No Cure for Murder (7 page)
“Bad...what are you talking about?”
“Jacob and Dr. Spelling ordered some nerve tests...something’s going on in my nervous system.”
“They must have some idea,” she said as her voice moved up an octave.
“They do...”
“P.J., don’t do this to me. I’m your wife and I love you. Whatever it is, we’ll deal with it.”
His dry mouth felt like paste. “Have you heard of ALS or Lou Gehrig’s Disease?”
“I’ve heard the name, but I don’t know anything about it.”
“I’ve known Jacob all my life, and I’ve never seen him so upset as when he said this was most likely ALS. Jacob’s seen a lot in life, and if he’s upset...”
“You’re still young. You’re the strongest man, the most determined man I’ve ever known. We’ll beat this, whatever it is.”
P.J. pulled Julie beside him on the sofa. He grasped her hands, and in a near whisper said, “If it’s ALS, medicine has no effective treatment.” He hesitated, then continued, “Did I ever tell you about Matt Hazeltine and Gary Lewis?”
“No, I don’t think so.”
“Both young. Both healthy, perfectly conditioned athletes for the 49’ers who died of ALS in the 80s. Few live more than five years. Matt Hazeltine died in two.”
“That’s a long time ago. They must have learned something about this disease by now.”
“They’ve learned a lot, except how to treat it. They have a few new drugs, but nothing works for long.”
“Something must be useful...”
“I don’t know how much we should get into this until they confirm the diagnosis, but... ”
“What?”
P.J. struggled with the words. “It’s a horrible, debilitating disease. Eventually you can’t walk, talk, dress, or bathe yourself. You may not be able to swallow. It’s awful...just awful, Julie. I thought I could face anything, but this...”
“Does it affect your mind?”
“Oh, if you have a perverse perspective on life, that’s the good news. Your mind remains perfectly intact. I’ll have a ringside seat to my own destruction.”
A week later, nerve and muscle testing established the diagnosis. Jacob referred P.J. to Michael Brader, the Chief of Neurology at U.C. Medical Center in San Francisco. His examination and review of the testing confirmed the diagnosis.
Julie leaned forward. “Don’t you have anything that works?”
“I’ve talked to Jacob about treatment. We have a few drugs that might help, but I won’t mislead you; so far nothing has had a permanent effect on halting the progression of the disease.”
Robert Hughes took the elevator to Brier Hospital’s fifth floor. He knocked on Carleton Dix’s door.
“Come in, Doc.”
“Do you have a moment?”
“Of course, Bob. Moments like this make up my daily life. What can I do for you?”
“I’d like information about your teen group.” He hesitated. “We’re having a tough time with Sarah.”
“I know.”
“You know?”
“This isn’t that large a community. I work with teenage girls who attend Piedmont High with Sarah.”
“We’re in trouble with her. We’ve tried everything but a nunnery, and I’d consider that too, if I believed it would work. This is way beyond mere teenage rebellion. Her behavior is destructive and we’re ready to admit that we can’t handle her anymore.”
“I’d like to help you Bob, but...let me be honest. I’ve heard a lot about Sarah from the other girls, none of it good. It isn’t that I avoid the tough cases, you should see what we’ve had in the past. But for the sake of my girls, I avoid taking on anyone who may adversely affect the dynamic of the group.”
“I understand, and to be completely candid, I can’t blame you. Do you have any other recommendations?”
The chaplain thought a moment then licked his lips. “Why don’t I sit for a few minutes with Sarah. Maybe we can work something out.”
Chapter Eleven
After dinner the next night, Robert Hughes paraphrased his conversation with the chaplain.
Sarah stood. “Carleton Dix! The chaplain? Are you out of your fucking minds?”
Robert stared at his daughter. “Use that language with your friends, if you will. It doesn’t impress me.”
Marilyn’s eyes were red from crying. “We’re trying to help you before it’s too late.”
“You want me to join with those dorks, those slackers who are only in that group because they got busted.”
Marilyn shook her head. “That’s not true. They discuss things that are important to girls your age. Kelly Cowan is in the group and her mother says she loves it.”
“Keep it real, Mother. I don’t hang with Kelly since she got back from the loony bin.”
Robert tightened his jaw. “Make it hard or make it easy, but go you will.”
“You people will never learn.” Sarah ran to her room and slammed the door.
Marilyn turned to Robert. “This may be a mistake. If she doesn’t respect the man, I don’t think he’ll get anywhere.”
“How much worse can it get? One day soon, if we can’t get to her, she’s going to leave.”
The YMCA on Allston Way in Berkeley donated a room each Wednesday night for Carleton Dix and his TeenTalk group.
Sarah Hughes sat on the sofa in the foyer outside the meeting room picking at her fingernails. She wore a short black skirt and a blue tank top.
Kelly Cowan smiled as she arrived for the meeting. “What are you doing here?”
“What do you think?”
Kelly sat next to Sarah. “I think you’re seeking spiritual enlightenment.”
“Right.”
“I don’t know what happened, Sarah. We were tight.”
“Until you went all lame on me. That loony bin did something to your mind.”
Kelly looked at her feet. “It was bad, Sarah. I went bonkers. They helped me see that I was giving away my future. For what? In many ways, I feel more in control of myself than I ever did with the drugs and the booze.”
“I have a flash for you, Kelly; it’s all a load of shit, the easy way out. You really want to be like them?”
“Them?”
“Your ‘rents?”
“At least my mom and dad have done something with their lives. You and me, girlfriend, we were heading for the big crash. I’m out of that life, and I’m staying out.”
Just then, Carleton Dix arrived. “Go in, Kelly. I’ll join you in a minute.”
He turned to Sarah. “I know you’re not exactly stoked being here, but why not give it a try?”
Stoked? Sarah thought. Who’s he kidding?
“I’m not into this, but to make peace, I’ll sit in just this one time.”
“Sit in. Don’t sit in. It’s all up to you.”
“I don’t like anyone preaching to me, chaplain...is that what I should call you?”
“That’s okay or reverend or Carleton, and I don’t preach here, I moderate. The girls do the talking, that is those who have the guts to do so. If you want preaching, I can send you to any number of churches.”
Afterward, Kelly approached Sarah. “What do you think?”
“Lame...it sounded pretty lame to me. I got enough problems without listening to a bunch of whining preps.”
“Come on, Sarah. It wasn’t so bad. At least they speak a language you can understand, and don’t tell me their problems are totally foreign to you. Why don’t you come over for a while. We can catch up.”
“Sorry, Kelly. I got a date.”
Chapter Twelve
Nothing prepared P.J., Julie, or their girls for the reality of ALS.
Six months after fighting it with all his strength, P.J. found himself confined to a wheelchair. The family sat at the dinner table with a roast chicken in the center.
It smells great, P.J. thought as he looked down at his bowl filled with an unidentifiable gruel. Pureed and soft foods were all he could handle.
He reached for the plastic cup of orange juice, raised it with difficulty to his lips with trembling hands and sipped. He choked and coughed as fluid entered his windpipe and his lungs.
P.J. reddened as tears streaked down his face. He continued to cough, then shook his head. “Get me out of here, Julie. I can’t stand this.”
His weight declined from 160 to 130 lbs. Speaking had become more problematic, an especially difficult loss as the house was always full of strong vibrant voices. Julie pushed the wheelchair into the family room.
“Please sit with me, Julie, I need to talk with you while I can.”
“Of course,” she replied sitting next to him on the sofa. She watched the movement of his mouth as he tried to control his speech and saw the twitching, the fasciculations, on his tongue.
“You must make me a promise.”
“Anything.”
“When I reach the end...when they say, if we don’t put him on the ventilator, he’ll die, I want you to say no, and I want you to say no to resuscitation. I want a DNR, Do Not Resuscitate order in my medical records.”
Julie placed her hand across her mouth. Tears rolled down her cheeks. “You don’t have to worry. You’ve signed all the documents, the living will and the advanced directive for medical care. That should do it.”
“That doesn’t mean shit, Julie,” he choked over the words. “In the end, the hospital and Jacob will accede to your wishes. I want your promise.”
“I don’t know if I can...”
“Julie...it’s what I want. Let me die in peace. It’s bad enough for the girls to see me this way, let’s not make it worse.”
“What about the hospital? At some point, you’ll need to be admitted...we may not be able to take care...”
“No, that’s fine. I understand. It’s a miracle you’ve done so much.”
“I can only think of one miracle, sweetheart.”
“I know.”
Julie Manning hugged Jacob as he arrived after office hours to visit. “You don’t have to do this. I feel guilty taking up so much of your time.”
Jacob came three to four times each week, staying long enough to see how P.J. was doing and offering support and grandfatherly wisdom.
“Time...time? Let me introduce myself to you, Jacob Weizman, P.J.’s doctor.”
Julie smiled then came again into his arms, her head lying on his shoulder as she sobbed.
“It’s horrible, Jacob...watching him struggle this way...brave, loving, and always worrying about me and the kids instead of himself. One minute I’m heartbroken, the next I’m in awe of the best and most courageous man I ever knew.”
“I have a forty-six-year investment in P.J., Julie. I remember the day I delivered him. He nearly slipped through my hands as he wriggled for freedom at birth, and you know something; he never did stop struggling.”
“I don’t know how you do it, Jacob. After all these years, here you are.”
Jacob sat next to Julie on the sofa, holding her hands. “The death of a son or daughter is devastating. Parents can’t comprehend the possibility that they’d survive their child. That’s the way I feel about P.J. and all the others I’ve outlived. I’ve had a long life. I’m reasonably intelligent, yet I find no sense to any of it. It’s the one place where faith, if you have it, offers the solace denied to reason.”
She squeezed his hands. “We’re so lucky to have had you all these years, Jacob.”
“Don’t think of me as a saint, I’m not. I don’t think I need to be one. It doesn’t take much to show the love I have for my patients...well, most of my patients. If they know I really care, if they respect my judgment and experience, and if they trust me to suggest what’s best, the amount of time I spend isn’t an issue. I can’t move into your home, that’s the surest way to destroy your fantasies about my sainthood, but you can reach me any time, day or night. I consider it an honor to see this through with you.”
“P.J.’s care is becoming more difficult, Jacob. I don’t know how much longer I can keep him at home.”
“I’ll make sure you get whatever support you need so he can remain here as long as possible, but a time will come...”
“You know how we feel about hospitals and end of life care. You’ll make sure they follow P.J.’s wishes?”
“Julie, honey, that’s the last thing you need to worry about.”
One month later, P.J. lay in his hospital bed on Brier’s fifth floor. A large Do Not Resuscitate sign hung on the door and over his bed. Julie and the girls just left for the day.
P.J. felt his nose itching, but couldn’t raise his hand to scratch or push the nurse call button. Something about paralysis sharpens the other senses, he thought. He remained fully aware of his world, every sight, sound, smell, and touch...all mind and no body.
Ginny Harrison turned to Marion Krupp as they began the morning shift. “I have five patients already. You’d better take P.J. Manning.”
Marion picked up P.J.’s admission sheet and scanned it. “Why did they bother putting him in the hospital? He’s practically dead already.”