Nothing Was the Same (9 page)

“To stars,” he said.

I reminded him of the quotation from Byron’s
Don Juan
that I had used in dedicating one of my books to him: “To those who, by the dint of glass and vapour, / Discover stars, and sail in the wind’s eye.”

“To you,” I said. “To safe sailing.”

When I look back on it now, my Valentine’s gift to Richard was an absurdly optimistic one. I had made reservations for us to spend a week in Big Sur in early April. We had not been there together and it was something we had always wanted to do. It was improbable, but not impossible, to do it now. The trip would be long but manageable; once in Big Sur, we could read and drive along the coast and mull and enjoy ourselves. We could relax; we could stop time again. Richard expressed concerns about the practicalities but was enthusiastic. When we got home, he sat down with my maps of Big Sur and I watched him with delight. Our trip was something to reach for, a race of hope against death.

Within the month, we knew that we would not go to Big Sur together. Richard was too sick. I told him I planned to cancel my lecture at the University of California at Davis, as well as the trip to Big Sur, but he was vehement that I not do this. “You’re exhausted,” he said, “and we have a difficult time ahead.” I argued that I didn’t want to go anywhere without him, but he insisted, and he was right. I
was
exhausted, physically and mentally. For three years I had been taking him to appointments at Hopkins and visiting him when he was in the hospital, sometimes driving from Washington to Baltimore and back twice a day; waiting with him for the results of scans and blood tests, meeting with doctors, requesting consultations, getting prescriptions filled; reading up on his illnesses and treatments; fixing meals and looking after the house. I was hopelessly behind in my work, struggling to maintain my psychological bearings, and trying to keep up his spirits and those of our friends and colleagues. Above all, I was worried sick about him.

We compromised. I would go to Davis for a day to give my talk, and then drive down to Big Sur for two or three days. My mother said she would come to Washington to help look after Richard while I was gone; she also said she strongly agreed with him that I needed a few days off. She told me that I sounded exhausted and that she was worried about me. She felt, like Richard, that Big Sur was exactly what I needed. I felt guilty about leaving and was fearful that Richard would get worse. Terrible things could happen quickly.

Richard and my mother were right. I needed Big Sur. I needed to stand at the edge of the ocean and see the Big Sur coast and the mountains and renew some of what was broken inside of me. Even if that renewal lasted only as long as it would take to get me through Richard’s death, it would be an essential thing. Big Sur gave me back some of my spirit, and that, in turn, I gave back to Richard.

I went to Pfeiffer Beach shortly after I got to Big Sur and read the note Richard had given to me before I left Washington. “We wanted to do this for so long and didn’t,” he had written in his childlike scrawl. “We have done other things. It will not happen in this lifetime and, as you know, I do not believe there is another. But you will know that I am with you in Big Sur. Love, R.”

I walked on the beach and read and slept in the sun. And then I slept some more. Only after the first day did I realize how bone-weary I really was. Richard and I spoke every hour or so, and as he said he was feeling better, I felt somewhat less guilty than when I had left Washington. I reread one of my favorite books,
The Once and Future King
, and was struck by King Arthur’s resolution and tempered optimism in the face of tragedy. I understood better this time, in the reading and from knowing Richard, the rarity of that kind of strength.

The weather was glorious, which is not usually the case in Big Sur. I ate California artichokes and figs and apricots and walnuts. I filled myself with the sun and the breeze and the ocean and the great tall trees. I looked to the sea and I lifted my eyes to the hills, from which, with the Psalmist, I drew my strength. It passed through my mind that I would not be able to be in Big Sur with anyone other than Richard.

When I returned to Washington, Richard was worse. Within two weeks, he was shorter of breath than he had ever been and he had lost nearly ten pounds. He caught pneumonia. He ate next to nothing and slept more; I watched him lose a bit of his life each day. The intimacy in being together during the approach of death is unimaginable. We knew that what he was going through was final. We lay so close to each other in our bed that we were aware of everything that went on in the other’s body. It was a long and private farewell.

In mid-April, Ettinger told us that Richard’s disease had “progressed.” The way in which he said this gave us no hope. Bob Gallo made arrangements for Richard to enroll in an experimental drug trial at George Washington University Hospital and sent his medical records and scans to a gene therapist at Vanderbilt. Richard was enrolled to participate in the NIH vaccine protocol in the fall, but it seemed unlikely that he would live that long.

He started on Iressa as part of an experimental trial to test the drug’s efficacy in patients with lung cancer. It had “shown promise,” a phrase we had come to doubt, but there were not many options left. His energy was deteriorating, he spent less time at his computer, and it was only infrequently and with great difficulty that he was able to get up and down the stairs. Friends visited more often now, but their visits were shorter.

We had quiet evenings and somewhat disjointed days from that point on. We waited. We hoped against the reality that we knew. Richard slept more, and I lay next to him and didn’t sleep. I read to him for hours a day, although he often fell asleep, and friends and colleagues continued to stream in. At the end of April, Richard and I decided we should have a dinner party for our closest friends to thank them for their friendship and for their extraordinary efforts in trying to save his life. It was our last dinner party, but it was wonderful. I set the table with masses of candles of different heights and azaleas from the garden and made a dinner of papaya with lime and crystallized ginger and figs and salmon and champagne. Everything was alight and beautiful, and the evening was warm with friends who knew exactly what was what.

The next day, I went to Rock Creek Cemetery to pick out a burial plot for Richard and myself. Richard was too ill to come, but he knew the cemetery because we had been there on several occasions to visit the Saint-Gaudens memorial for Clover Adams. It was the last day of April and there were great blossoming trees everywhere. I called Richard from my cell phone at different sites to describe them to him and to ask which he preferred. We agreed on a place in one of the older parts of the cemetery, near clusters of old trees and within sight of a lily pond. Richard loved the idea of our being near a lily pond in perpetuity and suggested, with a laugh, that I could drop an occasional goldfish into the pond when I came to visit him. It was a sad business.

I did not leave the house unless I absolutely had to. If I was not with Richard, I was distractible and anxious. The only thing that helped was to be with him. In early May, Bob Gallo recommended to Ettinger that Richard try an additional drug, one he had been working on in his laboratory and that had shown antitumor activity. Richard took Gallo’s drug along with the Iressa and the Folkman regimen, nibbled at his cottage cheese and canned peaches, and remained in unflappably good spirits. He did not complain. He worked on writing up scientific papers when he had the energy and asked me to read to him when he did not.

There were terrible things to do. Some were small—I bought a black hat with a veil from a saleswoman who was kind enough to match my silence with hers—and others were not. I went to a funeral home to make arrangements and was assisted by a very nice man who asked me if my husband knew I was there. I was surprised by the question, and said, “Yes, of course.”

“You would be surprised how many wives don’t tell their husbands they are coming here,” he said.

Not for the first time or the last, I was grateful to Richard for his directness in dealing with death and his incapacity to deny the inevitable. I picked out a simple birch casket and explained to the funeral director that Richard would just as soon be thrown to the fishes but that I wanted his physical presence for myself, and for how others would remember him. I told him that Richard was a doctor and a scientist who had saved many lives and that I loved him beyond reckoning. I told this man more than I needed to tell him, but then I am sure I was not the first to do this.

In May, Richard and I continued the discussion of funeral plans that we had started in California. Only now we were not on a bench under the sun and we knew that time had run out. Richard was propped up against pillows at the head of our bed and I sat up against the footboard. We discussed friends he wanted to serve as pallbearers and ushers and who should give the eulogies, who should do the readings. A friend of ours, John Harper, who had been the rector of St. John’s Church on Lafayette Square, where I had been a parishioner before switching to Christ Church in Georgetown, had been by to visit Richard on several occasions during his illness. He gave Richard tapes of hymns, and indicated to him the ones most often used in funeral services. Richard asked if there was any way he could have all Christmas carols, but the priest suggested this was probably not going to be acceptable. Richard and I just laughed; he was a thorough nonbeliever, but he loved Christmas carols even more than I did.

Richard asked me to read to him the funeral service in
The Book of Common Prayer
, and then asked if there were any biblical passages about medicine or science. I said I did not know, but spoke later with Stuart Ken-worthy, the rector of my church, who suggested a reading from the Gospel of Luke. Then we turned to hymns. Richard knew unequivocally that he wanted “Amazing Grace,” and had picked out two others he liked from the music John Harper had given him. He asked me what my favorites were so that he would include one that I particularly liked. We lay in bed and listened to the three hymns I suggested and he gave his reactions.

Under the circumstances, he said wryly, he thought he would pass on “How Great Thou Art.” He neither liked nor disliked my favorite, “Lead, Kindly Light,” so he said he thought he would pass on that one as well. He asked to listen to “Immortal, Invisible, God Only Wise” again and then said, with the honesty of a dyslexic who had engaged in a lifetime war with poetry, “I have no idea what the words mean, but I like the music.” So he chose a hymn he knew I loved and one that he did not understand. As he pointed out, he didn’t really have to understand it.

We did a run-through of the funeral program. I read from the copy of
The Book of Common Prayer
that we had used in the blessing of our marriage in Los Angeles, and we played the hymns in the order of the program that they would occur. I got out Jessye Norman’s recording of “Amazing Grace,” which Richard loved, and we listened to it. When it had finished, I looked at Richard, who had a slight smile on his face. “Sounds great!” he said. “Let’s do it!” He laughed easily, I less so.

The days and nights did not get any better for Richard. He slept more and, despite oxygen, now and again would gasp for air as a fish will when taken from the sea. He did not respond to either of the experimental drugs and, with that, a cold dread came into the house and stayed. I returned to the funeral home to talk with the man who had assisted me before. He was kind and direct and reassured me, “We will take good care of your husband.” They had taken care of Oliver Wendell Holmes and Franklin Delano Roosevelt, he said, and Thurgood Marshall and John F. Kennedy. I told him my husband would be pleased, especially about Thurgood Marshall. I turned to leave.

“We’ll see you later,” he said.

I tried to respond but my heart had stopped.

It was early June 2002. The foxglove was high in our front garden, and the honeysuckle was climbing every which way over the stone walls. I picked armfuls of pink and white peonies and put them in the bedroom. Never, in seventeen summers with Richard, had I seen so many butterflies as there were now, in this early June. I tried to catch a small white one to keep Richard company, but I couldn’t keep up with it. And, as Richard said, I shouldn’t have tried. The butterfly ought to be free to fly in the garden.

He said this without envy or regret.

J
OY
B
E THE
S
TARLIGHT

We spent most of our last day at home together reading and writing in the room across from our bedroom. Richard worked on a foreword he had agreed to do for a colleague’s book and I read. He was very tired, and fell asleep now and again, but it was a good day. A peaceful and private day. I read to him what I had written the day before for my book on exuberance, a habit we had slipped into after he first became ill with lymphoma. I had quoted Robert Louis Stevenson, and he had asked me to read to him from Stevenson’s original essay on youth and old age.

I made us a cup of tea and began reading. “We may compare the headlong course of our years to a swift torrent in which a man is carried away,” Stevenson had written. “We have no more than glimpses and touches; we are torn away from our theories; we are spun round and round and shown this or the other view of life, until only fools or knaves can hold to their opinions. We take a sight at a condition in life, and say we have studied it; our most elaborate view is no more than an impression.”

Richard was intrigued by Stevenson’s assertion that no
matter
how carefully man studied something, his understanding was incomplete, an impression only. He seemed both heartened and disconcerted by the observation, and spoke about partial, shifting knowledge in the context of his own science. The advances in the understanding of schizophrenia and the brain were rapid, but however much was being learned, relatively little was actually known. Much of what was known would not last. He talked at length about how much he regretted dying without being a part of the discoveries to come. He would never know what causes schizophrenia or how to prevent it. He did not know now, he said, most of what would be commonplace science in twenty years.

What he said was true. Discovery is the boon and the chafe of science; much of what is learned will be supplanted by newer findings. There was no good answer to his regrets except to say that the pursuit of new knowledge is reward in its own right and that knowledge begets new knowledge. For those doing medical research, there is the reward that comes from easing pain and saving lives. I reminded him of how deeply he had loved his scientific work and being a doctor, and how much he had improved the lives of those who suffer from schizophrenia and other psychiatric illnesses. He had passed on his enthusiasm, curiosity, and intellectual rigor to the hundreds of young scientists he had trained. For them and for his colleagues, including me, he had been the best possible example of discipline, imagination, and the refusal to give up.

“Perhaps,” he said.

Still, he knew that what I said was true. His colleagues and those he had mentored had made clear to him their respect for his science and his character. The impending death of a colleague fosters hyperbole, but the sincerity of the tributes from his peers was obvious.

“Perhaps,” he said. “Perhaps.”

But he smiled, and his mood was brighter.

Richard did not want to die, but he was not afraid to. He did not want to end his explorations of the brain, but he knew he had had a passionate run. He had used a fine brain to study the brains of those less fortunate, and he had made a difference. He was not lucky to die when he did, but he was lucky to have lived as he lived.

That night, I lay in Richard’s arms for a long time, thinking about us, thinking about him. I was peaceful in a way I had not been for months and felt some hope that we might have longer together than we thought. When I woke up in the morning, Richard was gasping for breath.

We drove immediately to George Washington University Hospital, where the doctor who examined him said that both of Richard’s lungs had collapsed. In all likelihood, he said, this had happened over a short period of time and, with luck, inserting a chest tube would allow him to breathe more easily. Richard underwent surgery, and I sat with him that night as long as the hospital would permit. He did not look better, however. Indeed, he looked sicker than I had ever seen him look.

When visiting hours were over, the nurse insisted I leave his room. I was deeply unsettled by this; it was, I know now, the primitive distress of an animal being taken from its dying mate. I had worked in hospitals for nearly thirty years, however, and saw the need for rules. Rules matter, except when they should matter least.

As I got up to leave, Richard said, “I love you, sweetheart.”

“I love you, too,” I said. I reached over to kiss him good-night. “See you in the morning.” It was the same exchange we had had every night for nearly twenty years, but this time it was our last.

At four o’clock the next morning, a doctor in the hospital’s intensive care unit called to tell me that Richard’s health had deteriorated and he was in grave condition.

“I think it is important that you come to the hospital as quickly as possible, Mrs. Wyatt,” the doctor continued. “His chances are not good.”

My drive to the hospital was a nightmare, my half-sprint to the ICU worse. When I finally found Richard’s room and saw him, I knew he was going to die. He was unconscious and connected to a tangle of tubes, monitors, and a ventilator. Although unconscious, he was struggling with the ventilator because of earlier damage caused by radiation to his esophagus.

Richard never regained consciousness. His face swelled from the fluids he was given to fight infection and to keep his blood pressure elevated. By the second day in the ICU, he was unrecognizable. The doctors extended next to no hope for his survival. Even if he survived the wildfire sepsis, they said, it was hard to imagine, with his diseased lungs, how he could ever get off the ventilator. I watched the numbers on his monitors lurch about, and with them lurched my moods.

Stuart Kenworthy, the rector of my church, came by the hospital to visit, and I was surprised by how much better I felt after talking with him. It was consoling in an ancient, essential way. Perhaps because priests see human life from baptism to death, they have both a more profound and a more pragmatic perspective on death than others do. He was certainly more comfortable in an ICU than I was. I found it hard to deal with the physical changes in Richard and told Stuart that I doubted I would ever be able to get rid of the images of Richard’s bloated face. It was the least of matters, but it was one that haunted me. He said that I would, in time. He suggested I put my favorite photographs of Richard around the house and that eventually I would remember him as he had been. It was good advice, practical, and it worked.

After Stuart left, I picked up my copy of
The Book of Common Prayer
, looked up the Order for the Burial of the Dead, and started to read. “I am the resurrection and the life, saith the Lord,” it began, and I thought: Not yet; I will hear this soon enough. I closed the book. But then, as minds will do during such times, I suppose, I sought out the past to prepare for and provide solace for what was to come.

Standing by Richard’s bedside, I thumbed through the prayer book and read aloud to him one last time. It was a prayer the priest had read to us in Los Angeles. “Let their love for each other be a seal upon their hearts. Let it be a mantle about their shoulders, and a crown upon their foreheads. Bless them in their work and in their companionship; in their sleeping and in their waking; in their joys and in their sorrows; in their life and in their death.”

The words had meant a very different thing to me when life was what we had and death was unimaginable. I had heard then
love
and
companionship
and
joys
. Now I heard the force of different words,
sorrows
and
death
. But I heard
love
as well.

The attending physician came to me not long after and said, “Mrs. Wyatt, we need to talk about what your husband would have wanted done.” He was direct and kind; he was very professional. We went through the details of Richard’s advance directives, which were unambiguous, and decided upon the medical conditions for removing life support. I went to a hotel nearby to get a few hours of sleep, afraid to risk getting manic, desperately hoping he would live through the night so that I would be with him when he died.

He lived through the night. The next morning, the ICU doctors asked me if I wanted to stand in with them on their rounds as they discussed Richard’s medical situation. I listened to what they said, appreciative that the clinical discussion made it clear that his death was inevitable. He had organ failure in his heart, lungs, kidneys, liver, and whatever else there was that could fail. His pupils were fixed and dilated. There was no hope for survival. We went through his advance directives again and I made the decision to have his blood pressure medications and ventilator withdrawn. The decision, which was a straightforward one, seemed anticlimactic to the preceding days of unsustainable, chaotic monitor numbers. He was, in reality, already dead. It remained for me to give sanction to it. I did this with cold fear.

An ICU, of necessity, is a well-lit and exposed place, but the nurses did the best they could to lend privacy to Richard’s death. What they did and their way of doing it was thoughtful and habitual. They removed the trails of plastic tubing and the bleating machines, drew the curtains around his bed, and dimmed the lights. He was alive, but scarcely and not for long. I had no idea what to say to him other than to repeat, again and again, “Thank you for such happiness.”

To myself I said,
I want my husband back
. It became a mantra over the weeks to come.
I want my husband back
.

I looked at Richard’s body, which had been through so much for so long, and I was, by the grace of books, given the gentlest of images. I remembered Hazel, the
great-hearted
and open-minded leader of the band of rabbits in
Watership Down
, a book both Richard and I loved. When Hazel died, he simply left his body on the edge of a ditch and then ran off free of his tiredness, through the woods and into a field of primrose. Hazel’s fairness and self-assurance had always reminded me of Richard—both in how he lived and how he died—and the image of Hazel’s light taking-leave-of-life was genuinely comforting.

It was the beginning of my true knowing of the consolation of language. I would soon learn that the images that drift in and out of one’s mind during grief are not always kind. The mind can cut both ways; it can throw up memories that disturb or delight, relieve or agitate. The mind is unpredictable. I should have known this, of course. But, whatever was to come, the image of Hazel’s release was a gift when I most needed it.

I put my head on Richard’s shoulder and broke down completely. Then I kissed him good-bye and went into another room to complete the paperwork that goes with death.

The rest of the day filled with the practicalities of autopsy permissions, funeral arrangements, whom to call, and what to do. Why to do it was not an option of thought. That night, the night that Richard died, my mother, my brother, and Richard’s and my close friends sat outside, on long grassy grounds in Maryland, and drank mint juleps before dinner. It was a beautiful, early June evening, and given the circumstances, we had a strangely lovely time. Despite the awfulness of it all, everyone drew together and reminisced and laughed. We were so different, Richard and I, and that made for much of the laughter. As it always had. My friend Jeremy ordered a bottle of champagne and offered a toast to Richard, and we raised our glasses: first to him, and then to Richard and me, and then to the band of friends that we were. Our friends and family had made Richard’s and my last years not just bearable but exceptional. They would continue to do so in the months to come; they would make his death endurable.

A colleague of mine from Hopkins and his wife, good friends to both Richard and me, came down from Baltimore to have dinner the next night. They brought not only kindness and shared memories, but also sleeping medication. The latter was to avert my becoming manic during a time when I was likely to lose sleep. My colleague made it easy for me. Instead of my having to call one of my doctors and wait at a pharmacy, which I was unlikely to do, he took it into his hands to get a prescription filled. It was a small act of kindness but enormously important. I benefited from the fact that many of my friends and colleagues were not only practicing psychiatrists, but specialists in mood disorders as well. Most particularly, I benefited from their compassion. Over the coming months, they called me often to make sure I was getting enough sleep, that I was not manic, not depressed.

There were so many things to do. Someone from the funeral home called to ask me to bring over clothes for Richard, a task I found abhorrent. I picked out a shirt I had gotten for him in London, the silk tie he had worn the day we married, and gray slacks. I could not imagine why I was picking out such uncomfortable, formal clothes for him to wear, but that seemed to be what one did. It was dreadful and pointless and I cried the entire time. Days later, when Richard’s body finally was delivered to the funeral home, I had to formally identify his body. He was scarcely recognizable to me. I signed yet another paper of death and asked them to close the casket and not allow anyone else to view his body.

The funeral was held in St. John’s Church in Georgetown, a few blocks from my own church, which was being restored. The church was packed and the service beautiful. The soloist sang “Amazing Grace” magnificently, and I wondered how closely Richard had attended to the words. I thought I knew the hymn well, but it was only in hearing it sung on that afternoon, in that way, and for Richard, that I heard the words
dangers and grace
as they were meant, and that grace would lead him home. I don’t think he ever thought of himself in terms of grace, but I did. Or at least a particular kind of grace. Certainly, Richard would not have thought of “going home” in any hymnal sense, but it was a lovely rendition all the same. And it was for him.