Authors: Daniel Palmer
A few minutes after her last time check, Julie heard the front door open. In shuffled Trevor. She listened to the familiar sounds of her son reentering his home. First came the thud when he dropped his backpack on the floor. Then the closet door swung open with a creak, followed by a clatter of hangers as Trevor hung his coat. Then she heard the bathroom faucet running while he washed his hands.
“Hi, sweetheart, I’m in the living room. Dinner is in the oven.”
The apartment—fifteen hundred square feet of living space consolidated on one floor, with three bedrooms and two baths—smelled of chicken curry, a recipe Julie had stumbled on while browsing Pinterest. It was the first real meal she had cooked since the accident.
“I’m going to put Winston in his ball,” Trevor said. “And I don’t have any homework.”
Winston was the family guinea pig, a woeful substitute for the dog Trevor had begged for since his eighth birthday. Julie was sorry she could not accommodate her son’s wishes, but a dog simply did not fit their lifestyle.
“Come in here and talk to me. I want to look at your folder.”
“It’s fine.” Trevor had perfected the “leave me alone” tone and gave it just enough edge not to be totally rude.
“It’s not fine. We have an agreement.”
No response. Bad sign.
The agreement was for Julie to review Trevor’s schoolwork and check over his grades until he pulled them from Cs to Bs. She’d stop when it looked to her as if he was performing at or near his potential.
“Trevor?”
“I’ll be there in a minute.”
A rolling rattle alerted Julie to Winston’s imminent arrival. Sure enough, his plastic ball came skirting across the hardwood floor in front of the television at a high rate of speed. The mostly white-furred guinea pig had spots of brown and black and dark eyes and a very cute little face. Julie had taken quite a liking to Winston.
Eventually Trevor came shuffling into the living room, still wearing his dirt-splattered practice uniform and looking a bit ragged.
“How about a shower before dinner,” Julie said.
Trevor plopped down on the couch and tossed his school folder onto the coffee table. He had a tentative air that gave Julie pause. Had he failed a test? Possible, given the week they had just endured.
Julie set down her glass of wine as Trevor turned the channel from A&E to ESPN with speed that belied human capability. Trevor could have what he needed; he had done her a favor.
“How’s Sam doing?” Trevor asked.
Julie gave her son an appreciative glance and pulled him in for a little hug. “Thank you for asking. He’s not getting worse.”
“But he’s not getting any better, is he?”
Julie bit at her lip. “If by better you mean moving his arms or legs, then I’m afraid the answer is no.”
A week of healing had mended the gash to Sam’s chin, but his arms remained encased in casts with pins in the bones. His left leg, also in a cast, was suspended above the bed in a traction pulley system. His head CT read negative, and several neurosurgeons who had evaluated Sam had reached the same conclusion: the outcome could not be improved. Parts of his spine had been cut into pieces by shards of broken bone that acted as machetes.
There were more MRIs, more exams, and more tests, including electromyography, where multiple needles were inserted into Sam’s body to assess electrical activity of his skeletal muscles and motor neurons. Every result disappointed.
“I’m sorry, Mom.”
Winston came rolling by, his little legs churning furiously. Trevor giggled, and the sound of her son’s laughter brought a smile to Julie’s face. Her first, it felt, in ages.
Julie redirected her attention to the folder and got her second smile of the week. Trevor had gotten As on both his history and science tests.
“Honey, this is wonderful,” Julie said. “Well done.”
“Yeah, it was easy.”
“Or maybe you just applied yourself.”
Trevor shrugged it off, but in his eyes Julie could see he agreed. Her son had so much potential. Getting him to do the required work continued to be the major obstacle.
Julie glanced at Trevor’s agenda, which detailed the homework and projects due in the coming weeks. It should have been Trevor’s responsibility to plan and complete all his assignments on schedule, but until he got back on track, Julie felt justified hovering in that helicopter-parent way.
“You’re all set with
To Kill a Mockingbird
?” Julie asked.
Trevor’s color drained. He rose quickly from the couch and nearly punted poor Winston like he was a soccer ball.
“Honey, what’s wrong?”
Trevor did not answer. But she heard the sounds of him rummaging through his backpack. Trevor came storming back into the living room on the verge of tears.
“Everything all right?”
“That stupid book is at Dad’s, and so is my English folder.”
Julie checked the time. “That’s no problem. We can get it out of the library. Or we’ll take a drive to the store.”
“My essay is at Dad’s!” Trevor said. His shoulders slumped and his face crumpled.
“I’ll just call your—” Julie stopped herself when she remembered that Paul had left town for the night.
“The essay is due tomorrow, and now I’m going to get an F and then you won’t let me play soccer.”
“Take it easy. Relax. We can tell your teacher. She’ll understand, given everything that’s going on. It’s not going to be a problem.”
The logic appeared lost on him. “You’re gonna make me quit the soccer team. That’s what you said if I got an F.”
“No. No, I’m not.”
“Any F and you’re off the team. School is more important.”
“This is an exception.”
“It wouldn’t have happened if I didn’t have to keep track of my stuff. Between here and Dad’s, I’m never just in one place.” The tears that had been threatening began to leak out.
Julie understood that Trevor’s frustration went far beyond this one English assignment. Behind it all—the fight in school, the falling grades, the incomplete homework—lay sorrow.
“Come, sit down,” Julie said, patting the sofa.
Trevor remained standing, arms locked across his chest. Winston chose that moment to come scuttling by. He hit a wall, redirected, and was on his way once more. But the incident proved amusing enough to get a slip of a smile from Trevor.
“Honey, I get it,” Julie said. “It’s not easy having to jump around between here and Dad’s.”
“And now it’s just going to be worse.”
“Worse how?”
“Sam.”
“Oh.”
“You’re not going to still marry him, are you?”
“Trevor!” Julie understood that kids could be direct to the point of being crass, but Trevor’s comment had crossed a line.
“I’m sorry. I just mean—I like Sam. I think he’s a really nice guy, and he’s been great to me. You know? But think about what it would be like for me if you two were married and he was like, living here. He can’t move his arms or his legs. He can’t do anything for himself.”
“For right now. He can get better.”
The look Trevor gave his mother said he did not believe it. Deep down, going to that place she hated to go, Julie had to admit she felt the same.
“Him being here, with us … it would change everything.”
Julie took a moment to collect her thoughts. Her throat had gone dry, which made it hard to speak. “I understand your feelings, here. Honestly, I do. Here’s my promise to you. We’re going to take this one day at a time. I don’t want you to worry. You have enough on your plate.”
“I just don’t see why you can’t fix it with Dad,” he said.
“Fix it how?”
“I saw how you were with him at the hospital. You were close.”
“And?”
“Why can’t Dad just come live here again?”
And there it was. The real issue flushed out into the open where it belonged.
After the divorce, it had not taken Julie long to scrub the apartment of any traces of Paul. His artwork had been stripped from the walls, and his trinkets and favorite dishes took up shelf space in his new home now. This was her home and Trevor’s home. No matter what happened with Sam, she would never live with Paul again. In her son’s eyes, though, it remained a distant possibility.
“Come sit.”
Trevor finally obliged and Julie pulled him in close.
“Your dad and I tried very hard,” she said. “But we just couldn’t make it work. I do like your father. He means well, and we’re friends. Sometimes I want to slug some sense into him, sure, but I know how much he loves you. He’d do anything for you. But no matter what, your father and I aren’t getting back together.”
“Well, it sucks for me.”
“Language, please.”
“It stinks,” Trevor said with some bite. “I can’t keep track of my stuff. I don’t even know when I’m supposed to be at Dad’s and when I’m supposed to be here.”
“This week has been hard on us all. It’ll get easier. I promise.”
“Yeah, but by then I’ll have failed my other courses.”
“Don’t be dramatic. We’ll deal with this English paper. Just take it easy on me right now. I’m going through an awful lot, and I need your support. Can I count on you?”
Trevor shrugged and said, “I guess.”
Winston came back into view, ball spinning. Trevor picked him up. “I should put him back.”
“When things get settled, we’ll look at the schedule with your dad. Maybe we can simplify it. I don’t know. And I’ll e-mail your teacher after dinner about the essay. Okay? Now go wash up.”
“Sounds good, Mom.”
Trevor and Winston headed off.
“Trevor?”
He turned back around.
“I love you,” she said.
“Love you too, Mom.”
No pause at all from Trevor, no need to collect his thoughts. It was how he felt about his mother. Julie’s heart swelled. She had made a vow after Sam’s accident to say those three simple words to her son every chance she got.
“Kill me, Julie. Please help me die.”
Sam’s anguished plea tore at Julie’s heart. Fresh flowers filled the stark ICU cubicle with bright colors that failed to offset Sam’s dark mood. He slept most of the day away, with Julie at his bedside every moment she got.
“You don’t mean it. It’s hard now, but it will get better.” Julie entwined her delicate fingers around Sam’s and gave his hand a slight squeeze.
Sam could not squeeze back. Nor could he touch Julie’s face, or stand, or run, or feed himself, or do any of the countless things he used to do before the accident.
The gentle rise and fall of Sam’s chest, the passing of his tongue across dried lips, the blinking of his eyes were the only indications he could move his body at all. The face that had been so full of life was sunken, his skin pulled close to the bone, dark circles marking the pain in his eyes. September became October, and in the weeks since the accident, Sam seemed to have aged a decade. With his beard shaved, Julie could better see how his face had lost its luster.
This was the new normal. Today was just another day in Sam’s ongoing care in the ICU. It had been sixteen days since Sam fully regained consciousness and there were no major crises, no life-or-death medical procedures. All he had done on this day and the day before was to lie in his hospital bed, hooked to wires and tubes like a human marionette.
“Please, Julie. I can’t live like this.”
How many times had he asked to die? Julie had lost count, but it had started the moment Sam could speak again. Nothing Julie said could shake his despair. She understood it, felt it in her core.
“I’m sorry, baby,” she said. “I’m so sorry for what you’re going through. I’ve called someone who can help.”
“Nobody can help me, but you. You’ve fought for death with dignity for years, now fight for me.” Sam’s voice was a hiss of air, a faint echo of his former self.
Julie shut her eyes to battle back another wave of distress. “It will get better. You have to believe it will.”
“You’re a hypocrite.”
His words stung, but Julie understood his need to make it hurt.
“No, it’s different for you. There’s a lot of evidence that quality of life for—for people with your type of injury is about support and reintegration into the community.”
“My injury,” Sam said, the contempt almost palpable. “I’m quadriplegic and that’s what I am going to be for the rest of my life. I don’t want this. I don’t. I’m going to live out my days helpless in a hospital of some sort, and you know it. You know it and you have to help me.” Sam’s body might have been broken, but his mind was crisp and working strategically.
Julie had made a career out of keeping people alive who were on the edge of death. The torment and pain she’d observed over many years had altered her beliefs about administering care to the supremely sick. She always did her job to the best of her ability, but welcomed the day when caring for patients would mean having the option to end their suffering in a dignified way.
Sam wanted to die. Should he have that right? Was Julie being a hypocrite? It was true her beliefs were easier to maintain when she had no deeply personal connection to the patient wishing to die.
“I believe you can make a life,” Julie said, her voice not so convincing. “We can make a life together, and I want to be the one to help us do that. I know it can be a good life, too.”
“You believe that as much as you believe Nancy Cruzan should have been kept alive.”
“No. Nancy had no life whatsoever. It’s different.”
In one of her prepared talks about death with dignity, Julie had referred to the case of Nancy Beth Cruzan, who had been involved in an automobile accident that left her in a persistent vegetative state. Citing the due process clause of the fourteenth amendment, Nancy’s parents went to court to get their daughter’s feeding tube removed. In a five-to-four decision, the Missouri Supreme Court had ruled that individuals had the right to refuse medical treatment as long as they were competent to exercise that right. Without any clear and convincing evidence that Nancy Cruzan desired her treatment to be withdrawn, the tube remained in place. Nancy’s parents eventually proved to the court’s satisfaction that their daughter would not wish to be on life support. Nancy’s feeding tube was eventually removed, and soon after she died. The case gave rise to the broad adoption of advance life directives.