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Tuesday, March 1, 2011

16.(18-19) Descent into the Valley

Slim Novel 16 - http://adventuresofkimi.blogspot.com - See Homepage
18. The Cancer Marches On
Nina has a good month. Then she starts to notice a disturbing trend. Her attempt to lose the excess weight fails; she seems not only unable to lose, she is gaining. And her abdomen enlarges. After a week She asks, "Eddie, am I getting pregnant or what?"
   They visit the surgeon. After examining Nina, sitting with her and Eddie at his desk, he says, "You are accumulating fluid in the abdominal cavity - ascites - we call it."
   "What does it mean?"
   The tumor inside is pressing on the normal liver blocking its lymph drainage. So the lymph fluid backs up and starts dripping off the liver into the abdominal cavity"
   Nina makes a face, "It's starting to hurt."
   "I'm going to prescribe a diuretic. You will urinate a lot but that will be the abdominal fluid. It ought to relieve you."

The diuretic works for a week. Nina's enlargement goes down. But the diuretic has Nina running to the toilet seat all night.  Then it stops working and she balloons.

She wakes Eddie beside her at night. "I can't stand the pain." He gives her a shot and she sleeps. In the morning they go to the surgeon. "It will need a tap," he says.

Ten minutes later she is on the examining table on her back. The surgeon with a nurse washes the front of abdomen and cleanly inserts a wide-bore needle midway down through the abdomen skin. He takes about an hour to drain several gallons of yellow fluid.
   "Oh, doctor, thank you, thank you!" and, turning to Eddie who stands beside her on the other side of the examination table, Nina says, "Darling, suddenly I feel more hungry and thirsty than I've ever felt in my life. I could eat a horse but I'd prefer hamburgers and french fries and ---" She stops and glances toward the surgeon. "Is it OK to eat that kind of stuff, doctor?
   "Yes, The strong appetite is because you have just lost a couple of pounds of protein some of which needs to be replaced, and the lowered salt concentration in your blood is the source of the thirst."
   To Eddie, he says "Take her to a good restaurant and enjoy as much as you please."
   Nina says, "A McDonalds will be fine with me. A nearby one because I feel like I can't wait."
   The rest of day Nina is relaxed and happy with Eddie by her side. After the restaurant they go home and have good sex. Then she enjoys her morphine. Her abdomen is collapsed and normal looking now.

19.  Inexorable Cancer
A week later, a new affliction. First, her urine goes deep amber brown and looking in mirror she sees the whites of her eyes have turned yellow. A day later, her skin yellows and it itches.
   "Eddie, is this it?" Nina asks with frightened look. "I feel so drowsy and weak like I don't want to even sit up in bed."
   Eddie has known for days it is a late stage of liver cancer, when the tumor has replaced so much liver tissue that the liver bile stops being excreted into the intestines and backs up into the blood. But he finds he cannot answer what he knows.
   "Neen, I'll take care of you at home.--"
   "No, Eddie. I know my time is up. Thank you for being kind and not bluntly saying it. I do not want to die at home, making you a slave to my illness. Please put me in a hospital bed and let them take care of me at the end."
   Eddie does not argue. He has already said to himself - months before when he was sure it was Nina's last year - "I am going to be with her, following her orders to the end, whichever way she wants it."
   He calls an ambulance and phones the surgeon.

Nina is in a private room. She asked for no visitors even including Eddie's mother and father or friends. Only Eddie sits by; sometimes reading to her, sometimes conversing; sometimes sleeping. In the first week she is fairly alert and lucid, and even curious. "Eddie, why am I getting so drowsy?  Tell me truth. I want to know why?"
   "It's your blood ammonia, Neen. Ammonia is the final product of the body's breakdown of protein that constantly goes on in good health or bad. When the liver is working, it immediately gets rid of the ammonia. But now, not enough liver so the ammonia is piling up in the blood and brain and it makes you sleepy."
   "Thank my atheist goddess for that, Eddie dear." 
   She is silent a few minutes. Then, "Eddie?"
   "Yes, Neen?"
   "Please, when I go into coma, I want you to end it quickly. You know what I mean. Like we talked about at home."
   "OK, Neen. Don't worry."
   She smiles. "Thank you my husband."

A little after 2 AM. The nurse has just left after stopping by on rounds. Eddie sits by the bed. He has noted that Nina is in coma and remembers his promise. He takes out a syringe already prepared with 15 mg morphine sulfate. First he gets up and checks at the door that no one is coming down the corridor to the hospital room. The nurses have completed rounds and are having a snack at their desk. Then he comes back to Nina in the bed and unsheathes his morphine syringe needle and  sticks the needle tip into the rubber tubing of Nina's intravenous drip. He injects the full dose rapidly and sits down. After several seconds, Nina takes one breath and stops. Eddie waits fifteen minutes and checks she is dead. Then he goes out in the corridor and tells the nurses. "My wife just stopped breathing." As this is an expected exitus from terminal cancer, there is no great excitement. A nurse calls the intern on duty who pronounces Nina dead. The body is taken to the morgue.  A postmortem exam will be done because Nina had asked for it, knowing it helps the hospital accreditation to have a goodly percentage of postmortem examinations.

Eddie goes home and sits on the sofa alone. Successfully psychoanalyzed, he understands his feelings. Over these last months, months ago, he had felt the sadness of Nina's imminent leaving. Now he feels its relief that it's over.
   He feels hungry and decides to make a spaghetti dinner. Then he lies down and sleeps.
   End of Section. To continue next, click 16.20 A New Life







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