Paul hurried down the hall to the critical care unit. He pushed the access button and waited for a nurse in pink scrubs to open the double metal doors and admit him.
“I’m here to see Isabel Turner.”
“I’m Nina,” said the coffee-skinned woman with tiny doll-like features. “Are you Paul Madsen?”
“Yes. How is she?”
“There’s been no change. But your mother is conscious at the moment.” Paul didn’t correct her. As far as he was concerned, Isabel was his mother, even though he’d never called her that. He was grateful she was old enough to have a med card, but she was enrolled in the new Medicare and her voucher only afforded a skimpy coinsurance policy.
They moved past several rooms, all with elderly patients who looked near death. Paul’s fear deepened. “Will she recover?”
“We don’t know.”
The nurse stepped through the doorway to room 302 and said, “Isabel, your son is here.”
Paul moved to the bed and reached for Isabel’s hand. Her eyes were closed and it scared him. The hospital gown, the tube in her nose, the slack grayish skin-for the first time he saw his foster mother as an old woman. “I came as quickly as I could.”
“Paul.” The word was barely a whisper.
He fought back tears as he struggled for what to say. He wanted to be positive, but not ridiculous. “I love you. I need you in my life. Stay strong.”
She opened her eyes. “I don’t feel strong.”
“You’ll get better.” Paul pulled up a chair. “Tell me what happened.”
“I was walking home from the senior center, then I woke up here.” She seemed to draw strength from his presence, and her voice became clearer.
“Have you been taking your meds?” Isabel was on three maintenance prescriptions for metabolic disease, but now that dementia had started to set in, she sometimes forgot to take them.
“I think so.” She winced.
“Are you in pain?” Paul turned, but the nurse had gone.
Isabel shook her head, her gray hair fanned out on the white pillow. “You know what my only regret is?”
He knew what was coming.
“I wanted to see you get married and have a family.”
“I’m still trying.”
Her eyes opened wider. “Something has changed. I can tell by your expression.”
“I’m seeing someone at work. I hope it could get serious.” He and Camille weren’t exactly dating yet, but he wanted to give Isabel some good news.
“Why didn’t you tell me when we had dinner last week?”
“I wanted to be sure.”
“What’s her name?”
“Camille. She’s a little younger than me, but she’s smart and beautiful.”
“You’re happy?”
“Yes, I think so.” Or he had been until an hour ago. “I’m worried about you, though.”
“I’ll be fine.” Isabel closed her eyes and Paul sat and watched her breathe. After a few minutes, he realized she was sleeping and he went to find the nurse. Nina was at a central station farther down the hall.
“I’d like to see my mother’s doctor.”
“I’ll page her.”
Paul waited in Isabel’s room, reading the evening news on his Dock and glancing over at the hospital bed every few minutes. His foster mother slept with labored breathing, but the sight of the white blanket gently rising on her chest kept him calm.
After twenty minutes, the doctor slipped into the room. Her hair was so short, at first he thought she was man, then he noticed her breasts and delicate features.
“I’m Jalene Walsh, on the cardiovascular service.”
“Paul Madsen. Isabel’s foster son.”
“You’re not biologically or legally related to the patient?” The doctor scowled, looking a little less delicate.
Paul didn’t like the sound of her question. “Technically, no. Why?”
“We may have to make some decisions. Does she have any other family?”
Paul bristled at the implication. “I’m her family. Her husband and daughter died in a car accident many years ago. She has a sister, but she’s in a nursing home in Florida with Alzheimer’s.”
“I didn’t mean to offend you, but we’re in a complex situation here.”
“What you do mean?”
“Isabel has a blocked artery and needs bypass surgery to survive. But because of her metabolic disease, her health insurance won’t pay for it.” The doctor paused, giving Paul a chance to respond, but there was no point. This was the new reality for the elderly. The doctor continued. “If we treat her aggressively, she’ll likely hit her yearly expenditure maximum after about three days. Beyond that, she’ll leave you with a substantial debt. If we give her a minimum of care, her coverage will last longer but she might not.”
Anguish threatened to overwhelm him. Isabel was going to die. The only person in the world who had ever genuinely cared about him would soon be gone, leaving him once again alone in the world. Somehow they expected him to make a rational decision about how many days she had left, versus how much money to spend.
He shook his head. “I think you should do everything you can for her.”
The doctor sighed. “Then that’s what we’ll do.”
Isabel died four days later, despite the blood thinners and oxygen therapy. She’d lapsed into unconsciousness the second day, so Paul had gone back to work and tried to distract himself with projects. He’d visited the hospital every evening, but Isabel hadn’t known he was there. When he’d showed up this evening, she was gone.
Paul stood by the bed and said goodbye, his heart pulsing with mixed emotions. He felt abandoned, lonely, and angry. Who would he turn to now to share the little things? He still had Lilly, but she couldn’t verbally remind him that his life had value. Camille, even if they got together, would never love him unconditionally the way Isabel had. Paul let himself cry for a moment.
Footsteps interrupted his grief. “Mr. Madsen?”
“Yes?” He turned, irritated.
“I’m Liz Jung. I work in the business office. I’d like to make an appointment for us to talk about your mother’s hospital bill.”
Her body was still warm. Something inside him snapped. “Get away from me!”
She left the room as quickly as she came in.
The hospital bill weighed on Paul’s mind as he drove home. With a coinsurance policy, Isabel had to pay thirty percent of everything. Paul guessed she owed at least twenty thousand for her hospital stay. He knew he wasn’t legally obligated to pay the bill since Isabel had never adopted him, but she was his mother and she would have hated to leave a debt. He would find a way.
He took the next day off and drove to Isabel’s apartment in the Silver Spring area and used the key she’d given him to get in. He missed the house he’d grown up in, but Isabel had sold it years earlier to pay for hip surgery when she was fifty-eight. Their little home had been cozy, with warm colors and soft rugs and pillows. Walking into Isabel’s cheerful living room as an abused and abandoned child and seeing her smile had been the first ray of hope in his life. Paul wished he’d visited her more often in the last year. One Sunday dinner a month had not been enough.
After sitting for an hour looking at photos, Paul forced himself to get moving. He spent the afternoon organizing a small memorial service for Isabel, even though few would attend. He informed her neighbors, her church pastor, and a friend from Isabel’s time as a state-sponsored foster parent. He notified her sister’s caregivers too, then wondered if Isabel had any money in savings and what would happen to it. Would the hospital get it all? Paul had never counted on an inheritance, so it didn’t matter that much to him.
He ordered pizza to be delivered, not caring if he blew his diet for one day, then searched for a will. Why had they never talked about what would happen when she died? Because Isabel had only been sixty-nine. He’d always thought they’d have more time.