A Ride to the Hospital

Egg casseroles and scones – that’s usually the extent of my contribution to my synagogue’s caring committee. But that Wednesday, I’d offered to drive Carol, a temple member, to see her husband in the hospital in a city about an hour away. I imagined dropping her off and enjoying a coffee and pastry at my favorite bakery while I waited. That morning, however, I got a call from the rabbi, who was too ill to go to the hospital. “Can you go in with Carol and find out what’s really wrong with Arthur?” he asked. “She’s overwhelmed.”

“Me?” I didn’t know the couple, both around eighty, except to say hello to at services. “Are you sure she wants me in her husband’s hospital room?” Yes, she did, he said. So now I was going into the hospital. Goodbye, apple strudel, hello ICU.

I picked Carol up at her house. I hadn’t taken into account the fact that she lived twenty minutes in the opposite direction, so I was grumpy about this mitzvah, this good deed, that was going to require three hours of driving. One is probably supposed to do a mitzvah with a happy heart, but I wasn’t all the way there yet. Also, I’m not the most talkative person, and Carol isn’t either, so the ride was strained. But I did manage to learn a little about her and Arthur – where she’d grown up (Massachusetts), how they’d met (through friends), and where (Boston). I knew they didn’t have kids, and Carol told me she had only one brother, far away, and Art didn’t talk to his relatives, so they had no family around. OK, however awkward this was, my help was needed. Fine. This would count as my mitzvah for the week, maybe even the month, if there were a rating scale.

When we got to the hospital, we made our way to the ICU. We arrived at Art’s room, and I had my first visceral “what am I doing here?” moment. The only thing I knew about Arthur was that each week at services, when we recited Kaddish, he would remember the dead in a military battle that had occurred on that date. And here he was, lying in a hospital bed in a johnny, eyes closed, gauze around his head, a ventilator helping him breathe, machines measuring his brain waves, and a nurse giving him an ultrasound. Carol stood by the bed, occasionally asking, “Can you hear me?” in her gravelly, Massachusetts-accented voice. I stood back, not knowing where to look. This was too personal. I didn’t belong here.

A first-year resident came into the room and, in a quavering voice, told us everything that was wrong with Art – pneumonia, sepsis, kidneys failing, liver injured, and the inexplicable lack of consciousness. Art’s eyes would open occasionally, the doctor told us, but he didn’t track anyone’s movement or respond to commands. I scribbled rapidly, trying to get it all down to tell the rabbi later. At least I had a purpose now.

He asked Carol about “do not resuscitate” instructions, and her only answer was, “I don’t know what he wants. We never talked about it.” So, for now, Art was “full code,” they were treating his infections, hoping he would wake up, and we should come back in two days.

I asked, but no one else from the caring committee was available on Friday, so what could I do? I drove Carol again. I was really piling up those mitzvahs. While we waited for the doctor, Carol stood next to Art’s bed, refusing the offer of a chair. A few times she asked him, “Can you hear me?” but received no response. After an hour, a different doctor took us to a conference room. He spoke simply, with clarity and kindness. Art was not improving. His kidneys were shutting down. While they had one more test planned, an MRI to make sure they weren’t missing something, Carol should start thinking about next steps.

In the past, the doctor told us, medical professionals focused on the next test, the next procedure they could do to keep the patient alive, no matter what. But now, doctors worked with patients and their families to determine what the patient wanted, what represented “quality of life” for each individual.

“I don’t know. We never talked about it,” Carol repeated.

“Yours is the toughest seat in the room,” he told her compassionately. “Come back on Sunday, after we do the MRI. We’ll see how he is then. But start thinking about it.”

I drove Carol home, we talked more about ourselves, and this time, when she got out of the car, we hugged goodbye. Again, awkward, but we both needed it.

Elizabeth Patterson, Mulholland Drive No 6, colored pencil, graphite and solvent on illustration board. Courtesy of CK Contemporary, San Francisco. Used by permission.

The next time, I didn’t even ask anyone else about driving. Having spent hours in the car and hospital with Carol, writing down everything about Art’s condition, listening to the doctor present this impossible decision that had to be made, I now had to see it through with Carol. When we arrived, Art’s eyes were open, but he didn’t answer any of Carol’s questions or track her presence. The doctor immediately took us back to the conference room. The MRI had shown that Art had suffered multiple strokes. The strokes would almost certainly have caused significant damage, so he could be unable to speak or function. Art would require ongoing dialysis, and he’d be bedridden, which would require him to live the rest of his life in a rehab center with in-house dialysis, the only one over an hour away in another state. The medicines to treat his issues would interact negatively with each other. Being bedridden would bring its own complications, ones that would quite likely land him back in the hospital in worse condition in a few months.

One phrase, “bedridden,” caught Carol’s ear this time. “He wouldn’t want to be bedridden,” she said definitively. “I know that. He hated even using the wheelchair.”

The doctor told her to take some time to think it over. We left the room, and Carol went back to Art’s side. I was outside the room when I heard her ask him, “Do you want to live? Squeeze my hand,” and then, “Do you want to die? Squeeze my hand.”

I left them alone and went down the hall to the chapel. Carol joined me a little while later. She said, “When I asked Art if he wanted to live, he didn’t do anything. But when I asked him if he wanted to die, he squeezed my hand.”

 “I guess he gave you his answer then.”

“Yes.” A pause. “He did.” Another pause. “I’ll ask the doctor about comfort measures.”

Later, in Art’s room, with Carol holding Art’s hand, we listened as our rabbi, weeping for his old friend, recited the Viddui, the prayer in contemplation of death.

Art died at nine the following morning.

I stayed involved with Carol over the next week. I attended the service and funeral. I helped her bring things to the town dump. I also bought four AARP end-of-life planners and sat down with my in-laws and my husband. We filled them out, drilling down into the advanced directives, answering for ourselves what we would have wanted in Art’s situation. Once we were past the discomfort of the topic, the conversation became more animated, discussing funerals, favorite songs, poems, and food.

Some of the questions involved burial. I’d always assumed I’d be cremated and my ashes scattered. But later that week I asked my daughter, who told me she’d prefer to have a grave to visit. I took a walk to the small cemetery on our road. I’d wandered there before, but I’d never wondered, what would it be like to be dead here? It was quiet and simple, surrounded by tall pines. For the first time I felt that, if I were going to be buried, this would be a good place. I called the cemetery to find out about buying plots.

A card arrived in the mail the following week. In a crabbed handwriting, Carol had written, “Thank you for driving me to the hospital for the last week of Art’s life. You’ll never know how much this meant to me.” Me too, Carol. Me too.

Names have been changed.