It was an unspeakably awful thing to say.
After an exhausting and unnecessary verbal battle, the hospice’s medical director–who had been openly skeptical of my physician husband’s emphatic wish not to die in a hospital (at least when I was the one to express that wish as his medical proxy)–asked whether my husband wanted to drive with me from the hospital or wanted an ambulance to take him.
“Held on to hope like a noose, like a rope
God and medicine take no mercy on him
Poisoned his blood, and burned down his throat
Enough is enough, he’s a long way from home . . . .
Laid up in bed, you were laid up in bed
Holding the pain like you’re holding your breath
I prayed you could sleep, sleep like a stone
You’re right next to me
But you’re a long way from home.”
Referring to the ambulance, that doctor added, out of my earshot but not that of our friend and my sisters-in-law, “You might as well, for your last lap.”
This remark’s casual cruelty–its trivialization of my husband’s determination to come home, its grotesque appropriation of the fundamental unit of an unending journey, when we all knew this was a one-way trip to an imminent and early end of life–makes my heart race even now, as I sit alone in a different home in summer rain’s dappled quiet more than five years later.
One of the many privileges of parenthood has been getting to know my children’s remarkable friends. Not long ago I went to a senior honors presentation by one of them, who gave a talk about linguistics and Jacques Lacan, and introduced me to a French Holocaust survivor’s account of a uniquely healing moment.
Gérard Miller’s film “Rendez-vous chez Lacan” shares her story of having been haunted for two decades by her nightmares of the Gestapo seizing her and her family; she was describing a recent nightmare when Lacan leapt up and ran his hand along her face– converting the terrifying power of the word “Gestapo” into, in her native French, a tender touch, a g’este à peau that she was able to recall as a physical memory.
In the ambulance on the way home I had clutched the neon pink card-stock portable DNR in my left hand, rolled like a diploma and splotched with my tears. I had touched my right hand to the side of my husband’s temple and cheek. A g’este à peau.
It’s well past time for me to reclaim that journey home, our last trip together.
The ambulance arrived at the hospital late in the afternoon, an hour-and-a-half after we had been assured it would come.
We had a quiet ninety minutes, no one checking vital signs, no one trying to administer medication or appearing awkwardly at the door. No machines buzzing or beeping. I had not realized how unaccustomed we were to being undisturbed.
The room’s single window could not be opened, and the temperature seemed unbearably to rise. We lay together on the hospital bed.
Eventually growing restless, Jim mustered the energy to walk a single circle around the unit floor, leaning against me. This was the same hospital where he worked, and every physician and nurse and staff member who saw us looked at us somberly and silently, some of them wiping away tears.
Our children and friends had been at our house for hours, setting it up for Jim’s return.
The ambulance’s two-person crew appeared at the entrance to Jim’s room as I gathered his things. By that time the things we carried were few. The driver seemed surprised to see me there. My older brother, who had flown in from Chicago, had driven Jim’s truck back to our house from the hospital.
“It’s OK if I ride with you?” I asked the ambulance driver.
“Yes, but you understand you have to ride in front. You can’t be in back.”
“That’s fine.” I said.
I walked alongside the gurney and into the elevator, my hand on Jim’s shoulder. We stepped out on the first floor, through a sequence of sets gently whooshing sliding doors, to intense late-afternoon sun. I squinted and turned away to see Jim’s boss, our friend, speed-walking into the hospital just inches away, into a rare Friday evening meeting.
She immediately hugged me and I became undone, hysterically weeping into her shoulder, “He wants to go home and I just can’t stand the thought. . .” I did not mean the thought of going home, but of his dying. I simply could not believe that time had come.
The ambulance crew stood there, and by the time Jim’s boss had disengaged from both of us, looked at me—undoubtedly an immeasurably pitiful sight, weeping and holding that pink paper anyone in that line of work can identify—and said, “You can go in the back.”
I sniffled into my sleeve. “No, that’s OK, I can sit up front.”
They looked at me and spoke in unison. “Please get in the back.”
For the first among thousands of trips we had made together on the same road, we faced backwards, our view of the familiar obstructed only by the outlined letters spelling “Ambulance.”
The siren was off.
And so we traveled back home, a twenty-five minute ride. Until Jim was too sick to drive, he was invariably at the wheel every time we drove.
Only afterwards did I begin to imagine, when seeing a silent ambulance, that it might contain someone truly on the way home.
Jim brought up two subjects, one wildly practical, and one from his heart.
His conversational palette cleanser was a ministerial reminder to me, from his cautiously frugal side as the family financial planner who had in each child’s infancy begun saved money for another college. All that money is now gone. He did not live to see any of his children graduate.
As the ambulance pulled out in front of the hospital building where Jim had been bombarded with fruitless chemotherapy and radiation, he said, “You need to remember to cancel my phone line, because it’s a hundred dollars a month.”
That out of the way, he paused and told me quietly, “It’s important to do something for Bob.” Our Doctor Bob.
I would have to think about that for several weeks more.
Jim’s last trip covered the same stretch of road we had traveled thousands of times, to and from Jim’s work, our daughters’ high school, and my work far away along the highway to which it connects.
We had turned left onto that road on the way to the hospital when I was in labor with our first child, then nicknamed “Bud,” on an uncharacteristically cool August day.
We covered exactly the same path when Jim had driven us from our first home to the hospital where our next three children were born. Each time, the return trip on this road was made with the newest addition swaddled in an over-sized, grandmother-knit sweater—first white, then mint green, then yellow–slouched into a backward-facing infant seat. Summer, spring, and twice in winter.
The only other time I had been in an ambulance on this road, all of the children (then numbering three) had been with me. Jim had calmly been waiting in the emergency room on the other end: Noah, at two, had hit his head in a fall onto cement and had an ostrich egg-sized lump on his forehead. The ambulance crew gave him a green velvet teddy bear, a gift that provided him comfort long afterwards.
When we first began driving on that road there had been two working dairy farms. The children never tired of exclaiming “Moo cows!” every single time they saw the rural wonder of wandering cows, any more than the beagles tire of the sound of the same food clattering like tiny pebbles into their metal bowls twice every day.
We passed the bakery where we had picked up treats for family celebrations, and where on the way to preschool years earlier a well-weathered man had given our four-year-old daughter a two-dollar bill that he said had been passed along to him in a bakery for good luck when he was about her age.
“Has it worked for you?” I asked him.
We passed the SPCA, where our younger daughter had fallen in love with countless animals and we had brought two of them home forever.
We passed the family farm stand where we had picked out juicy summer tomatoes, buttercup corn, fall pumpkins, and gourds.
We passed the fairgrounds where we had gone every summer, one son somehow deftly outmaneuvering the games’ designers so he could bring back arms full of enormous stuffed animals for his little sisters.
This was the same park where we had trudged through many annual fairs, including one only days before an August birth, when my feet were so swollen that I had to borrow huge tennis shoes from our visiting friend Jon’s trunk. He took a look at me and laughed heartily, dubbing me “Preggo the Clown.”
We had traveled that stretch of road either at the beginning of nearly all our family vacations, loaded with sand toys and summer books, or ski equipment in a rack on top that I invariably forgot about before doing some degree of damage pulling into the garage at trip’s end.
Almost every day our daughters spent at high school involved at least two nearly identical round-trips.
The road branched off at about the half-way point towards our dear friends Randy and Judy’s house, which had been the siren call to moving across the state line when Jim began practicing medicine–two weeks before our first son was born.
Eventually we had driven the same route between home and the hospital to get Jim to the Emergency Room for a sequence of horrific complications. It was always in a blizzard.
This time we pulled into our driveway just in front of a van bearing bright spring tulips from relatives in California. Our friends and family were there to meet Jim. He declined the stretcher and walked inside on his own steam and he never suffered again.
The ambulance pulled away.
Inside our home, until he peacefully lost consciousness less than a day before he died, Jim laughed with friends among endless tender words and gestures.
“At last I was sure
That you weren’t far away from home.”