Life Support (7 page)

She took another stitch and drew the suture through his skin. "The old guy cut pretty deep," she said. "You're lucky he missed your eye."

"I think he was trying for my throat."

"And he's on round-the-clock sedation?" She shook her head. "You'd better double the dose and keep him locked up."

"He usually is. We keep the Alzheimer's patients in a separate ward, where we can control their movements. I guess Mr. Hackett slipped out.

And you know, sometimes those old guys can't handle the libido. The self-control's gone, but the body's still willing."

Toby snipped off the needle and tied the last stitch. The wound was closed now, and she began wiping the site with alcohol. "What protocol is he on?" she asked.

"Hen?"

"The nurse said Mr. Hackett was on some kind of protocol."

"Oh. It's something Wallenberg's testing. Hormone injections in elderly men."

"For what purpose?"

"The fountain of youth, what else? We've got a wealthy clientele, and most of them want to live forever. They're all eager to volunteer for the latest treatment fad." He sat up on the side of the table and gave his head a shake, as though to dispel a sudden rush of dizziness. Toby thought with sudden panic, The bigger they are, the harder they fall.

And the harder they are to pick up off the floor.

"Lie back down," she said. "You got up too fast."

"I'm fine. I've gotta get back to work."

"No, you sit there, okay? Or you'll fall and I'll just have to stitch up the other side of your face."

"Another scar," he grunted. "More character."

"You're already a character, Dr. Brace."

He smiled, but his gaze looked a little unfocused. Warily she watched him for a moment, ready to catch him if he passed out, but he managed to stay upright.

"So tell me more about the protocol," she said. "Which hormones is Wallenberg injecting?"

"It's a cocktail. Growth hormone. Testosterone. DHEA. A few others.

There's plenty of research to back it all up."

"I know growth hormone increases muscle mass in the elderly. But I haven't seen many studies using it in combination."

"It makes sense though, doesn't it? As you get older, your pituitary starts to fade out. Doesn't produce all those juicy young hormones. The theory is, that's the reason we age. Our hormones conk out."

"So Wallenberg replaces them."

"It seems to be having some effect. Look at Mr. Hackett. Plenty of get up and go."

"Too much. Why're you giving hormones to an Alzheimer's patient? He can't give consent."

"He probably gave consent years ago, while he was still competent."

"The study's been going on that long?"

"Wallenberg's research dates back to 92. Check out the Index Medicus.

You'll see his name pop up on a dozen published papers. Everyone working in geriatrics knows Wallenberg's name." Gingerly he lowered himself from the table. After a moment, he nodded. "Steady as a rock.

So when do these stitches come out?"

"Five days."

"And when do I get the bill?"

She smiled. "No bill. Just do me a favor."

"Uh, oh."

"Look up Harry Slotkin's medical record. Call me if there's anything I should know. If there's anything I might have missed."

"You think you might have missed something?"

"I don't know. But I hate screwing up, I really do. Harry may be lucid enough to find his way back to Brant Hill. Maybe even to his wife's room. Keep an eye out for him."

"I'll tell the nurses."

"He shouldn't be hard to miss." She reached for her purse. "He's not wearing a stitch of clothes."

Toby pulled into her driveway, parked next to Bryan's Honda, and turned off the engine. She didn't climb out of her car but simply sat there for a moment, listening to the tick-tick of the engine cooling off, enjoying these quiet moments, undisturbed by the demands of others. So many, many demands. She took a deep breath and leaned back against the neck rest.

It was nine-thirty, a quiet hour in this neighborhood of suburban professionals. Couples had left for work, the kids were packed off to school or day care, and houses stood empty, awaiting the arrival of domestics who would vacuum and scrub and then vanish, leaving behind their telltale scent of lemon wax. It was a safe neighborhood of well-tended homes, not the most elegant section of Newton, but it satisfied After the unpredictability of a shift in the ERa manicured lawn had its attractions.

Down the street, a leaf blower suddenly roared to life. Her moment of silence had ended. The yard service trucks had begun their daily invasion of the neighborhood.

Reluctantly she stepped out of the Mercedes and climbed the porch steps.

Bryan, her mother's hired companion, was already waiting at the front door, arms crossed, eyes narrowed in reproval. He was jockey size, a trim young man in miniature, but he presented an imposing barrier.

"Your mama's been bouncing off the walls this morning," he said. "You shouldn't do this to her."

"Didn't you tell her I'd be late getting home?"

"Doesn't do any good. You know she can't understand. She expects you home early, and when you don't get here, she does her thing at the windows. You know, back and forth, back and forth, watching for your car."

"I'm sorry, Bryan. It couldn't be helped." Toby walked past him, into the house and set her purse down on the hall table. She took her time hanging up her jacket, thinking, Don't get annoyed. Don't lose your temper. You need him. Mom needs him.

"It doesn't matter to me if you're two hours late," he said. "I get paid. I get paid a lot, thank you very much. But your mama, poor thing, she doesn't get it."

"We had some problems at work."

"She wouldn't touch her breakfast. So now she's got a plate of cold eggs."

Toby shut the closet door, hard. "I will make her another breakfast. " There was a silence.

She stood with her back to him, her hand still pressed to the closet, thinking, I didn't mean to sound so angry. But I'm tired. I'm so very tired.

"Well," said Bryan, and in that one word he communicated everything.

Hurt. Withdrawal.

She turned to face him. They had known each other for two years now, yet they had never gone beyond the relationship of employer-employee, had never crossed that barrier into real friendship.

She'd never visited his house, had never met Noel, the man with whom he lived. Yet she realized, at that moment, that she had come to depend on Bryan more than she depended on anyone else. He was the one who kept her life sane, and she couldn't afford to lose him.

She said, "I'm sorry. I just can't handle another crisis right now.

I've had a really shitty night."

"What happened?"

"We lost two patients. In one hour. And I'm feeling pretty awful about it. I didn't mean to take it out on you."

He gave a slight nod, a grudging acceptance of her apology.

"And how was your night?" she asked.

"She slept all the way through. I just took her out to the garden. That always seems to quiet her down."

"I hope she hasn't picked all the lettuce."

"I hate to break this to you, but your lettuce went to seed a month ago."

All right, so I'm a failure as a gardener too, thought Toby as she headed through the kitchen to the back door. Every year, with high hopes, she started a vegetable patch. She would plant rows of lettuce and zucchini and green beans, would successfully nurture them along to seedling stage. Then, inevitably, her life would get too busy and she'd neglect the garden. The lettuce would bolt, and the beans would hang yellow and woody from the vines. In disgust she'd yank it all out and promise herself a better garden next year, knowing that the next year would produce only another crop of zucchinis as inedible as baseball bats.

She stepped outside into the yard. At first she didn't see her mother.

The summer flower garden had grown into a weedy jungle of chin-high flowers and vines. There had always been a pleasant randomness to this garden, as though the beds had been dug with no plan in mind, but rather had been expanded by the original gardener's whim, season by season.

When Toby had bought the house eight years ago, she'd planned to tear out the more unruly plants, to ruthlessly enforce some form of horticultural discipline. It was I Ellen who'd talked her out of it, Ellen who'd explained that, in the garden, disorder was to be cherished.

Now Toby stood by the back door, surveying a yard so overgrown she could not even see the brick pathway. Something rustled among the flower stalks, and a straw hat bobbed into view. It was Ellen, crawling on her knees in the dirt.

"Mom, I'm home."

The straw hat tipped up, revealing Ellen Harper's round, sunburned face. She saw her daughter and waved, something dangling from her hand.

As Toby crossed the yard and stepped through the tangle of vines, her mother rose to her feet, and Toby saw that she was clutching a fistful of dandelions. It was one of the ironies of Ellen's illness that although she had forgotten so many things� how to cook, how to bathe herself�she had not forgotten, would probably never forget, how to distinguish a weed from a flower.

"Bryan says you haven't eaten yet," said Toby.

"No, I think I did. Didn't I?"

"Well, I'm going to make some breakfast. Why don't you come inside and eat with me?"

"But I have so much work to do." Sighing, Ellen looked around at the flower beds. "I never seem to get it all done. You see these things here? These bad things?" She waved the limp plants she was holding.

"Those are dandelions."

"Yes. Well, these things are taking over. If I don't pull them up, they'll get into those purple things over there. What do you call them . . ."

"The purple flowers? I really don't know, Mom."

"Anyway, there's only so much room, then things have to be cleaned out.

It's a fight for more room. I have so much work, and I never have enough time." She gazed around the garden, her cheeks ruddy from the sun. So much to do, never enough time. That was Ellen's mantra, a recurrent loop of words that remained intact while the rest of her memory disintegrated. Why had that particular phrase persisted in Ellen's mind?

Had her life as a widowed mother of two girls been so stamped by the pressures of time, of tasks undone?

Ellen dropped back to her knees and began rooting around in the dirt again. For what, Toby didn't know, perhaps more of those hated dandelions. Toby looked up and saw that the sky was cloudless, the day pleasantly warm. Ellen would be fine out here, unsupervised. The gate was locked, and she seemed content. This was their routine during the summertime. Toby would make her mother a sandwich and leave it on the kitchen countertop, and then she would go to bed. At four in the afternoon, she'd wake up, and she and Ellen would eat supper together.

She heard the rattle of Bryan's car driving away. At six-thirty he would be back to stay with Ellen for the night. And Toby would leave, once again, for her usual shift at the hospital.

So much to do, never enough time. It was becoming Toby's mantra as well. Like mother, like daughter, never enough time.

She took a deep breath and slowly released it. The adrenaline from this morning's crisis had worn off, and now she felt the fatigue weighing down on her like so many stones on her shoulders. She knew she should go straight up to bed, but she couldn't seem to move. Instead she stood watching her mother, thinking how young Ellen looked, not elderly at all, but more like a round-faced girl in a floppy hat. A girl happily making mud pies in the garden.

I'm the mother now, thought Toby. And like any mother, she was suddenly aware of how quickly time passed, moments passed.

She knelt down beside her mother in the dirt.

Ellen looked sideways at her, a trace of bewilderment in her light blue eyes. "Do you need something, dear?" she asked.

"No, Mom. I just thought I'd help you pull a few weeds."

"Oh." Ellen smiled and lifted a dirt-stained hand to stroke back a tendril of hair off Toby's cheek. "Are you certain you know which ones to pull?"

"Why don't you show me?"

"Here." Gently, Ellen guided Toby's hand to a clump of green. "You can start with these."

And, side by side, mother and daughter knelt in the dirt and began to pull dandelions.

I Angus Parmenter turned up the speed on the treadmill and felt the moving belt give a little jerk under his feet. He accelerated his stride to a brisk six miles per hour. His pulse sped up as well, he could see it on the digital readout, mounted on the treadmill handgrips. 112. 116.

120. Had to get that heart rate up, the blood flowing. Push yourself!

Oxygen in, oxygen out. Get those muscles pumping.

On the movie screen mounted in front of him, the "boredombuster" video played scenes from the cobbled streets of a Greek village. But his gaze remained focused on the digital readout. He watched his pulse climb to 130. At last, target heart rate. He would try to keep it there for the next twenty minutes, give himself a good aerobic workout.

Then he would cool down, letting his pulse gradually drop to a hundred, then eighty, then down to his usual resting pulse of sixty-eight. After that, it was time for a session on the Nautilus, an upper-body workout, and afterward he'd hit the showers. By then it would be time for lunch, a low-fat, high protein, high-roughage meal served in the country club dining room. With the meal would come a few of his daily pills, vitamin E, vitamin C, zinc, selenium. An arsenal of magic remedies to keep the years at bay.

It all seemed to be working. At eighty-two years old, Angus Parmenter had never felt better in his life. And he was enjoying the fruits of his labors. He had worked hard for his fortune, harder than any of these whining kids would ever work in their lives. He had money, and he intended to live long enough to spend it, every last goddamn penny. Let the next generation earn their own fortunes. This was his time to play.

After lunch, there'd be a round of golf with Phil Dorr and Jim Bigelow, his friendly rivals. Then he had the option of riding the Brant Hill van into the city. Tonight they were planning a trip to the Wang Center for a performance of Cats. He'd probably skip that one. All those ladies might go wild over singing kitty cats, but not him, he'd seen the show on Broadway, and once was more than enough.