Even with his masklike face, Dad appears to be glowering at his old friend Dr. Kirby. Red eczema blotches mark his parched yellow skin, and his shock of white hair looks almost wild, which tells me he hasn’t let Mom cut it in a while. The yellow tinge to his skin has been there for the past three months, but looking at him in the late-afternoon light spilling through the window, it seems to have worsened.
“Duncan,” Dr. Kirby begins, “you’re not going to be happy about this visit. But I’ve given you all the rope I can. I got your latest liver enzymes back today, and there’s no good way to put this: you’ve crossed into end-stage liver disease. You keep drinking, and your liver will kill you long before the Parkinson’s lays you low.”
Dad takes this with the stoicism he always displayed when I was a boy—as though he’s heard nothing that must be acknowledged, much less attended to immediately. Jack Kirby understands him well enough to know that the prognosis was heard. Now he drives it home, as my mother sits silently on the sofa, wringing her hands.
“I’ve known you since we were boys,” Jack goes on. “And I’ve been practicing medicine long enough to realize that your intended goal may be to die from cirrhosis before the Parkinson’s reaches its final stage. But let me tell you why that’s a bad plan. You’ve been living with heart failure for a while now. Combined with that, liver failure might not give you the result you want. It might cause your kidneys to fail. Or all your issues together might stress your system badly enough to trigger a stroke, or even a series of them. You might have to sit in a wheelchair all day. You might be permanently bedridden. Then you wouldn’t be able to drink unless Blythe held the bottle and let you suck it through a straw. And I know she’ll draw the line there.”
Dad still has not acknowledged his friend’s words. He’s watching Wolf Blitzer give some paid flack airtime to canonize his employer. Sometimes I wonder whether Dad’s reticence is the result of shame over what the disease has done to his formerly powerful voice. The resonant baritone that once steadied Stars and Stripes reporters in Korea, pushed back Ku Klux Klansmen in 1960s Mississippi, and delivered heartbreaking eulogies over friends has been reduced to a reedy whisper, a ghost of its former self.
“You could live quite a while that way,” Dr. Kirby continues. “The Parkinson’s would continue to progress, but your lovely bride would be feeding you by hand and wiping your butt twenty-four-seven, and for a long time. That’s not right, Duncan. Not if it’s in your power to prevent it. You know that.”
Dad sits with unusual stillness for several seconds. Then without looking at Kirby he whispers, “She put you up to this, didn’t she?”
“No, damn it,” Dr. Kirby says firmly as my mother closes her eyes. “About the only thing Blythe ratted you out for is living on ice cream. I know it’s tough for you to swallow, but you’ve got to eat some mashed-up vegetables to survive. You’ve lost nearly fifty pounds since my original diagnosis, and we don’t want to add diabetes to your list of problems.”
“I want to see those tests,” Dad demands, his head jerking suddenly. “I want to see if they’re as bad as you say.”
With his jaw set in anger, Dr. Kirby pulls a folded sheaf of paper from his inside coat pocket, carries it over to the La-Z-Boy, and drops it in Dad’s lap. “There you go, you hardheaded son of a bitch. You don’t know enough chemistry to read them, but you can see the red warning highlights, with low or high screaming off every line.”
With quivering hands, Dad struggles to hold the papers in his grasp. Dr. Kirby mutters something and does it for him, even though he knows this is a pointless charade.
“Did you see what Trump said today about the New York Times?” Dad asks as he studies the quivering papers before his face.
“I don’t give a goddamn what he said. I stopped caring a long time ago.”
“Not caring is the same as begging for fascism,” Dad grumbles.
Dr. Kirby stares down at him for a while. Then he says, “I tell you what, Duncan. I’m going to have a word with Marshall outside. I need to talk to him about something for the newspaper. A Medical Society statement on Medicaid expansion. I’ll look back in before I go, after you and Blythe have had a chance to talk.”
“Go right ahead.”
The doctor motions for me to follow him back to the kitchen, but even there, we’re too close to my father for comfort. At Kirby’s suggestion, we step out onto the small redwood terrace that overlooks the wooded backyard.
“Poor Blythe,” Jack says. “I see it all the time. All the men I grew up with act like kings in their dotage. They expect to be waited on hand and foot, regardless of how obstinate they are or what silly whims they come up with. I’ve seen a man send his wife and children thirty miles in every direction to find him a goddamn Nehi soda.”
“I can imagine.”
The doctor sits on the redwood bench against the rail and squints up at me. “Marshall, before I speak, I want to be very clear that everything I’m about to tell you is off the record. Is that understood?”
“Absolutely.”
“I’m about to break a bunch of HIPAA regulations, or laws, and you’re going to keep quiet about it.”
“Yes, sir.”
“And please don’t call me ‘sir.’ It’s Jack, all right?”
“All right, Jack. Off the record.”
He takes out a cigarette, a Winston, and lights it. After blowing out a long stream of blue smoke, he holds up the cigarette and says, “Do as I say, not as I do.”
“Noted.”
“All right. In the next day or two, an autopsy on Sally Matheson is likely to say she was healthy when she died. But in truth, she was ill. Very ill.”
My reporter’s radar throws back a hard echo. “Really? If she was that sick, why won’t the autopsy pick it up? Are they getting that local pathologist to do it? Like they did with Buck Ferris?”
“I don’t know who’s doing the post, but medical fraud isn’t my worry. About four months ago, I diagnosed Sally with a rare condition called amyloidosis. It’s a blood disease. A progressive one. You’ve probably heard of amyloid proteins—they’re what’s deposited as plaques in the brain in Alzheimer’s disease. But there are different types of amyloidosis. Some you can live with a long time, others you can’t. Sally had an incurable type.”
“Did she know that?”
“Oh, yes. But she told me she didn’t want anyone to know she was ill—not even Max and Paul. She was adamant. And my policy with longtime patients like Sally is to honor their wishes. At least until it becomes a serious risk to them. Of falls, et cetera.”
“Were you treating her for this condition?”
“Symptomatic treatment. There’s really no treatment for the disease itself. Not for her type. She was a borderline candidate for a bone marrow transplant, but she ultimately decided against it.”
Jack’s revelation has already altered my perception of both Sally’s death and her husband’s alibi. “You still haven’t said why the autopsy won’t pick up her illness.”
“The disease is subtle, at first. And they won’t be looking for it. Tests involve collecting twenty-four hours’ worth of urine, doing skin fat tests, things like that. Depending on the extent of organ damage at this point, a first-rate pathologist might detect it, but my guess is it’ll slip through.”