Lessons from Living, Dying and Living Again

Chapter 3

Distant Thunder 

         By July 2019 my blood draws and periodic visits with the doctors and nurses at Leever had become routine. The blood counts remained stable and so did I. There’d been something of a surprise in February when a letter from Dr. Bowen arrived in the mail. It began with the words “With regret,” which is maybe not the first thing you want to hear from your oncologist, but then it went on to say he’d be retiring in late March after four decades of good service. I soon learned that my new doctor, if I chose to stay with Trinity Health, would be Yueming Chang, who I wouldn’t meet for a while. Helping in the transition between doctors, and much more, was Karen Pollard Murphy APRN, who often saw me when the doctor wasn’t scheduled to do so. The APRN stands for Advanced Practice Registered Nurse, and here we enter the confusing world of APRNs, nurse practitioners and physician assistants. All are important positions in the world of medicine and medical patients, but as to who does what to whom, I just don’t know. I probably never will know, despite some mild googling on my part. What I do know is that it was Karen Pollard Murphy who saw me that July after my blood draw, who sized me up, asked me how I was doing, and ran her practiced fingers along the sides of my neck.

         “How long has this been here?” she asked.

         My neck? How long has my neck been here? She took my index finger and with it traced the lymph node underneath my right ear. It was swollen, no doubt, the first I knew of it.

         That tender moment soon evaporated, however, as I was sent off to yet another St. Mary’s doctor who would conduct a biopsy on the offending gland. After several days, I was called back into his office to learn that my myelofibrosis had now been joined by notorious sidekick leukemia, chronic lymphocytic leukemia (CLL) to be exact, aka the “good kind” of leukemia as some halfwit, no doubt by now deceased, once put it.

         The cancers were now on the march as a team. They still needed some time to organize themselves and determine the paths they would take, but they would work in tandem in order to speed up the assault against me. I really didn’t know what to make of having two cancers at once. It was of course worse than having just one, but how, specifically, would this be so? No one seemed to know. Leukemia was much more common than myelo, and many strategies had been developed to fight its various faces. But having myelo in the mix greatly complicated matters. I met with my new oncologist, Dr. Chang, a native of China with a concerned, empathetic manner I liked. She was well-versed in leukemia but I thought less familiar with myelofibrosis, a word she could not always remember. The strategy, at least for the time being, was to continue as is, paying very close attention to the blood numbers and being on the lookout for signs – fevers, infections, night sweats – that the dam might be ready to break. So as the calendar turned to 2020, the caution lamp had been lit but wait-and-see remained the prescription. And the idea of stem-cell replacement still hadn’t entered the frame.

         It was during this period, however, that I first began thinking of myself as a completely new and different person. Ever since I was a boy, I’d thought of myself as essentially healthy. I’d had a bad case of pneumonia when I was in sixth grade and a few hellacious allergic reactions to poison ivy. I’d had stitches only once, on my head, after falling off a rope swing onto a rock, and never a broken bone. I had laparoscopic surgery on a torn meniscus at age 35, bringing my basketball career to an abrupt end. Still, I remained basically intact. I’d never spent a night in a hospital. Lots of dental work, yes, but they don’t hospitalize you for that.

         But two cancers puts you on the other side of the line. I could no longer pretend not to belong in the waiting room, so I began to engage with the people there. Doomed as we might be, we were buddies, like a bomber crew or a company bound for Normandy on D-Day. We were all packed into the LST under gray skies, headed through rough seas for Omaha Beach and God knows what we’d find there. I began to think more and more of those of my contemporaries who’d already gone overboard. A dear friend who years ago had lost her struggle with pancreatic cancer. A guy in our golf league. A new friend who’d gone as quickly and quietly as a ghost. A local attorney who I’d seen and spoken with in the Leever waiting room. And then there were those I knew who were at various stages of their disease – liver, lung, blood, breast – and differing levels of not feeling well. I’d secretly assess them in a new way when I saw them: “Looks pretty good,” “Having a tough time,” “Dying,” and of course I wondered how they saw me. I got some clues from the doctor’s comments I found on my patient portal. “Looks stated age” was encouraging, as was “normal gait.” “In no acute distress” is always a good way to be. With friends, you looked at them looking at you. Their words were almost always kind and encouraging, but what did you see in their eyes. Was there alarm? Did they have to look away. Not yet, it seemed. Not quite yet.

         Especially tough to witness as I surveyed my side of the cancer line were those among us claiming to be free of the disease after treatment and then, later, and even much later, finding themselves back in harness, grimly watching “House Hunters” on the waiting room TV. Some people, and their doctors, dared to make the “free of cancer” or “remission” claim more than once. The longtime ESPN college basketball analyst Dick Vitale seems like he’s made it four or five times. I usually don’t know what to think when I hear it. I hope they’re right, of course, and never bothered by it again, but that they’re prepared for if and when it comes back. My bottom line was that with two cancers I was well established in that overpopulated field now – certainly not free of cancers but not yet feeling or showing the toll they were taking. I was still moving freely about my life and in and out of the lives of others.

         Marcia and I were in Florida, spending the month of March 2020 in a lovely rental house on Kitching Cove along the St. Lucie River when COVID struck America. We’d driven down a few days after the celebration of my 70th birthday at a local restaurant in Connecticut. Again, family and friends showed up, but the celebratory feeling of the 60th wasn’t quite there. I’d survived those 10 years, fooled everyone, foiled their expectations, so now maybe they weren’t going to be quite so open and forthcoming about how great I was. I didn’t blame them. For one thing, I knew that I wasn’t all that great. And second, once you’d spilled your guts 10 years earlier, what more was there to say or sing? My mother, who’d come up from Washington for the party, got off what I thought was the best line when she announced, rather theatrically, “I don’t mind being 94 but I don’t like the idea of having a child who’s 70.” Still, it was nice to have a reason to get everyone together and especially to get them all back to their homes before the pandemic arrived in force.

         As I recall, it rose, crested and broke on March 13, a Friday. Overnight, it seemed, the country was under attack, the hospitals began to fill up, people started dying and Donald Trump began his fascinating nightly dumbshow full of preening, posing and denial. In Florida, we could pretty much stay to ourselves, go to the beach over on Hutchinson Island or read peacefully by the river. Certainly, in those pre-vaccine days, we didn’t want to catch the disease. I didn’t know how compromised I might be. So when I had to go out to Publix for groceries I wore a mask and gloves, and when I came back home I put my clothes into the washer and jumped into the shower while Marcia washed down all the produce. We scrubbed our hands with extraordinary diligence. We said we completely understood as would-be visitors from up North, including family and my Saratoga golfing buddies, cancelled their plans and stayed put. And when the Florida governor abruptly decided to close the beaches, we decided the time had come for us to go back home, too.

         But there was another reason we couldn’t stay in Florida, a terrible one, one that made my own problems seem like nothing. Our son, Matt, 33, had fallen in love a few years earlier with Dhanushka Gunasekera, six years younger, whom he’d met while they were both out on the town one night in Brooklyn. Their relationship had grown rapidly, they’d traveled together and eventually very happily moved in together to a spanking new high-rise overlooking the Gowanus Canal. In 2018, he’d proposed marriage and they began to plan a big wedding in Newport and maybe even a trip to her homeland of Sri Lanka. But late in 2018, she began experiencing severe, lingering headaches, and before long was diagnosed with cancer of the brain, a glioblastoma, and all plans were off. Instead of the wedding of Dhanushka’s dreams in Rhode Island (they’d booked a waterfront venue), they married at Brooklyn City Hall in June 2019. It was a happy day full of laughter and tears but the cancer was uncaring and relentless and soon became the focus again. Operations, therapies, alternative remedies, prayers, even astrology – nothing did any good. Matt was an exceptional caregiver, devoted, attentive, always there to make her more comfortable or to tease out her lovely smile with a word or two. Once we returned from Florida, we’d drive from Connecticut down to a Manhattan that was eerily emptied out of traffic and people by COVID to visit Dhanushka and Matt and her devastated parents and family – she was an only child – at New York Presbyterian Medical Center on the East Side. She still hoped, hoped to the very end, for a late-stage miracle, but it was clear to all that she was leaving us, which she did at age 28 on June 15, 2020, one day after their first wedding anniversary.

         Dhanushka’s death was a tragedy that defied understanding. Matt came to live with us for a little while because he was reluctant to face alone the enormity of what had just happened. He was welcome to stay as long as he liked. Meanwhile, our family was doing its best to supply him with major events to let him know he was still a part of something. On June 10, he’d become an uncle for the first time when his older brother John and wife Liss gave birth to a baby girl, Penner Amelia Monagan. The wonderful news was somewhat muffled by events, of course, but it was hard not to see the promise, and the future, in Penner’s big bright eyes. John and Liss had met at Ethel Walker School in Simsbury, an all-girls boarding school, where both of them worked as teachers, and John also as the head coach of varsity basketball and softball. They’d gotten married in the campus chapel, with Liss’s father and grandfather, both Congregational ministers, presiding, in June 2017. And now, a most welcome new arrival, a granddaughter, an event that shot through that horrible plague year like a fierce ray of hope.

         Then our youngest, Claire, got into the picture with an event of her own. She and her fiancé, Peter O’Hanlon, had planned on getting married, too, over Memorial Day weekend, in Quechee, Vermont. But those plans were also dashed by COVID, and it was hard to see when all the embargoes would be lifted. We were headed down to Quonnie in Rhode Island for two weeks in July to a cottage with a nice green lawn and blue ocean views beyond. If you really want to get married, I asked, why not get married there? It would be a tiny COVID ceremony with only the two direct families attending (12 in all) and I offered my services as the celebrant. A few years earlier, I’d obtained a position in the ministry of the Universal Life Church so I could legally officiate at a nephew’s wedding in Toronto. And so, with not too much fuss, it was done. It was a beautiful summer day by the sea, we managed to make a surprising amount of noise, and Claire still would have her big party in Vermont with her friends over the coming Labor Day weekend.

         Meanwhile, my myelo, and now my leukemia too, seemed quietly amused that all these other things were getting my attention while they continued to burrow ever deeper into my substrata. By April 2021, my blood numbers began to jump in a way that could no longer be dismissed. The infection-fighting white blood cell count rose to 10.4, at the very upper limit of the normal range, showing that the battle against leukemia had begun. By December, that number had risen to 18.3. As the numbers rose, I was reminded of the best advice I’d ever received as a young would-be writer when a dear college friend of my father, and a lifelong toiler in the writing vineyards, told me, “No one will ever be as interested in what you’re doing as you are.” And so it was with my blood. As 2022 arrived, I was becoming genuinely alarmed, but the medics remained calm. Apparently things still hadn’t gotten serious enough for action.

         I stayed busy writing and also going around like a vacuum-cleaner salesman to Connecticut libraries with a presentation I’d put together that was tied into my book Connecticut Icons, a series of essays that I’d written for Connecticut Magazine. I felt much more tired as I played in my golf league that summer, and, very notably, I lost interest in the post-round drinks that were at least as important a part of the day as the golf was. I joked that I’d reached my lifetime limit on beer but wondered to myself how I could have lost my taste for it, and whether and how it might be a part of everything else that was going on inside me. Another disturbing development was that on nights following golf, while I was sleeping, I began experiencing pretty severe – let’s call them agonizing – leg cramps, mostly in the calfs and ankles. It never happened while I was playing, only after a six-hour delay, in the middle of the night. By morning, all signs of discomfort had disappeared and there were no lingering effects. I felt like I was gradually breaking down, kind of like my golf game itself.

         Then, with my August 2022 blood draw, I finally got what I considered to be the full attention of the authorities. The results showed my white blood at a whopping 39.3 (again, high normal is about 10), red blood below 3 and hemoglobin below 9. The civilized thrusting and parrying with my cancers had abruptly turned murderous. The false war was over. The days of rage had finally arrived. Someone rang the chemo bell.

Lessons from Living, Dying and Living Again

Chapter 2

My Memorial Service

            It’s hard to know what doctors hate more, Google, where patients and patients’ families and friends can turn for thousands of poor, incomplete, misleading, wrong-headed or possibly even accurate takes on important medical subjects, or patient portals, where test results and other data are posted with remarkable speed and are thus open to misinterpretation before any professional input can be considered. The correct answer is probably Google, where I was quick to turn once I felt my diagnosis had been well and truly confirmed (there were no such things as patient portals back in 2009 anyway).

            What I found under “myelofibrosis” then and in the years since has been riveting, even the many parts I haven’t understood. The pages on “Causes,” for example, I thought would be about things like smoking and working in asbestos factories. Instead, they talked about “an acquired mutation of JAK2, CALR or MPL in a hematopoietic stem/progenitor cell in the bone marrow.” I kept reading because they were talking about what was going on inside of me, but, honestly, how deep into the capital letters was I expected to go? There was a reason I didn’t apply to medical school, even with doctors in my family background. And if you told me that the names of some of the chemotherapy drugs – Ojjaara, Inrebic, Vonjo – were international soccer stars, I would have believed you. Occasionally an interesting, more relatable tidbit turned up. Exposure to benzene, for example, is widely cited as increasing the risk of developing myelo. Benzene is described as a colorless, flammable liquid with a sweet odor. It is naturally produced by volcanoes and forest fires, found in emissions from burning coal and oil, gas stations and car exhaust. It can also be found in detergents, drugs, dyes and pesticides. I went down the list. Volcanoes? Certainly not. Forest fires? No. Burning coal? No. In fact, I couldn’t claim more than normal exposure to any of the benzene carriers. As anyone would, I wanted to blame my myelo on something specific, like the pack of Larks I smoked back in 1974. But most of the time, apparently, according to all that’s known today, it just happens.

            Sometimes a Google search yields a tremendous trove, however. It’s where I found something called “Overview of MPNs: History, Pathogenesis, Diagnostic Criteria and Complications,” the author of which is my own Dr. Ronald Hoffman at Mount Sinai and two of his colleagues. It’s a very detailed, meticulous summary of what was known at that point about myelofibrosis and other MPNs (myeloproliferative neoplasms), with the promise of more detailed papers by other experts to come. I didn’t read every word, of course, not even close, but I did learn some things:

            1. Myelofibrosis was first reported in 1879 by German surgeon Gustav Heuck, who’d identified two of his patients with massive splenomegaly, leukoerythroblastosis and bone marrow fibrosis. Eponyms for the disease are Heuck-Assmann Disease or Assmann’s Disease, for Herbert Assmann, who published a description under the term “osteosclerosis” in 1907. It wasn’t until 1951 that Dr. William Dameshek connected the three conditions which he termed myeloproliferative disorders – polycythemia vera, essential thrombocythemia and primary myelofibrosis. He found them to be biologically related but otherwise distinct.

            2. Myelofibrosis is a rare disease, affecting 0.3 in every 100,000 persons, meaning one person in New Orleans might have it. It tends to attack older folks, the median age being 60, but those younger, even including children, can get it, too. It’s more common in males.

            3. There is something in our bodies called the “splanchnic bed,” which I’d never heard of before. It really has nothing specifically to do with myelo, but I just wanted to let you know about its fantastic name.

            4. There are lots of different leukemias, which can be fellow travelers with myelo. The one that late-stage myelo can morph into, with nearly always fatal consequences, is acute myeloid leukemia (AML). Much, much effort is made to avoid AML at any and all costs. My doctors and I would end up going to great lengths to avoid it, too.

            5. The dawn of hematology occurred in the mid-1650s when a Dutch biologist, using a new device called a microscope, detected the red blood cells of a frog.

            6. The survival rates of the myeloproliferative disorders go like this: essential thrombocythemia – 20 years is the median from time of detection; polycythemia vera – 14.1 years; “overt” myelofibrosis – 3.1 to 5.8 years.

            Seeing such grim numbers may explain why I, for the most part, eventually decided to stay away from Google and the internet. There are those among us who haunt the online myelo pages in search of the latest news from the research front, reports from experts in the field and stories from fellow patients. I didn’t want to do that. I felt that the “latest news,” if it was actually a breakthrough of real merit, would come find me. And my interest in the stories of others, and the keep-your-chin-up dispatches from the myelo support groups, was minimal. In fact, after an initial flurry, my interest in my disease itself eased off as the months and then years went by and my condition remained stable. To some degree, absurdly, I felt that if I didn’t think about it, it wasn’t there. Or maybe, like a loudly humming refrigerator, it would somehow fix itself. Even so, things would occasionally intrude to remind me of the truth: a clock somewhere out there was ticking.

            The first of these came on March 8, 2010, my 60th birthday. Normally, a “0” birthday calls for a celebration beyond the norm, maybe even a big party. Mine, however, was like the classic memorial service for someone who’s still alive. Marcia had set things up, a catered evening affair at a local country club, and invited dozens of family and friends. Everyone knew about my recent bad news, and so the undercurrent in the room was hard to miss: “We’re losing Charley. Let’s not spoil things by saying anything overt, but let’s give him a good send-off!” Consequently, the tributes flowed freely. My early years were recalled with affection, songs were sung, my children, even middle child Matt, beaming in from South Korea, recalled their own early years and my loving and occasionally (to them) hilarious place in the middle of it all. As for me, I started out strong but eventually was reduced to tears. I couldn’t be coolly philosophical about it. I thought I was dying, too, and all of this being put before me, these many faces that I loved so much, were exactly what I wanted to hold onto. It was proof that I wasn’t ready to leave. Not at 60. There were too many more stories to be told, songs to be sung and toasts to be drunk. 

            Sometimes the reminder of my own condition came more starkly and unexpectedly. One morning in June 2010 I chanced to read in my local newspaper that a man named Jonathan Wolken, age 60, had died at Mount Sinai Hospital in New York, with the cause reported as myelofibrosis and complications from a stem-cell transplant. Wolken had been a year ahead of me at Dartmouth and, with a couple of college mates, had started the remarkably innovative dance troupe Pilobolus, based not far from us in Washington, Connecticut. We’d seen them perform several times. I’d felt a special affection for them because of our college connection, but I loved and admired their spellbinding takes on dance and movement, too. Now I was startled to see that one of the founders had died of something I also had. Same age, same college, same disease, same hospital – it was like he was the unlucky version of me, or I was the lucky version of him. I probably didn’t even really take in the news story’s reference to stem-cell replacement. I still was unaware of it as something that might be for me. It was seeing the word “myelofibrosis” on the printed page that made me sit up straight. You just never saw it in black and white like that, as if it were a weapon found at a murder scene. I tried to bravely spoon up my Wheaties that morning, but in truth I’d once again felt the hard summoning tap on my shoulder.

            I couldn’t afford to dwell on it, though. I had too much to do. I’d soon finish up my 24-year tenure as Editor of Connecticut Magazine and begin some types of writing I’d never tried before. The magazine had been a wonderful, sustaining job for a long time. We got many good things done there, even winning some national journalism awards, but its purchase by the now defunct Journal Register Company and its arrogant, inept and personally offensive leadership marked the beginning of a protracted decline. In retrospect, I shouldn’t have stayed as long as I did, but I guess I felt an attachment to the staff and loyalty to the magazine itself. I may have been worried about my medical insurance coverage, too, although Marcia’s benefits at her work were far more generous. Anyway, I hung around until they started the salary-dumping phase of their hideous regime, just before they sold the magazine off to a rapacious hedge fund. They came for my head, and salary, in mid-2013. We said our sad goodbyes and I lit out for my desk at home. I found some good freelance work and started on my boy’s dream of writing fiction.

            Maybe my myelo was pushing me to try new things before it was too late, or maybe it was my recent birthday, but the decade of my sixties proved fruitful. First came writing the book and lyrics for a musical, “Mad Bomber,” and seeing it staged in 2011 at Seven Angels, our regional theater in Waterbury. It was based on the story of local guy George Metesky, who in the 1940s and ‘50s set off a string of pipe bombs in Manhattan and became known in the city tabloids as the Mad Bomber. I had no background in the stage so I don’t know what made me want it to be a musical, but I did and that’s what it became. We never did quite figure out a good final number for the show, but it was exciting for me to sit up in the top row of the theater and listen to my words and rhymes coming out of the actors’ mouths.

            Three novels came next in the busy decade. The first was “Carrie Welton,” published in 2014, a historical fiction based on another actual Waterbury figure, this one from the mid-19th century, a young woman who was in some ways ahead of her time but prone to personal mishaps and misadventures. It was fun for me to research Waterbury, New York, Saratoga Springs and Boston as her story took her from place to place, and I loved going along for the ride, giving her and her contemporaries simple, smart and outrageous things to do and say. The second novel, 2018, was a mystery/thriller “The Easter Confession,” a Waterbury story set in 1955 involving art theft, murder and a Catholic priest who, tossed by circumstances, must solve it all basically by himself. The third novel, “The Darlings,” also written during this period, is still looking for a publisher, but no publisher seems to be looking for it.        

            Anyway, not bad production from an anemic cancer patient. Also not nothing were our Sunday group hikes of three to five miles through the Connecticut woods, or my participation in a weekly golf league, or spending a part or all of March in Florida and all or part of July on the Rhode Island shore in the little beach community of Quonochontaug, commonly called Quonnie, where Marcia had gone in summer for her entire life and where we, as a family, felt happiest and most at ease.

            During this period, people very rarely asked me how I was feeling. Maybe I looked healthy enough. Maybe they were afraid I’d give them an answer they didn’t want to hear. I continued to regularly visit Leever for blood draws and an occasional consult. I became very familiar with the blood routine. Everyone seemed most concerned with my white blood cells, hemoglobin, platelets and red blood cells. My first counts, taken for my initial visit with Dr. Bowen in January 2010, were 6.7 for white blood (in the normal range), 11.6 for hemoglobin (a little below the 12.0-18.0 norm), 3.82 for red blood (4.20-6.10) and 534 platelets (higher than the 150-400 norm). I would have blood drawn literally hundreds of times over the next 14 years and each of these blood components would demand its troubling, dangerous time in the spotlight. For that first decade, though, the numbers stayed generally the same: normal range for white cells and platelets, low red cells and hemoglobin (thus my persistent anemia).

            But a peace this weak and wobbly couldn’t last. Too many things conspired against it. Everyone knew, right from the start, that the bad days would eventually arrive. As it turned out, 2019 would be the year they’d begin, slowly at first but then, like an old steam engine leaving the station, picking up speed.

It’s kind of a dream come true to grow up in Waterbury, going to movies and concerts at the legendary Palace Theater, and then one day have your own name and image on the marquee (with a “Sold Out” addendum no less!). But that’s where I was 4/1/25 for a presentation based on my “illness memoir” called “First They Kill You,” based on my recent nearly overwhelming medical setbacks and the subsequent miracle of stem-cell replacement. If you’re interested in reading the first chapter (trust me, it’s entertaining), it’s posted below, with more to follow. I’d love to find a publisher for it, but this will have to do for now.

Lessons From Living, Dying and Living Again

Splenomegoly Days

            A sultry August late night in Saratoga Springs, N.Y., in the middle of the 2009 racing season. Beneath a full moon, the downtown streets – Caroline, Putnam, Phila – were crawling with college kids and overserved railbirds pounding one last pint and hanging around for one last song. Our little group of four was escaping up Broadway in the general direction of our motel. It’d been a long day. Up at dawn after way too little sleep for an early golf starting time, 18 holes, back for a shower, a change and a long walk to the track. Then race after race, losing hard-earned money with mechanical regularity, grabbing a few beers and some fried chicken, baking in the sun in between races. Later, rum drinks at Siro’s, the trackside bar, then a downtown crawl, bouncing from place to place, nodding to the live music, girl watching, as if it was 1977 again when we, delusional as always, saw ourselves as the stars of the show.

            We’d been making this Saratoga trip for 34 years. It began as a day excursion, about a 2-hour-plus drive from our Waterbury, Connecticut, home, for three guys – old friends – then four of us. As the years went by, the trip came to include one overnight, then a two-night stay, while our numbers grew to eight, then twelve, and even fourteen at one point before coming back down to eight again. We all went back a long way. Some had even gone to grammar school and played Little League together. For years, we’d played softball and golf in summer, basketball in winter, and then retreated to friendly locals for beers and true camaraderie. But Saratoga every summer was the undisputed jewel on our social calendar.  It was much anticipated as it neared and lamented in its passing. The previous 33 trips had supplied us with innumerable memories and stories that we repeated among ourselves until they passed into legend. So when one in our group wandering up Broadway that August night in 2009 suggested a final stop at a newish place called Limoncello, who were the other three of us to say no?

            The truth was, however, that I was in quite a bit of pain and very, very tired. As we found a booth at Limoncello, I was hurting enough to be seriously alarmed by my condition. As had been the case for months, maybe even longer, the pain radiated from my lower left abdomen and up my left side to the shoulder, where it perched like a dyspeptic parrot. As types of pain went, it felt deeper and more fundamental, and had certainly lasted far longer, than a pulled muscle or a bruise. It radiated down there in my terra incognita, south of the heart and lungs, just north of the digestive tract, where the lesser known organs joined together and practiced their unknowable mumbo-jumbo. Every now and then over the months I’d wondered what the specific source might be. The kidneys? Didn’t seem likely given their location. The liver? Wrong side (although hadn’t I read about people with the liver on the left side?). The spleen? Could be, but why, and what does the spleen do anyway? The stomach? Maybe, and come to think of it I had experienced unusual feelings of fullness from time to time. The gall bladder, pancreas, duodenum? Now we were getting into the truly deep splanchnic jungle, one I felt unqualified to explore.

            But sitting there at Limoncello, weary and probably a bit withdrawn, I made the decision to at last deal seriously with the problem. The pain and fatigue, and my putting up with it, had reached a critical stage and I was not too drunk to realize it. I was 59 years old, after all. I had a family I loved – a wife of 25 years and children aged 23, 22 and 19. It was time to take these red flags seriously. Even as I downed an unnecessary Sambuca nightcap, I vowed to call the doctor as soon as I got back home.

            Steve Rubenstein was my hometown GP. I’d come to him by a circuitous route. Marcia and I had become social friends with him and his wife, June, some years earlier. He was from the same city in New Jersey – Bayonne – where my mother had grown up – practically the same block. This gave us some gritty common ground to chat and laugh about. When I finally got thoroughly fed up with my previous doc, I asked Steve if I could climb aboard his patient list. I liked his serious, low-key, common-sense approach, his experience and confidence, and the way he began many of his sentences with the phrase “In terms of,” in the manner of a beloved med school lecturer. I hadn’t been much of a believer in annual check-ups, so he probably hadn’t seen me in quite a while. Still, after only a little prodding and probing of my abdomen, he came right to the point.

            “I terms of your complaint, your spleen is enlarged,” he said. “It might be pointing to a problem in your blood. Do you know Joe Bowen? I’m going to send you over to him.”

            I didn’t know Bowen personally, but I knew who he was. He was an oncologist, a cancer guy, and not the category of specialist that you wanted popping up on your go-see list. My Limoncello concerns were escalating rapidly. I had a few questions for Dr. Rubenstein, but he danced around them. I’m sure he believed Joe Bowen could answer them more authoritatively. I probably didn’t quite believe a sore spleen could be anything too serious, at least not right away. But I couldn’t dismiss the look on my good doctor’s face. 

            Bowen’s office was located in the Harold Leever Regional Cancer Center, an up-to-date joint effort opened in 2002 by our two local hospitals, Waterbury and St. Mary’s. It was located in Waterbury, about 15 minutes from where I lived. I’d driven by it many, many times, seen it under construction in fact, but now I’d be making my first visit. It was, and is, a full-service facility, housing doctor’s offices and examination rooms, high-tech scanners and other equipment, a chemo wing, meditation room, meditation garden, and a cancer-savvy nutritionist and social worker. Of the most interest to me on my first visit, however, was the patient waiting area and the people who were waiting there. After checking in and finding a seat, I took a look around at my neighbors. Could this be my new cohort? I studied them as hard as I could without being caught out as nosy or weird. The L-shaped room was small, seating maybe 15, but it was large enough to allow me a good sampling of our illness’s impressive range. So many hard miles on their faces. Those few in wheelchairs were most prominent. They were approaching the final frontier and might, if they wanted, have terrible stories to tell the others in the room who were further back in line. The guy in the corner with the smoker’s mug tried to muffle his persistent liquid cough. Others stared vacantly or spoke quietly with the person who’d brought them in. And although the nurses who circulated in and out were friendly and even cheerful, they couldn’t do much to ease the worry and fear that hung in the room like wallpaper.

            I didn’t say anything or strike up a conversation with anyone, but I tried to silently convey that I didn’t really belong there. I was an outsider. The new kid. If all went the way I hoped, this might be my only visit. These weren’t my people, I thought. They were sick. I really wasn’t, and I wouldn’t easily be brought into their ranks. But of course I hadn’t even seen the doctor yet.

            The feeling of being examined by Joe Bowen was very different from that of being looked over by Steve Rubenstein. Both were worthy veteran doctors, but Bowen was a specialist, Rubenstein a generalist. Bowen had immersed himself in the many faces of cancer and was qualified and ready to make pronouncements that could land like hammer blows. He came into the examination room, listened to my story, asked me some questions and had me lie back on the table for a little probing and poking. Like a conjurer over a Ouija board (and like Steve Rubenstein), his fingers came to rest over my spleen – my stupid bloated spleen. He sat me up again and in an avuncular, oddly comforting Waterbury way of talking (he was a native of the city) covered all the bases, but with a notably special emphasis on a condition, a cancer of the blood, called “myelofibrosis.” It was the first time I’d ever heard the word. He said it was probably what I had, and he didn’t leave much room for doubt. He asked me if I’d had fevers, vomiting, diarrhea, bruising, rashes or night sweats. I was relieved to say that I hadn’t. In response to my questions, he said myelofibrosis had no known cause and no cure yet, but that an encouraging number of treatments were becoming available. He added that for confirmation he wanted me to come back in for a bone marrow biopsy, another first for me, and the sooner the better.

            I returned to Leever a few days later, this time feeling I had a bit more in common with the waiting-room crowd. As I waited, I wondered what the set-up for a biopsy might be. I fantasized bright operating-theater lights, a rack of IVs and a bristling medical team. Instead, I was ushered into a nondescript back room and told to remove everything but my boxers. After several minutes, Dr. Bowen came in and had me lie flat, face down, on the examination table. I think he gave me a local anesthetic in the region of my pelvis. As Bowen set to work, my general feeling was one of disappointment. Where were the movie-set color and lights? Instead, I felt that I’d been transported back to an earlier, possibly illicit, gas-lit practice of medicine, maybe in the frontier west, where a crusty old solo practitioner played by Thomas Mitchell would do the best he could with a bottle of whiskey and the few tools at his disposal.

            It would take me a long while, and several more biopsies administered by others, to appreciate how sure-handed Joe Bowen was in his technique and how good he was. He explored expertly but, I gathered, came up empty – a dry tap, as it’s known. Fibrosis had built up so much in the bone that it prevented an extraction of marrow. I wish I could have witnessed the process, but with my face down on the table, I could only go by what I could hear. It wasn’t a terrible process. I didn’t feel pain so much as that weird, uncomfortable sensation of bone – inner bone – being disturbed by a metal tool.

            He patched me up and asked me to come back a week or so later, when he confirmed his initial diagnosis. He described the things in my blood/bone/marrow that didn’t belong there, things I’d never heard of but that were without a doubt cancerous. He said there were courses of chemotherapy that could be helpful to me. He even mentioned the removal of my spleen, a splenectomy, as something to possibly consider further down the line. He wanted me to come back in three months for a blood draw. I thanked him and told him that as a matter of course I’d seek a second opinion. He said he understood.

            My next stop was Yale-New Haven Hospital, about 30 miles away in New Haven. It’s a large teaching hospital, highly respected, and affiliated with the Yale School of Medicine. But I wasn’t there to sample all of Yale’s many wonders. I was merely asking for confirmation – or not – of Joe Bowen’s verdict. I presented myself, and my data, to Dr. Peter Marks, who looked me over, did the Ouija board thing with my spleen, asked me some by-now familiar questions and then retreated for consultation with his team of oncologist/hematologists. I liked Marks, and enjoyed talking with him (he’s the same Peter Marks who more recently, as the nation’s top vaccination administrator, resigned his post after butting heads with Robert F. Kennedy, Jr.), but I wasn’t yet in the mood to seek an alliance with a particular doctor. I don’t remember if it was the same day or several days later that I sat with his team of three specialists. They felt certain that the diagnosis of myelofibrosis had been correct. They recommended I keep a close eye on blood counts, fatigue levels and any other worrisome symptoms that might appear (the forbidding “night sweats” rose once again like a vagrant moon).

            When I got back home, I understood that an initial checkpoint had been reached. With the verdict so plainly in, Marcia and I needed to spend some time going over what it was, what it meant and what we might do about it. Luckily for me, she loved nothing more than talking through a difficult personal problem, ideally over a glass of wine. Generally, I preferred she do this with one of her friends rather than with me. I was less likely by nature to open up, but in this case didn’t see how I could avoid it. So for a couple of weeks in the fall of 2009, I’d get home from my job as Editor of Connecticut Magazine and Marcia from hers as a development officer at Choate-Rosemary Hall School and we’d take stock. Our conversations took many different sidetracks and scenic routes, but they always ended up in the same place. There was no doubt that I had a serious, essentially incurable form of cancer, one I’d never heard of and didn’t know anything about. Day to day, I felt its presence, but as long as I didn’t overdo things, as I had at Saratoga, it didn’t really intrude. True, I couldn’t sleep on my right side because I felt it a little too much, but any other position was fine. In other words, in its present state, I could live with it. And Marcia could, for the time being, live with me living with it. Someone along the way, I think it was Dr. Marks, had told me the cancer could blow up and demand action in six months or in as many as ten years. I told him I’d opt for the latter.

            Yet something inside me demanded even further confirmation. I felt the need to consult a doctor, and a practice, and preferably a whole research team, that specialized in what I had. I wanted to visit a place where they talked about and thought about myelofibrosis all the time, even in the break room and on the elevator. I wanted the keenest myelo minds and the latest myelo breakthroughs. Even myelo gossip would be fine. Another thing Dr. Marks had mentioned during our consult at Yale was the name of a doctor/researcher in New York who seemed to be at or very near the head of the field. It wasn’t long before I put the words “Ronald Hoffman” into my Google search box. And it was shortly after that that I found myself driving down to Mount Sinai Hospital in Manhattan for a visit to the third floor of its Ruttenberg Treatment Center on Madison Avenue.   

            The waiting area at Ruttenberg was enormous, with seating for about 100. With its steady murmur of voices and stream of half-intelligible announcements, down-on-their-luck patrons, and names being called for blood draws and appointments, the room had something of a bus terminal vibe, only, tragically, with all the buses headed to the same destination. Just about everyone was identifiably sick, some in that late stage of uncaring, disheveled stupor, and all were clearly in need of care. They sat with their phones or laptops or a book or knitting. Others just sat. A few were in wheelchairs or even came through on gurneys. Others came with friends or family who’d be able to help them get around or take down what the doctor or nurse had to say. Every once in a while, a volunteer came around with crackers and apple juice. Even knowing what I then knew about my own condition, I remained aloof. I had trouble thinking of myself as this deathly sick or of these poor souls as my new tribe.

            If Mount Sinai was the healthcare equivalent of Yankee Stadium, with its 7,400 doctors and 42,000 employees spread out across several campuses, Dr. Hoffman was one of its most reliable all-stars. For more than 40 years he’d been helping to pioneer the fight against myeloproliferative disorders. His stated long-term goal was to “advance the cure,” identifying abnormalities in the stem cells and then finding ways to deplete or eliminate them. Progress by 2009 had come in fits and starts, stalling but not ending the takeover of the disease with various chemo pyrotechnics. Meanwhile, stem-cell replacement, also known as bone-marrow replacement, was emerging more and more as a viable alternative. It was increasingly being performed but was still too uncertain and risky to have entered the main stream of treatments.

            Certainly it was not mentioned by Ron Hoffman during our brief get-together. He saw me in his office, and I think he knew what he was going to see. He asked me the usual questions and probed the usual places. His manner was affable, open and absolutely authoritative, and he was ready to hear my questions. He even gave me his cell-phone number. But his analysis was straight to the point and nothing I hadn’t already heard. My myelo had not yet reached a critical stage and might not for some time. I would feel the effects of anemia and my enlarged spleen. I might want to play 9 holes instead  of 18. I would need to get my blood counts read regularly.

            So ended my initial run of doctors and their waiting rooms, and so began a decade of pax sanguis – of treading water, feeling not so terribly bad, and defiantly taking 10 more trips with the boys to Saratoga. I didn’t keep my condition a secret. I thought it best for people to know that something might be coming. But I really spoke about it very little. And if someone asked me about it, I’d smile and say, “It’s asleep.” But of course it wasn’t asleep. With cancer’s unerring industriousness it would remain hard at work over the course of the coming 10 years – fully occupied with the perverted, single-minded task of turning my own blood against me.

One writing form I’d never really tried my hand at was the short story. Until now. One day recently I heard about a distinguished old couple who’d made a very difficult decision – and a story, a short one, immediately took shape for me. I know that elderly WASP couples aren’t fashionable these days among fiction editors and publishers, but I do think that life in our nation’s retirement communities and assisted-living facilities, where millions reside with their stories and fading memories, is well worth exploring.

The Washburns

The news raced through the corridors of The Hearth at Pilgrim Hill from the moment Rick and Kit Washburn announced that they were going to starve themselves to death.

By the next day, the initial shock had begun to wear off, but only a little.

“They’ve obviously thought it through,” said Gigi Sands at lunch. “They don’t want to wait for the unknown to come and sweep them away. I think we get that.”

“We also get that they want to go at the same time,” said Gene West, who just two days earlier had played gin with Rick Washburn.

“More or less the same time,” said Evie Coviello.

“Yes,” said Gigi. “It’s an inexact science.”

They spooned through their soup. Cream of broccoli. Carl Nevers, who was not a broccoli person, busied himself with a tiny packet of oyster crackers. They’re starving us already anyway, he thought but didn’t say. Their group of five—three widows and two widowers—tried to gather for lunch every day. They called themselves the Lost Spouse Club. On many days, doctor’s appointments or other obligations interfered with their having a full table, but today all were present. Each of them, either openly or not, had been shaken by the news of the Washburns.

“Is what they’re doing legal?” asked Betty Samuelson.

“To not eat?” replied Gene West, leaving the rest unsaid.

“Unless it becomes a big deal,” said Evie.

“Yes, right,” said Gene, trying to seize authority on the issue. “If it becomes a big deal, someone will step in and stop it.”

“Put a tube down their throats,” said Carl.

“I don’t think it would come to that, Carl,” said Gene. “Rick and Kit want to go peacefully, not in a struggle with the authorities.”

“They’re trusting we won’t let word get out,” added Gigi. “Even staff isn’t supposed to know, although Kit didn’t mention that specifically.”

“Staff already know,” said Carl. “You can’t keep this sort of thing quiet.”

“Especially when you issue a proclamation about it,” said Gigi.

“I wonder what they’ll do,” said Betty. “Management, I mean.”

“If they do anything,” said Evie.

“Maybe they’ll just let it ride,” said Betty. “That’s what they’re good at.”

Few would feel comfortable saying so, but death and dying were more often than not the topics du jour at the Hearth. On any given day, a new name from the population might be revealed as being ill, or on the way out, or gone. There was even a shrine of sorts out by the front desk, where photos of the recently deceased were displayed, along with brief biographies and expressions of admiration and support from other residents. Death at the Hearth could be quick: familiar faces, longtime staples of the dining room and movie theater, could disappear without warning, never to be seen again. Or it could be gradual: if someone was said to have “moved on,” it meant they’d left independent living for the obscurity of the medical wing. Betty Samuelson once called the medical wing “The Terminal,” and the name stuck.

In most cases, the end was accompanied by familiar language. “X” had waged a brave battle. “Y” had remained notably cheerful throughout. “Z” had faced excruciating pain with equanimity. Which is what was making the Washburns’ decision so remarkable. They weren’t about to go down a dark, messy path chosen for them by fate. They were choosing their own route and their own language. Theirs would be a story of their own making. Suddenly the Washburns were the only thing anyone wanted to talk about. And it wasn’t just the Lost Spouse Club doing the talking. It was all of the Hearth.

Because of a recent joint birthday party, everyone knew that Rick Washburn was 95 and Kit 94. He’d seen brief service in World War II, on a ship in the Pacific, and then had come home to a degree from Bowdoin and a long, far-reaching career with the State Department. Kit was from a prominent Eastern family. She’d been a much-honored newspaper reporter and later a syndicated political columnist under the name of Andrea George. They had two children, a daughter, Harriet, who lived outside Cleveland, and a son, Jim, on the Delaware shore, now both pushing 70 themselves. Rick and Kit had zigzagged across the globe for many decades before finally settling down on the Cape, but, somehow, most likely with some very good and loyal help along the way, they’d made it all work. They’d been married 68 years. Even in very old age, they were a handsome, modest, devoted couple, and a distinguished presence. Day after day, they could be observed roaming the broad corridors of the Hearth, lately with Rick leaning heavily on a cane and then in a motorized wheelchair, and always with at least a nod and a smile to those they encountered along the way. They hosted lively discussion groups and annual carol sings, and more often than not made sure to be present for public events and celebrations. Their minds remained remarkably sharp and even probing. In their own way, and certainly without looking for it, they were considered by most to be the stars of the Hearth.

It was Kit who’d handled the announcement of their starvation plans. She’d come into the dining room at peak dinner time and moved among the tables, distributing a letter—a straightforward disclosure that affirmed her newspaper background:

Dear Friends,

After a long, productive, happy time together and with others, Rick and I have decided that we are going to end our lives. Beginning this day, November 9, 2021, we have stopped eating. We plan to take only water until such a time as our bodies give out entirely and we starve to death. This may seem an abrupt and extreme measure, but we have done the research and thought it through. And, yes, we’ve discussed it with Harriet and Jim, who are both fully on board with exceptional understanding and compassion. They’ve both promised to be with us at the end. As some of you may be aware, we have experienced a number of health reversals in recent months, none serious, but each foretelling an increasingly bleak future. Everything—seeing, hearing, walking, eating, even thinking—has become increasingly hard for us. As we approach 100 years, we’d prefer to go out more or less as we are now—in one piece, as it were. Starvation isn’t necessarily painless, but it is relatively peaceful and organic. We won’t be introducing poisons into our systems or resorting to the violence so often associated with suicide. We figure that at our ages we probably have days rather than weeks left, and after the first few days we expect to be in a weakened state and confined to our apartment, where we’ll be under professional care. We will be doing a lot of hand holding, the two of us, and thinking of past days and of course all of you. We hope we haven’t shocked you. We think it’s only fair that you be informed of our plan, but we ask that you not spread the news too far and wide. We don’t want it to become a “thing.” Again, please don’t think this a rash or reckless decision. It’s simply what’s best for us.

Avec amour,

Kit and Rick Washburn

Kit hadn’t stopped for conversation. She’d simply walked out of the dining room, leaving tumult in her wake. At some of the tables, the statement was read aloud by one voice. At others, it was passed around. After that, it quickly circulated among those who, for one reason or another, hadn’t come to dinner or were confined out in The Terminal. The expressions of shock and disbelief that night were widespread. Yea and nay judgments flowed freely and often loudly. But there was, too, an undercurrent feeling that the Washburns had knocked down a wall of sorts by giving public voice to private feelings shared by many, and, beyond that, that they were openly and even flamboyantly committing to a final act that, in one form or another—whether by starvation, overdose, suffocation, carbon monoxide or gunshot— had up until now been one of the Hearth’s most respected and tightly protected rituals.

After their lunch with the group, Evie Coviello and Betty Samuelson relocated to seats by the gas fireplace in the Hearth’s main lobby. They were old friends, going back to their days as young housewives in Swansea. It had been Evie who’d discovered the Hearth and fallen in love with its scrub pine vistas and frequent infusions of pungent sea air. She and her husband, Ray, bought in and then convinced Betty and Stu to follow. Ray and Stu played golf and card games together, but they never felt happy or at home in their new surroundings. They died within six weeks of each other—Ray of a heart attack, then Stu of natural causes in his sleep. That was eight years ago. Since then, Evie and Betty had become better friends than ever, often sharing confidences they’d never share with anyone else.

“I’ve been wondering what Greta would think of all this Washburn stuff,” said Evie. “God rest her soul.”

“Funny, I thought of her this morning, too,” said Betty.

Greta Jensen had been a close mutual friend who, three years earlier, in order to escape the frightening depths of Parkinson’s, swallowed an entire bottle of Luminal one evening right after dinner. She was discovered the next afternoon, lying on her perfectly made bed, her various letters and legal documents arrayed around her like peacock feathers.

“’Take with food,’” said Evie, which once again made both women laugh. Even for an intentional overdose, Greta had followed the prescription’s instructions.

“She wouldn’t have liked this sort of attention, though,” said Betty after a moment. “She went quietly.”

“Like a mouse,” said Evie.

“And she wasn’t the only one.”

Over the years, there’d been any number of episodes at the Hearth. Some were later confirmed as suicides while others remained mysterious. Hugh Gaffney, depressed after losing Nancy, had certainly shot himself on purpose, even taking care to first cover his head with a pillow. Darby Bly, on the way out with late-stage ovarian cancer, slit her wrist in a warm bath. No two ways about what her intention had been. But Kay Seabright remained an enigma, either confused or purposeful about her major doses of OxyContin. For that matter, always suspicious of the words “natural causes,” Evie had long wondered about Betty’s own Stu, although she never dared ask about it. Anyway, the point was that none of them, or any of the others, had announced their intentions to a full dining room, which now the Washburns had done.

Betty took two sugar cookies from her jacket pocket and gave one to Evie.

“Well, they better go through with it,” she said.

It was four days later that the Washburns’ apartment door, 207B, was shut permanently to the outside world. Except for family and caregivers, no one would be allowed to enter. The final act was now under way. The evening before, Kit made herself available in the music room for what turned out to be something like a last briefing. She was now in a wheelchair herself, having weakened considerably. She spoke slowly but precisely. Rick was confined to his bed, she said, at that very moment lying fully clothed on his back, atop the covers, with his legs crossed at the ankles and his head propped up. They’d moved their beds to the living room, where big windows allowed them a view of woods, a distant meadow and, in recent days, an evening moonrise. Soon, Rick would be permanently changed into his bedclothes, and so would she. They were listening to Mozart and the Mormon Tabernacle Choir and looking at old family movies and photographs. From time to time, she said, one of the caregivers read to them from a book, but it was mostly for Rick’s benefit and she was embarrassed to admit she couldn’t recall the author’s name. Finally, she said, “When we close our door tomorrow, that will be it. We’ll be on our own.”

When she was done, she looked around briefly as if to entertain questions, but no one in the small group, which included Carl Nevers, felt like asking anything. Instead, they said their goodbyes and watched as Kit was wheeled back down the corridor. As she neared the corner, she didn’t turn around to face them—she couldn’t—but she weakly raised her right hand in a sort of final salute.

Carl relayed the details to the others the next day at lunch.

“Shutting the door like that,” said Gene. “It reminds me of when the astronauts used to climb into the capsule and close the hatch behind them.”

 “I just went by their apartment on the way down here,” said Gigi. “Their door was definitely closed. I mean, all the doors are closed, but there was a finality to theirs, with us knowing. It had almost an aura to it.”

The others nodded. They’d all walked past it at some point.

“Kit described the scene so well,” said Evie. “You could picture Rick lying there in bed.”

“The scary thing is, that could be me she was describing,” said Gene. He held up half of his BLT. “I’m not starving myself to death—far from it—but I’ll admit I do spend a lot of the day lying on my back in bed, fully clothed, just like Rick.”

“That’s too much information, Gene,” said Evie with a laugh.

“He’s right, though,” said Gigi. “How different are we from the Washburns? Just a little further back in the line.”

It was clear that by now, nearly a week after the Washburns’ announcement, the initial agitation had subsided, and a general understanding and acceptance had crept into its place. If there was one thing this group—the whole Hearth population—was good at, it was taking upsetting news or the day-to-day calamities of life and burying it under a thick blanket of happier thoughts, well wishing, prayer and forgetfulness. But even as they began to move on a bit, they could still quietly admire Kit and Rick for being trailblazers. What they were doing, and how they were doing it, would make it easier for others to contemplate doing the same if and when the time came. Not everyone would want to, of course. Most never would. But the ones who did would realize that they could chart their own course, make their goodbyes, and then just go.

On the eighth day, an ambulance came and took Rick Washburn’s body away. According to a couple of the Hearth’s night owls who’d noticed activity around the front entrance during the 3 a.m. hour, the stretcher had come in and then gone back out again without ceremony. An aide had walked it down to the entrance and seen it off, and on her way back upstairs told them that it had been “Mister” who’d been taken away. Now it would be only Kit behind the door at 207B. How conscious had she been of Rick’s departure? How different would it be now without him beside her? How much longer could she possibly go on nothing but water and ice chips?

These were the questions that bounced back and forth among the Lost Spouse Club early that afternoon.

“She’s a stubborn old Yankee,” said Betty. “She never ate much to begin with.”

“Broccoli raw at lunch and cooked at dinner,” said Evie.

“And gin martinis,” added Betty. “She could still have a ways to go.”

“But now her husband’s not with her anymore,” said Gigi.

“Well, it’s not like you can speed up the process when you’re already starving yourself to death,” said Carl.

“You can always stop taking the water,” offered Gene. “But it’s useless to speculate.”

“I guess we just wait until the ambulance comes again,” said Carl.

As it happened, when the next ambulance did come, it came for Carl. Later that same afternoon, in the mood to purchase a windbreaker,  he was walking up a short flight of shallow stone steps by the golf clubhouse when he somehow lost his way and pitched forward, hitting his knee and elbow against the stone, and the side of his head against a water spigot protruding from the clubhouse’s foundation. The ambulance arrived promptly and departed without delay, but Carl didn’t survive the ride to the hospital.

An accidental death such as Carl’s was a little unusual for the Hearth. There were loss-of-balance accidents all the time, of course, with so many residents being in their 80s and 90s, but a fatality had to be deemed just very unlucky. Gene took a special interest in his friend’s arrangements, knowing Carl was estranged from his only child, a son, and had no other family to speak of. He wrote up a brief obituary and sent it to the newspaper in Carl’s hometown of Troy, NY, and also to the Fairfield University alumni office. In it, he noted Carl’s service in Korea, his long career in advertising and his special interest in the UConn women’s basketball team and wading shore birds, which had drawn him to Cape Cod.

Gene also spoke briefly at the memorial gathering that took place two days later. Carl hadn’t been a religious man, so the Hearth’s well-practiced vanilla service would be all he’d require. Gigi, Betty and Evie also spoke. They mentioned Carl’s good nature and his fondness for the Hearth kitchen’s macaroons. Betty very unexpectedly sang an unaccompanied version of “I’ll Be Seeing You.”

At the reception that followed, the surviving members of the Lost Spouse Club stood in a cluster and took in a steady stream of condolences. If the words of comfort at times seemed a little pro forma, it’s because these gatherings were so commonplace at the Hearth. In a big room, with so many voices going at once, no one could hear anything anyway. The exact words didn’t matter as much as the look in the eyes.

After forty minutes or so, Gene, Evie, Gigi and Betty took their macaroons and coffee to a table and sat down. They marveled at the turnout and the affection for Carl, who had always been so unassuming. Betty called him “a dark horse.” The level of conversation swelled when Sharon Delfino sat down at the piano, as she so often did, and began playing her medley of popular show tunes. What could have been a solemn, sad event to see off one of their own had turned into a mid-afternoon celebration, not only of Carl’s life, but of each other. All would have agreed, if asked, that this was the Hearth at its very best.

It was also why no one noticed when an ambulance pulled up once again to the main entrance and a stretcher was wheeled inside. Only the staff at the front desk was on hand to witness the removal of Kit Washburn’s body from the building, and to remark on her passing.

“Isn’t she the lady who wanted everyone to know that she and her husband were starving themselves?” one asked the other. “Should we go tell them?”

“They’ll find out soon enough,” the other said. “Let them have their fun.”

Goodreads Book Giveaway

The Easter Confession

by Charles Monagan

Giveaway ends September 22, 2020.

Enter this GoodReads giveaway to pick up a free ebook copy of “The Easter Confession” to read on your Kindle or other device. Nothing to lose, right? Enter today!

See the giveaway details at Goodreads. Enter Giveaway

I just wanted to pass along the excellent story on my new novel “The Easter Confession” that appeared in this morning’s Sunday Republican under the byline of Alan Bisbort. I’m not sure how or why the paper had on hand a 1958 photo of the Monagan family – and really not sure why they chose to use it – but it does show how nicely parents dressed up their kids back in those days. Anyway, here’s the story. You can find the book for purchase – ebook and paperback – at Amazon.com.

https://www.rep-am.com/life-arts/2020/08/15/before-the-flood-waterbury-author-uses-historic-event-as-backdrop/

MAD was the magazine most kids like me loved as they grew up. But Help! . . . let’s not forget Help!

https://pleasekillme.com/harvey-kurtzman/