At my second visit with Win and Felix, they have iced tea sweating in glasses and small almond cakes. I hope they did not go to this trouble for me; I am supposed to make their lives easier, not more cluttered with things to do.
I’ve decided to take her on as a client, if she is similarly inclined to work with me. I keep telling myself it fits into my schedule well—I have several long-range clients with illnesses that will keep them alive for years, rather than weeks—but I know that there is more to it than this. There is something about Win that I cannot tear my eyes from. There but for the grace of God, and all that.
Felix is staring down at his notes. I know, for many caregivers, this blunt conversation is the first time they really, truly understand that the person they love is going to die. Not even the doctor’s diagnosis is as frank. “Do we…have to sign something?”
I wait for him to look at me. “No. But I do have a secret handshake I’m going to have to teach you.” His eyes widen and I smile. “I’m kidding. Yes, there’s paperwork. But we don’t have to worry about that yet. I’m as good as my word, and I am assuming that you are, too.”
I pull out a small notebook and write Win’s name at the top of a blank page. By the time Win dies, this book will be filled—with notes from our visits, memories, requests, medication logs. This is the paper trail she will leave behind. “If you’re feeling up to it,” I say to Win, “I’d like to ask you a few questions to start. Have you had a conversation about a DNR yet with anyone from hospice?”
She tilts her head. “DNR?”
“Do Not Resuscitate. There’s a form for the hospital and one for out-of-hospital. It’s something you sign if you don’t want anything done, should you stop breathing.”
“Like what?” Felix asks.
“Resuscitation. Calling 911.”
“So you mean…”
“Allow natural death to happen,” I say. “Yes.”
Win puts her hand on Felix’s arm. “Baby, that’s the finale here. No matter what.”
“I know. I just…I mean, what if there are other options—”
“On average, people who code and get CPR do live another eighteen months. But you’ll be doing that with cracked ribs, because once compressions are started, by law they have to continue until you’re resuscitated or you are pronounced dead. So…if you do survive, you’ll be in pain, and we also won’t know how long your brain was denied oxygen.”
“And if I don’t want that?” Win asks.
“Then you sign the DNR.”
She looks at Felix and nods sharply.
I ask her about feeding tubes, ventilators, defibrillators—all life-sustaining measures—confirming that she doesn’t want any of those. I talk about medical power of attorney, and financial power of attorney, about sedation, about antibiotics for comfort during UTIs or other infections. I talk about cultural traditions and funeral planning, whether she wants music as she’s dying, or religion, or neither. Who she’d like to be with her at the end, and who she doesn’t want to see. Just because someone is dying doesn’t mean that they can’t call the shots. As I tick off the items, Felix seems to draw further and further into himself, until finally I turn a bright smile toward him. “Do you by any chance have some coffee?” I ask.
He goes into the kitchen to brew some, and as soon as the door swings closed behind him, Win meets my eyes. “Thank you,” she says.
I nod. “He’s not the first husband to be overwhelmed by details.”
“There are times I think this is harder on him than on me. I mean, I get to leave at the end. He’s stuck here, reliving these weeks.”
“I will make sure he’s not alone. I’m here for him, too.” I can hear Felix banging around in the kitchen. “Plus, this next part would have probably put him into a fetal position. Have you thought about what you’d like to happen to your body?”
“You mean like burial or cremation?”
“Those are two options,” I tell Win. “But there are green burials. And aquamation—you put the body in a vat of alkaline solution, like lye, and all the muscles and fat and tissue dissolves, and then the bones are ground up and given back to the family.”
“That sounds like how the Joker died in Batman,” Win murmurs.
“It’s not legal in Massachusetts yet, but it is in Maine.”
“That’s okay. I’m not dying to try it.”
I raise a brow. “I see what you did there,” I say. “There’s also a living forest.”
“Where I’m buried and a tree grows over me?”
“More like the cremains are used to mulch the trees. The hot new thing is recomposition—human composting. It’s being pitched for urban centers where there isn’t space for cemeteries.”
“What about donating my body to science?” Win asks.
One of the things I notice most about talking to those who are dying is that they’re eminently practical. They know they have a checklist to tick off, and many people are ready and willing and able to discuss it with objectivity, a weird dual state where they know they are the one who will be gone, but they also want to make sure they have the agency to decide how that is going to happen. One of the other things I notice most about talking to people who are dying is that this conversation rarely happens in front of a loved one, as if one of the last acts of grace you can perform with your death is to protect your spouse from the nuts and bolts of the process.
“Donating to science is definitely an option,” I tell Win, “but you need to be aware that if you do that, a lot of stuff may happen to your body that you’re not thinking about. True, you may wind up as a med school cadaver. But you’re just as likely to become filler for lip and butt implants, or be a crash test dummy, or decompose on a farm in Virginia for students of forensics.”
She shudders. “I do not want to wind up in someone’s ass crack.”
She means it as a joke, but that’s not how I hear it. “When people say that sort of stuff,” I begin delicately, “it tips me off that they think that body and spirit are one. That a part of you is still going to be here, after you die.”
She raises her face to mine, and I see it: the awareness that the road just…ends. That there’s no promise of anything coming after, at least not as far as we have proof.
“It’s a bummer, if not,” Win says. “I’d like to go to my own funeral. Eavesdrop on who’s saying nasty shit about me.”
“I had a client who wanted to be at her funeral, so she held it before she died. People gave eulogies and she clapped along with everyone else. She danced and she drank and she had a phenomenal time.”
“You can do that?” Win says, shocked.
“We,” I correct, “can do anything. There’s no template.”
“I used to joke around and tell Felix I wanted Snow White’s hermetically sealed glass case, until I went to the British Museum and saw the mummies. I don’t think I’m enough of an exhibitionist for that, even if I looked good for being four thousand years old.”
The last mummy I had seen was in the Egyptian necropolis of Tuna el-Gebel; the body of a wealthy girl named Isadora, who lived during the Roman reign of Egypt in the second century C.E. She fell in love with a soldier from Antinopolis on the east bank of the Nile, but her father didn’t approve. She wanted to elope, but the boat overturned while she was going to meet her soldier, and she drowned. According to Ancient Egyptians, anyone who drowned in the Nile was automatically made hesy, or the blessed dead. Her devastated father built an elaborate tomb for her in the desert, a small stone building with crumbling steps. Inside the tomb were ten lines of Greek elegiac couplets: To tell the truth, they are the nymphs, the water nymphs, who raised you, O Isidora.
Isadora was preserved at the site in a glass case. I remember the smooth, resined bulb of her skull; the gap of her open mouth and the glint of her teeth, the pinch of a nose. The narrow neck, rising from the modest white sheet that covered her from collarbone to ankle. Her toes peeping out.
When I visited her tomb, Wyatt was with me.
I shake my head, dislodging his name, and force my attention back to Win. “Egyptians didn’t get mummified just to look good,” I say. “It was a way to control decomposition of the khat, the corpse. In order for an Egyptian to reach eternal life, the body had to last forever and house the soul. It mirrored the path of the sun god Re, who became one with the corpse of the Osiris every night before he was reborn the next morning.”
“How did they do it?” Win asks.