost hope months ago.’ After a horrible fit of coughing he turned suddenly to Zorn. ‘When you moved me out of that pigsty to this good room, you didn’t change my view of myself. I’ve lost the battle. I’ve thrown away my life, and I want no aid, no sympathy. I just want to die.’
Dr. Leitonen sat on the bed as if he were a visiting friend: ‘Jaqmeel, I respect you and I understand what you’re saying. But you must remember that in this brutal game, we’re on opposite sides: you try to die, and I try to keep you alive.’
At three-thirty one hot August night Marjorie Duggan awoke in her private room in Assisted Living and, feeling a great urge to travel, dressed without assistance in a flimsy dressing gown thrown over her even more flimsy nightdress. Making her way to the door of her room, she suddenly stopped, looked down at her feet and saw that they were bare. Reason could not have warned her that what she planned was impossible if she went barefoot, for she had long since lost all capacity to reason, nor could she any longer plan ahead for anything. But apparently some instinct warned her to put on shoes, which she tried to do.
She was incapable of sorting out the footwear at the edge of her bed, for she could not differentiate between a walking shoe, a dress shoe and a bedroom slipper. By bad luck she settled on a pair of slippers so fragile that normally her nurse would not have allowed her to go on the porch in them. Thrusting her right foot into the left slipper and vice versa, she sensed immediately that something was wrong, so she kicked off the slippers, shuffled them and again put the wrong one on the wrong foot. Again she knew
that something was not right, so once more she tried, and this time, when she put them on, she got it right, and with a vague sense of accomplishment she set forth on what would prove to be a memorable adventure.
She had by accident stumbled upon that time of night when nurses were apt to be asleep and watchmen drowsy, so, by sheer accident she fell between the cracks, as it were, leaving her room without detection and making her way to the elevator, which, again through some instinct, she realized she could not operate without the assistance of another person. Quietly pushing open the door to the stairway that descended parallel to the elevator, she carefully grasped the railing with her left hand and moved down the stairs.
At the front desk there was no one awake to notice her, and the watchman was enjoying a cigarette out on a porch, since smoking was forbidden in the health center. She thus found herself safely out in the oval where none of the parked cars contained occupants who would have seen her. Exiting through the big gates, she came to the junction from which the main road into the Palms reached straight ahead, with the narrow lane reaching off to the south. Intuitively she guessed that she had a better chance of walking unnoticed if she took the lane, and this she did, walking through the balmy night air with a strong sense of determination both to remain undetected and to distance herself from Assisted Living. These two compulsions resulted in a rather rapid gait, and had some stranger watched her stride he might well have concluded that she was some health nut out for a predawn walk and determined to make it a vigorous one. Had he looked more closely, however, he would have discarded that hypothesis, for he would have seen that she was not only dressed improperly but also that she was almost grotesquely underweight: five feet six inches tall, one hundred pounds when properly clothed.
When she neared the point where the lane merged into the mall she seemed to know that if she went any farther she would find herself on the main street, Broadway, and this she did not want. Instead, she left the lane, turned south and entered upon that warren of little trails that crisscrossed the savanna, finding what she had sought from the moment she climbed out of bed, the freedom of the open air, escape from nurses and bells, the joy of striding along as the sun began to display its power in the east. As she made her way among the bushes, the scrub trees and the upward reaching palms, bits and pieces of ‘Mira o Norma,’ the duet from the opera that she had cherished so long ago, came flitting into her confused brain, and she smiled as she experienced a sensuous joy.
Her uninterrupted walk carried her well to the southwest toward the nesting place of the blue herons, and as she came humming past them they rose, flew a short distance from their nests, then winged back when they realized that the figure in the flowing gray and pink garment meant them no harm. A few hundred yards farther on she came to where the snowy egrets spent the night, but she was sufficiently far from them that they did not fly away, and for some moments she and the standing birds formed a handsome group, staring at one another, her clothing much like their downy feathers. Then the egrets flew off to do their early morning fishing.
Some distance farther along, but still in a southwest direction, she came to the Emerald Pool, shimmeringly beautiful in the growing morning light. Unaware of the danger she was placing herself in, she stepped in her bedroom slippers quite close to where the rattlesnake was hiding, nursing the wounds he had suffered during his ill-fated foray into the heron rookery. Seeing the cloudlike figure coming at him, he drew himself into a tight coil so that he could strike out if it moved any closer. Then, to give ample warning, he activated his rattle, which caused Marjorie to stop, listen admiringly and ask aloud: ‘What bird could that be?’ Then, without waiting for an answer, for she had forgotten her question, she moved on, leaving Rattler content that he had not had to waste his energy by striking at a target that he knew he could not eat because of its size.
What impelled Mrs. Duggan on this perilous safari? A doctor might come up with this analysis: ‘The patient knows in some primordial way that things are not as they should be, and thinks that it is somehow the fault of the nurses and the caretakers. The determination to walk, regardless of the difficulties, becomes overwhelming, and off he or she goes. With powerful men it is sometimes almost impossible to prevent their breaking away, for they are driven in ways that you and I cannot comprehend.’
Marjorie Duggan’s trek from the lane to the Emerald Pool and her close encounter with the rattlesnake had brought her deep into the savanna, but even so, she could have made her way back to the Palms with relative ease had she found the rough path that led to the snowy egret and the blue heron, but she was not capable of finding the path or recognizing it if she did find it. Some instinct told her to head back toward the rising sun, and this put her on a general easterly path, which she pursued with vigor.
But now she was in the uncharted savanna, a woman skimpily dressed and in footwear that could not withstand rugged terrain. Nor did she have an abundance of physical energy. But driven by whatever force had taken her from her bed and away from the security of Assisted Living, she plunged into the thickets the bulldozers had not yet cleared as if dressed in safari gear and guided by a compass. In the first few minutes she had to bend under the branches of a thorny bush which tore at her dressing gown, leaving most of its lower half in tatters. Feeling the thorns clutch at her gown without scratching her, she tugged at it with some force and tore it in several places before she dragged it loose. She plunged ahead, losing bits of her clothing as she went.
When she was again well north of the heron rookery, those stately birds heard the noise of her rough passage and flew over to see what was happening. Finding them in the air above her, she paused, looked up at their ungraceful but delightful forms and cried: ‘Hello, there. Who are you?’ She was unable to determine that they were birds, but when they stayed nearby as if to guide a friend, she pushed her way through what remained of the prickly brush, singing to them as they showed her the way. When they finally departed, satisfied that she had no food for them, she cried: ‘Good-bye!’ and pursued her way eastward.
It was now seven-thirty in the morning and she had some distance yet to go through the veldt before she would again intersect the lane. If, when she reached it, she had turned left she would soon have been back at the Palms, tattered and worn but intact. When she saw the road ahead, however, she was so delighted that she began to run. She was not aware that her clothes had been torn almost completely off her and that she was virtually naked. Nor did she know that both her legs were scraped and bleeding from her bruising battles with the thorny bushes. All she knew was that by heading east she had reached a kind of safety, so she ran toward the lane, kept to the east and wound up in the middle of the mall at the intersection of Route 78 and Broadway. Relaxing somewhat after her strenuous battle with the savanna, she suddenly realized that she had to go to the bathroom, and when she saw a planter—an architectural feature in which tiles were used to build a square container in the middle of a highway in which colorful plants can be grown—she mistook the tiles as part of a bathroom, hiked up what was left of her shredded clothes, and relieved herself in full view of the morning traffic.
The first official to be summoned was a tall young policeman named Johnson, who first thought from the cries of bystanders that someone had been hit by a car. Hurrying up and taking one look at the beautiful, vacant face, he behaved admirably, guessing that she might be some patient from the Palms, and wrapped his light uniform jacket about her shoulders.
After radioing to headquarters: ‘Call the Palms, they’ll be looking for her,’ he led her gently to a bench that fronted a store on Broadway, and there she waited, head on his shoulder, content to see what might happen next. She had been away from her room for five hours, and she had been walking constantly, much of the time through difficult terrain, but despite her fragile condition she would still have been prepared, and even eager, to resume walking had she been allowed.
People at the Palms who should have caught her as she le
ft her room and escaped into the night did not detect her absence until half after six, an unconscionable delay, and even then neither Dr. Zorn nor Muley Duggan was informed. Not until seven-ten did they learn that Marjorie had, as the nurses said, ‘gone a-walking.’ But as soon as it was generally known, search teams streamed down the roads and footpaths, for it was understood that when an Alzheimer’s patient broke loose on his or her own, the walking spree might carry the person anywhere. No distance was too great, no destination too bizarre.
With Andy at the wheel of the staff car and Muley Duggan beside him, the two set out for a rapid reconnaissance of the main roads, looking for the runaway, but also for any unusual cluster of early morning risers who would probably have gathered about a woman who was clearly in trouble. Afraid that she might have fainted in some isolated spot, they intensified their search, calling back on the cellular phone to Nurse Varney at the Palms: ‘Any news yet, Nora?’
‘Nothing. But everybody’s out searching.’
‘Any reports from the police?’
‘They’ve been here interrogating everyone. No news from their headquarters.’
Shortly after nine Nora called with the news: ‘An Officer Johnson found her on Route 78 and Broadway. Legs cut by thorns apparently, and near naked but not otherwise damaged. He’s keeping her there till we arrive. She’s warm and has taken some hot coffee.’
Overcome by the sickening report about his wife, Muley slumped forward and, covering his face, began crying. Andy tried to comfort him: ‘She’s alive, Muley. All the rest is of no consequence.’ When his car screeched to a stop at the intersection he saw the large crowd surrounding Marjorie, who kept her head resting on the policeman’s shoulder, happy and oblivious to the world. Incongruously the thought struck him: My God, she’s beautiful! and she was, with her translucent skin, perfect features and elegant bearing. In the morning sunlight she was more beautiful than she had been at nineteen.