into a moment of perfect fear.
III.
Weâve Come to This
A T THE AGE OF SEVENTY-NINE , A LBERT IS DYING.
A month ago he was diagnosed with cancer, and after much consultation with his doctors, he has chosen to refuse treatment. This is, he thinks, the right thing to do, the only choice. What he has is extensive cancer of the bowel, and treatment would require chemotherapy, and surgery, and a colostomy bag. As a result of these efforts his life might be extended, butâeveryone takes pains to be clear about thisâit will most assuredly not be saved.
His oncologist talks to him slowly, with a lot of eye contact, using phrases like
quality of life
, and
tough decisions.
But, to Albert, the decisions arenât tough at all. A man his age, he knows, is going to get caught by something. No one can guarantee heâll even survive the surgery, and chemo, they say, ishard on the heart and liver; the treatments are as likely to do him in as the cancer. Heâd suffer horribly for whatâa year? A year and a half? His wife, Elise, would be forced to watch. Albert knows that if he were a younger man, more forces might be marshaling in his defense, but he is not young. They can call it cancer, but this is what they mean by dying of old age.
So Albertâa man so healthy and hale itâs been joked about all his lifeâcan see his own end. Heâs a goner, and soonâa month, they say, maybe two. Heâll be given medication for pain, and, if the pain is severe enough, heâll be given an epidural, like pregnant women have.
I wonât lie to you, the oncologist says to him, when Albert tells him of his decision. Thereâs no easy way to talk about these things, but I feel you should know whatâs ahead of you.
And here the oncologist looks at both Albert and EliseâElise who sits straight and grips Albertâs arthritic knee with enough strength to make him grimace.
The oncologist says, This is a bad way to go, Albert. It gets, progressively, worse and worse. We might be able to keep ahead of the pain, if you work with us, but the methods we use will affect your ability to think and reason, and to act on your own behalf. These are serious narcotics weâre talking about. If you take anything out of this meeting today, make it this: See the people you want to see, and soon. Say your goodbyes now, while you can. Donât put off signing documents that need to be signed. The decline is faster than youâll think it can be. Iâm sorryâbut that needs to be said, and you need to accept it as quickly as you can.
Albertâs already on codeineâthereâs a live animal in his belly, most daysâbut the oncologist, before Albert and Elise leave, hands him a prescription for oral morphine. This willget you started, he says. The oncologist looks at Albert, his eyebrows raised, and says, in a low voice, Follow the instructions on the bottle. You donât want to mess around with this stuff. Understand?
At first Albert thinks the man is being condescending, but as he drives homeâElise canât; sheâs weeping, almost wailingâhe understands what the doctor has really told him.
During the next two days, when he sits in the study with his papers and his records, doing as the doctor instructed, he keeps the bottle of morphine pills nearby. Sometimes he reclines in his easy chair and turns the bottle around in his hands. Thereâs not much to go over, not much to weigh, but all the same he gives the possibilities a knock or two in his head, and then decides.
He has never kept a secret from Elise in his life, and cannot do it now.
I have had a choice to make, he says, standing in the doorway to the kitchen. And I have to tell you what Iâve chosen. I need you to be strong about it.
Elise, making him potato soup, stops stirring. The phone rings, and they say nothing until the machine picks up. The damn thing rings off the hook these days, since