Rules Get Broken (9 page)

“First floor lobby, sir,” answered the hospital orderly.

“Thanks. I’ll go there after we get my wife to her room. I assume that’s okay?”

“Yes sir, you can do that,” the orderly replied crisply.

He turned to our driver as soon as Peg’s gurney was out of the ambulance and onto the cobblestones. “Does the lady need a gurney, or is the wheelchair all right?”

“The wheelchair will be fine,” the driver answered. “We brought her down to the ambulance this morning in a chair. That’s okay, isn’t it, Mrs. Herbert?”

“That’s fine,” Peg said, speaking for the first time since we had turned into the cobblestone alley. “I don’t really even need the wheelchair.”

“Oh yes you do, ma’am,” the orderly quickly said with a laugh. “Hospital rules say you’ve got to be in a chair or on a gurney.”

While the orderly was helping Peg slide off the ambulance gurney and into the chair, the attendant got out of the ambulance and walked back to me with Peg’s overnight bag in one hand and a large, thick manila envelope in the other. “Mr. Herbert,” she said, “don’t forget your wife’s suitcase and her hospital paperwork. I’m pretty sure the attending physician here is going to want to see Mrs. Herbert’s test results and all.”

“Thank you for remembering,” I said with relief. “I forgot all about them.”

“Well, you’ve got a lot on your mind today,” she replied over her shoulder as she climbed back up into the ambulance.

“Got that right,” the hospital orderly agreed. “We all set now?”

“We’re set if you are,” I answered, trying not to let my growing anxiety show.

He deftly turned the wheelchair around in spite of the rough cobblestones and began to wheel Peg inside. I quickly extended my hand to the driver, thanked him for his help and caught up with Peg and the orderly.

We passed along one side of the emergency room, thankfully empty at this hour of the morning, and reached a bank of elevators. The orderly wheeled Peg into one, held the door open for me and two other people, punched the third and fourth floor for them at their request, and then punched nine for us.

“Floors seven through nine are for cancer patients,” he volunteered when the second of the two people who had gotten on with us left the elevator. “Floor seven is the pediatric cancer ward; floors eight and nine are for the adults. Mrs. Herbert will be on nine.”

A cancer ward
, I thought.
How in God’s name did we wind up here? In a cancer ward!

I reached out and touched Peg’s shoulder. In an instant her hand came up to mine, and she lightly squeezed my fingers. Somehow I knew she was wondering the same thing.

The elevator doors slid open, and the orderly signaled me to step out first. I did as he asked and found myself at the end of a long corridor with dark brown linoleum floor tiles, beige concrete walls and a high, vaulted concrete ceiling that had once been white. Ornate dark bronze lighting fixtures, each supporting five large milky-white glass globes, hung from the center of the ceiling every sixty or seventy feet.

God, this place is old
, I thought, looking down the length of the corridor.
Look at the ceiling height. Don’t see that anymore. And the walls must be a foot thick. Built like a fortress. But God, it’s old.

I waited until the orderly had wheeled Peg out of the elevator and then followed him a couple hundred feet down to a nurse’s station. He brought the wheelchair to a stop, walked over to one of the nurses and said something to her. She looked at Peg and me while he was speaking and then at a clipboard on her desk. Apparently finding what she was looking for, she pushed back her chair and came out to greet us.

“Good morning, Mrs. Herbert,” she said warmly, extending her hand first to Peg and then to me. “And good morning to you, Mr. Herbert. My name is Janet Reinart. I’m the head day nurse. We’ve been expecting you, Mrs. Herbert, and your room is all ready for you.

“This way, Jerry,” she said to the orderly over her shoulder, and she started to walk down the corridor back towards the elevators. Then she stopped and pushed open a heavy oak door on the right side of the hall.

“Here we are,” she announced cheerfully. She stepped aside to allow the orderly to wheel Peg into the room. I followed the orderly, and Janet followed me.

While Janet and the orderly helped Peg into bed, I looked around at what was to be Peg’s new home for as long as it took for her to get well. The room was on the east side of the building and, thanks to three over-sized double-hung windows, offered a wonderful view of the East River and of Queens and Brooklyn beyond. The bed was placed against the south wall, and a large corkboard hung on the north wall at the foot of the bed. The ceiling was at least twelve feet high, and a lighting fixture with a single glass globe hung from its center. Off-white walls, ceiling, and vinyl floor tiles made the room bright but stark.

“I’ll bring in some pictures of the kids tomorrow,” I said after the nurse and the orderly had left the room and as I was taking Peg’s things out of her overnight bag. “This place needs a little decorating, a little softening, don’t you think?”

“I’m hoping I’m not going to be here long enough for that to matter,” Peg said, her voice suddenly quivering.

“I’m sorry,” I said, seeing the terror-stricken look on her face and realizing how she had taken my comment. “I didn’t mean to imply that. I just meant…”

“I know. I know,” Peg replied, waving my words away as she reached for a tissue. “I’m just scared to death that I’ll never get out of this room alive, John.”

“You’re going to get well in this room, sweetheart,” I assured her. “Not die in it. And you’re going to walk out that door, healthy again, and come home to Jennie and John and me. Believe me.”

I wrapped my arms around her, and she buried her face in my chest and began to cry.

“I don’t want to die,” Peg whimpered into my shirt. “I just don’t want to die.”

He came in without knocking and was halfway across the room before Peg or I realized he was there.

“Mrs. Herbert,” he announced, “I’m Dr. Werner, Chief of Blood Oncology here at New York Hospital.”

Before Peg could respond, he turned to me and gave me a quick nod, acknowledging that he was introducing himself to me as well. “Mr. Herbert.”

We each muttered a quiet hello, almost simultaneously, and waited for him to continue. But instead of saying anything more, he opened the manila envelope containing the record of Peg’s stay at Huntington Hospital and stood next to her bed for several minutes, silently reviewing its contents.

He was a wiry man, medium height, about five-eight, probably forty-five or fifty years old, and his hair was salt and pepper. He came across as an intense man, and from the way he skimmed through Peg’s file, I could tell that he was a man in a hurry. He didn’t smile, and he made no attempt at warmth. When he was finished, he slid the folder back into the envelope and threw the envelope down onto the bed in what I took to be a disdainful gesture.

“So,” he began, “welcome to New York Hospital. I trust your trip in this morning was uneventful?”

“It was fine, thank you,” Peg replied uneasily.

“Good. Well, I see Dr. Goldstein ordered the standard range of tests. Unfortunately, we’re going to have to do most of them again so I can be absolutely certain we’re working with accurate information. I’ll try to avoid taking another bone marrow sample, because I know that’s a very uncomfortable procedure. But whether that’s possible will depend on the quality of Huntington Hospital’s slides. If they’re not as good as we need, then we’ll have to take another sample.”

He stopped talking for a second and looked at the bandage on Peg’s shoulder. “Sometime this afternoon I’ll remove that central line. I don’t know what Dr. Goldstein had in mind when he installed it, but there’s no need for one as far as I’m concerned.”

He looked at his watch. “It’s ten-forty now. We probably won’t be able to start any procedures until after lunch, but I’ll write up the orders now, and that should let us get started early this afternoon. If Dr. Goldstein’s diagnosis is correct, the treatment regimen, as I presume you know, will be a form of chemotherapy, which we should be able to start sometime tomorrow. Questions?”

Somehow the tone of his voice made it clear we shouldn’t have any and that he wouldn’t be thrilled about answering them if we did. But suddenly, his behavior changed completely, almost as if controlled by a switch, and he let a small smile creep across his face as he looked down at Peg.

“You must be very scared, Mrs. Herbert,” he said softly, “but I want you to know that you’re in one of the finest hospitals in this country staffed by some of the finest physicians in this country, and we’re going to do everything humanly possible to make certain you walk out of here a healthy lady. You just remember that, okay?”

“I will,” Peg murmured.

“Good. I’ll see you this afternoon then.”

He patted her shoulder, and I found myself wondering which Dr. Werner was the real Dr. Werner. He picked up Peg’s envelope from the foot of the bed, turned around abruptly and walked towards the door.

“Have a good day, Mr. Herbert,” he added as an obvious afterthought, and he closed the door behind him.

Neither Peg nor I said anything for a moment or two. We just stared at the door, half expecting him to come back and continue what had been an all-too-brief introduction.

“Well,” I finally said when it was obvious we were alone, “Mr. Personality he’s not, is he?”

“No, he isn’t,” Peg answered with a faint smile. “But then again, that’s not why we’re here, is it? For jokes, I have you.”

I gave a little chuckle. “Yeah, for jokes you have me. Seriously though,” I said, looking over my shoulder at the closed door, “are you okay with him?”

“First of all,” Peg replied, “what choice do we have now? We can’t go back to Huntington Hospital, can we? So we’re committed to New York Hospital and to Dr. Werner. And yes, I’m okay with him if he can make it possible for me to come home to you and my children. If he can do that, he could be Attila the Hun for all I care.”

I looked at Peg for several seconds, wondering what to say. And as I did, I realized her eyes were telling me everything she was feeling at that moment—sadness, fear, resignation. But perhaps most importantly, resolve. The look in her eyes told me she was getting ready to fight. As far as she was concerned, Dr. Werner’s brief visit had been akin to a referee’s instructions before a bout. And for her, the bell for round one was going to ring sometime early that afternoon.

It is said that one can get used to anything. There was a time when I would have taken exception to that maxim, but Peg’s ordeal at New York Hospital proved the adage to be true as we quickly settled into a routine that, if not comfortable, was at least workable.

My first step was to move into one of my parents’ guest rooms so I could spend at least a few minutes each day with Jennie and John. I stopped all overnight business travel and started leaving work every afternoon at three so I could be at the hospital by four-thirty. I stayed with Peg every night until seven-thirty and then drove back to Long Island. Occasionally I arrived home in time to see Jennie before she went to bed, but I saw John only in the mornings at breakfast.

My mother always had a hot dinner ready for me no matter what time I came home, and she and my father would sit with me while I ate and gave them the latest report on Peg’s condition. After I had eaten, the three of us would watch the ten o’clock news on Channel 5 and go to bed. Every day the routine was the same.

The shortened workday took a toll immediately, so I brought my office paperwork with me when I visited Peg. This worked rather well for the first few days and enabled me to keep up with most of my work. But by Thursday, August 7th, as the chemotherapy progressed, I found myself spending more time tending to Peg than to the paperwork. On Tuesday, August 12th, I opened the first of two briefcases only after she had fallen asleep and shortly before I left for home. And on Wednesday, August 13th, I realized I was kidding myself. When I left for the hospital at three o’clock that afternoon, I left my desk piled high with unseen reports, unanswered memos and unread mail. The briefcases stayed in my office closet.

The chemotherapy was brutal. Day after day the IV tube dripped poison into Peg’s body; poison intended to kill her cancerous bone marrow—hopefully at a faster rate than the poison was killing her. It penetrated every cell in her body and killed not only cancer cells, but also good, healthy cells, including white blood cells, the cells that defend us from attacks by bacteria, mold spores, fungus spores and all sorts of other invaders. With fewer and fewer white cells in her blood to ward off these attacks, Peg became increasingly vulnerable to the infectious agents that surround each of us every day.

As a result, Peg developed fungal infections, which in less than two hours progressed from a single black spot on her tongue or roof of her mouth to a growth large enough to cause her difficulty speaking or swallowing. She developed bacterial urinary tract infections so painful she was barely able to urinate without crying out in pain, and vaginal fungal infections—each in turn or simultaneously appearing as if from nowhere and rapidly blossoming into full-scale attacks.

The bacterial infections brought fevers. In less than thirty minutes, Peg’s temperature would soar from normal to over one hundred two and a half as the bacterial attack of the moment progressed, unchallenged by defending white blood cells. As soon as her temperature began to rise, an antibiotic drip was added to the chemo drip. Sometimes the antibiotics worked rapidly, and within twenty or thirty minutes Peg’s temperature would start to drop. Sometimes the antibiotics worked more slowly, and the fever would persist for several hours. And sometimes they didn’t seem to work at all—capable of holding the offending bacteria at bay but incapable of overcoming them—and the fever would remain, unabated.

Whenever this happened, if the attending physician decided the fever couldn’t be allowed to remain at its current level any longer, Peg was placed on a chill blanket, a contraption that matched the barbarity of chemotherapy, but mechanically rather than chemically. The chill blanket was basically a rubber pad interlaced with tubing through which water ran, refrigerated by a stand-alone chilling unit brought into the patient’s room. The patient was placed on this ice cold rubber pad, usually naked, in the hope that mechanical refrigeration would accomplish what antibiotics could not—reduction of the fever.