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Chapter 1

Alan Gleason’s end-stage cancer went on longer than anyone on his Dana-Farber team could believe. The bold predictions that the Eleprion would retard the spread had been dashed, revived, dashed again, and revived with the monotonous rhythm of a Ping-Pong match between twelve-year-old equals. By the spring of 2005, everyone had called time.

True, the clinical trial leader continued to tinker with dosages of Alan’s wonder drug. And, true, there was a chance that higher doses combined with a second wonder drug would buoy his failing body. But with pneumonia and complications lying in wait, even the most exuberant oncological forecaster would have to concur: by the first pitch at Fenway.

Alan had been a reluctant partner in dying for the twenty-six months since diagnosis. The more his body hung on, the more the trial leader brandished the sword of Novartis. Because his treatment was both aggressive and palliative, many hospices wouldn’t touch him. Thus the venue for demise had shifted from Harvard teaching hospital to four-star nursing home to merely adequate hospital to home (briefly); then it was hospice off 128, hospital under new management, home again (forty-eight hours), and finally nursing home known for its foul-mouthed nurses. People were born and people died. To Alan, it seemed that a lot more were dying.

At Crystal Pavilion the ball player from La Jolla and the wife of the Maytag executive and the guy who didn’t have a stomach—all less than a week. The thirty-ish daughter of the ball player found out she had pancreatic cancer and didn’t last the year. The forty-ish guy with the hair implants who gave the Pavilion’s whispering tours had an aneurysm and died while riding his bike in a Costco parking lot. And this was way back at the start, at the Mount Auburn nursing home. After that, things devolved to a blur of wheeling gurneys.

Terry, Alan’s wife, made the social connections and kept score at his bedside, sometimes with a tiny pencil in hand, like she was ordering from a sushi menu. “That Arab they brought in last Friday, with the marching band–size family. They’re giving him last rites.”

“He’s a Muslim.”

She made a cluck. “Cooked is cooked.”

By the time Alan was moved to what was believed his final destination, he had begun to converse—on the rare occasions he spoke—with the rusted-in-place folksiness of someone much older than his father if his father were still alive. He dreamt of himself as the last official “Mountain Man from Jaffrey” talking to the Sunday Globe, and as one of the Confederate veterans shaking bamboo canes at the newsreel cameras during FDR’s first inauguration. He was drifting in and out of consciousness owing to a pharma playlist that included two experimentals. But the fact that the Gleasons had pissed away almost every asset did not elude his lucidity.

The house in Boothbay Harbor went on the market a year into the ordeal—just as well with Alan since the refinancing had been a boondoggle and the neighbor was digging to China to find his septic tank. Next they sold Alan’s Lexus—the RX300 delivered a few days before Neddy told him, “Something funky’s going on in your right lung.” The QXR that nobody drove finding its way back to Riverside Toyota was a no-brainer, as was the Saab convertible that lacked a sincere claimant. But when it became clear that Terry’s car would have to go as well, she sat at Alan’s bedside bawling inconsolably. She’d bought the Audi at the time of the move to Crystal Pavilion, when no sane person would have borrowed $43,000 just because she’d seen a handsome doctor driving that model and color in the Beth Israel parking garage.

But Terry Gleason knew her husband was closing on dying just as surely as the Dana-Farber team did, and her husband had a $4.5 million life insurance policy. His prolonged passing was rendering the Gleasons penniless, but completion of the act would set the world to right. The tweedy lawyers at Nutter, McClellan & Fish, the funeral home in Arlington Heights, the mausoleum near the Audubon sanctuary, the décor-appropriate urn, the spot in the backyard where Critter last peed before he got the poison—all of it worked out down to the letter.

Besides his wife and the Paxton Place foul-mouthed nursing staff, the only person who regularly appeared in Alan’s diminishing field of vision was Todd Wilkins, the financial advisor who’d latently morphed into his family minder. “Alan, Alan. Terry has to do something about this $125,000 in credit card debt. And that’s just hers, not your kids’. It’s time to put the house on the market. Like yesterday.” Alan had mentored Todd a dozen years back—this former kid now opting for the time-released method of telling him he was going broke faster than he was going dead.

“OK, we’ll sell the house!” His wife’s distraught words pierced the cloud of delirium. “Sell the fucking house, why not? Pull the rug out from under me. I already live here anyway. We’re way behind on Ryan’s rent. He’s going to be evicted.”

“Alan, Alan”—again his wife’s distressed voice. “I don’t think I can go on like this. We put the house with Coldwell, and the broker thinks she already has a buyer who wants in ASAP. I’ll be homeless!”

His children, Meredith and Ryan, had already made their tearful partings and were not coming back—mother’s orders. Meredith with her hiccuppy little sobs—the same ones triggered by things like the discovery of cellulite—was so pretty your heart shattered. He wasn’t too far gone to notice that she cried harder about her cellulite than his carcinomas. “Daddy, Daddy, it’s just so hard for me to see you like this. I think I have to say goodbye now, Daddy. You look worse than Bill Clinton.”

He couldn’t stop wondering: Why does everyone have to say my name twice? Am I dead and this is what it’s like? Such was the philosophical jerky he and his pal morphine chewed on. Dead or alive—like the road-trip game he played with his kids. John Forsythe, Dom DeLuise, Doris Day—the names of the presumed dead from ten years ago constituted the CNN crawl before his closed eyes.

I hear from you wife you been like this a real long time, Mr. Gleason.

It was her all right. How could anyone not recognize that voice? Todd called her “Tracy the trash-talking nurse”—like the talking horse, the friendly ghost, the cat who could drive.

Can ya hear me or can’t-cha? That lying bitch Nicole says you smile at her, but I ain’t ever seen a twitch from that poker face you got. You the big man round here bein’ on more drugs than Elvis.

“I need to see to Ryan!” he remembered calling out. He wasn’t sure when he’d awoke. He was always sweating when he heard himself breathing.

Terry had been asleep in the chair, and his words made her kick the bed. “Shit, Alan, don’t scare me like that.”

“I was thinking of him, my son.”

“I know who your son is.”

“I need to see my son.”

“You know Ryan’s thing about hospitals.”

“Thing about hospitals,” he repeated.

“Because of the pond water.”

“The pond water,” he repeated.

“What is this, an ESL session?”

He could feel she was stretching out the process of finding her phone, opening it, clicking—something she usually mastered in one movement.

“We’re not in a hospital,” he said, not necessarily to her.

“It smells like one to Ryan.”

“To me it smells like a YMCA.”

“If it were a YMCA he still wouldn’t come, but for other reasons.”

“Ryan?” Alan spoke into the thing his wife held to his skull.

“Yeah,” said the voice.

“It’s Dad.”

“I guessed that.”

“I’m worried about you.”

Silence.

“I’m not going to be here to get on your case. You should take the LSATs anyway; it can’t hurt.”

Silence.

“I won’t get on your case. Tell me what’s new.”

“The Pope died,” said Ryan. “Finally.”

Terry Gleason’s unhappiness only got worse. “The stress of this house sale is killing me, Alan. There’s just no temporary money. Todd thinks he’s my father, that he can just pluck cards out of my hands. But I need cash, Alan. He doesn’t understand. The kids and I need cash. I’ve got to pay their car insurance, the T-Mobile’s way overdue. Meredith without a phone—Christ, I don’t want to think about that.”

One day near the presumed end, she told him, “Alan, Alan. I need a week off, maybe more. I need some time away from here. I’m really, finally, this time going crazy. I’m going to be gone for a while, OK? You’ve got the stuff you need, to make you comfortable. You know how to press for the morphine, right here. You’ve got people here for you 24/7. If you need something just ask for . . . well, ask for Tracy, the head nurse. The nice nurse Tracy. OK? Did you hear what I said? Did you hear what I said, Alan?”

“Nice Nurse Tracy.”

Lahoma that bitch-tramp, she supposed to give you a sponge bath, Mr. Gleason, and guess who didn’t get no bath?

Bitch-tramp, fag-hag, big-ass trannie—thus it went every time Nice Nurse Tracy manhandled Alan’s animated corpse.

Is you with me, Mr. Gleason? Yes? No? La-La Land? That doctor you got, the go-go guy. Dr. Shish-Kebab. He gotta be gettin’ kickbacks from every drug company under investigation by the feds. Oops! Stupid me. There ain’t no drug companies under investigation by the feds, is there, Mr. Gleason? I must be thinkin’ about homeless shelters or suh-hmm. Oh, sorry. That gotta hurt.

Of course it hurt, even if he couldn’t feel anything. He had run out of metaphors for pain. The pain of breathing was the worst. It brought tears to his dried-out ducts, which scorched and burned behind the flaps called lids. He had such nostalgia for the capacity to cry in the dark. Cry slowly but diligently for hours, alone. This would be the parting wisdom he’d leave his children if he had those kinds of children: Whenever you cry, appreciate that you have all the parts to do so. But there was no one to hear him. “Everything weighs heavily on my chest” is something he was unable to say to Nice Nurse Tracy or anyone else. He couldn’t get enough air, but then—he realized—that was always the case.

“Alan! Alan!”

His name sounded shrill, like he’d been caught picking his nose in class.

“I got a call from Shahib. There’s something amazing going on.”

The voice belonged to Neddy Sims, his friend and primary care physician. “Can you hear me? This is incredible, Al. Your blood looks good. You actually look good compared to how you looked just a week ago. Shahib’s fuming because the people here haven’t been monitoring your Eleprion—or the 7844.”

Alan opened his eyes. “Everything looks dark. You look dark.”

“I have a tan.”

“When did that happen?”

“Global warming. All of New England has turned to tropics.”

“Good,” he said, closing his eyes. “The snow-blower’s on eBay.”

Sometime later, when Alan was able to sit up by himself, no one was around to see. The IV had been removed at some point; he had fresh memories of brutal sets of hands making him swallow pills in the dark. Likewise for the catheter—hence the dream that a dog shark was going for his dick in shallow water. The stains on his johnnie told him he’d been force-fed something syrupy. When he sat up by himself, he said aloud, “Hey, look at me.” He realized that the guy lying in the other bed might well be dead, just like the rest of them—Sox fans in their “BELIEVE” T-shirts. There wasn’t even a phone to use, just a lot of stainless steel pans, like the only remaining action he could take was to drip on the floor.

He moved his body but was nonetheless terrified something would puncture and his innards would shoot out in streams like an Italian slasher film. It was stomach-turning looking down at his bare legs and feet, but he had to look if he wanted to walk. A sack of skin that was just about finished—the black banana peel on the sidewalk that wouldn’t wash away. It was hideous. He began to remember things—Shahib and other doctors had been here. He had been moved, there had been talk of tests. He’d lost all track of what constituted a day. At least the guy in the other bed was still breathing. He looked about ninety-seven. Clutching the bed’s rail, Alan found himself sickened—if such a feeling could still be had—at the bizarre desire to crawl in bed with the man.

That evening they wheeled out the other bed and wheeled in a television. The next morning Alan awoke to Dr. Shahib in his polo shirt, accompanied by a man in a suit. “How are you today, Mr. Gleason?” A hand extended into Alan’s face. “This is Dominick Brouse,” said the doctor behind the man behind the hand, “legal counsel for Paxton Place. He has to be here during my consultation.”

Alan pulled himself up.

“I tried to call Terry at home,” said Shahib, “but there’s a message says the number’s disconnected.”

“She’s moving,” said Alan. “We’re losing the house.”

“Sorry to hear that. But OK, not to dawdle since I’m supposed to tell you why.”

“Why?”

“Why the tumor markers are doing down, why your red blood cell count suddenly looks good. Your body’s turning around, Alan—and I have to stress that it’s been sudden. Phenomenally so. Why is that? I don’t know. Will it last? I don’t know that either. Was it the Eleprion or the 7844? That, unfortunately, I might know, but I don’t think you’re going to like what I have to say.”

“Try me.”

“You weren’t being administered the Eleprion or the 7844. The gentleman who’d been in that bed, he’d been given your doses of the Eleprion for eight days.”

“The man who died last night?”

He nodded.

“So what did they give me?”

“They don’t know,” he said, looking at the lawyer.

“Who’s ‘they’?”

“The people who run this facility.”

“Are you telling me that I was given that guy’s medication?”

“No.” He looked again at the lawyer. “He was supposed to get only painkillers. Everyone but you was not—or rather is not—being treated aggressively.”

“So what kinds of drugs have they been giving me?”

“They don’t know. It may have been one person’s, but it may also have been . . . an assortment.”

“Assortment?”

“Correct.”

“You mean like a Whitman’s Sampler?”

The doctor didn’t answer.

“For eight days?” asked Alan.

He shook his head. “I don’t know for how long, Alan. I only know it was eight days for that man because, well, that’s all the time he’d been here. As for how to proceed with treatment, and whether to continue with the trials, I’ll need to consult with my colleagues at Dana. As for the immediate situation, you have twenty-four hours to vacate this facility, Alan. It’s been forced to cease operation. As your referring physician I am legally obligated to tell you that.”

Alan’s two visitors had been passing a small bottle back and forth throughout. Now he realized it was disinfectant for their hands. The bedding, the metal rails, the tables, the walls and floors, his very person—stained and contaminated.

The absurdity of their words he couldn’t process. His dry eyes stung like hell. “But people come here to die!” he cried. He breathed with the sound of someone sobbing. “So what that they die before . . . I don’t know—before they really die.” He stared at Shahib. “I never believed in your drugs. I came here to die.”

“You came to a lot of places to die, Alan.”

Alone in the room, sitting up on soiled sheets as deracinated Homo sapiens, Alan noticed how crappy the bent blinds were at blocking out the bully of a sun. “It’s morning in America,” he said aloud in the voice of Ronald Reagan. He longed to laugh but couldn’t even make himself try. Tired, desolate, and lost were all he could feel, and it wasn’t just because he had no pants. He got out of bed, intent to yank up the filthy strips of plastic in the window.

What kind of life had he led for months and months and years and years? What kind of life constituted everything that came before the reality of this? The white light of the neutral world stung his eyes. Those formerly dormant tear ducts now worked laudably. Like a spontaneous parade everything came out, flowing in three, four, five routes to his chin, where, cooled and parceled, all surrendered matter-of-factly to the reliable force of gravity.

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