The Promise of Stardust (6 page)

Do you want the use of a feeding tube if you are unable to eat?

Yes

No

It had no pregnancy clause.
Shit
.

Elle's teenaged handwriting crossed the page with negative responses to every single question. In one simple sentence she wrote, “I do not want to ever be kept on life support unless it is likely I will recover.” Then her signature stretched across the bottom, all the loopy
L
s and
E
s. Making matters worse, Elle had taken the time and the effort to get the document notarized.

I rubbed my eyes and tried to unearth a memory. In the ER after Dylan's birth, did the hospital ask Elle if she had an advanced directive? It was policy for them to ask. Wouldn't I have paid attention if she'd said yes? Then again, I was probably too preoccupied by our son's lifeless body. I'd have to check the medical records. “It doesn't matter,” I said. “This is too old. Her legal status must have changed when we got married. I'm her husband, her next of kin.”

“Matthew, you have to know a living will isn't about next of kin and it has nothing to do with marital status. It's about who she designated, and that's me,” Mom said.

“What do you mean?”

Mom flipped the paper over and there on the back Elle authorized my mother to make any more specific decisions if Elle could not make them for herself. This document gave Mom Elle's medical power of attorney.

I held my hand up in an effort to stop her. “Ah, no. Elle's pregnant. You know how much she'd want a baby,” I said.

“I'm with Linney,” Christopher said.

“We're not taking a vote here.” I crumpled the living will.

“Give that to me,” my mother said.

I held it tight in my fist, wondering how far this situation might devolve. My mother scolding me as if I were a two-year-old? Me stomping my foot? At some point one would think we could move past these dynamics where she thought she could give me the eye and I would fold.

“We're not going to keep her on life support. I'm paging the nursing supervisor,” Mom said.

“Why do you need a nursing supervisor?” I asked. Jesus, I didn't want this to become something which would cause hospital gossip.

“Because Elle picked me to watch out for her, and you are seriously considering keeping her on life support, and that's not what Elle wanted. It's just wrong to keep her in this state, as an incubator for something that isn't even a baby yet. Women are more than vessels for offspring.”

My heart was pounding in my chest so hard I was seeing spots. “She's not an incubator. She's the baby's mother.”

“Honey. Be realistic,” Mom said, her voice noticeably less combative. “It's barely a fetus, and even if it were further along in its development, God knows what kinds of things happened to it yesterday. The CT? The X-rays of her back? The drugs? You aren't thinking straight. You're too upset.” Mom held out her hand, palm upward, waiting for me to pass the living will back to her.

I didn't.

I was certain Elle had never considered this scenario. “I know all that, and I am worried about the X-rays and medications, but—”

“But nothing,” Christopher said. “Stop it. You're not going to keep her alive.” He turned and marched off.

My mother touched my arm, and I withdrew.

Elle's nurse was staring at us as we barreled up to the nurses' station.

“Get the nursing supervisor. I want to talk to her. I want to talk to the CEO, and the hospital attorneys. I need the ethics committee to convene. I want to talk to the head of Medical Records. Now,” I said.

The nurse paled.

“Never mind,” I said. “I'll make the calls.”

Five minutes into the ethics committee's meeting, the hospital chairman, attorney, and pastoral council were embroiled in a heated debate. My mother slapped the crinkled document on the table. “The purpose of the living will is to avoid this sort of thing.”

“In Maine,” the hospital attorney, who was a pudgy guy with ears that stuck out like butterfly wings, said, “whatever a patient states when he has capacity—in other words, when he can speak for himself—overrules
anything
else.”

I pulled out Elle's medical records from our son's birth. “But right here, they asked her if she had an advanced health care directive. She said no.”

“Well, she did. Obviously.” Mom tapped the living will.

“Elle signed that half her life ago,” I said. “She never would have considered these particular circumstances.”

“And how would you know? She wouldn't even speak to you at that point,” Mom said.

It was true. For a few years, when Elle and I were in college, we were not on speaking terms. “She changed her mind about me, and about a lot of other things, too. It was seventeen years ago,” I yelled.

The hospital CEO stood. “Stop. The hospital is not going to take the liability for this decision, not when it's in dispute. I don't know what the legality is on this.”

“It really isn't about what the family wants or doesn't want,” the attorney said. “It's about what this patient wanted. That's the bottom line. What concerns me is that we have two conflicting documents.”

The CEO drew a deep breath and said, “Get a judge to decide. Get a court order.”

   5   

I pulled out the business card:
Jake Sutter
,
Attorney
. The previous spring Elle and I ran into Jake in a movie-theater lobby. He handed me his card and said, “Give me a call. We should get together for a drink soon.” Until yesterday, when I had to search for our insurance information, I'd forgotten I'd stuffed his card in my wallet.

Telling his receptionist I was Jake's college roommate yielded an appointment in a week's time. Telling her I was Elle's husband fared better: one minute on hold, and then straight through.

“Matt? Holy smokes. I heard the news. How is she?” Jake asked.

“Not good.” I lunged into the story and talked for five minutes before I stopped for air. “I'm not sure how to handle this, legally, that is.”

A moment of silence preceded his words. “I do know how to handle it, but first, let me tell you how sorry I am about Elle. Yvette wanted me to reach out to you last night when the news broke, but I thought you'd be at the hospital, and it sounds like you haven't left Elle's side.”

“No,” I said, “except when I attended the ethics committee's meeting.”

“What the hospital's attorney said is right to some degree. A judge will want to determine what Elle would want under the circumstances,” he said. “This could be tricky, but I know exactly what to do. When can you come to my office? I'll clear my schedule.” As always, Jake thought he knew everything, and this time I hoped he was right.

“I don't want to leave her. Can you come here instead?”

“Ah …” He gulped. “This isn't something we could discuss easily in a hospital room.”

Damn, I'd almost forgotten how much he hated hospitals, and I didn't have time to deal with his medical phobias.

Jake and I landed in the same college dorm room because someone putting freshmen together that year thought geography would give us something in common, but we didn't have much beyond that. Jake was the son of a former Maine governor, and I was the son of a blue-collar worker from one town over. His neighborhood was considerably more upscale than mine. Nevertheless, we were both ambitious, so although we were never buddies, we were compatible as roommates. We kept in touch for a while afterward, but once I was in med school, I found it difficult to talk to him. If I so much as said the word
blood
, he turned a little green and he said if God wanted us to see blood, He wouldn't have given us skin.

“Look, this involves a slew of medical issues,” I said. “If it isn't something you're comfortable with, can you give me a name of someone who—”

“Come on, Matt. My job is not at the bedside. I'll be in the courtroom. Yeah, hospitals set me on edge. All those people complaining and the smells and—When my wife was in labor with Janey … I couldn't stand to see her like that, suffering. Maybe I'm too sensitive. So no, I don't like hospitals. I don't know how you do it. But I can deal with the verbal and written part.”

On a different day, at a different place and time, I would have laughed at the way he characterized himself. He truly thought he was a righteous man, but whenever people told me they were “too sensitive” to take care of someone injured or sick, the hypocrisy drove me crazy. I was a pragmatist with a do-something-about-it approach—help people instead of looking away—but for this situation it didn't matter if Jake was sensitive or not. I didn't need him to hold Elle's hand, or mine for that matter. I needed someone with the expertise to beat my mother in court. “Jake—”

“Shoot, you're my friend. Under the circumstances I'll come there. How about this?” he said. “Find a place where we can talk freely—a waiting room—no, an office would be better. I'll walk you through what you'll need to know going forward. No obligation. Feel free to consult another attorney. I'll tell you what questions you should ask, but no one else in Portland has the experience I have.”

Although Jake never suffered from modesty, in this he was understating his platform. I doubted anyone else in Portland, Maine, had argued cases in front of the Supreme Court of the United States. “Okay,” I said.