CARING FOR RENEE
This is for Renee.
In April 2000, my wife of 33 years, Renee Efland Rabin, and I were as happy and optimistic about the future as a “young, old married couple” could be. She was 52 at the time, and had been just 19, my English student at the University of North Carolina, when we were married in 1967.
Our two kids had graduated from university in 1999, both with highest honors, and were launched on their careers… though still very close to Mom and Dad. We were done paying their college expenses, had more than enough money for our needs, a nice home in Washington, and were on our way to Rome for a short working holiday.
We had a wonderful time in Rome, but Renee complained of shortness of breath and aches in her chest and neck, and she was glad she had already made an appointment with her doctor for when we returned.
Her doctor found her to be a bit anemic, prescribed iron supplements and scheduled her for a number of tests, including a colonoscopy to take place on June 22nd.
In the interim, we took another short trip to Arizona to visit our daughter, who had just launched on a job with the Phoenix New Times. Though we had another wonderful time, Renee was very fatigued, had developed a dry cough and had great difficulty climbing the steps of the baseball stadium in Phoenix, where our daughter and her boyfriend had gotten us tickets for the Memorial Day ballgame.
Back home in Washington, just a few days before Renee’s scheduled colonoscopy, I came home from work to find her sitting at the small table in our kitchen, looking very tired, her face glistening lightly with sweat. “I haven’t gotten dinner,” she said, “could you go over to the Booeymonger and get me a turkey sandwich and piece of apple pie?”
Never in all our years together had she gone out of her way to ask for a piece of apple pie… I looked at her and said, “I am terribly worried about you. I want to take you to the emergency room, now.”
We drove over to Sibley Memorial Hospital, the same hospital where are kids were born, and checked her into the ER. After a long night and following morning of tests and observations, it began to become quite clear that something was very wrong.
She was still anemic, despite daily iron pills, and her liver enzymes were way out of kilter. X-rays showed that her diaphragm was elevated and pushing on her lungs, undoubtedly causing her frequent coughs.
The colonoscopy and an MRI revealed the final, awful truth. Renee had colon cancer, and as the tumor was located very close to her liver, the cancer cells had simply jumped across and taken over virtually the entire organ.
We were told that she had three months to live.
Well, I worked in health care communications, knew dozens of oncologists and was actually working with some people who had developed a new technology to deliver radiotherapy directly to liver tumors. I told Renee and her doctors that we were not going to accept this prognosis.
So I became a caregiver… and an anguished participant observer in the decline and death of the most beautiful human being I will ever know.
There was immediate surgery to remove the primary tumor.
My daughter moved back home, and we bought a house a few blocks away so that my son, daughter and her boyfriend could be nearby but not need to be at a home that all too soon became filled with IV pumps, soft foods, bedpans, adult diapers, plastic sheets, and an entire pharmacopia of medicines.
Chemotherapy began in July, with some harrowing reactions, but also with some very good days that included a September trip to the beach and the early October wedding of one of our son’s best friends, where Renee and I danced in each other’s arms for the last time.
By late October, the end of the original three months she had been given to live, it was clear that although Renee was not in immediate danger, the chemotherapy was not having any significant effect and her doctor said there really was not anything left to do.
“I want to visit New York,” she said, “because the last of the three-part show on the art of the twentieth century is at MOMA.”
We went and had the last “normal” vacation of our lives together, a visit to the museum, a lovely dinner with champagne, a slow walk in Central Park in late Fall.
On the train ride home, she turned to me and said, “I still feel sort of OK, but I know that this cancer is taking me over completely, Ken. I want to go to South Beach with the kids for my birthday (her 53rd, December 26th), so can you get your doctor friends to give me this new treatment you have been working with?
The procedure took place at the University of Maryland in mid-November, just a few days after she had sat in line to vote for Al Gore, a personal friend whose disputed defeat became an ongoing news story and a useful ongoing distraction in our lives over December and January.
MRIs, in fact, showed that the radiotherapy procedure had destroyed masses of liver tumor, and Renee rallied enough to tolerate a week of home IV that was sufficient enough to see her through the flight to Miami, the walk through the airport (“No wheelchair, I will not be seen in a wheelchair.”), the long wait for a table at Joe’s Stone Crab where we played cards with the kids to kill time, too many hours in bed at the National Hotel, punctuated by a memorable afternoon by the pool and the return flight home.
Just after New Year’s, I came home to see that Renee, who had majored in art and worked as an art director in an ad agency, had made some small drawings of a couple of pieces of furniture she wanted to fill out our dining room and living room.
On January 6th, on our way home from her last visit to University of Maryland Hospital, where the doctors said that there was less tumor but offered only guarded hope, we stopped at an antique shop in Kensington, Maryland, where we found the exact 20s liquor cabinet she had drawn, and had it delivered to our house that evening, to Renee’s immense satisfaction.
A week later, lying in bed in the morning, after I had brought her a nutrition shake that she could not drink, she began to suffer uncontrollable spasms and chills. I got the kids to come to our house, where we called 911, and Renee was rushed back to Sibley Hospital as we rode alongside.
The doctors said that she had a massive infection throughout her abdomen, and we were urged to call her family in North Carolina, as death was imminent.
It wasn’t. Massive doses of antibiotics pulled her through.
We brought Renee home again in late January, and settled her into bed, surrounded by her entire extended family – Mom and at various times all of her 6 brothers and sisters, wives and kids.
Renee said to me, “Look, I don’t know how much longer I can hold out, but this is where I want to die. No more hospitals, please.”
With the help of an enormously gifted and compassionate IV nurse, we kept Renee clean, clear of infection and as comfortable as possible for the next several weeks. During her lucid moments we talked lot, and at several points she was able to sit up alongside me in bed, complain about both our new President and the state of our beloved Washington basketball team, and watch movies on TV.
In mid-February, by which time Renee was on steadily escalating doses of morphine and her organ systems were shutting down, the IV nurse called me aside.
“Have you talked to the Hospice, yet?” she asked.
“Renee wants to stay here,” I said.
“Yes, and she can, but if you do not bring a Hospice nurse in now, and she dies here at home, you will actually be subjected to a homicide investigation.”
The things you learn…
It actually took a fair amount of battling to get Washington’s leading hospice to provide us home nursing, but the nurse they sent was truly wonderful to us.
On the morning of February 25th, 2001, woozy from morphine, Renee opened her eyes for a second, turned to me and said, “Am I still here?”
Later that day, the hospice nurse advised me to cut back on the morphine dose.
Just before dawn on the morning of 26 February 2001, Renee sat bolt upright in our bed and said, “Help me, I can’t breathe.”
She coughed up huge gouts of black blood, and was gone forever.
Even now, almost five years later, though I am remarried and living a wonderful and fulfilling life in Europe, I relive this last moment every single day.
But I also relive our life together and how blessed we were to have the time we spent as husband and wife. Someday, perhaps, we will meet again.