“Are we? So what are you trying to achieve?”
“Obviously, I’m trying to extend your wife’s life for as long as possible.”
“Then we’re not on the same side.”
“Oh? What’s your objective, then?”
“To end her suffering as soon as possible.”
“It’s really Mrs. Knacker’s decision, when she wants to call off further treatments. But when I spoke to her about peritoxamil, she sounded keen to try it. Obviously, we’ll make every effort to keep her comfortable. But to talk about … Well, simply planning to ‘end her suffering’ once and for all is defeatist.”
“Fine. I am defeatist,” Shep announced. “I have been defeated. I admit it: mesothelioma is too big for me. If this really has been a battle,” with weather, he thought, “maybe it’s time to lay down our arms. As for that being my wife’s decision, I realize she’ll try anything. But it is not my wife’s decision if she’s not the one who’s going to pay for it.”
Goldman was overtly discomfited by this kind of talk. He kept averting his gaze, working his face without concealing his disapproval, and edgily hitting his keyboard’s space bar. Shep got the impression that making a medical decision of any magnitude in consideration of how much a treatment cost, in mere money—”only money,” as his father would say—was crude, foreign, and offensive. “I want to be very clear, Mr. Knacker. This drug is our last hope.”
“I was fired yesterday, Dr. Goldman. I just lost my job.”
It was interesting, the subtle but discernible change in the internist’s demeanor, once he registered the implications. “I’m sorry to hear that.”
“I bet you are. But I’d been repeatedly absent and late for work. My wife’s illness alone has substantially raised the health insurance premiums for my employer. As the former custodian of that company, I applaud my being dropped from its workforce as an astute business decision.”
“That’s an awfully understanding spin to put on your own misfortune.”
“I am known,” said Shep, “for my understanding. But as a result of my early retirement, the World Wellness Group will not only neglect to pay a hundred K for pterodactyl, or whatever it’s called, but it won’t be paying your bills, either.”
“I see,” said Goldman. “And I infer that your personal resources are somewhat depleted.”
“Somewhat? You could say that.”
“With what you just informed me, I can see why you might be feeling a little angry.”
“No, you do not see. Getting fired was the nicest thing that’s happened to me in over a year. But you’re right that I’m ‘a little’ angry. I realize this is just what you people do. It’s the way you’re programmed. You just keep plowing through the drugs, working down the list, keeping everyone’s chin up, looking on the bright side, never saying die. My wife, for example, never says die. Honestly, I can’t remember the last time I heard her use the d-word. Nobody in this biz is ever supposed to throw up their hands and call it quits, so long as there’s any last teensyweensy, teeny-tiny smidgeon of a chance that some new therapy will eke out a few extra days. So you’ve just been following the script. But can we, for once, with Glynis not here, drop the pretense? This ‘experimental drug’—you don’t really believe it would make any difference, do you?”
“I did say it was a long shot.”
“What are the odds? Fifty-to-one? Willing to put any of your own money on that?”
“It’s hard to put a number on. Let’s just say the chances are distant.”
“Me, I wouldn’t put a hundred grand on ‘distant’ even if I were a betting man. Would you?”
Goldman declined to answer.
“Secondly, let’s skip the ‘I don’t believe in making prognoses’ thing. You’ve been around the block. You know more about mesothelioma than anyone in the country, you’re an expert. So tell me: how long has she got?”
The expression on Goldman’s face reminded Shep of wrestling as a boy in Berlin, when sitting on Jeb’s chest and pinning each wrist to the ground he finally got his friend to cry uncle!
“Maybe a month? Possibly more like three weeks.”
Shep crimped forward, as if from a gut punch.
“I realize that’s difficult to hear,” Goldman continued softly. “And I’m very, very sorry.”
Three weeks was within the range that Shep had forecast himself, but it was different hearing the bleak estimate from a doctor. It wasn’t possible to keep being pugnacious, aggressive, and hostile, although as the humor slipped he knew he would miss it. This appointment excepted, the amount of his life that Shep Knacker had spent being pugnacious, aggressive, and hostile probably totaled under five minutes.
As Shep recovered himself, the doctor filled the silence. “I think of all the patients I’ve ever had, your wife may have shown the most tremendous spirit. She’s put up a remarkable, a truly admirable struggle.”
“That’s nice of you to say, and I realize you’re trying to pay her a big compliment, but … this way of thinking …”
Shep stood up, and paced the small patch of carpet before the door. “Struggle. Surmounting the odds. Like, the online support group that Glynis joined for a while was always talking up hanging tough. Refusing to let go. Not giving up. Going the last mile. You’d think they were organizing a grammar-school sports day. Dr. Goldman, my wife is very competitive! She’s a high achiever, a perfectionist—which is why, though it doesn’t seem to make sense, she hasn’t been as professionally productive as she would have been with lower standards. A striver like that—how’s she not going to rise to this stuff? And then you guys jack up the stakes even more. It’s not just a potato-sack race, it’s a war. The battle against cancer. The arsenal at our disposal … You make her think that there’s something she has to do, to be a good soldier, a trooper. So if she deteriorates anyway, then there’s something she didn’t do: she didn’t show courage under fire. I know you mean well, but after all this military talk she now equates—dying—with dishonor. With failure. With personal failure.” It was the first time that Shep had put it together for himself.
“The military language is just a metaphor,” said Goldman. “A way of talking about medical issues that laymen understand. It’s not meant to hold the patient accountable for a therapy’s results.”
“But for Glynis, when you ‘admire her struggle’ she thinks you blame her when it doesn’t do any good, don’t you see? That’s why she won’t quit. That’s why she and I can’t talk about … well, anything.”
“I see no reason for her to ‘quit.’ Glynis—Mrs. Knacker takes heart from her tenacity. Since I’ve come to know her somewhat, I think I’d counsel you to keep my prognosis to yourself.”
“What’s one more secret?” Shep said morosely, plopping back in his chair. “Though that’s a fucking big secret.”
“I’m only thinking of preserving the quality of the time she has left. Keeping her upbeat.”
“But won’t she know? What’s going on in her own body?”
“You’d be surprised. Not necessarily. Still, I’d advise you to contact her family and friends. Underscore that we’re talking days or weeks but not months, and they mustn’t delay a last visit. So they can say goodbye.”
“What good is saying goodbye when you can’t say goodbye?”
“Pardon?”
“If we’re not telling Glynis, nobody can say goodbye. Not even I can say goodbye.”
“Well, sometimes hasta la vista is just as warm, but it’s easier to hear, isn’t it? And we say, ‘See you later,’ to all kinds of people whom we’ll never meet again, really.”
“I guess,” Shep said reluctantly. “Maybe you’re right, Glynis doesn’t want to hear it. She sure hasn’t wanted to hear anything else.”
“I suppose I can see why you might want to pass on the peritoxamil. But she was very eager to take it. If you want to keep her on an even keel I could prescribe a placebo.”
Which really would entail treating Glyni
s like a twelve-year-old on “cortomalaphrine.” His wife’s final days being webbed in a skein of deceit depressed Shep more than he could say. “Maybe. I’ll let you know.”
“Meanwhile, keep me apprised of her condition, and contact me if you need any advice about how to keep her comfortable.”
“There is something you can do,” said Shep, looking at his lap. “I really don’t want her to die in a hospital. But also I don’t want her to experience any more pain than she has to. I’d like something to—ease the end.”
“There’s nothing easy about the end. It can be very unpleasant. Professionals have a better chance of keeping her comfortable.”
Repeated at least three times now, the set phrase jarred. Shep suspected that the medical establishment’s usage of comfortable strained the definition of the word.
“Are you sure you don’t want to reconsider, about the hospital?” the doctor pressed. “You feel strongly about this?”
“I do. And I honestly think that if Glynis ever faces up to what’s happening she’ll feel the same way, too.”
“Painkillers are controlled substances. We’re closely watched by the FDA. I can’t hand out capsules willy-nilly, because of the danger of addiction.”
“The government is afraid that my wife will become a drug addict when she’s dying?”
Goldman sighed. “I grant it’s not all that rational …” He bit his lip. “This is a little risky … But I suppose I can give you a prescription for liquid morphine. It’s not complicated. Just a few drops on her tongue when she seems—”
“Uncomfortable,” said Shep, with a trace of his earlier sourness. He stood up. “Thank you. And what I said before, you know, my ‘tone’—I didn’t mean that I’m not grateful.”
“I know you’re grateful, Mr. Knacker. And I’m sorry I haven’t been able to do more for your wife. We’ve tried everything we could—as you observed. But mesothelioma is a virulent, deadly disease. It’s not for nothing that asbestos means ‘inextinguishable’ in Greek. And you’re a repairman, so you understand: there are only so many tools in the toolbox.”
After they’d shaken hands and he was leaving, Shep turned back in the doorway. “One last thing. The surgery, all the chemo. The blood transfusions, the chest drains, the MRIs? According to my calculations, Glynis’s medical bills for all these treatments already come to over two million dollars. That sound about right to you?”
“It’s plausible,” the doctor conceded.
If in a moment of idle perversity Shep had worked out that so far they’d paid over $2,700 per day, he’d also estimated that Glynis would often have paid that much to skip one. Of course, he couldn’t vouch for the comparative awfulness of her disease left alone to its evil devices, but as for whether the cure or the cancer had been worse it was at least a contest. “So what exactly did we buy? How much time?”
“Oh, I bet we’ve probably extended her life a good three months.”
“No, I’m sorry, Dr. Goldman,” Shep said on the way out. “They were not a good three months.”
Back in Elmsford, Zach had left a message from Rick Mystic, leaving the lawyer’s home number. Since Carol and the girls would be arriving in an hour or so, Shep returned the call in his study right away, closing the door.
Rick got straight to the point. “They want to settle.”
They did not, for once, sort of want to settle. “That was quick.”
“These kind of cases can drag out for years, but when they move they can change your life in an afternoon. I bet Forge Craft’s people were kind of impressed by your wife’s deposition. But they were also kind of impressed by her—condition.”
“You mean they’re afraid she’s going to …”
“Yeah. In which case, the size of a jury award could sort of skyrocket. You’ve got them sort of scared.”
“So what are they offering?”
“One-point-two million.”
Since twelve divided evenly by three, calculating what would remain after the lawyer’s one-third contingency fee was elementary arithmetic; Mystic’s cut amounted to somewhat more than the U.S. government’s contingency fee for his sale of Knack. “So what do you advise?”
“Well, if you take them to court, especially once you’ve suffered—a greater loss, I’m kind of certain you could double that. But I’d be kind of remiss if I didn’t warn you what a jury trial would involve. It’s kind of brutal. Once liability has been established, the process is all about assessing what your marriage was worth. In dollars. So it’s kind of in their interest to prove that your marriage was sort of shitty. A sort of shitty marriage doesn’t, legally, merit nearly as high a compensation as a good one.”
“What business is it of theirs, what quality of marriage I had?” The past tense made him glad that the study door was closed. “You’re telling me they, what, deduct ten grand for every time Glynis and I had a fight?”
“You may find that kind of ludicrous, but you’re kind of right. I mean, they’d grill you on how often you had sex. They’d go after your friends and see if they could find anybody who described your marriage as kind of unhappy, or kind of fractious. I had one client who had a sort of iron-clad case on an evidential level; her husband had worked for twenty years in fireproofing with sprayed asbestos. But they dug up that she’d had a, sort of, lesbian affair during the marriage. She hated to let her family know, and withdrew the suit. It was a kind of blackmail, really. And in your case, what you told me about being sort of packed and ready to move to Africa? By yourself if necessary, right before you found out that Glynis had cancer? I promise you they’d find someone who knew that story, and it would look kind of bad.”
“If I accept the settlement, how soon could they cut me the check?”
“You’d have to sign a nondisclosure agreement. But after that? They’d cut you a check in a heartbeat. Especially with Glynis in sort of rough shape. They wouldn’t want to be, uh, overtaken by events—when you might have, you know, kind of a change of heart. The worst coming to worst could make you decide to sort of go for the jugular.”
“I’ll have to talk to Glynis. But if you get us that money ASAP—and I mean, like, Monday, not weeks from now, because we don’t have weeks—then I say take it.”
Once he hung up the phone, Shep once more thought mournfully about Jackson. It was criminal that his best friend never lived to witness this conversion: from Mug, to Mooch.
Chapter Eighteen
Shepherd Armstrong Knacker
Union Bancaire Privée Account Number 837-PO-4619
Date: 21 February 2006
Our reference: 948378
Funds transfer: $800,000.00
Shep packed with a surety born of rehearsal. Rather than select a few arbitrary implements, this time he would take his whole trusty toolkit, toted from job to job from the earliest days at Knack. After all, these ancient wrenches, awls, and pliers were of a sturdy quality that you couldn’t buy anymore. Rolling the tools with pristine newsprint from an unread New York Times, he lodged the bundles snuggly inside the familiar two-tiered box. Most of the once-bright red paint had chipped off the metal, like a beloved childhood wagon. He nestled the tools so that they didn’t rattle, then hooked the metal clasps. He bound the box in a blanket from among the many pieces of bedding that he planned cheerfully to abandon, then wrapped it tight with twine. The toolbox had survived intact for thirty years, and he didn’t want it to dent in its dotage on baggage belts; this was the same care that he would soon apply to his animate cargo. The likelihood that the toolkit would incur overweight charges was a matter of supreme indifference.
Next he wrapped and boxed the Wedding Fountain, having installed a new pump. He retrieved Glynis’s flatware from the kitchen drawer—the Bakelite-inlaid fish slice, the knurling sterling chopsticks, the copper and titanium ice tongs—already conveniently bundled for transit in loving layers of sea-green felt. He even trotted up to the attic to rescue the plain sheet of heavy-gauge silver, with its single wobbly
saw cut of less than an inch. As before, of course, the StairMaster, the salad spinner, the burdensome furniture would stay mercifully behind, but every work of Glynis’s hand was guaranteed a place in the ZanAir ark.
He had researched the weather, and a few pieces of light clothing would suffice for most of the year, although yesterday he’d also purchased top-shelf rain gear from Paragon for the monsoon season. Having emailed Fundu Lagoon’s management, he was now up to speed on electrics. Prepared for European 220 current, he packed three Radio Shack converters that would connect with British-style three-prong sockets. After grabbing a fistful of spare brush heads, he unscrewed the Oral-B charger from the bathroom wall. Nothing about the Third World obviated oral hygiene, and he would take the electric toothbrushes.
It was a relief this time around to shed the sheepish skulking—to pound boisterously down the hallway with the floorboards squeaking beneath the carpet, still stained from Glynis’s nosebleed last spring; to let the screwdrivers clatter unashamedly against one another as he rolled them in bunches with newsprint. Otherwise, the exercise was a faithful repetition, like having conducted conscientious fire drills when the house was truly ablaze: duct tape; a selection of screws, bolts, and washers; silicon lubricant; plastic sealant; rubber bands; a small roll of binding wire. A flashlight, for power cuts, and a stack of AAs. A stock of Malarone tablets, and a fresh tube of cortisone, for the skin condition on his ankle that had thrived under the stress of the last Jobian year. This time, a packet of enemas, an overkill of antibiotics, and, reverently nestled between rolls of socks, the liquid morphine.
Improving on his dry run last January, he had bought a thicker, more serious Swahili-English/English-Swahili dictionary in preference to a mere phrasebook. He had pulled the Arts sections from the last month’s newspapers, and torn out the crosswords; it had been years since he’d had the leisure for this frivolous pastime. Shep had always been terrible at crosswords, and without practice he’d be worse, which was a fine thing; they’d last longer that way.