Chapter 15: Difficult Discussions

September 30, 1983, Chicago, Illinois

"Jonathan Kane," I said to the nurse, who I guessed was about my mom's age and who was waiting at the house when Keiko and I arrived on Friday evening. "And this is Keiko."

"Hi, Keiko," the nurse said. "I'm Jennifer, a Registered Nurse. Let's get you settled. Did you bring the paperwork from Doctor Morrison?"

I handed her a manila envelope with his written instructions and pages for whatever chart the nurse would keep at the house. We went to the Japanese room, where I saw the bed that had been delivered, along with a portable IV stand and a monitor similar to the one at the hospital. Keiko and I sat in one of the Mamasan chairs while Jennifer reviewed the paperwork.

"You have the antibiotics?" she asked.

"Yes. In the Styrofoam cooler."

"We'll use one and put the other four in the refrigerator. That will be the full course. Keiko, you had a transfusion today, and the antibiotics, plus acetaminophen as an antipyretic?"

"Yes," Keiko replied.

"May I ask about that last term?" I inquired.

"It means the drug controls a fever," Jennifer replied.

"Thanks."

"Keiko, the doctor's orders do not require you to stay in bed, but you need to minimize your exertion. He didn't write anything about masks."

"We have both a whole-house and room UV and electrostatic air purifiers," I said.

"OK. Just limit your interactions, and if anyone has even a cough or a slightly runny nose, they should wear a mask around you. For now, you're mobile enough to not need a catheter; just be careful going to and from the bathroom while you have your IV. No baths or showers until Tuesday, after you've had the full course of antibiotics. Jonathan, let me show you how to use and read the monitor."

"OK."

"Every hour, you clip this plastic unit on one of Keiko's fingers, preferably index or middle, then turn on the power. You'll see three numbers displayed – pulse, temperature, and oxygen level, or pulse ox. Write down the numbers on the chart. There's a card on the machine with guidance of when to call us or, if necessary, the paramedics, though I understand Keiko has refused further hospitalization."

"She has."

"OK. Then just call us if her temperature goes above 102°F, her pulse is over 110 for more than brief periods, or her oxygen level is below 90% while she's awake. Doctor Morrison's orders already include oxygen by nasal cannula, so I'll show you what to do to put that on, which you should do before you place the call. I'll check Keiko's blood pressure each day on my visit. Let me show you how to use the oxygen."

"Let me call two of my housemates to watch as well," I said.

I went to get Bianca and Kristy, and they joined us in the Japanese room so they could see how to administer oxygen to Keiko if it became necessary.

"The last thing I have in my notes is that you're having a wedding ceremony a week from tomorrow?"

"Yes," Keiko said.

"I strongly recommend you have someone from Horizon Hospice in attendance. They can dress in regular clothes, so it's not obvious, but given the stress of the day, I'd advise it. And you should wear a mask for as much of the ceremony as possible."

"We'll do that," I said. "I assume that with visits seven days a week, we'll see a different nurse two days?"

"Yes. Maria will be your nurse on Saturdays and Sundays. Our usual visit times will be about 1:00pm. Someone will call if we're delayed. For that Saturday at Chicago Botanic Garden, another nurse will be assigned because it's for several hours. Will someone be with Keiko all the time?"

"My grandmother will be here during the day," she said.

"OK. Then I think we have everything in order. Maria will see you tomorrow and will change the IV bag. Keiko, if you need to use the restroom or want to change, do that now, and I'll hook up your IV."

Fifteen minutes later, Nurse Jennifer had left, and Keiko and I were sitting together in a Papasan chair with her IV on the portable stand.

"Promise you won't call the paramedics or let them take me to the hospital," she said.

"I promise, Keiko-chan."

"And when the time comes, you'll hold me?"

"Yes," I replied with a very heavy heart.

We sat together until dinner was ready, then we ate with Bianca and Juliette. I helped them clean up, then they left, leaving Keiko and me alone for the evening.

"There is something I want to do," Keiko said.

"What's that?"

"On Saturday night, we sleep in our bed and make love."

"Whatever you want, Keiko-chan. I love you."

"I love you, too, Jonathan."

October 1, 1983, Chicago, Illinois

The contractor arrived at 8:00am as Marcus had promised, and introduced himself as Bob Woods, a retired firefighter. I explained what I wanted, then showed him the bathroom and the basement.

"This is really straightforward," he said. "The drain will connect to the same branch line that the toilet and sink connect to. The water feed can come off the same feeds as the sink. You'll need a new sink, of course, given the current one has a wooden cabinet as its base. I can do all the work, and I'd need two days — one to do the plumbing work and install the sink and shower. The second would be for the tile and grout. It would need to set for forty-eight hours after I finish."

"That sounds alright. I'd want you to provide all the materials."

"I can do that; I'll get them at Handy Andy and simply charge you what I pay for them, plus my hourly rate. What color tile?"

I thought about it for a moment.

"For the floor, black and white checkerboard. For the walls, black."

"White sink?"

"Yes. What about the light fixture?"

"I recommend you replace the old combination fan and light fixture now, given it appears to be at least twenty years old. I'll get one that's suitable for a damp environment."

"Sounds good. Anything else?"

He smiled, "I offer a ten percent discount for cash on work that doesn't involve permits."

It was clear he wasn't going to claim it on his income tax, but that was between him and the government.

"I'll pay cash," I said. "When can you start?"

"Tuesday, 6:00am."

"Write up your estimate, and I'll sign it," I said. "I can give you $300 now, so you aren't out of pocket too much for materials."

"You don't want to know what it's going to cost before you agree?"

"I believe you'll give me a fair price because the last thing you want would be for me to complain to Marcus Washington at Brown Construction."

"You got that right!" he declared.

He wrote out an estimate, which I felt was fair. I signed it, then peeled six fifties from my money clip and handed them to him.

"OK, maybe I should have priced it a bit higher!" he grinned. "But I'll take referrals."

"I'm buying a pair of two-flats," I said. "If the work is as good as I expect it to be, I'll recommend you to the management company I'm using."

"Thanks."

We shook, I showed him out, then went to hang out with Keiko until I had to leave with Bianca for her pre-natal checkup.

"I hate to ask this," Bianca said once we were in my car. "But how long?"

I shrugged, "No clue. It really depends on how her body deals with the infection she has, which the doctors couldn't identify, and how long it takes for her blast count to rise high enough to crowd out the healthy cells. Doctor Morrison refused to speculate, and nothing in my research provided anything other than generalities. Days, weeks, or months, but not years.

"She made me promise not to call the paramedics and not to allow anyone to take her to the hospital. She signed a 'Do Not Resuscitate' order, along with a healthcare power of attorney and a living will. Those aren't strictly necessary because we're married, but the hospital paralegal with whom she spoke suggested them in case Keiko's parents try to fight us on her care."

"You're awfully calm, even for you."

"What do you want me to do? Wail and weep and be an emotional wreck? Rage in anger? Deny reality? I need to stay strong for Keiko; as I said, there will be time after..."

"And I'll be here for you in whatever way you need."

"I appreciate it. Violet effectively made the same promise."

Bianca smirked, "I bet not!"

"OK, yes, of course, but I don't think that's a solution to being depressed."

"No, of course not, but I had to make the joke. And I promise I will NOT try to take advantage of your emotional state, but you have to promise you'll see a counselor at the appropriate time."

I considered what she said and nodded.

"I will," I said.

"Not to be insensitive, but what does she want in the way of a ceremony?"

"A Buddhist funeral. The saying is that Japanese are 'born Shinto but die Buddhist' because Shinto has an aversion to physical contact with the deceased. If I understand correctly, the ceremony would be at the Buddhist temple, and then she'd be cremated. An urn with her ashes would go in the Japanese room for forty-nine days, then it will be interred in the family crypt at Montrose Cemetery. There are more details, but Keiko didn't actually know all of them. I'll discuss it with Ichirō-san and the Buddhist priest when the time comes.

"I know I can ask you this — what do people wear?"

"Men wear black suits, and women wear black dresses or kimono. Keiko will wear her white wedding kimono."

"You may not have thought about it, or maybe you have, but you?"

"I have no idea. For right now, if something were to happen to me, I'd want to be interred next to Keiko, which I'm sure her family would permit. I'd count on you to make that happen."

"Cremation?"

"I think that's required because the plot they have is designed for the interment of urns with ashes."

"Do you want a ceremony of any kind?"

"Throw the biggest fucking party you can imagine!" I declared.

"Seriously?"

"Seriously. The last thing I want is everyone moping around! Get drunk and party!"

"Your mom might object."

"So, have the party with my close friends. And if you want to do a memorial service of some kind, that's fine; just promise you won't let any clergyman come anywhere near me."

"That I can absolutely promise! I take it we agree we're not christening our baby?"

"To what end? It's not even an effective bath!"

"I agree, but I wanted to make sure. I wouldn't object to baptism, but I'm not going to suggest it unless it was something you wanted, which I know you don't. But I had to ask."

"And I appreciate it."

"Circumcision?"

"Someone convinced my mom that it was 'normal' and necessary for health and cleanliness. Given I wouldn't willingly allow someone to chop off part of my dick, I can't imagine agreeing to do that to my kid."

"I agree. On the topic of the baby, I think we'll need to start looking for a nanny or whatever you want to call it in March so I can go back to work in May. Well, assuming the little tyke is born mid-April. According to Violet, the daycare where she used to work will accept one-year-olds if we want to go that route."

"Between the two of us, we can easily afford a nanny," I said. "The only concern would be if they were sick or on vacation or whatever."

"There are services that supply nannies, similar to the nursing service, where you have a regular person during the week, and they provide a backup for sick days or whatever."

"OK. I'll leave that to you to arrange."

"You'll want a veto, right?"

"I think anyone you approve will be fine."

"You know, we never talked about parenting style."

"I have zero experience with either being a dad or having a dad, so I'm going to have to make it up as I go along."

"I think pretty much everyone does," Bianca observed. "What's the saying? No battle plan survives contact with the enemy?"

"Helmuth von Moltke. Another one of the quotes in Spurgeon's training guide. That's the one I ran up against with KAL 007 because my plan did survive."

"I was surprised at how little actually happened because of that."

"To tell you the truth, so was I, but I was positive that the right thing to do was stand pat and hold fire, given we weren't immediately at war. Of course, if we HAD been immediately at war, none of it would have mattered, as we'd all have disappeared in a flash of light."

"A scary thought."

"In that conflict, those killed immediately would be the lucky ones."

"For sure."

I pulled into the parking lot of Loyola Medical Center, and after I parked, Bianca and I went inside. We had to wait about ten minutes for Bianca's name to be called. A nurse took her vitals, weighed her, and drew blood, and about five minutes after that, Doctor Wisniewski came in. She performed a basic exam and pronounced Bianca healthy, pending the results of the blood tests.

"You're scheduled for an ultrasound, which we'll do, but there isn't much to see at this point. Mainly, I'll check for placement of the placenta and good amniotic fluid volume. I can give you a more specific due date based on measurements. Let me tell you what you'll see so you won't be surprised. Your baby's face will be broad, with his or her eyes widely separated and eyelids fused. You might see buds for teeth as well.

"What you won't see is that red blood cells are beginning to form and circulate. Another thing you might or might not see is the initial formation of his or her external genitalia, but it won't be discernible as male or female at this point. At your next ultrasound in about two months, we'll be able to determine if you're having a boy or girl, but it's up to you if you want to know."

"I'll leave that to Bianca to decide," I said.

"Right now, I don't think so," Bianca said.

"You have plenty of time to change your mind," Doctor Wisniewski said.

"How big is the baby?" I asked.

"At this stage of fetal development, about two inches long from the crown of the head to the rump. He or she weighs around a third of an ounce."

"Only seven or eight pounds to go!" Bianca declared.

Doctor Wisniewski performed the ultrasound, and I was awestruck by the life I had helped create, which was now growing in Bianca's womb. Doctor Wisniewski took measurements and consulted a chart and a calendar.

"I'm going to give you April 8th as your due date," she said. "That lines up with what you told me about your last period. Just remember, it's an estimate, and a week, either way, is normal, with a slight preference for being 'late', though we won't call you 'late' until April 15th, given the chart I used is about averages. Any questions?"

"No," Bianca said.

"Keep taking your vitamins and folic acid, and avoid alcohol and tobacco. I'll call you if there are any concerns with your blood work, but given what I saw last time, I don't expect any. See you in two months unless you feel a need to see me. If you spot, call and make an appointment to come in."

"Spot?" I asked.

"Drops of blood from the vagina that spot panties or a pad. Mostly, it's benign; that is not a sign of anything wrong, but we'll want to check."

We thanked her, Bianca got dressed, and we left the room. We stopped at the reception desk so Bianca could make her next appointment on December 11th, which was slightly more than eight weeks, but not a problem, according to the young woman at the reception desk. Once that was done, Bianca and I left to do the weekly grocery shopping and make a stop at the dry cleaner.

When we arrived home, Maria, the weekend nurse, was with Keiko. Maria was a Hispanic woman who looked to be in her mid-twenties. She had replaced Keiko's IV bag, checked her vitals, and was just about to leave. Keiko introduced me, and then I went to help Bianca put away the groceries. Once that was done, I went up to Deanna's loft studio.

"I need a favor," I said.

"Anything!" she replied.

"On Tuesday and Wednesday, a contractor will be here to remodel the powder room as we discussed. Would you supervise for me?"

"Of course. I'm here all day Tuesday and Wednesday afternoon."

"OK. I think Keiko can manage on Wednesday morning."

"Do I need to watch the guy work?"

"No. Just check on him occasionally and let him know you're available for questions or whatever. I'll be here on Tuesday morning when he arrives."

"What is being done, exactly?"

"The sink will be replaced, the floor and walls tiled, and a shower and drain installed. He'll also replace the old light fixture."

"Sounds simple enough. How is Keiko?"

"Happy to be home, but otherwise, well, you know."

"Yeah. Can I ask you an unrelated question?"

"Of course. What?"

"Did you arrange to buy any of my paintings?" Deanna asked.

"No. Why?"

"Curiosity. Selling four paintings for at least the reserve price surprised me. And the gallery owner exercised her right to buy one. I received a check today."

"That's awesome. I promise I didn't buy any of them."

"OK. She called today, and I agreed to sell her the other two for my minimum."

"Congratulations! Make sure you keep track of the income."

"I will! This is all new to me, but after the article ran in the Trib, someone obviously took enough interest that four sold outright."

"Do you know who bought them?"

"No. That's never revealed unless the purchasers do it themselves. Often, what happens is they simply ask the show coördinator or gallery owner when more paintings will be available. In some rare instances, there is direct contact. Well, there's a good chance I met the buyers on Friday; I just didn't know they bought."

"Could I commission something?"

"What?"

"I know it's not your usual style, but a portrait of Keiko; before?"

"You have photos, right?"

"Yes, several. I believe a couple of them are appropriate for a portrait."

"What size?"

"I'll leave that to you, but I plan to hang it in the Japanese room."

"Then I think 11x14 would be most appropriate. It won't overwhelm the room."

"Keep it to yourself, if you would."

"I will. Do you have a timeframe?"

"I wish I could tell you," I replied.

"Ah, OK. Let me see what I can do. I won't rush it, but I won't dawdle, either."