Kimberly M. Davis

For Jake’s Sake

The automatic doors opened with a whoosh just in time for me to pass through as the antiseptic smell of the hospital engulfed me like a cloud, seeping into my clothes and hair and making my already upset stomach clench. I paused for a moment to get my bearings and saw a myriad of people sitting around the emergency waiting room to the left, some wincing in different degrees of pain, others pacing the floor, and still others staring off into space. I saw a waist-high counter opposite the door where one man spoke loud Spanish words to a triage nurse who looked confused. It seemed that he thought the louder he spoke, the better she would understand him. The dial clock on the wall behind the nurse’s station read 6:32 p.m. I turned left and walked through the crowded emergency waiting room to the elevators at the far end, all the while praying I wasn’t too late.

The elevator doors opened to an empty car and I boarded, punching the fifth floor button and waited for the doors to close. The hollow music that drifted through the speakers was supposed to be soothing, but it only grated on my already frayed nerves. Finally the doors closed and I was lifted the five floors to the grief that awaited me.

The elevator opened again and I stepped out, looking quickly to the right and left, deciding to follow the long corridor to the left. About midway down the corridor I came upon another nurse’s station with a squat woman, graying hair, and about fifty-five sitting behind the desk. She looked up from her chart and asked, “How can I help you?”

“I got a call that my brother was admitted a little while ago…Jackson Thomas,” I replied.

“Yes, sir. He’s in room 536, just down the hallway there,” she said. “I’m his charge nurse, and I’ll page the doctor to let him know you’re here. He’ll meet you in the room shortly.”

I nodded my thanks and headed down the hall again, searching the doors for number 536. Finding the room a few doors down on the right, I knocked lightly and entered the room.

The blinds were closed and the room was in shadows, only a hint of the outside light peeked in through the slats. A muted television mounted on the wall flickered colors across the screen. I closed the door behind me and said, “Jack?”

“Jerrid?” I heard a raspy voice reply.

“Yeah, it’s me,” I answered, and approached the bed.

The sight before me made my heart sink. Where once was a solid, strong man, now lay a slight, almost gaunt, sickly stranger, only a hint of the person I used to know. He was attached to several machines and intravenous drips, all intent on keeping him alive. One monitor had a line that jumped in time to his heartbeat, while another had numbers that flickered up and down depending on his oxygen level. The steady drip of the IV provided much needed nourishment and pain medication to help him cope with the ordeal his body was being put through.

            “You shouldn’t have come. I know how busy you are,” Jack said.

            “They called me, I came. Simple as that,” I said. “You’re my only brother and I have an obligation to be here, so just shut up and let’s work through this.”

            “I’m glad…you…are here.” At this, Jack coughed a heavy, deep cough that wracked his prone body. He wrenched up off the mattress, grabbing the bedrails in an effort to aid himself, only to sink back down against the mattress when the fit subsided. Seeing my younger brother in so much pain made me want to cry.

            Just then, the door open and Dr. Robert Smith walked in. Even though he was older, had a head full of graying hair and a disheveled jacket, it still did not distract from the fact that he oozed that all-too-familiar doctor self confidence. If there was anything that he knew, it was how to treat his patients.

            “Hi Jackson,” the doctor acknowledged his patient first, and then turned to me, “You must be Jackson’s brother. I am glad that you could get here as fast as you did. Jackson’s condition has worsened and I felt it was important to call you.”

            “I’m Jerrid Thomas,” I supplied as I held out my hand to shake the doctor’s. “What’s going on with Jack? The last time I talked to him, about three months ago, everything was fine! He didn’t say anything about being sick. Then I get the call from your nurse saying Jack is dying.”

            “Jerrid, have a seat and I’ll explain,” Dr. Smith replied. He took a seat in the chair against the wall while I sat on the edge of the bed.            “Jackson has been battling Pulmonary Fibrosis for almost a year. It was probably caused by the asbestos that he was exposed to while working in the oil refinery. The disease is particularly harsh in your brother’s case. It is in the advanced stages. Unfortunately, we caught it late. Basically, the asbestos has built up, layer by layer in his lungs, which is causing decreasing airflow. As of now it is not cancerous, but the only thing that will help him is a lung transplant. The problem is that Jackson has contracted bi-lateral pneumonia, which has been complicated by an infection that we can’t seem to beat with the antibiotics that are currently available. This complication rules a transplant out. I called you because I don’t believe Jackson has much time left.”

            My head was swimming as I absorbed all that the doctor had said. “So you are telling me that Jackson really is dying?”

            The doctor nodded, “I am sorry to have to say, but yes. Furthermore, Jackson and I have discussed the situation thoroughly, and he is unwavering in his decision to refuse more treatment other than pain medicine. It’s my opinion that to continue treating his condition would be more hurtful than helpful. I agree with Jackson’s decision. We need to make him comfortable and let nature take its course.”

            This cant be happening, I thought to myself. Jackson is in the prime of his life – only 28 years old! He’s the only family I have left since mom and dad passed two years ago. This just CAN’T be happening!

            “Dr. Smith, Jackson dying just isn’t an option. There has to be something else that can be done! You said he could have a lung transplant; what can we do to get him one? I have money – that’s not a concern. I’ll pay for whatever he needs. And medicine -- get him whatever he needs! Import it from Timbuktu if you need to! Just do whatever needs to be done!” I cried.

            The doctor looked at me patiently through knowing eyes, “Jerrid, I know this is a shock, and it is an unimaginable situation, but there is really is nothing else we can do. We’ve run the gamut of medications available, and nothing is helping. We’ve tried everything possible. It’s really Jackson’s decision of whether or not to continue treatment, and he’s refused all medications other than pain medicine. We’ve increased his morphine in order to make him comfortable.”

            Dr. Smith stood to leave. “I’ve got rounds to do, and I’ll leave you guys to talk. Jackson, take it easy, rest and let the nurses know when you need more pain medicine. It was nice to meet you, Jerrid, even if the reason for our meeting was not. I’ll come by tomorrow.” At that the doctor walked out of the room, softly closing the door behind him.

            I watched the doctor leave, and then turned to look at my brother.

            “Jackson, you can’t give up. You’ve got to fight. I need you to fight!” I said.

            “I’ve been fighting for a long time. You just don’t know how much it hurts to breathe, to sit up, to eat…everything hurts. I need relief, Jerrid. I want to die.”

            I felt the wetness drip onto my hand before I realized that I was crying. It had been years since the last time I cried, and I kicked myself for showing weakness. The CEO of a multi-billion dollar company does not cry. I eat other companies for breakfast, buying competitors and selling them off piece by piece. I’ve made others cry – I don’t cry. I’m the ironman. But there were tears rolling down my cheek at the exact moment that it hit me – I was losing my only brother! The only family I had left in the world. When Jack left, I would be alone. I had never felt so lonely in my life.

            “It’s ok, Jerrid. You’ll be ok. You have your life, your work…all those pretty models hanging all over you. I always wanted to visit you…meet a few of them. Is that Candy as pretty in person as in those pictures I see of you with her?” His enthusiasm made the awful truth hurt more. Jackson lapsed into another coughing fit. I rushed to the bedside table and poured him a cup of cold water, handed it to him, and sat in the chair the doctor had vacated earlier.

            “Thanks,” he said after the bout subsided. “I just can’t…get…my breath. It hurts…so much.”

            I sat there silently, not knowing what to say, the tears rolling down my face. What could I do to make it not hurt anymore? I remembered Jackson when we were young, so vibrant and full of life. We never got along, like normal brothers, but we always stood up for one another. There was that time when I was 10 and Jack was just 7 that the neighborhood bully was picking on Jackson. I came upon them when the bully had him backed against a neighbor’s fence with his fist back, ready to smash it into his face. I raced into action, pummeling the bully with my body, straddling him when he was down, pounding my own fists into his body, his face, his chest, his arms…wherever I could reach. Jackson had to pull me off, and almost got a bloody nose himself for the effort. We never spoke of it again, but that same protective instinct was there now. I just had to do something.

            But what? The doctor already said there were no other medicines to try. And Jackson was being his own stubborn self in refusing medicine other than pain medicine. What could I do? I had my back up against the proverbial fence, and Jackson wasn’t there to pummel the bully. The bully, the disease, already had him down for the count. I relegated myself to the fact that I just had to be there for Jackson. I had to support him, give him what he needed most right now, my acceptance of his decision.

            I said, “OK, Jackson. If this is what you want, I’ll be here for you till the end.” I stood up and walked to the door. “I’m going to get a soda; I’ll be back in a minute.”

            In the hallway, I turned left and went back toward the elevators. Just past the elevators to the right was a vending area with snack machines, soda machines and a microwave. I pulled change from my pocket and inserted the money into the soda machine. I pushed the button, and nothing happened. I pushed it again, and again and again. Still nothing. My anger, compounded by the grief and frustration, welled up and I started kicking the machine, hitting it with my hands, giving the bully all I had. I sank to the floor on my knees, my sorrow wracking my body with sobs. I bent over till my forehead touched the cool floor, and cried for all I was worth. The ironman fractured.

            Once my anguish had been spent, I sat up, wiped my eyes on my shirtsleeves, and looked around. There was no one in the room to see my breakdown. Thank Heaven for small favors, I thought. Pulling myself together, I stood up. Just as I got to my feet, I heard a thunk as my soda was vended from the machine. Go figure! I reached down and plucked it from the holder, popped it open and took a big swig.

            Returning to the room, I set my resolve and entered. The clock over the chair read 8 p.m. Jackson was asleep, so I sat myself in the chair in the dark. I stared at my brother, and thought.

            At 12:35 a.m., Jackson woke up, weaker than I have ever seen him. He waved me over, his breathing labored. I sat on the bed next to him, listening closely to what he wanted to say.

            “Jerrid, I’m not doing well. I don’t think I am going to make it through the night. I need to tell you something: I love you,” Jackson said between gasps. “You are my big brother, and it means so much to me that you came tonight. I really needed you. I didn’t want to die without you here, but now that you are, I can rest easy.”

            “Jack, just hold on and I will call for some more pain medicine,” I said as I reached for and pressed the nurse call button. Panic welled up inside me, knowing Jackson’s time was almost up.

            The nurse came and administered more morphine, saying that she would call Dr. Smith as she left. The medicine didn’t seem to help; his breathing didn’t ease.

            “Jerrid, I want you to do something for me.”

            “Anything,” I said.

            “I want you to bury me next to mom and dad. I want to be near them.”

            “I will,” I promised.

            The nurse returned a short time later and said that Dr. Smith had ordered more morphine. She sat him up and administered the ration.

            “I also want you to live. Find a good woman, settle down and have a fulfilling life. Live the life that I will never have. Know that I will be in a good place. Heaven is the ultimate prize. Mom and dad will be there. Grandma Rose will be there. Maybe even old Hank will be there.” I smiled at Jackson’s reference to our dog when we were kids being there to greet him. “And most of all, don’t forget me.”

            “I could never forget you, Jack,” I assured him, taking his feeble hand in mine.

            We sat there in the dark holding hands, my healthy one holding his skeletal-like one. I was baffled by an illness that could change a man so completely in just one year. One that could take the life of a person so savagely, so quickly, leaving a shell behind where once there was health and energy.

            I held his hand as Jackson took his last breath. The clock read 1:47 p.m. There was one big gasp and then all was quiet. Calm settled over Jackson’s features, and I knew he was gone.

I don’t remember much about the events directly following Jackson’s death, only the feeling of being numb. I do remember walking out of the room, turning left, and thinking that the hallway just kept going. And that’s what I had to do; keep going. For Jack’s sake…for mine.

Revision Account

My inspiration for this fiction piece was my uncle Glenn who contracted pulmonary fibrosis while working in the oil refineries in Texas City. His condition required a lung transplant, which he never got. His condition was worsened when he contracted bi-lateral pneumonia, which finally took his life. In order to ease his suffering, he and his family decided to stop treatment, and only allowed the doctor to give him pain medicine. The doctor ordered a massive dose of morphine, which helped ease him to his death. I actually wrote another piece about his death, which I used as the basis for this one. I took many liberties with the facts because I was not actually there with him when he died. I wrote the original piece after speaking with his immediate family.

I found this story difficult to write in several ways. First, trying to imagine my reaction as a man was difficult. I am a softie, prone to many moments of weakness. While Jerrid was the “ironman”, I consider myself the exact opposite. Writing for this role was definitely a challenge. Second, creating a terse relationship between Jerrid and Jackson was a challenge for me as well. I am extremely close with my family and could not even imagine a time when they would not all be by my bedside if I were as sick as Jackson. I based the interactions of this relationship on the feelings I have gotten from other books I have read. I am always wishing this character said this or that character said that, so I went with it. Third, I am one who wants to put down every little detail. I found that I had to hold myself back from boring my reader with every detail. I had to go through after I had written the first draft and consolidated many of the actions of my main character. I imagined myself going through all of the actions that I wrote for Jerrid, and considered how I might have acted. I wanted to leave enough action to allow the reader to put themselves in Jerrid’s role.

I want to take the time to thank my many reviewers. Among them were my classmates Alana N., Lauralie, Heather T. and Susan B. Each of these ladies was very kind in their agreeing to review my fiction piece. Each gave me outstanding suggestions, of which I used many. Outside of class I had family members and several close friends read the story for content.

Several of the corrections pointed out to me included matching tenses and contractions that will make the piece read smoother. There were some phrases that were reworded to make them less confusing.

Alana began by suggesting that the doctor might not be on a first-name basis with Jerrid, and I changed his line:

Was:

“Doc, Jackson dying just isn’t an option.”

Now:

“Dr. Smith, Jackson dying just isn’t an option.”

Why:

Alana felt “Doc” sounded a little informal since this was the first time that they met, and also taking into consideration the conditions surrounding their meeting. I agreed – I believe that the “ironman” would struggle to keep his distance by using the doctor’s full title, even though he is going through a bit of a panic in this scene.

There were a few places that I had trouble wording, which Alana picked up on and suggested changes:

Was:

Is that Candy as pretty in person as in those pictures I see you with her?”

Now:

Is that Candy as pretty in person as in those pictures I see of you with her?”

Was:

I turned from watching the doctor go to look at my brother.

Now:

I watched the doctor leave, and then turned to look at my brother.

She followed her suggestions with things that she really liked, including the characterization, saying that it rally connected her to the characters. She also felt that the details like the Spanish speaking gentleman, pushing the buttons on the elevator, the music and the references to time helped her to imagine really being there.

Lauralie suggested that Jackson might not have said “You shouldn’t have come” when Jerrid first arrived. I opted to keep the line because I wanted to show how tough Jackson was being. He had held his secret for more than a year, and almost didn’t want to have his brother see him in his current state.

I appreciated Lauralie suggesting to use the ellipses to promote strengthening of Jackson’s words and his breathing interfering with what he says:

Was:

I’m glad you are here.

Now:

I’m glad… you… are here.

And

Was:

“Thanks,” he said after the bout subsided. “I just can’t get my breath. It hurts so much.”

Now:

“Thanks,” he said after the bout subsided. “I just can’t…get…my breath. It hurts…so much.”

Some other suggestion Lauralie made that I included in my piece are:

Was:

Things are not good and I wanted to talk to you both at the same time.”

Now:

Jackson’s condition has worsened and I felt it was important to call you.”

Was:

The problem is that Jackson has contracted bi-lateral pneumonia, which has been complicated by an infection that we can’t seem to beat with the antibiotics that are currently available.”

Now:

The problem is that Jackson has contracted bi-lateral pneumonia, which has been complicated by an infection that we can’t seem to beat with the antibiotics that are currently available. This complication rules a transplant out. I called you because I don’t believe Jackson has much time left.”

Was:

Import it if you need to!

Now:

Import it from Timbuktu if you need to!

Why:

I needed to expand on the suggestion to import medication.

Was:

I will come by tomorrow.

Now:

I will check on you later, Jackson.”

Why:

Lauralie suggested this change because the doctor knows how quickly Jackson is deteriorating and believes he may not live through the night.

Was:

I want you to place me next to mom and dad. I want to be near them.

Now:

I want you to bury me next to mom and dad. I want to be near them.

Why:

Lauralie stated that “our inclination is to avoid difficult words like bury, but as a person faces his own death, I think that using the word is a part of the process of acceptance.”

Was:

I wondered at an illness that could change a man so completely in just one year.

Now:

I was baffled by an illness that could change a man so completely in just one year.

Was:

It was while we were holding hands that Jackson breathed his last breath.

Now:

I held his hand as Jackson took his last breath.

Heather offered the following suggestions:

The title: “For Jake’s Sake”

Was:

Older, a head full of graying hair and disheveled jacket did not distract from the fact that the doctor oozed self confidence.

Now:

Even though he was older, had a head full of graying hair and a disheveled jacket, it still did not distract from the fact that he oozed that all-too-familiar doctor self confidence.

Susan offered the following suggested changes:

Was:

The elevator doors opened to an empty car and I boarded, punching the button that read 5 and waited for the doors to close

Now:

The elevator doors opened to an empty car and I boarded, punching the fifth floor button and waited for the doors to close.

Was:

The elevator opened and I stepped out

Now:

The elevator opened again and I stepped out

Why:

This was repetitious

Was:

The blinds were closed, the room in shadows, only a hint of the outside light peeked in through the slats.

Now:

The blinds were closed and the room was in shadows, only a hint of the outside light peeked in through the slats.

Was:

He wrenched up off the bed, grabbing the bedrails in an effort to aid himself, only to sink back down against the mattress when the coughing subsided

Now:

He wrenched up off the mattress, grabbing the bedrails in an effort to aid himself, only to sink back down against the mattress when the fit subsided

Was:

Just then, the door open and Dr. Robert Smith walked through the door

Now:

Just then, the door open and Dr. Robert Smith walked in.

Was:

Jackson has been battling Pulmonary Fibrosis, probably caused by the asbestos he was exposed to while working in the oil refinery, for most of a year now. The disease is particularly harsh in your brother’s case, as it is in the advanced stages. We caught it late. Basically, the asbestos has built up, layer by layer, in his lungs causing decreasing airflow. As of now it is not cancerous, but the only thing that will help, due to its advanced stage, is a lung transplant.

Now:

Jackson has been battling Pulmonary Fibrosis for almost a year. It was probably caused by the asbestos that he was exposed to while working in the oil refinery. The disease is particularly harsh in your brother’s case. It is in the advanced stages. Unfortunately, we caught it late. Basically, the asbestos has built up, layer by layer in his lungs, which is causing decreasing airflow. As of now it is not cancerous, but the only thing that will help him is a lung transplant.

Was:

We’ve increased his morphine, and are just trying to make him comfortable.”

Now:

We’ve increased his morphine in order to make him comfortable.

I plan to submit my fiction piece for publication. I have always wanted to be a writer, and this piece has been fun to write. My future plans are to continue writing with plans to publish.