The Final Straw

by

Jan M. Flynn

I’M LATE TO MY SISTER’S SUICIDE AGAIN. I’ve gotten to the facility at the tail end of visiting hours, which means a shift change for the caregivers, which is why I’ve been standing out here for ten minutes waiting for someone to let me in. I ring the doorbell a third time.

I adjust the shoulder strap on my purse, my right hand cramping from gripping the other bag. I set that one, very carefully, on the broad edge of a planter. There’s a bench, but between the plane and the rental car my back is stiff from sitting. Besides, I’m too keyed up.

A woman in scrubs appears on the other side of the glass door. I pull on my facemask.

“You’re Laura’s sister, right?” she says as she lets me in. “She’ll be happy to see you. She’s been waiting for you.”

“My flight was delayed,” I say. I probably sound defensive. She waves a thermometer at my forehead and checks me in on the visitor log. Above her own mask her eyes crinkle, suggesting a smile.

“I’ll show you to Laura’s room,” she says.

“It’s okay, I know the way,” I say. She gives me another crinkle and heads toward the lounge, her clogs squeaking against the linoleum.

Other residents, slumped in wheelchairs or sunk into couches, watch Audrey Hepburn and Rex Harrison on the huge glowing screen above the fireplace in the lounge. The fireplace is never lit, but the television is always on. CNN and talk shows until noon, then a repeating loop of vintage movie musicals. Tonight, once again, it’s My Fair Lady. One of the ladies, who looks like a half-deflated doll, her pink scalp showing through hair like cotton candy, stares at me as I pass. I wave a greeting but the woman’s gaze slides back to the television.

My sister Laura is fifteen years younger than the youngest of these people. She’s older than me, enough so that I was still playing with Barbie dolls when she left home. But she kept tabs on me when Dad left and Mom went dark. It was Laura who kept me on track, who made sure I went to college, who talked me into a study-abroad semester despite my never having been east of Reno. Late in that dank Paris winter, Laura surprised me by showing up at my dingy student flat. She spirited me off on a hunt for the best croissants in the city, which we munched while huddled together on a bench near the Palais Royale, laughing and covered in crumbs, magnolia buds breaking above us.

Three years ago Laura was a sharp-dressing community activist who championed worthy causes and chaired fundraisers, including ones for this facility. Three years ago, Laura and I had a bucket list trip to Cambodia all planned.

Initially, her neurologist said that the progression of her disease was impossible to predict, but could be very slow. Now he describes her case as rapidly advancing. She and I have long since given up on seeing Angkor Wat together, and every time I visit I’m again startled to realize she looks as frail and glassy-eyed as anyone else in here.

I step into Laura’s room. A young man in rainbow-patterned scrubs is transferring her from her wheelchair into her bed, a complicated process that I can no longer help her with without risking injury to her or myself.

“Oh, look who’s here,” she says in her wispy voice, smiling and gesturing with her right arm, the one she still has some control over. “It’s my baby sister! Jeannie, this is Edward!”

I bend to give my sister a kiss and on the way down share a friendly wink with Edward. He’s Laura’s favorite caregiver, and she introduces me to him every time I visit.

She chatters as happily as she used to when hosting parties. “Edward wants to apply to a physical therapy program I told him about, and I’m going to write him a, ah, um –”

“Recommendation,” I say, and at her crestfallen look I want to slap myself.

“That’s what I – no, no, wait! I’m falling!”

“You’re all right, Laura, I’ve got you,” says Edward, who certainly does. He’s careful, gentle, expert at his job. He’s also big and burly enough that he could hoist my diminished sister with one arm if he had to. At the moment he’s got her positioned only inches above the mattress, but that’s not how it feels to Laura.

My sister’s disease chews away at multiple regions of her brain, including the one that tells her where her body parts are in space. For Laura, being settled into bed or a chair can seem like she’s about to pitch backward over a cliff. From what I can tell, her days are a series of barely controlled terrors, moving from bed to chair to shower to dining table and then back again, in between long bouts of waiting for something to happen.

No wonder she’s looking for the exit ramp.

It’s harder for Edward to maneuver Laura while she’s distracted, so I move further into the room, out of her sightline. The television yammers at half-volume, some mindless reality show the Laura of a few years ago wouldn’t have allowed in her house.

I put my purse down but hang onto the other bag, unwilling to let it go until my sister and I are alone. Laura keeps talking about Edward’s professional ambitions, his partner, his disapproving family, and everything else she’s learned about him. My sister’s greatest talent has always been making friends; she has more of them than anyone I’ve ever known. But her sense of what constitutes oversharing seems to have gone offline, and because she’s caught up in storytelling and paying no attention to the task at hand, Edward’s job takes much longer. I marvel at his patience. Laura’s voice grows breathless and airy, indecipherable over the TV. I turn it off.

“Are you tired, Jeannie?” Laura, tucked in at last, is obviously fatigued. Edward takes the opportunity to extricate himself from the conversation. He waves goodbye as he shuts the door. The room grows dimmer, quieter.      

Visiting hours are over and I need to check in at my hotel. I’ll be back here in the morning. But Laura, who has waited all day for me, will be disappointed if I say goodnight too soon. I’ve learned not to sit on the edge of her bed because that will trigger the alarm that warns of a fall, so I crawl in under the top blanket beside my sister.

“I’m sorry I got here so late,” I say. “I called Stephen to tell him my flight was delayed.”

“He didn’t tell me,” Laura says. Her brows draw downwards.

Stephen, Laura’s older son, did tell her. He was in her room with her, checking in on her after he’d gotten off work, when I called from the car rental counter. I heard him explain to his mother about the delay. 

She mumbles something I can’t make out, her eyes barely opened, losing focus. I wait until her breath evens out and lengthens before I slide out of the bed. I retrieve my purse, the other bag still in my hand.

I’m halfway to the door when Laura’s voice penetrates the dark room. “Did you bring the stuff? Can I see it?”

Startled, I return to her side. “I’ve got it,” I say. “But are you sure it won’t keep you awake if we look at it now? Maybe you’d rather wait until morning.”

“I’ve waited long enough.” There’s an edge to Laura’s words.

I turn on the bedside lamp, empty the bag, and arrange its contents on the bedspread. Out comes a stack of sealed and addressed envelopes. Out comes Laura’s favorite canned fruit nectar, then the mortar and pestle, and the deadly pills, and finally the special cup and straw.

Laura flails, trying to see more closely, until I raise the head of her bed and wedge another pillow behind her back. Her left arm spasms, sweeping everything into confusion.

“No worries,” I say as I hurry to locate and rearrange all the items, counting to make sure I haven’t missed anything. It’s all there. I give Laura a thumbs-up, and see that her eyes are closed again, her mouth open and slack in sleep. I gather everything up and put it back into what Laura, in a flash of dark humor, once named her go-bag. I kiss her forehead before tiptoeing to the door.

Her voice rises from the bed again, plaintive. “I don’t have any dresses.”

I pause, unsure if she’s sleep-talking.

“Do you have my St. John knit, Jeannie? The one with the gold trim?” Her voice has an edge of suspicion now.

“It’s in a dress bag in my closet,” I say. “I can send it to you anytime you want.” She hasn’t worn that dress in over twenty years. Some things seem to stick in her brain, like signposts pointing to her greater losses.

I wait for a response; none comes. “Good night, sis. Love you,” I whisper.

Darkness blankets Laura as I edge the door closed behind me.

THE HOTEL DESK CLERK RECOGNIZES ME. “Tried to get you an upgrade again this time, but we’re jammed,” she says. “But I got you in the Fountain Court section.” She smiles, her expression in danger of tipping over into pity. This isn’t a big town, and until recently Laura was a large presence in it.

“It’s okay, thanks,” I say. “I’ll take my bags myself.”

The room is small but comfortable, and the gentle splashing from the fountain outside the window is soothing. I stow my things, put Laura’s go-bag in the room safe, and take a hot shower. I haven’t eaten but I don’t have the energy to cope with the restaurant across the street. I wash down a protein bar with the sauvignon blanc from the mini-bar, call home to say goodnight, and fall asleep to a meandering crime drama.

An infomercial jars me out of sleep. I fumble for the remote and switch off the TV. There’s an objectionable feature to this room after all: one of those bedside clock radios that projects the time onto the ceiling in huge glowing digits: 3:24 AM. I drape a washcloth over it, which turns the digits into a blurry patch of poison-green light hovering above me. I throw the washcloth on the floor. At least the numbers don’t look so spectral.   

I know how things will go in the morning. Laura will be more alert after her shower and her breakfast. We’ll chat for a while. Then she’ll ask me to lay out all the stuff in the bag again. She’ll announce her intention with tearful resolve, as though it’s a new decision. She’ll insist on seeing the printed list I keep for her, the names and numbers of the people I’m to call when it’s over. She’ll look at all the envelopes and go over the directions for where she wants the dusty echoes of her failed body to be scattered.

And when all that is done, she’ll be quiet for a minute. Then, suddenly cheerful, she’ll start talking about something completely unrelated. The moment will have passed.

For nearly a year now, this has become a ritual, a fixture of our visits. It repeats with surprising fidelity given Laura’s condition, right up to when and how she changes her mind. The first time, the second, even the third, I steeled myself for days ahead, trying to nerve myself up but starting each trip in a halfway out-of-body state, amygdala on full alert.

But every time, just at the brink, Laura retreats. The first few times the experience buried me in a slurry of emotions – relief, frustration, attenuated grief – leaving me knackered. I moved through life like a zombie for days after returning home, barely a placeholder for my colleagues at work. My husband said it was like living with a polite ghost. 

By now I’ve learned to think of these drills as rehearsals for an event that will never take place, even though everyone in her family is on board. According to her state’s law, someone else can prepare the mortal elixir, but Laura has to be able to drink it without assistance. With her condition worsening, the chance of her being able to go through with it is fading. But none of us have the heart to point that out to her. At least the rehearsals seem to give her a measure of peace, even satisfaction. Each time, once Laura defers her final moment, she shows no further interest in discussing it.

Until weeks or months later, when I’ll get a call from her son Stephen telling me that she’s again saying it’s time, that she’s had enough, that she’s ready. Then I arrange the flights, the car, the stop at Stephen’s to retrieve the necessary supplies – he’s willing to store them, but he can’t bring himself to handle them. Living as far away as I do, this is the one service I can still render.

It’s hardly a role I’d have chosen, the Angel of Death. But it’s looking less and less likely I’ll end up having to play it. At some point, not far in the future, the day will come when Laura either can’t physically manage the cup and straw, or whatever mortar that still holds her brain regions together crumbles to the point where she can’t remember her exit plan.

And then what? Her disease is always terminal but never directly so. Its sufferers most often die from pneumonia, aspiration, or complications from a fall. None of the options are swift or elegant. I get why it’s important to her to practice with the cup and straw.

What if it were me in her place?

Once that thought lodges itself in my brain, any hope of sleep evaporates. When the ceiling announces 4:50AM, I give up.

I climb out of bed, pull on jeans, a sweater, my parka, and grab my purse. The hotel is just off downtown, a safe enough area in this touristy college burg, and I head out into the predawn hush, walking fast, trying to outdistance my spiraling thoughts.

It’s warmer here than where I live, and soon I’m unzipping my jacket even though the late spring sun has yet to make it over the ridge of hills to the east. Headlights glow at the intersections, early commuters beginning their daily orbits. I walk uphill, enjoying the slight burn in my leg muscles. The air tastes of damp pavement and the tang of ocean mists trailing in from the coast.

The sky lightens. The streetlights dim. I angle down a side street near the railroad depot and find myself in a section of town that’s transitioning from industrial grunge to hipster renaissance. A coffee house I haven’t seen before, housed in a renovated garage, beckons with its teardrop lights and the mingled aromas of espresso and fresh pastries.

I place my order and join the crowd of waiting patrons, realizing with a start that I’m the oldest person here. I look around at the unlined faces, the glossy hair shoved into buns or beanies, the innocence of whole, supple, unsuspecting bodies. When the barista calls my name, I retrieve my cappuccino and croissant and perch on a tall bench at the counter by the window.

The cappuccino is perfectly brewed and blended. The croissant shatters into an ecstasy of crumbs when I bite into it. Conversations surround me in a mixture of deep and piping voices, a comforting, half-heard concerto. Through the window, the fingers of mist catch the rising sun’s rays. There’s a momentary riot of iridescent pinks and golds before it burns off. I dip a morsel of croissant into my milky coffee and raise it with a small flourish.

“Here’s to you, Laura,” I whisper. “L’chaim.” I toss back the last of my cappuccino, accidentally knocking into a server as he hurries past.

He regards me with a look of slight concern. “Need something, ma’am?” he asks.

“Nope, nothing,” I say, smiling at him as I stand and shoulder my parka. It’s all I can do to keep from enfolding him and his badly groomed beard in a hug. If I could, I’d gather every one of these fearless, fragile young things in an embrace. I’d buy a round of croissants for the house, if that was a thing. On my way out I buy just one, to bring to Laura.

I walk back to the hotel, my footsteps light on the downhill path. I take a quick shower, put on better clothes, gather the promised package and the croissant. Its scent wafts through its wax paper bag, perfuming the rental car’s interior and making me feel unexpectedly buoyant, as though my crust of resistance has been brushed off. I’m ready for the next rehearsal.

THE SAME STAFFER who let me in last night is pulling a double shift. Something about the look on her face as she checks me off on the visitor log sends an uneasy ripple down my spine. From the lounge comes a low nattering of local TV news that nobody is paying attention to.

I arrive at Laura’s room to find a gathering. Stephen is here, and he’s brought his guitar. My other nephew, his younger brother, is here too, along with his wife who jiggles their four-month-old daughter in her arms while exclaiming softly over the robot toy their little boy – three already – brandishes.

“Jeannie, you made it,” says Laura. Propped up in bed, receiving her audience, she looks better than I’ve seen her in months. An unreasoning hope flares beneath my sternum. Could there have been a miracle?

Someone else is present. A slight, bespectacled man wearing tasteful athleisure and a stethoscope. “You’re Jean,” he says. “I’m Dr. Peralta. We’ve spoken.”

“Yes, of course,” I say, more croaks than words, as I shake his hand. My limbs seem to have turned to putty. Dr. Peralta is Laura’s neurologist, the one who has coached her, her sons, and me in the protocol of the cup and straw.

Laura speaks now, a speech that I hear as though listening from under water. Then Stephen picks up his guitar. He begins strumming the song Laura chose, “You Are My Sunshine.”

This is not a rehearsal.

The song is my cue. With my putty fingers I open the bag, retrieve the pills, the mortar and pestle, and the can of mango nectar. Dr. Peralta observes, his expression benign. I’m weirdly proud when I manage to grind the pills, concoct the mixture, fill the cup and insert the straw without shaking or spilling.

The room becomes a long, cone-shaped tunnel, with Laura at its apex. “C’mon, Jeannie,” she says. “Please.”

I look at her sons for affirmation and immediately wish I hadn’t. The rawness in their faces sends my gut into spirals. I approach the bed while my imagination offers an alternate scenario in which I dash out of the room and dump the cup in the trash. 

I reach Laura. With fierce determination my sister holds out her right hand, seizes the cup, moves it in gentle jerks to her mouth. Her lips encircle the straw. She drinks, and drinks, and drinks.

The cup drops from her hand. “That’s that,” Laura says. Then she laughs, her old laugh, her real laugh, wry and joyous.

It takes time. People, I notice, can only devote themselves to vigil for so long. Dr. Peralta sits in the corner by the window, gazing into his laptop. The other adults talk in low voices, to each other or to their phones. The baby nurses with noisy gusto. The three-year-old grows restless, so I read him a story, surprised that my voice still works.

Laura descends. At first, it’s like sleep, until it becomes something weightier and deeper. Her breathing grows irregular, sputtering. I stop reading. The little boy twists in my lap; I wrap my arms around him, rocking in rhythm to the tune I hum next to his ear. Edward, the caregiver, pops his head in, reads the room, and withdraws.

A shadow crosses the window, a bird winging past. All at once, silence descends on everyone, even the three-year-old, even the baby. I startle at the sound when Dr. Peralta rises from his chair, approaches the bed, and employs his stethoscope.

“She’s passed,” he says, and then, as though to avoid confusion, “Laura is gone.”

I stare at my sister. I want to ask, passed what? Gone where? The long tunnel forms again, its apex now shifting between the doctor and Laura’s sons as they discuss next steps. The little boy extracts himself and rejoins his mother, leaving a cold space in my lap.

“Can you make the phone calls, Aunt Laura?” Stephen’s words jar me. I nod, rise, and step out of the room.

Out in the hallway, in the lounge and the dining room beyond, the day’s routine unfolds. Dishes clink, the smells of tuna casserole and pallid coffee compete with freshly laundered sheets. Edward and another caregiver roll residents from the dining room to the lounge where Hello Dolly shimmers on the screen above the hearth. 

I startle when someone touches my shoulder.

“How you doing, honey?” It’s the woman working the double shift.

“I’m okay, thank you, really,” I manage, and take a long, shuddering breath. The warmth in her eyes threatens to undo me. “But I need to make some calls.”

“Of course,” she says, and I realize she’s a veteran of such moments. “Why don’t you use the office; there’s nobody in there right now. You know where it is, right?”

Behind a door studded with staff schedules and notices, I perch on a chair in front of a faux wood desk. The familiar attributes of a standard workspace help to steady my breathing. Laura has given me a job to do, has designed a purpose for me in this moment.

The first number, Laura’s oldest friend Tammy, is already in my phone. I try to keep my fingers from lurching with urgency as I place the call. With my free hand I rummage in my purse for the list of other numbers.

The phone clicks into life, Tammy’s voice on the other end. “Hi, Jean! Are you in town?”

An expectant pause roars in my ear. This is impossible. I’ve imagined the cup and straw so often. How is it I’ve failed to anticipate this moment, this very beginning of afterwards?

“Jean? Is that you?”

My free hand, dredging in my purse, finds the croissant. It waits, heavy in its waxen bag.