Of course, as letdowns went, Beryl was in a class by herself. An additional $8,300 per month for their father’s nursing home was accelerating the ravagement of Shep’s resources. Even assuming that he was hardhearted enough to contemplate such a prospect, the Merrill Lynch account was now much too depleted to finance a solo retirement to Pemba or anywhere else. The issue was now covering the co-pays, co-insurance, and prescription charges for Glynis’s treatment, period. So on the phone with Beryl in early November he hazarded the notion that they might have to start thinking about transferring their father from Twilight Glens to a public home. He might as well have suggested sending the man to Auschwitz.
“Those public homes are cesspools!” Beryl shrieked. “They let you lie for days in your own shit, and then you get bedsores. Public homes are always understaffed, and the nurses are sadistic. The food is awful, if you’re lucky enough to get any, since some of these biddies are so neglected that they starve to death. You can forget any facilities like at Twilight—no rec rooms, no physical therapy machines. They don’t have any events—no classes, no sing-alongs. Maybe a few magazines, and that’s about it.”
“Well, besides a steady supply of detective novels, about all Dad really requires is a stack of newspapers and a pair of scissors.”
“But these public places are like Dumpsters for the elderly! Old ladies in wheelchairs slumped in hallways with their mouths open, drooling on their nighties and mumbling about how tonight they’re going to the prom with Danny because they think it’s still 1943. You’d do that to your own father? He’d never forgive you, and neither would I.”
Personally Shep suspected that the difference between public and private care was exaggerated. He’d seen plenty of dementia at Twilight, and plenty of drool there, too. Unless he was leading the congregation in a rendition of the Doxology, Gabriel Knacker would never participate in any “sing-along” in the most palatial of institutions. Nevertheless, Beryl’s grim image had popular currency. So he’d not have minded that she conjured the stereotype had it truly been fear for their father’s misery that had brought the picture to life. Nor would he have minded her insisting so strenuously on continuing private care if Beryl were helping to pay for it.
He did mind that her righteous defense of their father’s comfort hailed from somewhere else. The sole purpose of the transfer he’d suggested was to shift the fiscal burden to the public purse. It was his own fault that she knew the sequence of events that would accomplish this modern financial miracle, because he’d told her himself in July. To qualify Dad for Medicaid, first and foremost they’d have to sell the house. Or, as she surely alluded to the structure out of his hearing, her house. (Maybe Jackson’s idea was technically feasible: simply refusing to pay Twilight and letting the cogs of bureaucracy creak along until the government seized the property. After all, to his quiet amazement, Shep and Beryl had no legal obligation to care for their father or to pay his bills. Yet that wasn’t the way Shep Knacker had ever conducted his affairs. Walking out on his obligations and expecting someone else to clean up the mess seemed sloppy, disrespectful, negligent, and irresponsible. He was, Shep thought wryly, who he was.) The proceeds of the property sale would go to nursing home fees until their father was officially indigent. Bye-bye free digs, bye-bye inheritance—and that was the source of the outrage piping through the telephone.
Still, Shep lacked the resolve to fight her. He had his own misgivings about public nursing homes, and a strong sense of filial duty. Twilight was probably nicer. Dad might not have liked it there much, but he was at least getting used to it. Besides, were Shep to keep hemorrhaging $99,600 per annum a juncture would rapidly arrive at which he would not pay for Twilight not because he was a bad son but because he did not have the money. Obviously, it was wasteful to spend down his own last remaining dime before ending up in the exact same place: shifting Dad out of Twilight, liquidating the pension fund, selling the house. Yet in its simplicity, perfect helplessness might prove a blessing. Jackson was surely right, that in a country that confiscated up to half of your earnings, and that demanded an additional backhander every time you did anything from buy a screwdriver to go fishing, you were not truly free. But in that case, there was a genuine liberty to be found in going broke.
Meanwhile, Shep tried to talk to his father roughly twice a week. The broken femur seemed to be mending, slowly. But for the first half of November the phone at his father’s bedside rang unanswered. Rather than talk directly to Twilight staff, he made the mistake of getting the medical lowdown from Beryl. All she said was that he seemed to be losing weight. Or that’s what the staff must have said, since that was the same phone call in which Beryl had announced that she was “on strike.”
“You can’t expect me to keep visiting him all the time. It’s not fair. Just because I’m nearby I shouldn’t have to take on that whole burden. Really, Shep, I’m starting to feel used. I can’t take it. Visiting is too depressing. I have a film to edit, and I have to protect my, you know, chi.”
“How often do you regard as ‘visiting all the time’?”
“I’m just not into it, Shepardo. All I hear about when I do go is why I haven’t been to see him in so long, when it seems like I just saw him, like, that morning. If you think it’s so important for him to enjoy the constant attentions of family, you’re going to have to come up here once in a while yourself.”
Shep sighed. “Do you have any idea what I’m dealing with here?”
“We’re both dealing with stuff. And he’s your father, too.”
He reluctantly promised to try to make it back up to New Hampshire soon. As they wrapped up the call, Beryl raised, “Before I forget, what’s the deal with the heating? I just got some, I don’t know, eviction notice type thing from the gas company.”
“I transferred the bill to your name. I’m sure I mentioned that.”
“Well, to my name, fine, but you don’t expect me to pay it?”
He took a deep breath. “Yes, I do.”
“Do you know how much it costs to heat this place during the winter?”
“Of course I do. I’ve been paying the fuel bills for years.”
“Look, I’m doing the house-sitting. House-sitters aren’t expected to cover utilities. Sometimes they’re even paid to take care of places.”
“You want me to put you on salary?” Shep asked incredulously. Beryl had nimbly inverted her co-optation of the family home into a big favor. It was just the kind of ingenuity in his sister that had always wowed him.
“I don’t have the money for the gas bill, period. So unless you want me sitting here with icicles in my nose while I burn the furniture to keep from perishing, you’re going to have to send them a check.”
Beryl had discovered the giddy liberation of penury years ago. He was envious.
Shep headed up to Berlin Thanksgiving weekend, planning only one Saturday overnight. The traffic coming home would be horrific, but at least an evening visit and another Sunday morning during a season of traditional family get-togethers might temporarily alleviate his father’s sense of abandonment.
Twilight Glens was no country club, but it looked clean; perhaps the slight fecal whiff penetrating the astringent disinfectant was inevitable in any facility caring for the old and sick. For that matter, like the blackened Victorian hospital of his childhood, the institution might have benefitted from a few streaks of grime, which would have provided the plain square building a little character. As it was, Twilight had been given an architectural lobotomy. In fact, Shep was impressed. Surely such a perfect dearth of identity constituted as much of an achievement in the physical world as it would have in the social sphere, were an individual to succeed in generating no personality whatsoever. The lobby and hallways were decorated with potted plants and anodyne prints. The linoleum was bright and beige. Private rooms were trimmed in blond polished maple. The effect was dreamscape. After all, some nights your mind simply wasn’t up to contriving one more backdrop with satisfying
symbolism, and Twilight was the kind of non-place where your brain sets forgettable, second-rate adventures: those aimless confabulations with poor logic, distortions of passing acquaintances who don’t matter to you, and frustrated searches for a bathroom.
At least when Shep spotted his father from the hallway, the old man wasn’t catatonic or burbling about his upcoming high school prom, but was propped in bed wearing his reading glasses, intently underscoring a passage in The New York Times. Terrific: business as usual. But when Shep went in and kissed his father’s cheek, he was unnerved. The weight loss was more dramatic than he’d been prepared for. Shep had had enough of living in the fattest country in the world while watching the people he most cared about evaporate.
“What’s the article about?” asked Shep, pulling up a chair. The bedside table was layered with clippings, just as he’d imagined.
“About how much these blasted CEOs are getting paid. Millions, tens of millions a year! It’s obscene. While the rest of the world is starving.” Stahving. Unlike his son, Gabe Knacker had clung gladly to his Hampster accent.
“Yeah, well, in case you’re wondering, I didn’t pay myself tens of millions of dollars a year when I ran Knack.” This was as close as he would come to alluding to Twilight’s price tag, about which his father had never inquired. The Reverend seemed under the convenient illusion that the government was still picking up the tab.
“In my view,” his father growled, “no single human being can be so gosh-darned important” (impahtent) “that he’s worth ten million a year. Not one soul, not even the president. Well—especially this president.”
“But if you think there’s a limit to how much you should pay any one person as a salary,” Shep speculated, “is there also a limit to how much you should pay to keep any one person alive?”
His father grunted, the rivulets in his furrowed forehead deeper and more numerous than in July.
Shep laughed. “I’m sorry. I meant that abstractly. It’s not like Beryl and I are trying to decide whether your existence is cost-effective.”
“I didn’t take it personally. It’s a good question is all. What a life is worth, in dollars. When resources aren’t infinite, which they never are. When money spent on one person isn’t spent on another.”
(Pahsonally … what a life was wahth … resahses aunt infinite … isn’t spent on anuthuh—music to Shep’s ears, in which a N’ Hampshah accent was the very soundtrack of earthiness and probity.)
“It’s not as neat as that,” said Shep. “Like, if Twilight Glens saves five bucks by giving you generic ibuprofen instead of Advil, the money doesn’t end up in Nairobi Hospital. But … the question still bothers me.”
“Glynis.”
“Yes.”
“You don’t have any choice. You have to do everything in your power to help your wife.”
“That is the … expectation.”
“But theoretically,” said his father, sitting up straighter and putting on a display of vigor that Shep hoped was not an act, “how would you arrive at a number? You’re allowed to spend a hundred thousand dollars on a single life, but not a hundred thousand and one?” (The Reverend’s citation of this laughably small figure elicited a wan smile from his son.) “And the wealthy will always be able to circumvent any limits. You cap expenditure on health care, you really only cap it for poor people.”
His father was still sharp, and Shep thought, this is the kind of conversation that I’ll miss when he’s gone.
“More importantly,” Gabriel added, “how is Glynis?”
“The chemo is wearing her down. She’s always angry, and at this point that’s a good sign. It’s when she stops being angry that I’m afraid of.”
“There’s nothing to fear.” Feeyuh. “She’ll have to make her peace: with herself, with you, and with all her friends and family. I know it’s hard to see it this way, but grave illness is an opportunity of sorts. An opportunity you don’t get when you’re run over by a bus. She has a chance to reflect. A chance to turn to God, though I’m not holding my breath for that. Certainly a chance to say all the things that she wouldn’t want to go unsaid before she’s gone. In the strangest way, she’s fortunate. I hope for both your sakes that this is a time you’re very close.”
“I doubt Glynis thinks of cancer as ‘an opportunity.’ Although I’m damned if I know what she does think. She doesn’t talk about it, Dad. As far as I can tell, she still believes she’s undergoing chemo to get better. There’s none of this—saying of last things. Is that normal?”
“In this area, there is no normal.” Nahmal. “And what would it matter if she were abnormal, when that’s the way she is? People hold onto life with more ferocity than you have any idea. Or maybe you do have an idea now.”
“She’s always been so honest. Scathingly so. Frighteningly so. And now, with the biggest thing she’s ever had to be honest about …”
“Remember: you don’t know what it’s like. I may have broken my leg and had a scare,” scayuh, “but I still don’t know what it’s like, either. Neither of us will until it happens to us. You have no idea how you might react. Maybe in the very same way. Withhold thy judgment.” Gabriel’s tone wryly mocked his own sermons, and Shep was glad of any inclination toward the withholding of judgment, with which his father had always cudgeled him in the past.
“There’s one other thing I wanted to ask you,” said Shep. “When you were a minister. You’d have had plenty of dealings with folks who were ill. In your day, were people … good about that? Attentive? Did they stick by each other? And I mean, to the end. The whole ugly, bitter end.”
“Some did, some didn’t. For me, it was my job to stick by them. One of the things the ministry is good for—even if you don’t give it much credence yourself.” The admonishment was almost welcome. It issued from the father he remembered, and in Twilight that was a relief. “Why do you ask?”
“People … her friends, even immediate family. They’ve—lots of them have deserted her. I’m embarrassed for them. And this disappearing act so many folks have pulled, well, it hurts her feelings, even if she pretends that she’s glad to be left alone. I’m very discouraged. I wonder if people have always been so—weak. Disloyal. Spineless.”
“Christians accept a duty to care for the sick. Most of my parishioners took that commitment seriously. Your secular friends only have their own consciences to prod them, and that’s not always enough. There’s no substitute for deeply held beliefs, son. They call you to your finest self. Tending the sick is hard work, and it’s not always pretty; I don’t need to tell you that now. When you’re relying on some flimsy notion that coming by with a casserole would be thoughtful”—an odd spasm of concern crossed the old man’s face, and he briefly closed his eyes—”that tuna bake may not … may not make it to the oven.”
“Dad, are you okay?”
Reaching for a buzzer, his father said, “I’m sorry, son, I know you just got here. But you’re going to have to leave me alone for a minute with the aide.”
A few awkward minutes passed, while his father curled in acute concentration and couldn’t talk. Bedpan in tow, a Filipino bustled in, wearing whites ill-suited to her purpose. Shep waited in the hall. She came out a while later with a ball of sheets. A watery brown stain betrayed that she hadn’t arrived in time.
“Fifteen times a day if it’s once,” Gabriel grumbled in fresh pajamas when Shep returned. “You imagine a body gets used to this, think again. It’s humiliating.”
Shep stirred uneasily, and moved his chair a few extra inches from the bed. “You pick up some sort of bug?”
“You could say that. A bug the size of a small dog. Clostridium difficile. Or c-diff, as it’s affectionately known around here.”
“What’s that?”
“One of those infections that take hold of whole hospitals. Half the patients in this institution have it. Nurses wash their hands here like Macbeth, which far as I can tell doesn’t make a darned bit of difference. Notice
, even in the hallway? It smells. They’re pumping me full of antibiotics, but so far that’s like trying to shoot an elephant with a pop gun. Gotta lick this thing, too, since it’s the biggest obstacle to my going home.”
The even bigger obstacle was Beryl, but Shep had other matters on his mind. He stood up, hands held from his side, fingers extended, trying to remember every surface he’d touched since he came in. “I can’t apologize enough, Dad. But I have to go.”
In the hallway men’s room, Shep sudsed his hands for minutes, and on up the arm, turning the taps on and off with a paper towel whose dispenser he had cranked with the tail of his shirt. He used the same shirttail to open the restroom door.
“You asked—I should say demanded—that I come up here to visit Dad,” he charged Beryl after his twenty-minute shower back at the house. “Before I obliged, why didn’t you tell me he had one of those hospital infections?”
“What does it matter?”
“These superbug strains are antibiotic-resistant. I can’t be exposed to something like that!”
Beryl looked perplexed. “You’re pretty healthy. It’s mostly old people who are at risk. I can see being worried about Dad, but I don’t understand why you’re so worried on your own account. It’s a small risk to take for the sake of your own father.”
“Even if I didn’t come down with it, I could become a carrier!”
“Well, that’s not great I guess, but so … ?”
“Glynis. Remember her? My wife. Glynis’s immune system is shattered. Something like c-diff could kill her.”
“Christ, you’re being awfully melodramatic.”