The following appeared in Volume 98, Number 2 (Spring, 1999) of the APA Newsletters
Newsletter on Philosophy and Medicine
Flourish Your Heart in This World
Felicia Ackerman
Brown University
Laurel knows she is not supposed to play favorites, but she cannot help liking Mrs. Noll better than the other hospice patients. Mrs. Noll is someone Laurel would like even if it werent a professional duty, someone Laurel would be happy to spend time with at a party. Now Laurel is sitting at Mrs. Nolls bedside, in the intricately carved teak armchair Mrs. Noll has brought from home. The chair is unupholstered and the wood is slippery, but it is surprisingly comfortable. "Did you get this chair in India?" Laurel asks.
Mrs. Noll nods, smiling. Although she is seventy and dying, she is still vaguely beautiful, with her blue eyes and thick white haira marvel in this place where most of the patients (Laurel keeps forgetting to call them guests) have had chemotherapy. "My husband and I got the chair and the rug on our twentieth-anniversary trip to Asia, and that" she gestures at the framed calligraphy-and-goldleaf Malory quotation on the wall "was his first-anniversary present to me. It is lovely to be able to have so many of my own things with me here. It makes up for all the psychobabble."
"I know." The homelike atmosphere you can bring your own furniture, redecorate your own private room, and one woman has even brought her parakeet is of course a major selling point for this residential hospice. Sometimes this reminds Laurel of the Richard Armour book that says college dormitories have a homelike atmosphere, especially for people who come from homes with hundreds of bedrooms, each of which is occupied by a stranger. But she has to admit that this is a much pleasanter place to die than the hospital where she used to work. Thats why she works here now. And there arent hundreds of bedrooms here, just thirty-four.
"And the coverlet is from Nepal," Mrs. Noll is saying. "I have no regrets about my travels. They were worth it."
"I know," Laurel says again, although she also knows that without the Asian trip, not only these exotic items but Mrs. Noll herself would not be here. "Hepatitis," Mrs. Noll said at the intake interview six weeks ago. "Hardly the worst thing you could pick up in Asia. It takes twenty-five years to destroy your liver, and for most of that time, there are almost no symptoms. And once people learn that your cirrhosis of the liver comes from unhealthy travel rather than unhealthy drinking, they become a lot nicer. Fascinating, isnt it?" she added, winning Laurels heart on the spot.
Now Mrs. Noll is inching her way up against her silk-covered pillows, inching her way farther into the sunlight that, streaming through the curtain, is making a lacy pattern on her face. "Have you heard anything more from your cousin in California?" she asks.
"I talked to her last night. She says that when youre actually doing it, you dont go around thinking, Isnt this weird, Ive gotten myself cloned. Youre just pregnant."
"When did they first clone a person, a couple of years ago?"
"A little more. 2003. Its still pretty experimental."
"How very interesting." Mrs. Noll sounds interested, which is part of her charm. Of course, the social workers are paid to be interested in the patients, not the other way around, but why shouldnt you like someone who takes an interest in what you say? And who often has a box of chocolates invitingly open on her night table Mrs. Noll no longer eats chocolates, but she likes to watch other people enjoy them. Laurel takes a chocolate-covered cherry, feeling the slithery sweetness spread through her mouth. She is about to say that Juliana, who has always gotten everything she wanted except a baby, is now getting to have the baby too. But Mrs. Noll is saying, "I suppose Im a hopeless reactionary. But I still think its unnatural. Like going to a Mercicenter instead of a hospice. Cloning, suicide people have to control everything nowadays. At my age I figure I have the right to be a reactionary if I want to be."
"You certainly do," Laurel says.
"I wanted children at first, but my husband and I grew to be very glad it was just the two of us."
"Juliana spent eight years trying to get pregnant," says Laurel. "I dont think she would ever have gotten to be glad. Shes not much for adjustment. Shes used to getting what she wants."
"I believe in taking life as it comes," Mrs. Noll says placidly. "Hardly a fashionable attitude for a woman these days. Unless shes seventy and dying in a hospice," she adds, her tone without rancor.
Laurel feels ridiculous saying "I know" for the third time, but in fact she does know. Seeing Mrs. Noll here, dying serenely but with flair, makes Laurel recognize the insidious contagiousness of the hospice mentality. How lovely it would be, she often thinks, how lovely to stop struggling to find a man who could love a woman who never had much verve and is now thirty-six and fading, to stop hoping for a stroke of good fortune to change her life, just to accept, accept, lie back in a perpetual warm bubble bath of acceptance. But only part of her feels that way. The other part cant bear to abandon her dreams.
"You dont like your cousin, do you?" Mrs. Nolls voice is weakening; her eyes are closing.
"Well," says Laurel, "I got off to a bad start. Juliana lived across the street from me until I was eighteen, and she had a bigger house, a bigger wardrobe, a swimming pool in her backyard, and a red BMW. Would you like someone like that?"
"As a teenager?" Mrs. Noll murmurs. "I doubt it."
"And all those fancy trappings couldnt hide the fact that underneath it all, she was prettier and smarter than I was."
Mrs. Nolls eyes snap open, as if she has received a sudden infusion of energy. "I suppose nowadays they would say you should sign up for one of those self-image therapy weekends."
"So I can think Im as pretty and smart as my Stanford-physics-professor cousin who has blond hair she can sit on?"
Mrs. Noll laughs, thrilling Laurel with how momentarily vigorous she sounds. "Oh, you are delightful," Mrs. Noll says, "especially as compared with the general run of people around here."
Laurel feels as if she has stepped into a pool of sunlight.
"And you can be attractive." Mrs. Nolls voice, kind as ever, has taken on an appraising tone. "All you need is lipstick and just a bit of moss-green eyeshadow and maybe blusher. You should also start wearing richer colors, to bring out the rich auburn highlights in your hair."
"What rich auburn highlights in my hair?"
"The highlights you will have when you start using an auburn rinse, which is something else you should be doing."
Laurel is actually considering following this advice. She puts her hand on Mrs. Nolls shoulder, recalling how last week Mrs. Noll said, "When you had thirty-eight years of marriage to a wonderful husband, the last thing you want is to have your hand held by a hired professional, but of course, its different with you, dear."
A moment later there is a knock on the door, and then Ellen Lefferts, the hospice director, is walking into the room, pulling up a chair, and sitting down by the bed. "I hear you had a bad night," Ellen says.
"Only for a bit," says Mrs. Noll. "Nicole came and gave me a shot right away. The symptom relief here is very effective."
"Thats what were here for," Ellen says.
"Thank you."
"I also stopped by to invite you to our support group that will be meeting at three in the solarium." Ellen leans forward; she is wearing a blue cotton dress with sprigs of coral flowers.
"No, thank you."
"Are you sure?"
Mrs. Noll nods.
"I hope you will let us know as soon as you are ready to talk about your feelings. Were caring for the complete you."
"Thank you."
As she is leaving, Ellen asks Laurel to stop by the office before going home for the day.
"How I wish there were some tactful way to get it across to her that while Im quite happy to die serenely, like a good hospice poster child, I dont want to talk about it," Mrs. Noll says, almost as soon as Ellen has left and closed the door behind her. "Its not an interesting subject. Besides, some things are private."
"Were caring for the complete you," Laurel says with a grin.
"Oh, well," says Mrs. Noll. "I suppose we shouldnt be too hard on her. When I think of how terrible I felt when I came here and how comfortable this place has managed to make me, Im ready to forgive her anything. Well, almost anything. I hope she isnt giving you trouble for spending too much time with me."
"Oh, no," Laurel lies.
"Good. Let me see your hands."
"My hands?"
"I had thought perhaps some coral nail polish. The flowers on her dress gave me the idea." All at once, Mrs. Noll looks exhausted. She is sinking back against the pillows, but she manages to say, "Were caring for the complete you," before drifting off to sleep.
* * *
Ellens office is full of plants. There is a thicket of pink begonias on the mantelpiece and an herb garden on the windowsill. There are two African violets in green flowerpots on the desk. A potted avocado tree is threatening to burst through the ceiling. Plants are the main decoration throughout the hospice building. Maybe Ellen has read that plants symbolize the cycle of nature, the passing of the old and the coming of the new. Or maybe she just likes plants. She is certainly good at growing them; the thicket of begonias is the most luxuriant Laurel has ever seen. Above it, a placard proclaims, "Medicine should be high-touch, not high-tech." Laurel figures this is not the place to mention Juliana.
"Did Minnie talk to you yesterday about the party?" Ellen is asking.
Minnie is Mrs. Nolls cousin and her only visiting relative, a retired nurse who began visiting recently and comes on Thursdays, dressed in tennis whites on her way to the courts. This strikes Laurel as tactless, but Mrs. Noll doesnt seem to mind, although she privately calls Minnie "Minnie Mouse." Minnie even looks a trifle mouselike, with her bright eyes, sleek gray hair, and perky features. "What party?" Laurel says.
Ellen rests her elbows on her oak desk, steeples her hands, and explains that Minnie will be having a sixtieth birthday party a week from Sunday. Most of the extended family will be there. It will be an opportunity for Mrs. Noll to reconcile with relatives shes been estranged from for years. But she is resisting the idea of going. "If you would talk with her and try to get at the root of the problem."
"Well," says Laurel, "if she doesnt want to go, I dont see what there is to talk about."
Ellen sharpens the steeple and reminds Laurel that patient plus family is the unit of hospice care.
"Mrs. Noll is dying." Laurel turns her head, with the result that she is staring into an African violet. "Im not going to push her to do something she doesnt want to do just to make her relatives happy."
"Its not just to make her relatives happy." Ellen has unsteepled her hands, which now lie flat on her desk. "People die more peacefully when they are at peace with their families."
If Mrs. Noll were any more peaceful, you could package her and sell her as a tranquilizer, Laurel is tempted to say. Then it occurs to her that Mrs. Noll might enjoy a new opportunity to poke mild fun at Ellens ideas about good adjustment. "Okay," she says. "Ill talk to her. Ill do it."
* * *
"You did it!" says Mrs. Noll when Laurel comes in after the weekend.
"Do you like it?"
"The hair is perfect and the lipstick is fine too. But the eyeshadow is all wrong. Oh, I dont blame you, dear. I blame myself. I should have seen that you needed golden brown, to complement your new auburn hair."
"How about this?" Laurel opens her purse and takes out her little palette of eyeshadows -- mauve, two greens, and mahogany.
A few minutes later, she is looking into Mrs. Nolls silver-backed mirror at her new mahogany eyelids and, since Mrs. Noll has gotten her to intensify the lipstick, brighter lips. Still no competition for Juliana, and maybe the effect is rather conspicuous, but why not?
"Tell me what youve been up to, aside from a makeover for the complete you," says Mrs. Noll.
"Well, I promised Ellen I would talk to you about Minnies birthday party."
"What?"
"She thinks you will be more at peace if you are at peace with your family."
"Tell her if I were any more at peace, Id be dead already." Laurel looks at her hands. The coral nail polish has already begun to chip. "Julianas invited me to visit in about seven weeks, after the baby is born."
"I thought you didnt like her."
"I cant really dislike her. Shes too nice. Anyway, a friend of hers will be at Stanford for a mini-course. She thinks he and I might like each other. She wants to"
Thats marvelous."
"Im not sure I want to go." But then Laurel realizes Mrs. Noll might suspect the reason Laurel doesnt want to risk being away when Mrs. Noll dies so, keeping her eyes focused on the embroidered Nepalese coverlet, she launches into an account of the contagiousness of the hospice outlook and how she seems to be losing what little get-up-and-go spirit she ever had. "Not that Id tell Ellen that," she adds. "Shes always talking about how the terminally ill can be an inspiration to us all. But I doubt this is the kind of inspiration she has in mind."
Laurel looks up, expecting Mrs. Noll to be amused. But Mrs. Noll looks horrified. "You musnt all this acceptance is fine for a dying old lady like me whose husband is dead and whose life is over. But a young person like you who has never had an abiding love You must take this opportunity, Laurel, flourish your heart in this world."
"What?"
"Flourish your heart in this world. Its from the Malory passage on the wall. Get up and read it. You might as well become familiar with it. I have left it to you in my will."
Laurels eyes fill with tears.
"Read it, dear," Mrs. Noll says gently. "And you must try not to cry when you are wearing eye makeup."
Laurel walks over to the wall. "Therefore, like as May month flowereth and flourisheth in many gardens, so in likewise let every man of worship flourish his heart in this world," she reads aloud after a moment.
"Worship meant honor in the fifteenth century. A man of worship was an honorable man. Wont that be a nice thing to hang in your living room?"
Laurel, working her way through the difficult calligraphy and unfamiliar phrasing, starts to giggle shakily.
"Whats so funny?"
"But the old love was not so; men and women could love together seven years, and no licours lusts were between them, and then was love, truth, and faithfulness," Laurel reads aloud.
"Licours lusts meant sexual pleasures," says Mrs. Noll. "What is funny about that?"
Laurel stifles a mental image of a man walking into her living room and seeing a wall-hanging that says he should go seven years without lusts. She turns around. Mrs. Noll is smiling, her eyes half-closed. Probably the passage reminds her of her husband, although Laurel doubts they waited seven years to have sex.
"I guess you dont read fashion magazines, with their articles about how long to wait before sleeping with a new man," she says, sitting back down at Mrs. Nolls bedside. "On the third date, or the fourth, or if youre really conservative, maybe wait a few months. I dont recall any of them saying seven years. But of course Ill put it up in my living room. I want to. I cant tell you how much I..." She swallows hard.
"Perhaps this will help you attract a better sort of man. At any rate," Mrs. Noll says sleepily, "the main thing for now is to get you to California. Ill go to Minnies birthday party if youll go to Juliana. Ill visit my cousin if youll visit yours. Is it a deal?"
"Yes," says Laurel. "Its a deal."
* * *
Her side of the deal didnt turn out so badly, Mrs. Noll tells Laurel on Tuesday of the following week. "They were all terribly sweet to their dying old relative, partly out of pity and no doubt partly because theyre all hoping to be remembered in my will."
Laurel glances out the window. The day is bright and blue, with pink and yellow flowers swaying in the hospice garden, the kind of day that would bring hope to anyone, even a dying old lady and an aging unloved social worker.
"Im going to have some fun," Mrs. Noll continues. "People who are after a dying old womans money deserve to be toyed with. Thats why I agreed to stay through yesterday so I could spend more time with some relatives I hadnt seen in decades. Minnies also invited me to a luncheon this Thursday for her granddaughter, and I agreed to go if I feel up to it. And if Im being unfair and all she wants is the pleasure of my company," Mrs. Nolls voice is fading, but her expression is still alert, "well, thats all shes going to get. Have you made your plane reservations for California? Have you practiced saying, Oh, she looks just like you?"
* * *
"Oh, she looks just like you," Laurel is saying six weeks later. "Youd better not commit a crime tomorrow, or she might get arrested."
Juliana beams, leaning back in her lawn chair, and runs a finger down the babys round pink cheek. Julianas cheekbones are high. Her hair is golden, and the baby is almost bald. Ten-day-old Beatrice Parker-Denison looks about as much like her mother as like Laurel. But if genes settle the matter, in thirty-six years Beatrice will have her mothers shining hair and perfect cheekbones. And Juliana will be seventy-two. Maybe still vaguely beautiful, like Mrs. Noll, but nothing to compare with the youthful version. Laurel has heard people say you have to be very egotistical to get yourself cloned. Now it strikes her the opposite is true. Generous and noncompetitive, thats what you have to be imagine bringing someone into the world who will be genetically just like you, but as you age, decades younger.
Paul, Julianas husband, is standing behind her lawn chair and dangling a red ball on a string above Beatrice, the way Laurel earlier saw him dangle a toy in front of the family cat. "Look at this," he says. "A family in their backyard, what could be more natural? I wish that patient of yours who says cloning is unnatural could see this, Laurel."
"Everything that is usual appears natural. Thats what Vicky always said," says Dan, opening a can of beer. "Of course, she got it from John Stuart Mill."
Laurel tries to catch Julianas eye, but Juliana is blissfully absorbed in the baby. As absorbed as Dan apparently is in Vicky. But at least Julianas daughter is alive. Dans wife Vicky has been dead for seven years, but except for the past tense, he talks about her as if she has just gone out to the supermarket. Vicky liked teaching middle school because no matter how ruthless the pecking order was, the girls were so young you could always tell yourself that someday the last would be first. Vicky didnt like wine and wasnt interested in learning to like it; Vicky said she worked at her work, she wasnt going to work at her fun. Vicky once had a pet swan. Laurel thinks she would have liked Vicky. But she cant imagine how she is supposed to attract a man who still sees himself as Vickys husband.
"Vicky" Dan begins again.
Beatrice shrieks. Good for you, Laurel says silently. "Excuse me," says Juliana and gets up, carrying Beatrice into the house.
Laurel hesitates, then follows. Juliana is sitting on a loveseat in the living room, a towel draped over her chest, breast-feeding Beatrice. Laurel is surprised. She had a vague idea that in California breast-feeding would be as public as politics.
"So what do you think?" Juliana asks.
"Shes beautiful."
"I mean about Dan."
"Dan?" Laurel sits down in a green velvet armchair that turns out to be even softer than it looks. "I think if he gets involved with me, hell be committing adultery. Why are you trying to fix me up with someone whos still in love with his wife?"
"Widowers who were happily married make ideal husbands."
"No, they made ideal husbands. If widowers want to get married again, it means they love marriage, not their wives. True love," Laurel picks up a pretzel stick from a bowl on the coffee table and holds it aloft like a scepter, "does not look for replacements."
Juliana giggles. "Whatve you been reading, Riveting Romances?"
"Malory. Mrs. Noll has got me reading him. People in Malorys world dont look for replacements."
"You cant really believe"
"I really believe Dan isnt looking for a replacement. Neither did Mrs. Noll. She wouldnt be so serene about dying if her husband were still alive." Laurel gazes straight ahead. The opposite wall has a mural of wildflowers. "Too bad Vicky died too long ago for Dan to clone her."
"So he could marry an infant? Besides, he wants Vicky, not a clone."
"Then why do you think hed want me?"
"You have a lot in common. Youre both so romantic. No one can mourn forever."
Oh yes, they can, Laurel wants to say. But Beatrice is falling asleep, and Juliana also seems to be shutting down, her face at once peaceful and exhilarated as she looks at her daughter, as though falling in love and assured of reciprocation. Mrs. Noll grew to be happy to be childless, happy to flourish her heart entirely unto her husband. Probably Dan, who is also childless, was the same way. Probably he was as wonderful a husband as Mrs. Nolls was. If only... Laurel is tired too, jet-lagged. She feels as if she is sinking into the field of flowers on the wall. She can almost smell the flowers; then she realizes there is a vase of roses on the end table. Julianas plushy cat, blue-gray like Dans eyes, is rubbing against Laurels ankle. How soft. Everything seems to be conspiring to make her fall in love. But she doesnt want to be like the women in Malorys world who fall in love with Lancelot because he is so devoted to Guinevere and they want all that devotion for themselves. They cant see that going after someone because of the stability he shows in his devotion to someone else is a losing proposition. If he shifts his devotion to you, he no longer has the stability that attracted you in the first place. Anyway, she barely knows Dan.
Laurel has an impulse to telephone Mrs. Noll and find out how she is, but it is too late and she is too sleepy.
* * *
The next morning Laurel awakens with an urge to giggle. Imagine, she was practically ready to fall in love with a total stranger just because he still loved his dead wife and Julianas living room smelled of roses. Thats what reading Malory will do to you, she envisions Mrs. Noll saying. Why not give her a chance to say it right now? And why not give her a chance to hear that Julianas daughter doesnt look like an unnatural clone, she looks like a baby? Laurel picks up the receiver to call Mrs. Noll, only to be interrupted by the cat, who has come into the guest room, bounded onto the bed, and is now inserting her velvety blue-gray body between Laurels mouth and the receiver, purring loudly. Three times Laurel pushes her away, but the cat keeps returning like a velvet boomerang. Laurel is so absorbed in trying to keep her mouth at the receiver that it is a while before it strikes her that the rings are not being answered. She hangs up, tries again, waits ten minutes, and tries a third time.
Maybe shes just out of her room, Laurel tells herself, dont get upset. But on the other hand, why not? People in Malorys world get upset all the time. They dont worry about being well adjusted. And Mrs. Noll is rarely out of her room anymore. In the past month, she has gotten weaker, although the hospice doctor predicts a couple of months more for her. He has admitted he cant be sure. Laurel will have to sound calm if she is going to call Ellen. Ellen thinks Laurel is too involved with Mrs. Noll, just as most people would think Dan is too involved with the memory of his dead wife. Where do they keep the rule book? Laurel picks up the receiver again, concentrating so hard on how calm she is going to sound that it is not until the telephone starts to ring that she realizes the cat is still on the bed.
"Ellen Lefferts."
"Hello. This is Laurel." She tries to push the cat away.
"This is a terrible connection. Do you hear buzzing on the line?"
"Its just a ca Yes, its a terrible connection." The purrs are rising like tidal waves. Laurel scoops up the cat and plops her on the floor. "Is Mrs. Noll all right?"
"I have such good news." The good news is that Mrs. Noll has gone back to Minnies for a few days. Minnie is a retired nurse, remember? Isnt Laurel glad she persuaded Mrs. Noll to go to the birthday party? Isnt it wonderful when terminal illness leads to family reconciliation?
Laurel gazes out the guest room window, which overlooks the backyard. Juliana is lying in a hammock, with Beatrice on her stomach. Julianas husband is pushing the hammock back and forth. And in the room, the cat is purring the loudest purrs Laurel has ever heard.
"Yes," she says, "wonderful."
* * *
And if Merlin could have enchanted him into believing I was Vicky, we would have lived happily ever after, Laurel is rehearsing in her mind eight days later as she knocks on the door of Mrs. Nolls room, her first stop in the hospice on the day after returning from California. Knock before entering; thats a rule of what Ellen calls hospice philosophy. Give our guests the courtesy you would give a guest in your own home.
"Come in," says a mans voice.
Laurels first thought is that it must be the hospice doctor. But the doctor would not be lying in the bed instead of Mrs. Noll. He would not be the reason the room now has none of Mrs. Nolls possessions, no teak armchair, no embroidered Nepalese coverlet, no Asian rug. No framed Malory passage. And the doctor is not an elderly black man with a fringe of white hair and a benign pedagogical expression, as if he has been reading fables to children.
"Good morning," says the man. "You must be Laurel."
* * *
"Shes as well as can be expected. She has gone to live with Minnie. Shell be there until the end, so she can die surrounded by her loved ones." Sitting under a hanging basket of ferns that is a new addition to her office, Ellen sounds as pleased as if Mrs. Noll has been cured and is off for a trip around the world.
Laurel presses her palms together. First the jet lag, then the fear, and now this. "I can keep on as her social worker. I want to. I dont mind the extra work."
"She wont be using home hospice care. The family wants to take care of her themselves." Ellen steeples her hands. "Minnie used to be a nurse, you know."
* * *
Of course, it is only because she felt so close to Mrs. Noll that Laurel feels so bereft now. Patients have chosen to leave this residential hospice before. Some go home to die. Occasionally people even leave because they have a remission, although Laurel can count on her eyeballs the number of times this has happened. Then there are the ones theyre not supposed to think about, the ones who leave the hospice to go to Mercicenters, pleasant facilities like hospices, except that at the end of a lovely day or two, you get free poison with your tea. Or theyll bring it to your home. Like hospices, Mercicenters have home care for people who prefer to die at home. Our role is to make our guests comfortable enough with us that they dont feel the need to turn to them, Ellen likes to say.
Mrs. Noll would never turn to them, would she? She scorns the idea. She thinks its unnatural. But if the nausea got out of control Laurel forces the thought away, but it keeps moving in and out of her consciousness, like a floater drifting across her visual field, until finally, as soon as she gets home, she telephones Minnie.
Ten rings. Twelve rings. No answer. Three occurrences of this pattern in half an hour, and its like being back in Julianas guest room except for the absence of purrs. Dont get upset. Well, why not? People in Malorys world... Eventually, at a quarter after nine, Minnie answers the telephone, and Laurel launches into her prepared speech. "Is this Minnie Larson? This is Laurel from the hospice. I was wondering how Mrs. Noll is doing."
"Shes doing as well as can be expected," Minnie says.
"I wonder if I could say hello to her?" Laurel draws a pair of concentric circles on her notepad.
"Im afraid shes past that. Shes quite disoriented. But at least she isnt suffering. Were keeping her comfortable."
Laurels throat feels scraped. "Maybe I could come and visit?"
"Im afraid she wouldnt recognize you, dear. But thank you so much for calling. She liked you very much, you know."
Not until several minutes after hanging up does it occur to Laurel to wonder why, if Mrs. Noll is so disoriented, she was left alone in the house for over three hours.
* * *
To find out if a particular person has died recently in your city, you can log on to the department of vital statistics at City Hall. Laurel remembers this from a murder mystery she read last month. But Mrs. Noll is not listed. So she hasnt died at a Mercicenter, with Minnie tactfully concealing it from the hospice. What else might Minnie be concealing? You could hardly expect to find Mrs. Nolls death listed if Minnie is concealing it in order to get her Social Security checks. But it wasnt her Social Security checks that Mrs. Noll said Minnie was interested in. It was her will. What if Minnie has gotten Mrs. Noll to make a will in her favor, and now Mrs. Noll is bound and drugged? Or maybe Mrs. Noll has become so weak and disoriented that Minnie has no need of rope or drugs to feel safe leaving her home alone. Or maybe Laurel reads too many murder mysteries. Maybe Minnie is taking perfectly good care of Mrs. Noll and just had her telephone unplugged for a few hours so as not to be disturbed.
All through the following morning, through the staff meeting and the session with the gentlemanly new occupant of Mrs. Nolls room, Laurel is making plans. At lunchtime she telephones Minnie. No answer. Then she drives to a jewelry store, where she buys a pair of garnet earrings she can always keep for herself if no one answers Minnies door.
"I found an earring wedged behind the night-table drawer. I figured it must be Mrs. Nolls," Laurel rehearses in her mind fifteen minutes later as she pulls up in front of Minnies house. The curtains are closed, a magazine sticks out of the mailbox, and no car is in the driveway. She walks down the marigold-bordered path and rings the doorbell. She waits five minutes, rings again, waits another five minutes, then bangs the knocker as loudly as she can. She puts her ear to the door. Still no sound from within. Of course, Mrs. Noll may be unable to scream. But Laurel is beginning to suspect there is no one inside the house.
* * *
"Maybe Minnie was taking a bath," Juliana is saying late that evening.
"And yesterday she just happened to have her phone unplugged until nine-fifteen?" Laurel shifts the receiver to her other ear. "Look, I went back today after dark, and still no one answered the door, and the porch light was on but the house was all dark inside. Even in back I drove around the block. I think Mrs. Noll isnt there anymore."
"But"
"Juliana, could you do something about the cat? I can hardly hear you." Laurel takes a sip of water. "I cant talk to Ellen," she continues after Juliana has removed the cat. "Shed probably say I need to go to a support group for stressed hospice professionals."
"Maybe you do. But that wont help you find out whether your suspicions are right. What you need," says Juliana, "is to go to the police."
Laurel stares at her hands. In memory of Mrs. Noll, she is still wearing coral nail polish. In memory of? Where did that come from? "I dont know if theyd get involved. Anyway, Id prefer something less official and more discreet. So if it turns out to be nothing, Minnie wont have to know. Maybe Ill investigate a little more on my own."
"Be careful," Juliana says.
* * *
Three times during the next week, Laurel takes one of the earrings to Minnies on her lunch hour. She drives past the house three evenings after dark. No one answers the doorbell at lunchtime, and in the evening there is never light in more than one place. Surely Minnie is out during the day and alone here at night? The vital statistics department still has no listing of Mrs. Nolls death. Laurel is now desperate enough to call the police department of missing persons. Mrs. Noll, however, does not qualify as a missing person just because she is missing to Laurel.
"Shes seventy and dying," Laurel protests.
"Theres no evidence of foul play. Nothing for us to investigate. Even dying seventy-year-olds are entitled to their privacy."
Laurel has to admit that the last part sounds like something she might say to Ellen. But that Saturday, after calling Juliana, describing what she is about to do, and ending, "If I dont call you back today, call the police," she drives over to Minnies and rings the doorbell.
Minnie looks so different in her old slacks, T-shirt, and no makeup that Laurel probably would not have recognized her on the street. Apparently, its mutual. Minnie is blinking and saying, "Yes?" in a pleasant but puzzled way.
"Im Laurel. The hospice social worker. I think Mrs. Noll left an earring...."
How odd Minnies expression looks, strained and almost pitying. Pinpoints of fear rise within Laurel like a fireworks display. "Is she alive?" she asks abruptly.
"Come in." Minnie steps back from the door. "I suppose I might as well tell you now."
"When did she die?" Laurel whispers.
"She is not dead."
Laurel does not remember walking through the hall and into the living room, but now she is seated on a sofa opposite a tapestry wall-hanging. "Is she still here?"
"She never was here," Minnie says, "and shes not my cousin."
* * *
Laurel does not try to sort out her thoughts until she is walking back down the marigold-bordered path. First comes relief, relief plus elation, because Mrs. Noll is not dead. Is maybe not even dying anymore. Is flourishing her heart, not to mention her liver, in this world. Laurel has a wild urge to laugh; then the second reaction sets in. Betrayal. The sweet old lady with her old-fashioned ideas about natural and unnatural, the sweet old lady serenely dying in a hospice, was a fake. What else was a fake? All that warmth and interest did Mrs. Noll come to see Laurel just as a dupe? Laurel could hardly ask Minnie that, but she did inquire about Mrs. Nolls husband.
"Yes, she loved him very much," Minnie said, as she poured iced tea into Laurels glass, "but that doesnt mean she was ready to die. You hospice people are all so apt to believe terminally ill people are ready to die."
Only the ones who come to us, Laurel answers silently now as she gets into her car. They dont have to come to us if they dont want to. But Mrs. Noll did want to, at first. Laurel turns on the radio to an oldies station. "Stop! In the name of love," floats into the car. Laurel cannot stop. She cannot stop thinking about how Mrs. Noll came to the hospice so weak and nauseated that she really was ready to die. But after a few weeks of the comfort care the hospice is so proud of, she felt better, so much better that she began having second thoughts. And when Laurel started to talk about Juliana...
Laurel turns the corner, drives several blocks, then turns another corner. She is driving aimlessly. Take the adventure, Malory says. Mrs. Noll took the adventure. Like most of the patients, she had her own telephone. No one in the hospice ever knew what calls she made. So she called the university medical center, a hundred and thirty miles away, just to see. Then she called her old friend Minnie Larson, not a retired nurse at all, but a part-time accountant.
How Laurel fell for Mrs. Nolls sympathetic interest in her and in Juliana! But Mrs. Noll was making plans. For a long time she had been ready to die; she hadnt been looking into last-ditch experimental treatments. But the university medical center staff told Mrs. Noll there was a brand-new possibility, a new kind of transplant, still experimental, but with no worries about organ rejection or waiting lists for scarce livers where a seventy-year-old would rank near the bottom. The procedure involved cloning her and making the cloned embryo cells turn into liver cells instead of developing into a fetus. So in a way the cloned embryo was sacrificed. So was the truth. You cant stay in a hospice if youre awaiting a transplant. Laurel knows this. Its right in the rules. Hospice philosophy means palliative care. If you want to take a chance on a life-extending experimental treatment, go somewhere else. Ellen would not have dumped Mrs. Noll on the street, of course. But there would have been a transfer to a nursing home for the six weeks between the cloning and the transplant, and who could be confident of finding a space in such a pleasant facility on such short notice? The hospice is so comfortable, and the symptom relief is so good.
"You have to understand, her life and her comfort were at stake," Minnie said, taking a gingersnap. "You know how important comfort is when youre so ill. She had no other choice."
No other choice but this elaborate deception? Well, Minnie admitted, looking embarrassed for the first time, perhaps it didnt have to be quite so elaborate. But deception is hard to keep in bounds. Hasnt Laurel ever found that? Minnie conceded that perhaps Mrs. Noll went too far, perhaps she even started to enjoy creating her own little world. But she needed an excuse for the preliminary sessions at the university hospital while they ran tests, evaluated her case, and finally harvested the cells from inside her cheek. That was what Mrs. Noll was up to when the hospice staff, so eager to facilitate a family reconciliation, thought she had gone to Minnies birthday party and then to the luncheon for Minnies granddaughter. Ironic, Minnie added, because although new life was being created, there would be no birth. Of course, a lot of people would think that is terrible, but Minnie and Mrs. Noll both think theyre terrible, especially the ones who think it is all right to have an abortion because you dont want to have a child, but not to produce an embryo on purpose because you want to try to save your own life. And what did Laurel think? Minnie asked.
But Laurel, sitting stiffly on Minnies sofa, was not thinking about embryos at all. She was thinking about deception and betrayal. She is thinking about that now as she finds herself driving alongside a golf course she has never seen before; she is out of the city by now. First relief, then knowledge of betrayal where has she previously encountered this pattern? In stories about wives, of course, wives who are afraid something dreadful has happened when their husbands dont come home one night, and it turns out something dreadful has happened, but not to the husbands. To the wives. The husbands are happily with other women. Laurels face feels singed. How unwholesome Ellen would find all this, perfect proof that Laurel is too involved and needs help whether she wants it or not. But this thought raises Laurels spirits. It makes her feel unconventional and daring, instead of pathetic. Who is Ellen to say whom Laurel should flourish her heart unto? Laurel turns the car again, and soon she is driving along a country road beside a field of wildflowers like the mural in Julianas living room, like the May in Malorys world, when hearts begin to blossom and to bring forth fruit. Laurels heart is beginning to bring forth fruit right now. Why shouldnt Mrs. Noll grasp at a second chance at life? And why suppose she was using Laurel? Maybe she was trying to protect Laurel by not letting her in on the deception. Maybe she was afraid Laurel would lose her job if she went along with the deception and Ellen found out. Maybe she was right. Laurels hands are gripping the steering wheel; she sees her coral fingernailsa memorial, no, a tribute, to Mrs. Noll. Surely all that warmth and interest was no fake. All at once, Laurel has the thrill of relief again, but now it is relief plus triumph, as if she and Mrs. Noll have carried off the deception together. Laurels talk of Juliana was what got Mrs. Noll thinking about cloning, after all. Surely she would be delighted to see Laurel. Laurel does not have to be back at the hospice until Monday. She can drive to the university tomorrow and appear in Mrs. Nolls hospital room with an armful of flowers. Maybe she should take along her copy of Malory, but on second thought, that wont be necessary. Mrs. Noll has undoubtedly brought her own.
* * *
Reprinted from M. Nussbaum and C. Sunstein (eds.), Clones and Clones: Facts and Fantasies about Human Cloning (Norton, 1998), 310-331.
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