Page 101 of Sinner (Priest 2)
“You know, this wasn’t as satisfying as I thought it would be,” he says as I finally let him go.
“Funny,” I say. “Feels plenty satisfying to me.”
I’m lying of course. There’s a quiet, clinical part of my mind that feels relieved: no more dealing with Valdman, no more dealing with that world at all. But I’m still that walking, breathing, bleeding hole—I’m just also a hole that’s unemployed now.
Sisterless, jobless, Zenniless and about to be motherless. Satisfaction is as far away from me as the North Star.
The clouds are back. The clouds are worse.
We stand in the room with the X-rays on an old-fashioned lightbox mounted on a wall. Mom is awake behind us, which I’m painfully aware of as the ICU doctor walks us through the progression of her pneumonia over the last few days. It’s like time-lapsed snowfall, like the spread of fog. But fog and snow are quiet and peaceful…beautiful. This white sprawl on my mother’s lungs is exudative effusion at work—or put simply, Mom’s lungs filling with fluid. It started at the bottom cove of one lung and now both lungs are covered with a smoky and thick white—nearly opaque with fluid and inflammation—with only the top part of one lung still black and clear.
“Her vitals are worrying,” Dr. McNamara says. She shows us charts on her iPad. “You can see here—starting two days ago—oximetry, blood pressure, and body temperature are down. The blood counts and gases show the infection overwhelming her systems. Her hypoxemia—dipping below 90% oxygen saturation—is bad enough now that it’s clear the BiPAP can’t keep up.”
“What does that mean, can’t keep up?” Aiden asks. He has his arm slung around Ryan’s shoulders, who is also being held by my dad. Both Business Brothers and the Baby Bell—I feel Tyler’s absence like a sudden kick to the stomach.
“Well,” the doctor says gently. “It means in normal circumstances, this is the time to move to intubation and a ventilator.”
She doesn’t finish her sentence. Because this is not normal circumstances.
You know how every time you check into a hospital, whether for a broken toe or a heart attack, they ask, “Do you have a living will or advanced directive?” And you think to yourself, I should really make one of those sometime? Well, when you have cancer, they stop asking and flat-out tell you to make one. Mom made hers eight months ago, and I know for a fact it’s on file here at this hospital. I know it’s on Dr. McNamara’s iPad. I know it by heart. It requests for her not to be resuscitated, and it also requests for her not to be intubated. A DNR and a DNI.
Dad and I are the first to meet eyes, and then we look away. Aiden takes a moment, then says, “Wait, that directive thing? No, this is different—that was for cancer, and she has pneumonia.” He looks at us like we’re kindergarten students, like we’re too simple to grasp this. “She didn’t mean for that to count now.”
“If she were ventilated,” I ask the doctor, giving Aiden a look that means we’ll talk in a minute, after we get all the information, “what would happen?”
“You mean, do I think she’d recover?”
“Yes.”
Dr. McNamara looks back at the X-rays, but I know she doesn’t need to look at them again. She’s simply staring at something while she gets her thoughts together. “There’s no way to tell for sure, ever. But I can tell you that her CT scan yesterday showed new tumors around her liver and in her intestines, and only a month ago, there weren’t any there. The odds of her surviving this pneumonia on a ventilator are low…but real. But if she survives, I’m not sure she won’t be needing that NG tube indefinitely, and I’m not sure that she won’t be back in the ICU within a matter of days. Her cancer is moving too fast for the treatments to keep up.”
I squeeze my eyes closed, open them again. None of the Bell men are saying anything, which means it’s up to me, I suppose. “And there’s nothing more we can throw at the pneumonia?”
“We’re throwing everything we can at it,” the doctor says, giving me a weak smile. “It’s overwhelming her lungs anyway.”
I take a breath, press my eyes closed again. All I want on this earth is for Zenny to be holding my hand right now, to be rubbing my back. To be in my arms so I can smell the sweet rose smell of her and bury my face in her hair.
“If we talk to her and she says the directive still stands,” my voice is a charred nothing of a whisper, just dead air saying dead words, “what does that look like?”
“She can keep the mask on,” Dr. McNamara says softly. “And it will still help. A couple days, maybe. Or if she’d like, she can take the mask off.”
I swallow. I wish for Zenny like I’ve never wished for anything before, but she’s not here, she’s not here to hold me or to comfort me or even just to stand next to me. I’m alone, because even with my brothers here and my father here, I have to be the strong one. The one leading the way. “And then what?” I ask in a raspy voice.
“She’ll be more comfortable. We’ll take out the NG tube and she can drink to thirst. We’ll also be able to provide morphine. It will help with the air hunger.”
“Air hunger?” Aiden repeats, looking stricken.
Another weak smile from Dr. McNamara. “It’s what it sounds like. It’s very uncomfortable, but the morphine muffles the sensation almost to nothing. We can start out low, so she will be lucid at first, and then increase it as needed.”
“And if she’d make it a couple days with the mask, how long could she make it without one?”
“It wouldn’t be long,” Dr. McNamara admits. “And if this is something you talk to your mother and she wants to pursue, then we’ll bring in her palliative care doctor for a more in-depth discussion. But I will say this, as an ICU doctor and as a daughter myself: life isn’t measured in days. It’s measured in moments. When you decide with her what happens next, consider what moments you want to create for her now.”
I turn back to Mom, I don’t know why, but I just need to see her right now, reassure myself that she’s still here. And she’s holding up her whiteboard.
It says, mountain dew?
Chapter Thirty
