Things I've Learned from Dying

The thirty-two-year-old nurse was filling her tank at two in the morning at a gas station where the lone employee was a middle-age Korean man who sat on a stool in a booth behind bulletproof Plexiglas and wouldn’t come out even to pee if anyone was nearby. Four young black men pulled up driving a maroon Ford LTD. One stepped out and said, Gimme the bag, bitch. She didn’t even hesitate, but he backhanded her anyway, using the hand that held his gun. The clerk later told police he could hear her jaw crack. She lay on the ground, just conscious enough to register the steel toes in the boots her assailant was wearing when he kicked her in the ribs. She heard him say to the other three men in the car, Let’s get the fuck out of here. Her name was Tamira, and she’d never forget his voice, or his face.

It was the beginning of a weeklong bender that ended with murder on a cool fall evening in a white-flight suburb north of Dallas. The same four had parked the LTD at the curb in front of Lucy McClain’s Tudor-style home. One stayed with the car, the other three finished their beers, tossed the cans on the manicured lawn, and walked up to the house.

Miss McClain was upstairs in bed, watching the news and knitting. She was eighty-four years old, with rheumy blue eyes and brittle white hair. A copy of O Magazine was on the night table, under her reading glasses, next to a smudged glass of lukewarm water she planned to use to wash down her nightly pills.

Demetrius Sanders said to the others, Y’all ready to do this? And he kicked in the door. He was eighteen. Eddie Waterman and his cousin, Harold Johnston, were nineteen. They led the way upstairs. The TV was turned up loud. Miss McClain probably did not hear the intruders until they entered her room. She clutched the knitting tightly in front of her breasts. She was scared, but she was calm. She told them they could have whatever they wanted. Waterman walked over to the night table. He had been a linebacker on his high school football team and had been recruited to play college ball at Oklahoma. He was massive, with short hair and a tattoo that identified his gang. Miss McClain cowered. He picked up a set of car keys.

Johnston pulled a gun from his waistband. Sanders said, What you doin’, man?

Johnston looked at Sanders and shrugged. He looked at Miss McClain, then he shot her in the left temple. The bullet exited through her right ear. Waterman jumped back. His left arm was covered with brains and blood. He said, Fuck, man.

Miss McClain was dead. Johnston handed the gun to Waterman. He took it and held it sideways. He fired a shot into her lifeless body. The slug from the 9 mm pistol entered Miss McClain’s left mandible, pierced her tongue, and exited through the bottom of her mouth. Waterman handed back the gun to Johnston. He said, That’s how you smoke a bitch.

Six months before his retirement party Peter felt a lump two centimeters below the left edge of his right scapula. He thought it was a persistent mosquito bite, but he asked Irmi to feel it anyway. She did, and she became alarmed. She urged him to see his doctor.

He did not heed her advice. For three months Peter held to his belief it was a bite. Irmi asked him again to have an expert look. He said he would, but for another two months, he did not. He finally went to his own doctor, a Hopkins graduate who practiced medicine in a strip mall office past the Woodlands off I-45. He was crammed between a Subway and a manicurist, and in the waiting room you could smell bread baking and hear chatter in a language that might have been Thai. The biggest cancer center in the world was forty miles south.

Katya and Irmi implored him to see an oncologist at M.D. Anderson, but he delayed for two weeks longer. He said, I cannot do that. It would be insulting to the young man who has taken good care of me for two years. He finally agreed to let the doctor cut it out, and even when his doctor urged him to see someone else, Peter did not.

Irmi finally made the appointment for him anyway. He went only because it would have been rude to cancel. He went back because he was impressed. The doctor said, It’s unusual. I wish you had come to see me sooner. Hearing that, Irmi felt fear, not satisfaction.

He was fifty-eight years old. His plan to spend the next year hiking and windsurfing and kayaking was imperiled by the fact he might not be alive for another year. His loyalty and denial were complicit in creating his predicament. Later he would know that.

A B C D is the dermatologist’s mnemonic for melanoma: A for asymmetry, B for border irregularity, C for color variation, D for diameter. Answer yes to any question and what looks like an ordinary mole is a Trojan horse carrying a miserable death. The lump on Peter’s back was four for four. It was large and it was ulcerated, two especially bad signs. The only remaining question was whether the cancer was already in his bloodstream, looking for beachheads in his lungs, liver, and brain. He was a scientist and an intellectual. The one thing he feared was losing his brain.

The doctor told Peter he needed immediate surgery to remove lymph nodes and probably chemotherapy after that. Peter called to tell us from the house on the lake. He was sitting outside so Irmi would not hear the despair in his voice. In the background I could hear waves splashing against the bulkhead. When we got off the phone Katya broke down. She said, I’m not even crying because he has cancer. I can hear it in his voice. He’s already given up.

Two days later Peter packed an overnight bag and drove wordlessly to Houston while Irmi sat beside him unable to read. He asked her to please go sleep at our house but she refused. She bought hot tea in the hospital cafeteria and paced the halls waiting for Peter to fall asleep, but every time she opened the door to his room, he looked at her and said, Not yet. Nurses walked in every two hours and wrote numbers on charts. At six they wheeled him into pre-op, and for the first time in a week he thawed. He let Irmi kiss him on the cheek. He held her hand in both of his, then held it to his mouth and said he loved her. She watched him recede around the corner, then went back to the room to wait. Katya and I arrived minutes before the surgeon. He came in and said everything went well. He had removed three nodes with minimal damage to surrounding tissue. If he told us his name, I missed it. He had all the charm of a traffic cop. Irmi started to ask him how to care for the wounds but he cut her off, said the nurse would answer any questions, and was gone half a minute after he’d arrived.

Peter went home the next day. The oncologist reminded him the first round of chemo would start in two weeks and told him to eat as much as he could between now and then. Peter didn’t tell him he might not be back. He wasn’t telling anyone yet that he wasn’t committed to the plan.

Melanoma staging uses three variables: T, N, and M. T refers to tumor size, the thinner the better; N stands for lymph nodes; and M is short for metastasis to other organs. Each of the three variables also has subvariables. For example, if a tumor is relatively thin (less than 1 mm), the staging calculation further relies on the tumor’s mitotic rate, which is an indication of how quickly the cancer cells are dividing (i.e., replicating).

Peter’s tumor was T4b-N2b-Mx. The tumor (T) was thicker than 4 mm (it was 4.15 mm) and ulcerated. There was macroscopic spread to at least two lymph nodes (N). The M value was unknown because the doctors were unsure whether there were tumors in other organs. If there were, his tumor was stage IV. If not, his tumor was stage IIIc, just a hair’s breadth better than the worst there is.

Katya and Irmi were inside unpacking boxes of shark cartilage and garlic capsules they’d ordered from a shaman online. Peter and I were sitting outside on the deck, looking out at the lake. After he read me the pathology report he took off his glasses and rubbed his eyes. He said, One drawback of being a scientist is I am aware it is hopeless. If I elect to do nothing further, Irmi and I can drive out west. We can hike and camp and live. I can die on a mountain. If we remain here, I will die in diapers in an air-conditioned room.

Winona came running around the side of the house. There were two tall pines, four feet apart. Winona ran between them, carrying a five-foot limb, and slammed into an invisible wall. She took three steps back, turned ninety degrees, and stepped through the trees. Peter said, That dog is smarter than me. He took the branch from Winona and slung it into the lake. She dived in after it.

I said, If you run away, this is what you’ll miss.

He threw the stick three more times then said, Enough. Winona lay down between us, her head resting on Peter’s bare foot. He asked what was going on with me. I told him I had been appointed by a federal judge to represent a new client. He said, Two men without a chance drifting to their fates.

I said, Maybe my client, but not you. You have options, you know. You’re not a leaf in the breeze. The chemo might work. There are other therapies. You don’t know enough to give up.

And I thought to myself, And your acting like your life is already over is driving your wife and daughter crazy.

He said, The power of will can be overstated. My tumor is greater than four millimeters in thickness and ulcerated. It’s probably spread. The five-year survival rate for people with this tumor is less than 50 percent. You think the people who lose the coin flip don’t want to live as much as the ones who win?

Among death penalty lawyers, inmates who want to surrender their appeals and march straight to the execution chamber are known as volunteers. Some lawyers think that anyone who volunteers is by definition mentally ill, and they try to thwart their clients’ desire to give up. But death row inmates spend twenty-three hours a day in a sixty-square-foot cell with a solid steel door and a slit of translucent plastic for a window. They do not have televisions or computers. They have one hour a day of solitary exercise and three showers per week. Their food comes from vending machines or cans. They get two radio stations. Barely literate, they couldn’t occupy their days reading even if they had the patience to do so. At conferences, I am not just being the devil’s advocate when I argue volunteers can be rational. I said to Peter, The fact that a good attitude won’t save you doesn’t mean a bad attitude won’t kill you.

He said, It’s the treatment that will kill me. I know how the chemicals work. The methylating agents interfere with the ability of the cancer cells to replicate. They’ll drip 200 milligrams of dacarbazine into me for five days. On the first day and on the last, they’ll add 3 milligrams of vindesine to the cocktail. In between, I’ll take lomustine orally, probably around 100 milligrams, and another 15 milligrams of bicomysin subcutaneously on days one and four. The doctor told me the toxicity level of this mix is acceptable. By that he means acceptable to him. From my perspective, it is a week off what remains of my life. Do you know there is not one documented case of a remission using this approach? Even in a best-case scenario, the poison won’t cure me. Maybe it gets me another three months. Maybe six. Maybe none, in which case I’ve traded seven days for nothing.

He paused and looked back over his shoulder. Through the window we could see Katya and Irmi setting the table. Peter and I were going to grill a leg of lamb. He said, It does no good to discuss this with Katya. She loves me. It clouds her judgment.

I said, Love does not cloud her judgment. It gives her perspective. If the only people you’re going to talk to are people who don’t care about you, you are probably not going to hear anything you’re interested in listening to.

He said, Maybe that is why monks stop talking.

He scratched Winona behind the ears and rubbed his eyes. He hadn’t yet lost his taste for champagne. He took a swallow and waited for me to argue. When I didn’t, he said, Let’s go cook the lamb.

After we put the meat on the grill, he asked, What did your client do?

I said, His name is Waterman. He killed somebody.

It’s a joke among death penalty lawyers. That’s always what they did. I told him about Miss McClain.

Peter said, And why exactly do you want to save this man?

I said, I’m not sure yet.

Katya and I got Winona before we were married. We bought her when she was six weeks old from a breeder in Waller who was selling defective Dobermans. Winona’s eyes were too light and her palate was cleft. Show dogs cost a thousand dollars. For Winona we paid a hundred. On the day we picked her up it was 106 degrees in the outdoor pen where she was lying on her side, her belly round as a softball, panting like she’d sprinted a mile. Katya held her on her lap for the drive back to Houston in my 1957 Chevrolet pickup. When I bought it from its original owner my dad asked why I’d get a car older than me. I opened the hood and pointed to the engine block. I said, Because I like things I can understand. The truck had five windows, two gas tanks, and after-market air-conditioning. Winona pressed her snout against the vent and smiled.

When she was seven months’ pregnant, Katya took Winona to the vet for routine vaccines. The vet looked at Katya’s belly and asked whether this was our first. She advised us to buy a doll to prepare Winona for the new arrival. You hear stories about Dobermans mauling babies. When Katya repeated the story to me that night I laughed. I said, People I don’t get, but I am absolutely positive there is zero chance Winona will hurt our son. I didn’t call him Lincoln, even though we had already decided on the name. There’s no upside in tempting fate.

From the day we brought Lincoln home, Winona stood sentry at his crib. Way before Lincoln could crawl, he would reach his hand through the slats and poke his index finger into her eyes or grab ahold of her floppy ears and tug them like taffy. Winona shook her head and licked his hand and took a step back, and kept standing guard, just beyond his reach.

Peter liked to take Winona with him on his epic walks. He called us two nights before we were going to meet them in Galveston for the weekend. He said, You’re bringing Winona, right? I need to give that dog some hard pets.

By this time I’d known Peter four years. We talked politics and history, physics and art. He loved music and theater and setting off at dawn with a daypack, a compass, a map, and not a plan. He taught me to windsurf and for my birthday bought Katya and me a week’s worth of whitewater lessons at the Harvard of kayaking schools. He cherished the solitude. I preferred the adrenaline. We paddled together four or five times a year until I started running sections of rivers he was too prudent to descend.

The day before Thanksgiving the year before, we put our boats in the salt flats off the north side of Galveston Isle. We paddled into the marsh, too far from shore for anyone to walk. We turned a bend and there were a thousand birds, maybe more, standing in the shallows. They’d probably never seen a person here. They looked at us, cur­ious but unafraid. I said, Wow.

Peter said, Yes.

We sat there and watched. He finally said, I think boating might have made you an environmentalist.

I said, Environmentalism is not a moral choice. It’s just an aesthetic preference, like choosing chocolate over vanilla.

He did not turn to look at me. Staring at the birds he said, You don’t believe that.

His first round of chemo was scheduled for the following week. When I asked him about it the eve before our trip to Galveston he was evasive. I said, Remember to bring your kayaking gear.

He said, I’ll try.

The next morning before driving to the prison I took Winona for a run and a swim. When we came inside at six, Katya was already up, making tea. She said, I’ve been doing some reading. I think it’s possible his tumor is a Merkel cell melanoma. If I am right, he needs to get radiation. If that’s not what it is, I think immunotherapy is his best option. I’m going to call him at eight.

One thing I’ve learned is that there are times you have to let the people you love hold on to hope the math rules out. To do that, you have to pretend not to worry. Honesty is important, but it pales next to support.

I said to Katya, Good. I told her his diet was high in antioxidants and low in fats. I told her those things even though I knew there was no evidence it meant anything at all. I used the term dysplastic nevi not to impress her, but to sound like I had done enough research to make my endorsement of her opinion worth respecting.

I didn’t tell her what Peter had said to me before he hung up the night before. He had said, There aren’t any surprises in life. Surprises are what we call things that happen when we aren’t paying attention.

I drove to the prison to see Waterman for the first time. A few years ago, prison officials found more than fifty cell phones on death row, one for every seven inmates. They conducted the cell-to-cell search because one of the prisoners used his phone to call a state senator known for being tough on crime. Here’s something I’ve learned: The death penalty cannot deter crime, and if you want to understand why, all you need to know is that death row inmates are the kind of people who use phones they are not supposed to have to dial up the home number of a state official and interrupt his dinner hour to complain about their treatment.