Woody couldn’t sleep. "Damn eye drops," he thought. The clinic nurse said the eye drops would help his glaucoma but that beta blockers sometimes have noticeable side effects–like sleep apnea. Woody remembered putting the eye drops back in the fridge after his Hungry Man dinner, but didn’t actually recall administering them.
Woody’s a retired Marine. And like other honed soldiers, shut-eye came as soon as he shut his eyes. The crazy shit that came after his eyes shut is another matter, but initially getting to sleep was never an issue for him. Woody got to sleep just fine, medicines or not, until last month. He just couldn’t sleep well without her. At eighty-two, Woody’s calm had left him.
He yawned as he rubbed his palm over the closely shorn hair of his youth. Despite his age, Woody’s flat top was thick and taut, his deep brunette hair now bunatti gray.
Naomi’s face was the most beautiful he’d laid eyes on. Not the sallow bearing she left behind. He first spied her bewitching profile illuminated in the light of the film screen. She was a peculiar beauty, one that warranted his full attention. Woody looked away when she first caught his gaze, but by intermission he’d managed to muster up enough stones to shoot her an all-out brazen stare. One to make her know that he meant business.
She had a natural look to her. Not all that Marilyn Monroe bleach blonde, heavy eyeliner, and red lips that the other girls imitated. Naomi’s beauty was subtle and her sweetness appealed to the young man who had boxes full of distant girls on paper at the barracks. Woody desired a nice girl. One that he might actually touch.
Naomi was petite. Short wavy cinnamon hair, blue eyes with flecks of gray, a freckled nose, and a full pout. Perfection. He watched her gloved fingers curl around that tub of popcorn as if it were Lana Turner doing a strip tease. Woody had waited months for High Noon to get to his neighborhood theatre, yet his eyes were fixed on the girl across the aisle and three seats down.
He closed his eyes and quietly moved his arm under the sheets to her side of the bed. He imagined scooping her up around the waist and pulling her in closer. It was routine after fifty-five years together. She’d laugh and push him away, then change her mind and giggle after a little convincing.
His arm twitched. Protesting its emptiness. Every part of him missed her.
He opened his eyes to inspect her pillow. A perfect rectangle. It hadn’t been touched except for a laundering every Tuesday, just as she would have done if she were still alive. The linens remained as crisply ironed as the day Naomi went to the hospital and didn’t come home.
She shared Woody’s disciplined nature. Their home was immaculate, even with her stage four cancer. But when evening came that day she was different. Pained and seemingly feeble. Her words came slowly and she shuffled about the house nervously, unlike the strong seasoned wife of a decorated Marine.
Her heightened confusion agonized him. The capable woman he loved had been broken down little by little, in increments that only he would notice. Her smile, from one of joy to one of consolation. She was embarrassed to need him so much. The medicines keeping her body from relentless pain were causing her to forget. Her faculties were slipping and she knew it.
That evening it took Naomi several minutes to ease into her nightgown and into bed. Woody sat down beside her and tucked an unruly curl behind her ear, then kissed her gently. He stroked her cheek until her breathing softened. When she nodded off, he picked up the bedside phone.
Upon hearing the receiver, her eyes opened. "Don’t call," she asked in a childlike voice.
"Mimi, honey, it’s been a bad day. I’m worried."
"I’m fine. Just tired, Chief. Tomorrow will be better."
"Can you feel it?"
"Just a little," she replied. But her admitting to it upset him. The woman never complained about anything. Maybe they could give her something stronger this time. He bowed his head and pleaded for less pain and more time for his bride.
Woody called the Medicare Emergency Hotline. He was transferred to a physician. He voiced his concerns then asked, "Can you call in something to help with her pain?"
"I’m sorry, but I can’t call in narcotics. She’ll need to go to the nearest hospital."
Woody confirmed their address with the national ambulance service as Naomi slowly got back out of bed and redressed. She couldn’t stand the thought of the ambulance staff seeing her in a nightgown. She then headed to the kitchen, picked up a sponge and spray bottle full of diluted vinegar and looked for something to clean. She didn’t want the EMT to think that she had an untidy home.
Woody asked his wife to sit down and relax, knowing full well that she considered sitting down in idleness a complete waste of time.
From the front bay window they watched the ambulance kick up dirt in the drive. Naomi and Woody looked at each other as they had many years prior. The look of a loving couple who would be separated. The same uncertain gaze they shared when his plane left for multiple tours abroad. Woody was barely twenty when he signed up. No one in town knew what Woody had accomplished in his years of service. Naomi was his last living confidant, and she would never tell.
"She wanted to stay home. I should have kept her home" he mumbled to himself as he brought a ragged slipper to his nose. He took a whiff and smiled, remembering all the times Naomi had thrown those slippers in the trash and he later fished them out.
Woody dropped the slipper beside its mate and slid in. Those cigar leather slippers with frayed flannel lining possessed a rather potent odor from fifteen years of wear. They were well past ripe. It was an ongoing joke between them.
"Woodrow Wilson Norwell! If you want to save our marriage then you’d better get rid of those slippers!"
"Save our marriage from what, my bride?" he’d reply with a wink.
Naomi would buy him new replacement slippers each Christmas, then he’d promptly donate them to the church benevolence box each December 26th. They’d always end up on Ernie Melbourne at the county old folk’s home because he and Woody were the only size thirteen feet in town.
But this Christmas there would be no new slippers. Woody went to the living room, sat down in his recliner, and began to weep. He couldn’t forget what he had done. In his concern for his wife’s pain, he had her admitted to the hospital.
They arrived shortly after dark. Naomi was sundowning and even more out of sorts due to breakthrough nerve pain. Woody followed closely as an attendant wheeled his wife into triage.
The pain meds were waning and it was beginning to show. Her lower lip quivered as a hindered grimace replaced the poker face she’d worn since diagnosed six months prior. The nurse asked her where the pain was. "Here," Naomi replied, motioning to her hip.
"…And what number on a scale of one-to-ten, how bad?"
"Eight or maybe nine," replied Naomi, as she held back tears.
"Have you been keeping a pain journal?" asked the nurse.
"No," replied Naomi. "I don’t want to dwell on it, so I haven’t been writing it down."
"Has the pain increased just this evening, or has it been building gradually?"
"Gradually, I suppose."
The nurse looked her up and down, seemingly concerned. "Mrs. Norwell, I’m looking at your chart. Last time we saw you, your weight was a hundred and ten pounds. Can you stand on the scale here for me?"
The nurse gently helped her out of the wheelchair, and reassuringly held the small of Naomi’s back as she stepped up onto the scale. Woody was directly behind.
"Hmmm. Ninety-six." The nurse sighed and cocked her head, furrowing her brow as she snuck a glance of Mimi’s reedy lower limbs. "Fourteen pounds is a lot to lose in two months, Mrs. Norwell. Have you noticed a decline in your appetite?"
Woody interjected, "Her medicines get her stomach bound up so she’s been eating less. Just soup and tea, maybe toast and butter. She’s not hungry much lately." The nurse again smiled, then typed out a few things on a laptop. Woody couldn’t see what she was writing.
"…And on that last visit, you were given localized pain medicine to numb the nerve that your tumor is pressing on. Did that help?"
"Yes. It helped for a couple of days. Could I have that again?"
The nurse replied sympathetically, "I’ll need to consult with the Medicare Compliance Representative and see what therapies are available for you this evening."
Then Woody blurted out the obvious. "Wouldn’t radiation shrink her tumor? That would certainly help with her pain."
"Well, yes, but radiation isn’t generally allocated for patients with advanced cancers."
"Well, it wasn’t advanced six months ago. Why wasn’t she given radiation then?" he queried.
The nurse closed her laptop and got up. "I’ll be back in a minute. Just sit tight. Can I get you a cup of coffee or tea while you wait? I can order one up from the cafeteria." Naomi nodded.
Ten minutes later, a young man in scrubs delivered tepid black tea in a plastic mauve container and two matching shrink wrapped cups. He avoided eye contact with them as he quietly set the tea service on the nurse’s desk then left.
Woody poured Mimi a cup of tea and pulled up a chair. They sat side by side for nearly ten minutes without speaking.
He took her empty hand, held it out and studied it thoroughly. Her skin was beautiful. She’d worn gloves all her life. A stark contrast to his calloused skin covered in broken capillaries and liver spots.
Woody kissed her hand intently then looked upon her face with ardent devotion. She was just as beautiful as that afternoon when his eyes first found her in the theatre. Mimi’s hair was silver now, but held the same soft uniform curls. And her smile, as disarming as ever.
She leaned into him and whispered with a devilish grin, "I feel better. Let’s just go home. I’ll let you rub my back…" But her posture was exposed as trembling hands made waves in her tea.
He patted her knee, "Let’s just see what they have to say, Mimi. You haven’t been eating much this week and you’ve been so quiet and sad. Maybe your pain meds just aren’t working anymore and you need to try something stronger…"
The nurse finally returned with a coworker dressed in a trim suit and heels. The women stepped inside the examining room, each wearing an empathetic smile and exceedingly warm bedside manner.
"Hello Mr. and Mrs. Norwell, I’m Joyce M., the Medicare Compliance Officer for this hospital. I’d like to discuss pain management for the stage of the disease you are currently in."
The nurse picked up the tray with half-empty cups "Are we done?".
"Yes, thank you." Woody replied.
The nurse then stepped out, leaving the door cracked.
Joyce M. rolled the physician’s chair over and sat down close to Naomi. She opened her laptop to scroll through Mimi’s medical history. "Would you mind answering a few questions for me?" Mimi didn’t answer. She was intimidated by the formalities of the suit, the polished bun in her hair, and corresponding makeup.
"Mrs. Norwell, you are eighty, is that correct?" she asked kindly.
"Yes." Naomi replied quietly.
"And you’ve been on Oxycodone and Ibuprofen as needed for chronic pain?"
"You’re significantly underweight, Mrs. Norwell. Stronger narcotics can have some nasty side effects if you’re not eating well. Have you had any trouble breathing?"
"I can’t recall," Mimi replied uncomfortably.
Joyce M. hammered out what seemed to be a paragraph, then asked, "Would you say the pain you’re experiencing this evening is more or less intense than previously experienced before?"
"More," she mumbled, embarrassed.
"Would you consider it to be ‘breakthrough’ pain? Meaning that your current pain relief meds are ineffective?"
"Yes, it’s been harder the past couple of days. But, I’ll be better once I get home… Unless there is something stronger I could I take."
"Mrs. Norwell, I’m so sorry, but, we only have access to limited quantities of the heavier narcotics. Most of which go to the People’s Hospice Program…"
"You mean, people who are dying?"
"Yes, but previously hospice was pain comfort and support services for the terminal patient. It served it’s purpose very well for the time. But, there was a distinct problem with the term ‘terminal’. It can’t be quantified. It varied from weeks to months to sometimes a year. These traditional hospice programs were very expensive to Medicare and actually extended the dying period, forcing suffering patients to live longer, and that’s just not compassionate care. The new People’s Hospice Program is against forcing a dying patient who is suffering to continue to live. Our new socialized form of hospice is end-of-life care for patients who are actively dying. It is patient-centric. Managing the pain until the patient resigns to remove the pain altogether…"
"I am actively dying. My doctor says I have eight weeks or less…Wouldn’t I qualify for pain management in the new hospice program?
"Yes, you would, if the only qualifier was your stage of disease. But, Mrs. Norwell, there is the issue of your age. Socialized hospice services are reserved for patients under seventy who are actively dying…"
Woody interrupted Joyce M. "Are you telling me that because my wife is over seventy that she does not qualify for pain management programs for the dying?"
"Not entirely, Mr. Norwell. Your wife’s age is certainly a disqualifier but you are free to petition for an exemption. My primary concern is your wife’s recent decline and weight loss. Additional narcotics could kill her if she is malnourished. We need to be mindful of others who could go without pain relief because a mature declining patient continued services…even at the risk of her own health…"
"Since when are pain meds rationed?"
"Mr. Norwell, please try to understand. Our government purchases a certain amount of medicine and related supplies for the entire country each year. This includes all medicines…Antibiotics, heart meds, diabetic strips, compression hose…Everything. Any additional needs must be purchased privately through an outside vendor."
"What, like the pharmaceutical companies?"
"We don’t have those in the U.S. anymore. They were phased out when our medical delivery systems were federalized…"
"Can I call a pharmacy in Canada for pain medicine for my wife?"
"Well, no, because it’s illegal to bring or ship narcotics into the U.S."
"So, I can’t order from an outside vendor is what you’re telling me?"
Woody’s voice was heated. But Joyce M. remained monotone with the same static grin.
Mimi was increasingly unsettled by Joyce M.’s confident tone and verbage. Joyce M. was just confirming what Mimi had feared when Woody picked up that bedside phone and dialed.
While Woody sat there, stewing, Mimi considered what was being asked of her. She thought about the attitudes that the younger people have towards older folks these days. How some younger politicians have even suggested seizing the assets of seniors to pay down the national debt. Programs for the aged had diminished in favor of federally funded university tuition and the Younger Workers Act. Old folks were considered a burden, and youth, a kind of currency.
Mimi reduced her voice to a mere murmur. "What would you call my condition if I don’t qualify as actively dying?" she asked respectfully.
"Failure to thrive," Joyce M. replied softly.
"Isn’t that what they call sickly babies?"
"It is, but the term is now used routinely with mature adults as well. The difference is that babies have a probable chance of recovering. Their healthy cells are still capable of multiplying rapidly. But, an aging person’s cells are dying faster then they can be replaced by new ones. The government uses cellular theory to determine reasonable treatment in each age-defined cohort group. It’s a very complicated mathematical formula and every possible criteria is considered so that service delivery remains fair to all."
Joyce M.’s knowledge and charisma was hard to dispute. And although what Joyce M. said initially felt wrong to Mimi, Joyce M. seemed like a very decent person. Besides, Mimi didn’t want to seem as if she didn’t care about anyone but herself.
Perhaps this was just modern, civilized thinking. Maybe it was better than being in pain or worse, cheerless, confused and slowly starving to death. Mimi had lived a very full life. She sat quietly with her hands folded on her lap, apathetic to her own demise.
Joyce M. sensed Mimi’s surrender. She leaned in and put her hand on Mimi’s forearm then whispered quietly, "It’s good of you to consider those who haven’t had the chance to enjoy life yet, Mrs. Norwell. We’ll replace your pain with tranquility this evening through euthanasia. Your suffering will end immediately, painlessly…" Naomi kept quiet, not wanting to upset Woody, who would surely object.
Woody stood up. "I’m not listening to this horseshit!" he furied. "I’m taking her home. We’ll figure this out on our own!" He grabbed the handles on the wheelchair and pushed his wife toward the door of the examining room.
Joyce M.’s warm smile straightened out as she addressed Woody, "Please Mr. Norwell, it’s the right thing to do."
Woody protested. "I would have just kept her home had I known this was your idea of pain treatment!"
"Now sir, if you can’t control yourself then you will not be allowed to participate."
"Participate?" he asked, shouting.
"Yes. You will be permitted to be present if you can be reasonable."
"I’m taking her home!" He thundered.
"I’m sorry sir, but you will need to leave the room. We can’t have you upsetting your wife or the other patients." Joyce M. reached under her blazer, pulled out her cell phone and dialed a short number sequence. Armed agents surfaced and physically escorted Woody to the elevator. Just after they stepped in, Woody was overcome with anxiety and fell to the floor.
The smell of spray disinfectants permeated his nasal passages. He woke up coughing and slumped over in a metal chair. The long hallway was void of decor, excepting the strange quotes stenciled on the walls in a frilly font, "A Gentle Death With Dignity", "Protecting the Rights of the Terminally Ill", and "Merciful Care."
The hall had no inhabitants. No nurses station. No emergency call boxes. Woody looked around for someone to help him find Naomi. He stood up then braced himself on the metal chair, again overcome with dizziness.
Still reeling, Woody reached for the door across the hall when he heard mumbling inside the room. It was locked. He tried to calm himself, to appear less agitated so he might convince Joyce M. that his wife should go home. He stood there determining what to do next when he heard footsteps approaching from the opposite end of the corridor. It was the nurse from earlier.
"Is my wife in there?" he pleaded. "I need to see her. I need to take her home."
"Now Mr. Norwell, I’m sorry but you will need to stay out here in the hall. She’s signing papers now then the procedure will take place directly after. You’ll be allowed to see her after she’s entered into clinically induced sleep."
"Clinically induced sleep? She’s clinically depressed! She’s in no shape to be signing papers that relinquish her right to live!" he pleaded, "Once her pain is under control she’ll be back in her right mind. Please, she wants to go home. Don’t do this."
"Mr. Norwell, I’ll be back in a few minutes. You’ll be permitted a visit with your wife then. I’m sorry." The nurse continued down the hall, her heavy clogs meeting the tile with the cadence of a second hand.
As the seconds slipped away, Woody remembered all of the years that Naomi took care of him. How she gently brought him out of the dark after each deployment. How she nurtured his spirit through her prayers. How she cared for his body, torn in the jungles of Asia. And how she restored his soul, pushing him to pursue his Maker.
He sat there, quietly, mournfully. How would they kill her? Would she feel it? Was she afraid? The guilt he felt crushed his chest as seconds fell into minutes.
Woody put his hand to the door, whimpering her name. He needed to be with her. He couldn’t let her die, certainly not with strangers.
"Mimi? Honey, please. We still have time. Don’t go like this. Mimi? Can you hear me? Please open the door, honey. Let me in. Sweetheart? Please let me in."
Woody paused and put his ear to the door. But the only sound was his own fatigue. No response from inside the still room.
It was over.
He sat down and closed his eyes, not believing what had happened. How she who had so generously given of herself was cast aside in old age because she seemingly had nothing left to offer, because she was dependent. And how their love story, a lifetime of relished codependency, would end with her hastened death.
The door opened and the unaffected physician stepped out to meet with Woody.
"Mr. Norwell, your wife went very bravely and peacefully. She did very well. You may see her now."
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