En Medias Res

On a table, in a large, window-lined waiting room, a telephone rang. It was dark outside, and my stepmother had just complained of hunger. She was diabetic. It was a concern, but that concern was arrested, utterly forgotten by the ringing of the telephone. It was for us, we knew. The monitors above the reception desk, and placed intermittently about the room, told us our that my father had been moved some time ago from surgery to a recovery room. He had been slow to wake up. It was my sister who answered the phone.

“We can go back,” she said when she had hung up.

She led the way. I don’t remember now how she knew which way to go, if someone had come to lead us back to the room or if, somehow, she, in her assertive way, just knew. We followed her, my stepmother and I. My sister, being the youngest and the favored, was always first when it came to any decision made in behalf of my father, only Ivy lived in Tacoma, an hour’s drive from my father and stepmother. During his battle with cancer, he needed someone close, so I had come to stay. I still felt, when my sister was around, that I needed to take a back seat. It wasn’t out of resentment I did this, merely a desire to keep peace, and to respect the fact that my sister’s relationship with our father was different than mine, closer, special, and that was ok. I had left Washington some years ago. There were consequences to that, ties that were strained. It was the price I had paid. At the time it seemed worth it. Now I wasn’t so sure.

In the recovery room, my father was just stirring. He wore no glasses and could not really see us. His false teeth had been removed, and the absence of these, combined with the ordeal of an hours-long surgery made him look ten years older. He would be eighty in another month. The room was very small, not really large enough for the three of us and the nurses and doctors who were busy coming and going. Neither was it truly a room, but more of a stall, really, with three walls all lined with medical instrumentation and the fourth formed by the pulling of a curtain, or, as it was now, absent altogether. My sister was first to approach him, taking his hands, speaking comforting words, rubbing his legs as he began to groan. June, my stepmother, took one look at his pale, pain-strained face, the tube that came from his nose and which was actively draining blood and fluid from his reconstructed stomach into a bag that hung on the side of his bed, and was instantly seized with a sense of panic. She couldn’t find her phone. Where was her phone! She turned from him and, finding a steel bed tray, emptied the contents of her purse onto it and began searching through her belongings, all the while demanding of each of us what we had done with her phone. Where had she left it? Did one of us have it? Had she left it in the waiting room? Of course neither of us were going to go check.

I consider myself an empath, though, to be honest, so does everyone I know, my sister included. The combination of my stepmother’s stress-avoiding behavior, my sister’s semi-convincing attempts to ignore her (their relationship had always been strained) and the emotional stress combined with the sight of my father lying there, writhing in pain, was something more than I could bear. A strange sensation came over me. My head began to feel very hot and I felt I couldn’t breathe, though it wasn’t the usual kind of breathlessness. This was not an asthma attack, but something I did not really understand.

The attending physician arrived then, took a passing glance at my stepmother, who related to him the emergency of her missing phone, then turned to my father, where he showed him how to work the button that would deliver to him an instant dose of morphine if the pain became too much. He pushed the button three times. My sister pushed it an extra time for good measure.

“He won’t take more than he needs,” she said to me, though I knew that wasn’t quite true. I had two years more experience than she with his self-medicating habits and knew he could manage that button just fine on his own.

“Ivy, do you have my phone?”

“I don’t know where your phone is! It’s not important right now!”

My vision began to blur. I felt I must sit down or fall. I sent a text to my sister. “I have to go to the bathroom.” And I walked, almost ran, to the lobby and out the surgical suite doors.

In the bathroom I leaned against a crook in the wall near the sink and, with my hands on my knees, held myself semi-upright. But my knees were too week, my head was spinning and the next thing I remember, I was lying on the cold tile floor. My breath came in puffs and my vision faded, not to black this time but into hazy, tear-filled abstractness. I was sobbing. Hungry, tired, stressed, heartbroken…

I raised myself to something like a sitting position. It must have been close to ten o’clock. We had been among the last in the waiting room that evening. I was not disturbed and I don’t think it ever occurred to me that I would be. Thinking back on it, I don’t remember what I was thinking. I just replayed in my head the sight of my father in pain. Our relationship was…complicated. He resented that I had moved away. He resented it more when he had been diagnosed with his first bout of cancer ten years ago. It was in his esophagus then, and though his prognosis was grim, he had pulled through it. I had two toddlers and an infant then and I couldn’t make it back. Ivy had cared for him then. It was my turn now. I had other reasons to need to be away for a while, but my heart was in Virginia. My children were in Virginia. And someone else was there too, his absence eating a jagged hole through the center of my heart. I had come for many reasons. I had come to repair, if I could my relationship with my father. I had come, if the efforts to stop the cancer did not prove a success, to say goodbye. I had come to do the sort of thinking that only distance can provide. To think, to decide. To get over. I was glad I was here. I was needed here. But this, being away, being here in Washington now, was perhaps the hardest thing I had ever chosen to do.

My phone buzzed against the tile floor. I pushed the home button. Ivy had texted me.

Where are you? June’s freaking out!

I’m in the bathroom. Didn’t you get my text?

Yes, but she’s pissed that you left. Oh, and she found her phone. It was in her coat pocket.


I pulled myself off of the floor and examined my reflection. I was blotchy red and swollen. I splashed water on my face, dried myself with a paper towel, took a couple of deep breaths, and returned to the surgical suite.

“There you are!”

“I texted Ivy to tell her I needed a minute in the bathroom. I got light-headed. I’m sorry.”

“How would we have found you?”

“Um… That’s why I texted. To tell you where I was.”

“You didn’t text me!”

It’s all I can do. I smile apologetically. “You found your phone?”

“Yes.” She’s frustrated with herself. She has been generally frustrated with herself. Her dementia is getting worse, and what’s more, she’s aware of it. She feels her life spinning out of control, and when my dad needs her most, and she’s scared. It’s hard to be mad at her. She’s not ordinarily a difficult woman. She’s been a kind and loving and very generous stepmother to us. I think she’s rather lovely, actually, but when she’s stressed… She’s difficult. And she’s hungry, too. I remember her saying so.

“Shall we go find somewhere to eat?”

Seattle’s University district is filled with restaurants, but for some reason, maybe it was the time of night, maybe it was stress, we couldn’t find anything nearby but bars. We drove through Freemont and Greenlake and…I don’t even remember. It was another hour before we found a restaurant we could all agree on. By then, June’s blood sugar had plummeted. There was some little relief now my dad was out of surgery, but his recovery would be difficult, and if they hadn’t managed to get the cancer… Or if there were complications from the scar tissue, of which there was a great amount, from his previous radiation treatments, it was hard to say what his outcome would be. There was some relief, yes, but tensions were still high. June had wine. Ivy had three Vodka martinis. I was not looking forward to the drive back to the hotel.

I don’t drink. At the age of fifteen I had aligned myself with the Mormon faith, and the way of life, and so I had sworn off alcohol. But that was not the real reason I didn’t drink. In my experience, alcohol made people dangerous. It made them say ugly, horrible things. It made them do ugly, horrible things. I didn’t need that. I needed clarity. I needed my mind to be clear and attuned at all times. It felt safer that way. People, at the best of times, were dangerous. I wanted none of it.

Dinner, despite the alcohol (and the undercurrent of remaining tension) seemed to be going relatively smoothly…until June mentioned something about one of her boys. Ivy, already in a sour temper, took this as an invitation to begin listing off her many grievances with our stepbrother. June, understandably, had no patience for this. She said some things in return, and then began to cry. We paid the bill and got in the car. It was a long ride back to the U. District. I’d like to say it was a quiet ride, but Ivy kept talking and June kept crying. Then, for a little while, there was yelling.

We returned to the hotel. June, who often stays up all night long, wanted to watch the news. I said no. It was the one negative thing I said all night (though I admit it wasn’t the first to come to my mind.) We turned out the lights and went to bed.

Ivy, usually an early riser, woke first.

“Are you leaving already?” I asked her.

“I want to see Dad before June wakes up. I don’t want a repeat of last night. He can’t handle it right now.”

“Don’t go alone. Let me come with you. I’ll show you how to use the shuttle and then I’ll come back and get June.”

“I don’t want to wait for you.”

“I only need ten minutes.”

Still she didn’t want to wait, but she did, though begrudgingly.

We left the hotel room around seven. June often slept till ten or later. I’d be back before she missed me.

At the hospital we found my dad resting. He woke upon our entrance. His voice was hoarse. He still had that horrible tube in his nose. The fluid was red and yellow and put me off my breakfast. He had a catheter. There was a lot of blood in that, too and I wondered if that was normal. We sat and watched him rest. We didn’t talk, though Ivy seemed to maintain a sort of noisy energy. She couldn’t manage to sit still, and even in her silence, seemed to create a lot of disturbance. I wondered if my dad could feel it too, or if he was too out of it. I hoped he was too out of it.

About eight the surgical team came in and explained the operation. They had gotten all the cancer. Good news! But had only been able to leave about 15% of the stomach. Basically they had performed a Roux-en-Y gastric bypass, only in a traditional gastric bypass, the remains of the stomach are left, tucked behind the new stomach. This is done because certain “factors”, digestive and metabolic enzymes, are created in certain parts of the stomach and intestines and it’s just better to leave them there, still functioning, though physically displaced, than to remove them. That wasn’t an option for my father, since cancer had taken residence in those parts of his digestive system. He would need B12 shots from now on, since his body could no longer metabolize it on its own. The old radiation scarring had been avoided, and it was his lower stomach that had been removed. The reconnected intestines should work just fine once they healed. They had not had to disturb his scarred esophageal tissue at all. The greatest concern would be weight gain and nutritional maintenance, particularly since its normal to lose 20% of body weight during surgery and recovery. His diet would be of clear liquids, graduating to all liquids. No meat. No nuts. No seeds. A J-tube had been surgically implanted so that he could deliver nutritional supplements directly to his lower intestine, bypassing his shocked and recovering stomach altogether. Only upon inspecting his incisions, they found the J-tube had gone missing. I could tell the surgeon, when he came again later, was nervous about this, but there was nothing for it now. The only other concern that yet remained was the condition of his heart, whose strength had ever been in question in relation to this surgery. He had been on a number of medications for congestive heart failure, but had been removed from all of them in the weeks prior to the surgery. Such issues were most easily monitored and regulated intravenously during surgery, but remained a grave concern during recovery, and something we would need to watch daily. For the most part, however, he had managed the surgery spectacularly. He might be in the hospital three days. He might remain two weeks. Who knew! But, for now at least, all was looking well for him. The doctors and surgeons were optimistic.

My father was more optimistic still.

“If I walk, eat and pee, I can probably go home tomorrow.”

Not likely, but that was him. When I first offered to come stay with him, he had told me that he would only need me for two weeks, through two rounds of chemo and recovery. I had been here nearly two months already. I would remain for however long it took to get him on his feet again.

My phone rang. It was June.

“Why did you leave me alone?” she asked me, her voice shaking through her tears. “Why would you leave me alone?”


“I’m sorry,” I answered her. “We wanted to come early and didn’t want to wake you. I was getting ready to head back. Are you ok?”

“You went without me?”

“Yes. We didn’t want to wait and we didn’t want to wake you.” I couldn’t exactly say, we didn’t want you raising a fuss like you did last night.

“I want to go home. I’m going to take a bus home. I don’t even feel like a part of this family.”

My dad, from the bed, could hear her. He shook his head in disapproval. He was annoyed. He didn’t need this. “Take her home,” he said to me under his breath.

“I’m coming. Don’t go anywhere. I’ll bring you here to see dad if you want, and then I’ll take you home.”

“Just take her home,” he mouthed once more.

“No, Just take me to the train station. Or the bus station.”

“I’m coming. Stay there.”

On my way back to the hotel, I received a phone call from a number I didn’t recognize. The prefix indicated that it was an Oregon number. Portland. I answered. It was June’s niece calling to ask after my dad. I filled her in as best I could, my mind a little scattered from my preoccupation with getting back to the hotel and what I’ll likely have to deal with when I get there. Marian responded with an appropriate amount of both relief and concern. She has always been fond of my dad and he of her, and I was grateful for her call. She asked if there’s anything she could do. Of course there isn’t. I thanked her again for her call and for her concern and promised I would pass her love onto my dad before hanging up.

I arrived at the hotel to find June crying and angry. She simply couldn’t believe I would leave her alone. She was acting like a child and I wondered for the first time if maybe taking her home, where she would then be by herself for possibly days, was a good idea after all. And yet I didn’t see what other choice I had. Dad didn’t want her at the hospital, not behaving like this, and I didn’t blame him. It was all about getting him well, and that meant rest and relaxation. He sure wasn’t going to get it with her around and acting like this.

On and on she went about how it’s rude to leave without leaving a note. (We’d left a note, it was how she knew we were gone.) And then something about how I just do whatever I want without thinking about others. I had a feeling she was yelling at both myself and my sister at this point, but since I was the only one to hear it, and as she’d prepared the speech already in advance, I was obligated to listen to it. I won’t say I listened quite patiently. Living with her these last weeks had been something of a challenge. I’m used to a fairly autonomous life. It’s true I come and go as I want to and I don’t really answer to anyone, despite the fact I have been married for twenty years. Still… I’m not certain it’s necessary that every move I wish to make be presented for approval before I make it. Just going for a walk in the neighborhood requires a ten minute conversation about which streets in their rural planned neighborhood are safe and how long I should be out and whether or not I should take the dog and how I shouldn’t let her poop in anyone’s yard, even if I am prepared to pick it up. “It’s better to let Molly poop in the street.” I personally don’t think standing in the middle of the street for any reason is appropriate, particularly with impressionable children and animals.

“You do still have to pick it up, you know, even if it’s in the street.” That was the answer I gave her at the time.

She looked at me for half a minute. “Oh, shit.” That was her answer. Apropos, I think.

It’s nice when I can turn her rantings and over-protectiveness into a humorous end. That wasn’t the case today. Her ranting had only just begun. I still had to listen to her as she put her makeup on, got dressed, packed her things up, and then drove her home two hours (supposing the traffic was good).

As it turned out, that would have been the short, sweet, and simple version of the day. Listening to her upset and ranting, feeling bad and wondering how I could have handled the situation better. No doubt I could have. But no. Neither was traffic a problem, though we had to traverse the greater part of the city, since the U-District is on the north end of Seattle and they lived well south of Olympia. I think it was in Gravelly Lake that June started acting funny, as she sometimes does. Her head started to lol and bob and I thought she was going to take a nap. I hoped she was going to take a nap. Sometimes she had fainting spells when her blood sugar wasn’t quite right, and after last night, waiting too long to eat, then eating…and the wine… I wasn’t even sure she had eaten breakfast this morning. In fact… I was quite certain she hadn’t.

“Are you ok,” I asked her.

“I want a burger. Is there a Dairy Queen?”

“Yes, I think so,” I told her, and turned off at the next exit. I bought her a burger. She took a bite of it, fell back asleep, then woke up ten minutes later and vomited it up.

“Do we need to stop?”

“No,” she said, her speech slurred from what I hoped was sleep.

I kept driving. Ten minutes later, she vomited again.

“Pull over,” she said. “I think I’ve wet my pants.”

There isn’t much rural space anymore between Seattle and Olympia, but, as luck would have it, the emergency presented itself in that quiet stretch of road between Dupont and Lacey. At least from the highway, the Nisqually Valley appears a sort of wilderness still. It isn’t exactly so and there are places enough to stop if you know your way. I didn’t. Or at least I couldn’t remember. It had been a good ten years or more since I’d traversed these roads on a regular basis. Much had changed since then. , through It’s not a long space, that stretch of near-wilderness, but when you have a passenger that may be in the process of urinating (I have kids so I’m familiar with this anxiety) it’s long enough.

“Pull over!”

“Do you want to use the side of the road?” I asked, and tried not to sound as irritated—or anxious—as I felt.

“No,” she said. “I need a gas station.”

“I’m trying.” I wondered if she knew of somewhere closer than I was headed, just anything off an exit, but I really was trying to keep the conversation to a minimum. I was under the impression she wasn’t quite in her right mind.

Finally I stopped. She used the restroom, and, miraculously, had not wet her pants, though she had sworn she had. She seemed to be recovering a little. She ate her fries, did not vomit them, and slept the rest of the way home.

Upon arriving, I got her into the house. The first thing I wanted to do was check her blood sugar. I was looking for anything too low or too high, though in truth, I didn’t really know what that meant or what it would look like, or what to do about it if I discovered either number was alarming. It was then I realized that it would have been wise to watch her do it before. I didn’t even know how to turn the meter on, though I knew where it was. I brought it to her as she sat in her favorite armchair, drifting off to sleep once more. I roused her, but she couldn’t remember how to work it either. I began to panic.

I called her doctor and managed to speak to a nurse. They didn’t want to talk to me because I wasn’t an emergency contact. I finally convinced the nurse to listen to me by promising I wouldn’t ask any confidential questions, that it was just general information I wanted and perhaps some advice. She listened. I told her about the day, my predicament, that I had brought my stepmom home but she was acting funny and I needed to get back to Seattle but didn’t feel comfortable leaving her. I told her I was concerned about her blood sugar, related to her what she had eaten and what had been the result and that we’d been unable to get a reading—that my stepmom couldn’t remember how to work her meter, though she’d been doing it thrice a day for as long as I could remember.

“Call an ambulance. Call 911.” So I did.

My dad lives just on the border of Chehalis and Napavine. Rush road is crossed by the freeway, and from the hilltop that goes into Napavine I could see the ambulance coming, just minutes after I had called. June had gone to her room and had fallen asleep. I went in and tried to wake her.

“I called an ambulance.”

“Why did you do that?”

“Because I’m worried.”

“I’m fine.” And she went back to sleep.

The paramedics came. They examined her. Her blood sugar levels appeared to be within normal limits, though her speech was slurred and her story didn’t make sense. I took one of the paramedics into the kitchen and showed them her pill boxes. The pills were in disarray. She had a habit of “reorganizing” them after my dad had filled them. My dad’s physical health had been a challenge for him for some time, but his mental acuity could be challenged by no one. Still, she didn’t trust him to do it right. She would empty out the pill boxes and reorganizing them. More alarming still, she kept changing her mind about the most appropriate time to take her amitriptyline. More of those were missing than any other pill in the box. It seemed her night time meds were fine, but the daytime box was missing every other day. Going back through them all and adding them up… It looked as if she’d possibly taken a double dose of amitriptyline.

Another of the paramedics, looking confused, joined us in the kitchen. “Your stepmom says you just came back from a funeral, that your dad died and you just buried him this morning.”

I blinked. “What? No. He had surgery yesterday. He had his stomach removed because of cancer, but he’s ok.”

“She’s refused service. We can’t make her come with us.”

Oh, God. What am I going to do?

Maybe I’m wrong to want to be in Seattle with my dad. Maybe this is where I need to be. But June has kids, too. Why am I here managing this by myself? Perhaps I’m selfish, but these are the thoughts I was thinking.

The paramedics left. One of the neighbors came by to check on us. They had grown close to my dad, and wanted to make sure the ambulance wasn’t for him. I explained to them the situation. Mrs. Horton asked to come in, and with her help I persuaded my stepmom to let me take her to the hospital.

An hour later, I’m in the hospital with my stepmom and they are running tests. She’s cold, she’s murmuring about bugs in the bed. I just want to be in Seattle with my dad. Hours pass. I’m still waiting for test results. There’s nothing wrong with her, though it’s possible she overdosed on one of her medications. I googled the side-effects of amitriptyline overdose. It fits.

As the hours passed, I grew more desperate to be with my father. Ivy has to return to work in the morning and I don’t want to leave him alone. Neither can I leave my stepmom alone. For a time I had begun to hope they’d admit her. It was the best thing I could think of, but once I realized that wasn’t likely to happen, I started frantically considering my other options. When at last she dozed back to sleep, I snuck out of her room and found a deserted hallway, where I sat down on the floor and called my stepbrother. He owns a business in the central part of the state. Though he was rightfully concerned about his mother, there was no way he could get away. I called her sister next. Neither could she come. I don’t know why it took me so long to think of it, but Marian had called that very afternoon. She had asked me if there was anything she could do—anything at all. Well, as it turned out, there was. I called her back.

She answered immediately. “This is Marian.”

“I need help.”

God bless her, she agreed to make the drive up, leaving her detective job, and her kids too, to help her aunt. I will ever be grateful to that woman. She arrived shortly after we returned to the house. I told her all we had learned, which was basically nothing, and all that I suspected. She agreed with my suspicions about the medications, as well as the out-of-control blood sugar, and immediately took everything in hand.

“We are going to sort out your pills,” she said to June after she’d returned from her bedroom where she had taken off her shoes and put her coat away. She was nearly recovered now, though still angry with me. “We are going to make a chart so you know exactly what pills to take and when. And no more alcohol!”

June didn’t like it, but she knew better than to argue with Marian. It was tough love, and, for some reason, to my stepmother the “love” resonated above the “tough”. Or maybe it was only amplified by it.

“She’s so good to me,” June said as I head out the door, my dad’s leg braces in hand. It was plain she was still very angry with me for calling the ambulance, and I could hear her relating the morning’s events, what she remembered of them, to her niece as I left the house, grateful to be on my way and looking forward to the peaceful drive back into the city.

By the time I reached Seattle, Ivy had moved into my dad’s hospital room for the night. It was too late to visit him. Even on the best of days, they were both used to retiring early. I was anxious for him, but I had no desire to disturb him. He needed all the rest he could get. I would bring his braces first thing in the morning.

I returned to the hotel, grateful to be alone. And, as I had become used to doing these last several months, I cried until I fell asleep. I missed my children. And I missed he whom I was trying to forget. Even with all I had to think about besides; my father, my sister’s ongoing drama with my stepmother, June’s failing health, the decision I had to make to end or save my marriage…I could not persuade my heart to forget. How I wished it would forget!


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