Before Your Last Trip to the Outhouse, I want you to know…

Jimmie and I have been dealing with health issues of late. I should say Jimmie has been dealing with the health issues and I have been following along behind trying to keep up with the details. I choose to think about these interludes as romantic getaways, because hospitals let you stay over, and provide you with a folding cot which makes your back feel the way it looks when it’s folded up during the day.

Four hospitalizations since August for the same man-plumbing issue have culminated in our most recent overnight stay at Good Samaritan after what is the surgery most dreaded by men. I have this on good first hand info from many of the men in my life who’ve had it and lived to tell about it. Ask any one of them what the worst word in the English language is. Starts with a c:

Catheter.

Watch them spit it out with disdain, a churlish look of scorn tinged with not a little fear. Watch their eyes dart to the left as their lip curls. P surgery, pee surgery it’s all the same thing in this case. But at 90, a surgery under general anesthesia is enough to get you thinking about death.

After the doctor left, having delivered the news about the upcoming surgery, we huddled together, Jimmie in the 1960s-era wooden hospital guest chair with the leatherette dun-colored seat that exhales like it’s farting every time you sit on it, and me, sitting on the edge of the bed, the sanguinating catheter bag huddled to our left like a resentful pet who has been ignored too long. Our conversation turned to the inevitable, which is, of course, truly the inevitable.

“The night my father died,” said Jimmie, softly, his gaze averted, “he went out to the outhouse up at the cabin in Maine. My sister Claire was there with Mom and Dad. He came back and sat down in the chair and then fell out of the chair onto the floor. Claire said she knew instantly that he was gone.”

“What did he look like before he fell over?” I asked, scanning Jimmie’s pallid face, so depleted from the significant blood loss over the past weeks.

“He looked fine. I think it was a happy time for him. He loved being up in Maine. It was a complete surprise. I always thought that’s the way I would go,” he said. “I don’t know if my heart will stand this surgery.” The other unstated message was that the recent events haven’t been a “happy time in Maine.”

That sat between us somberly, as did the knowledge of Jimmie’s older brother Jack’s untimely death from a heart attack and similar type of collapse. I felt my cheeks becoming hot. My optimistic, fix-it-all attitude was showing some pretty severe cracks. My rational mind struggled forward. “They aren’t going to suggest a surgery that they don’t think you can survive, Jimmie. Your cardiologist will evaluate your ability to withstand the surgery. It seems to me that the real question is whether you want to continue to live.”

This may seem like a really harsh way of asking someone, and I think it was, but I had just finished reading the Dornsife Magazine, Fall 2017-Winter 2018, the theme of which was “Grave Concerns: the Mortality Issue” so I was primed for the conversation. I looked into his eyes, still not looking at me, and he said, “Not if I have to live this way,” with no hesitation at all.

“Well, before your last trip to the outhouse, I want you to know….” I sought to convey my love and gratitude to him for our magical life of thirty-five years together, while nagging behind me was my arch nemesis and evil twin, Maude Lynn.

You’re overreacting, Els, she sneered. And as usual, she proved correct.

Jimmie took my hand, bringing it to his lips, and kissed it gallantly, as we professed our love for each other. “Let’s remember there were so many good times, and not dwell on these difficult times.”

I tend to be extremely pragmatic, accept difficult circumstances for what they are and move forward. It is a primary trait among stage managers and theatre people in general. But to be frank, looking directly at the loss of Jimmie and our life together isn’t something I feel pragmatic about. I prepared for this surgery knowing that Jimmie never expected to live past eighty; we’ve talked more than once quite frankly about death. He’s been more ill recently than I’ve ever seen, and the procedures he has been going through with this recent bout have created a new Jimmie, whom I have struggled to love as unconditionally as the old one. We prefer to be around people who are healthy and pleasant and upbeat. If that isn’t the case, you are probably in the health care profession. I so respect those in the health care profession; they don’t frequently get to see the old versions of healthy people, but dwell in the land of the sickly, frightened, enraged or deflated new versions of formerly healthy people. Earlier this week as I watched the RN in the Emergency Room working on irrigating the catheter, I said “It’s kind of satisfying, right?” Without hesitation, JP, a former youth hockey player, (we’d bonded about that earlier) now RN said, “Yes it really feels good to make improvements in the health of a patient.”

We recently changed doctors. Jimmie’s GP closed his private practice to reduce his working hours as he approached retirement. Jimmie’s new GP, is kind and direct and speaks loudly – either a result of his geriatrics training, or perhaps hearing loss from also being a musician (something I overheard him say rather loudly at his office during our first visit.) He described for us the romanticized Hollywood version of aging, a gentle slope of decline as you get older. He derided that fabrication. I watched him describe, his hands chiseling the air in a series of steps, that patients are more likely to go from a steady baseline condition, to an event such as a surgery, or a heart attack, or a hospitalization, after which they drop down to a new baseline. This process repeats and he said if he got to do a TED Talk, that’s what he’d tell us. This made a lot of sense. I’d prefer to hear it in a TED Talk than see it in my spouse.

Later that first night at the ER after Jimmie was admitted and settled into his room, I stumbled out of the hospital at 11:30 PM, exhausted after seven hours in the ER. The night nurse reminded me to bring Jimmie’s Advanced Directive to the hospital when I came back. I had, of course, forgotten. It took me two days to remember to bring it back with me. I didn’t want something written almost twenty years ago and hadn’t spoken of since to define our conduct should the need arise. Thinking about these choices is hard, but with the assistance of his doctors, we arrived at the decision to move forward with the surgery which happened two days ago. With a spinal, not a general anesthesia. They rolled him out of the operating room, and his eyes were open. I said, “Hi, Jimmie.” He said, “Hi, Els.” In retrospect, I keep thinking, “what was I so worried about?”

Every day we hear from family and friends, colleagues from work and we are buoyed by their support, their virtual hugs (Jimmie may be becoming a little bruised from all the passed along hugs) and the knowledge that this too, shall pass. Now that we are home, it’s my job to teach the new visiting nurses what medications he takes, and answer their incredulous question each time I open the door to a new person:

How old are you, anyway? (While looking down at their clipboards at Jimmie’s DOB).

We went to the park today and sat in the sun. Fingers crossed. Neither of us is ready for our last trip to the outhouse yet.