CHAPTER 36
Crossing the Threshold
Diary entry. January 27th, 2 A.M.: The moon was extra large and bright last night, the night you passed from this earth. This I know was a sign from you. Knowing you, you've probably forgiven. I haven't, and can never.
Diary date: Sunday, January 26th
The doctors seemed so, well, caring and concerned, nurses so attentive and pleasant, neighbors, friends and relatives so reassuring. And he was so strong, surely Tony will fight this one and pull through. Important, too, was that they had caught it early, so chances for recovery were good.
After all, this was Tony 'The Tiger' Salerno, champion fighter. If anyone could do it, it was Tony.
My father succumbed to a culmination of medical ignorance and bungling on January 26th to be exact, at 6:21 in the evening.
I was there. I sat by my father as he lay dying. Marci was by my side utterly overwhelmed by a deep sadness and palpable anger. This final scene would take place at my parents' house, in the guest bedroom, because here it was easiest to move furniture around to make space for what was to take place next. Hospice brought a special bed to the house. It looked like a baby crib for adults – a place where dad would now fight for each and every last breath.
". . . and in this corner, hailing from Long Island, NY, three-time New York Golden Gloves champion, Tony 'The Tiiiiger' Saaaleeernooooo!"
With each determined attempt to pull in air, his neck constricted creating an impossibly deep, concave abyss between the shoulders and neck, and just below the Adam's apple. I could feel him wanting to come back, still wanting to live.
The sound of the struggle to take a breath was the sound of a fighter not wanting to give up. The air hung heavy in the room and smelled of impending death.
"Com'on dad! Show 'em! You can do it!" I was in a state of shock.
But he didn’t, and each of his breaths gradually began to lose their fight.
And then a slight shudder, and then nothing.
"Tony! . . . Tony!" Marci, visibly shaken, raising her voice each time, as if she were trying to wake him up. This was beyond grief.
Kendu had been lying in one corner of the room, motionless, eyes wide open, darting from side to side . . . then he leapt up to Marci at the side of Tony's bed and tried to lick her face – then sat and let out a series of quiet yelps after which he seemed to not know where to go or what to do next. I half consciously stroked him gently – he was clearly agitated, sitting bolt upright, tongue out, breathing very quickly, staring undistracted at Tony's bed.
Until then, I had never known this kind of despair. I couldn’t feel anything and I could feel everything. I couldn’t cry, I couldn’t scream, I couldn’t react. I couldn’t believe what was happening. I refused to believe.
They came and took my father away to the morgue. A crowd had gathered at the house and were in the kitchen and den, chatting, there for the event but arms length from the reality. Dad was a community pillar and mentor, a competitive athlete, and a deeply loved member of his family. Marci, tears streaming down her face, was in a quiet state of raging.
Leaving the house that night, I was traumatized, dazed. Passing out of the front door and into the cool night air, there was a full, bright moon. And when I looked up at it I could see dad’s face, smiling like he always used to. And I imagined that the moon understood what was going on in me and that it somehow understood why this could happen.
Condolences were empty – the illusion of civilized was in severe jeopardy. This was beyond crying, screaming, or condolences. My father was healthy just six months before. He was killed dead by the very people he trusted most.
And no one seemed terribly shocked. None of his doctors or hospitals returned fees or offered condolences or apologies. In fact, they demanded payment immediately and threatened if they didn't get it. No one in the community saw any of it as unusual. The immediate family was traumatized and numb and forever changed. The church deacons and priests who knew my father well dominus vobiscumed the whole affair, safely assuring the faithful that Tony would have a happy afterlife.
My father was killed by the very people he trusted most – his buddies had killed him. A virulent, deadly disease had been created where there was none – records were sanitized. Doctors scrambled to right wrongs using the very same failed techniques that caused the injury in the first place – except they doubled dosages and used even more dangerous drugs. Certain of his doctors' behavior became increasingly bizarre and did nothing more than accelerate what was, clear and simple, a kind of passive euthanasia.
My engagement with other people became surreal – a kind of cultural vertigo set in. There were no reference points. The cat was out of the bag – the illusion vaporized, and in its place I could see who we really were.
CHAPTER 23
Aldo, the Turkey and the Cat
The Thanksgiving holiday had somehow sneaked up on us. No one was feeling thankful, the mood was somber.
Thanksgiving was usually a time of year when Marci and I, and our parents, would all convene at either our house or one or the other of the parents' homes for dinner. It was one of those annual family get-togethers that we all looked forward to, with way too much food on the table threatening waistlines and discussions that threatened internal peace. Our family gatherings were well known to all who knew us but, despite this, mom's friend, Clair Alice Barone, would never fail to invite us over to her place to share dinner with her family and the interesting assortment of repeat invitees that would be present there year after year.
We'd been, maybe twice, over the years. Same people, getting older; a fascinating mixture of personalities that should never be present in the same room for any occasion. But, there they were, no one ever missed. There was something about this habitual opportunity at a glimpse of the widely divergent possibilities of human psychology that was somehow unavoidably enticing – like laying out hard-earned money for a ticket to see the bearded lady at a circus, even though this was not normally something that would be high on the bucket list.
For some reason, we accepted Clair Alice's invitation this year, perhaps because we thought a slightly different venue might be good for Tony, might help him to shift his mindset a bit.
My father was feeling a little better around this time and, despite his diminished appetite, was looking forward to having Thanksgiving dinner at the Barone home. Ben and Mary, Marci's parents, were in agreement, and my mother was happy to do whatever Tony wanted to do. Having been before, Marci turned her eyes up when the subject was broached, but acquiesced, rationalizing that it might be a nice change of pace as well as very entertaining, in a slightly perverse way. Something told me that she might have been fascinated with the spectacle of a mix of people so intrinsically incompatible.
My parents and Marci's parents met at our house first, my mother and father arriving almost the same time as Ben and Mary. Ben bent down to give Kendu a good rub, followed by Mary, and then Tony – Kendu had to be satisfied with verbal greetings and a pat on the head from my mother. Dinner at Clair Alice's place wasn't for another hour, so we popped the cork on a bottle of wine and sat in the den making small talk. Tony couldn't have alcohol, so he asked for a glass of lemonade.
We mostly arrived on time and parked out in front of the house. There were already four or five cars in the driveway and on the front lawn indicating that we might actually be slightly late. The smell of oven-baked turkey and other marvelous aromas were already evident as soon as we exited the car. Clair Alice, and her mother, Iris, were magicians in the kitchen, which probably accounted for the loyal guest attendance.
Clair Alice's home was a single floor ranch style affair – three bed, two baths, ample adjoining kitchen/dining room, den and covered patio – typical of the homes that were in the regular, older neighborhoods in Pastel Lakes. The palm tree in the front yard hadn't born fruit since the Lethal Yellow epidemic, but the ficus bushes and the yellow oleanders did well and gave the property a more welcome feel. It was difficult to get things to grow here; the earth was a mixture of sand, shell and soil that did not retain moisture well nor contain nearly enough nutrients for healthy plant life. So-called 'scrub' thrived in this part of Florida, but little else, unless one was willing to bring in copious quantities of pricey, rich topsoil, purchased in small bags at the local garden center, along with plant food and other growth enhancers.
The front door was open, and you could see through the screen door that everyone was already seated. Lillian called through the door, and Clair Alice came out of the kitchen to greet us along with Marisa, her daughter.
"You're just in time! We're just about to put the food on the table." Hugs all around, and we headed for the table. The smell wafting out through the door was divine. The same crowd was there, looking just a tad bit older. Everyone exchanged greetings, shook hands, hugged, and made small talk. We took our places near the head of the table close to where Aldo always sat.
Aldo was a long-time regular; a sharp witted, relatively pint sized but muscular longshoreman, suspiciously retired at only fifty years old. One got the feeling that he'd been very lucky – or very well connected enough – not to have aroused the interest of local law enforcement for some of the things he'd have us believe he'd done. Things falling off the backs of trucks, new TV sets every year, among the cornucopia of appliances, tools and gadgetry that seemed to find their way into the bed of his Dodge pickup. He'd let us know from time to time that he was from New Jersey – he'd say New Joisey – and that people from New Jersey were God's unique gift to the world, or at least to the East Coast. Aldo was accompanied by his wife, Julia, also from New Joisey, er, New Jersey, who was a bookkeeper and noticeably larger and fuller in stature than he was.
Iris Barone couldn't stand him. Iris, handily as sharp witted, was from neighboring New York, actually New York City, born and raised. She'd been an accountant for some big players in the city and was familiar with Aldo's type. Direct, with a strong New York accent, she'd let Aldo know, from time to time during dinner, what she thought of him and his exploits. "You know what you are Aldo . . . I don't want to say because your lovely wife is here, but you know exactly what I'm going to say . . . you know alright . . ." as she'd point her finger and bore down on him with a gaze that would quickly clear a prison recreation room. The table would go silent with only the tinkling of utensils against plates and the occasional clink of a glass or cup. Julia would shift uneasily in her chair, smile sheepishly and pretend to be mostly interested in her meal.
Then there was Frank Stamack. Mr. Stamack was an IRS auditor. A big man, thin premature graying hair struggled to cover his pate. He seemed relaxed enough, perhaps a bit too quiet, and prior to taking his seat he'd always inform everyone at the table that he would appreciate it if there were no questions about what he did or about IRS matters in general. This was Thanksgiving day and he came for the meal, light conversation, and to relax a bit. This year he had a huge black and blue welt under and around his right eye. I could just feel Aldo wanting to jump all over that. Aldo had definite opinions about people who worked for the IRS – especially IRS auditors. Iris sensed this and was lying in wait; I guessed that this was probably the only reason why Aldo held his tongue.
Marci was mostly just audience cum dinner guest and did not have much to add, except for occasional small talk. At least, that was the case until Aldo told the story about when he shot and killed the Florida panther that was traversing his property at 1:30 in the morning.
Developers seem to be able to build almost anywhere they want in Florida, mainly because they're allowed to do that. Cozy political affiliations can get you that kind of carte blanche in the Sunshine State. So some build with an astonishing rapaciousness – especially in pristine wilderness areas, with the full blessings of regional government, promising new homeowners huge swaths of virgin land with a large residence whose discordant architecture was nothing less than startling in such a setting. That these wilderness areas have been home to a well evolved wildlife ecosystem for centuries seemed to have been lost on government, developer, and homeowner alike, perhaps due to the ever presence of the effects of swamp gas inhalation, and maybe just a touch of greed. Florida, especially within its wilderness areas, is home to a wide assortment of interesting fauna, like, for example, its snake population comprised of, but not limited to, eighteen foot pythons and at least a half dozen different highly venomous cousins; a thriving nest of arachnids are comfortable there, including tarantulas, brown recluse, and black widow spiders; scorpions and ant lions perpetually look for new meals, while a whole fleet of voracious no-see-ums, mosquitoes, horse flies and black flies seem to have insatiable appetites for human blood. And, oh yes, lots of alligators – big ones.
So when the new homeowner's kid gets eaten by a 14' alligator whose ancestors had been living in the lake nearby for generations, the police are called, a special gator SWAT team is brought in and a half dozen animals are destroyed – the area once again pronounced safe for human habitation. Of course, the alligators in the region had no idea that this had suddenly become a 'no reptile zone,' and, predictably, would return, and, unbeknownst to the homeowners in the area, their kids and pets were again being eyed for a gator brunch. That the parents of the hapless child victim are so detached from the realities of living in a wilderness area and have given little – or no – thought to the necessary precautions to protect family members from still roaming wild creatures, is truly astounding. Again, one is left to suspect that swamp gas inhalation may have had some influence over reasoning.
Arguably, one of the most regal animals in Florida's rapidly diminishing wilderness areas is the highly endangered Florida panther, a stunningly beautiful creature whose prey includes small animals, including, sometimes, people's pets.
On one occasion, Aldo's neighbor's little dog, Pixie, fell prey to a panther or other wild creature. The owners, an elderly couple, would regularly let the dog stray around and occasionally away from the property, completely oblivious to their pet's desirability as food for much of the rest of the food chain in the area.
A Florida panther had been sighted in the neighborhood on more than one occasion, and so it became guilty by default. No one actually saw the cat eat Pixie. But this small detail didn't seem to carry much weight in the defense of the panther.
When the neighbors told Aldo of the incident, he nearly instantaneously made the decision to hunt down the animal and bring it to justice. He took great delight in reassuring his neighbors of this and put together a plan.
And so, with his brand new hunting rifle, that no doubt fell off the back of a truck, Aldo decided, in his infinite wisdom, insatiable egomania, and, surely, swamp gas induced trance, that he was going to be New Joisy's answer to Ramar of the Jungle. Wearing a camouflage hunting jacket and matching pants, he lay in wait each night perched atop his bright white roof, brand new gun in hand, sticking out like a over-dressed pimp at a nudist colony. On the fourth day of his stake out, the animal crossed onto Aldo's property. 1:30 in the morning, blam, blam, blam, three shots fired at the predator, the last wounding it. Aldo quickly descended from the roof and cautiously approached the writhing cat, and then pumped three more shots into it. Lights went on everywhere within a mile radius.
Marci was incredulous at what she was hearing and made no secret of it. She just couldn't believe that this guy was actually getting off on telling this story and worse, on his role in this atrocity.
"So, um, Aldo? . . . Aldo, look at me . . . there you go." Marci, smiling politely, making no bones about looking directly into Aldo's eyes.
Knowing what was coming next, I pretended to be struggling with a stuffed pepper on my plate.
"Aldo, did we kill that animal?" Marci smiling that kind of smile when you know what's coming next could be troubling.
Aldo suddenly became indignant, "Damn right . . . killed it dead . . . have the head mounted in my living room."
"Really? So, you've ambushed and shot a highly endangered species and then you were dumb enough to hang the head in your living room? Who was your idiot taxidermist, Howdy Doody?"
"Hey, I was protectin' my neighborhood . . . I'm proud of what I done ."
"I'm so sorry, Aldo," Marci staring right down his throat, still with a slight smile and feigning politeness, "but just calling you an asshole, and leaving it at that would be doing you such an injustice. . . . The Florida panther is protected under the Endangered Species Act. There aren't that many left. Max sentence fifty grand plus a year in jail for even getting near one of these creatures. Have you ever considered just changing your name to Moron so people are forewarned when they meet you?" Marci continuing to smile politely.
Iris couldn't hold back any longer. "Moron? Moron? Ha . . . that's the best you can do? I can think of at least five names way better than that! At least!"
Tony and Ben were nudging each other over the spectacle, quietly laughing to themselves, a topic sure to surface when they got together later on. Ben's wife, Mary, who probably didn't want to give away her position, gave every appearance of enjoying her dinner. Knowing Mary, though, it's a sure bet she was secretly feeling like this was a you-go-girl moment, proud of her daughter for saying what everyone else at the table was thinking. My own mother seemed to be shocked at the whole exchange, and shot an embarrassed smile at Clair Alice, took a sip of her wine, and then looked over at Aldo in anticipation of his reaction.
Under the full glare of every pair of eyes at the table, Aldo suddenly became interested in his Thanksgiving dinner, almost untouched until now. His poor wife, Julia was red, and you just knew this would be a discussion when they got home.
Most of the others around the table had equally diverse backgrounds and points of view but were more interested in a peaceful holiday. After all, they came to relax and enjoy the amazing food.
Julia, by now desperately trying to change the subject and pall that had settled on the occasion, decided to ask Tony about how his recovery was going.
I wished she hadn't.
It was becoming apparent that by Wednesday, November 27th, Sidler was clearly attempting to distance himself even more from the family. Communication, when he participated at all, was brief, the information imparted was general. On this day he prescribed Diclofendac SOD, generic for Voltaren, a drug manufactured by Purepac – "1ea 50mg tabs to be taken 2ce daily" – for the chronic pain that Tony was now suffering.
Diary date:
Early December
During the early weeks of December, we were reminded again that my father had never been monitored for cumulative exposure to radiation throughout the entire treatment process. He had CAT scans and x-rays in multiple hospital facilities, and radiation exposure through radiotherapy in yet another location. We were advised, after numerous inquiries over the course of a week's time, that hospitals were only concerned with tracking the cumulative radiation exposure in their own facility, and did not take into consideration exposure in other facilities. Doctors readily confirmed that overexposure to radiation was indeed a cumulative phenomenon that could, over time, instigate new cancer growth.
Certainly by latest, mid-November, word of the disastrous new development had gotten out all over the community. Dad's church friends reaffirmed their promise to pray, and neighbors volunteered to help, such as they were able. Novenas were said. Christ – and his mother – were summoned. One couple, who was planning a trip to the catholic holy site, Medjugorje, said they would offer special prayers to the Virgin Mary when they got there. I'm sure they did.
But nothing changed. We needed to find answers quickly.
CHAPTER 18
Checkmate
(Author note: When the patient and, later, doctors discover a new, more virulent disease that seems to mysteriously appear out of nowhere, the patient asks for a meeting with the radiation oncologist (Bolton), the oncologist (Sidler), and the surgeon (Ferelle) elected to do the lobectomy. Marci Adams is a family member and lifelong friend of the patient, Tony Salerno, and has 'volunteered' to conduct the meeting. What the doctors at the meeting didn't know, aside from the fact that Ms. Adams had absolutely no patience for politically correct anything, was that Marci Adams, armed with all of the medical records to date, is a Harvard Law School graduate and veteran trial attorney. She had been shocked and saddened by the misguided treatment that Tony had been getting and was determined to get to the bottom of what happened. They had just completed the first half of the meeting where Ms. Adams had asked a series of innocuous baseline questions about radiotherapy and chemotherapy.)
Somewhere in the middle of the meeting . . .
"So, what are you suggesting?" Bolton shifting uncomfortably.
"I'm not suggesting anything. I'm telling you what happened!" Marci shifting in her seat to face Bolton squarely. "You'd have to be an imbecile not to notice that your 4100 RADs of radiation energy slammed right into, swelled, inflamed and then, in conjunction with a carcinogenic chemotherapy session in the presence of a severely compromised immune system, created an environment for secondary cancer in the exact area of the scapula that is now, coincidentally, rife with that disease. Gentlemen, how can I make this more clear: your protocols are the disease! A man who would have had years of healthy life ahead of him, could now very well be killed by a disease that you've created. And every one of you sitting at this table knows this full well – making all of you complicit."
Marci paused and there was a momentary dead silence to the room that even the assorted muffled sounds from outside the room could not penetrate.
"In fact, you all know this so well that you are now wink-nod sanitizing the records to make this new development look like nothing more than predictable happenstance – like it was all a naturally occurring result of a previous progression of events. The massaged version of these records helps to convince onlookers and would be auditors that you were following procedure as would be required under current medical board standards of care. . . ."
Sidler, now clearly incensed, unconsciously short-swiped his hand across the table scattering some of the paperwork in front of him over onto Ferelle's side of the table, Ferelle momentarily jerking in response, "Sanitizing the records? Prove it!"
"Gladly, Dr. Sidler. If you'll all find the document packet labeled Doctored," and in a lowered voice, "a reference that seems to work well for this group," Marci looking at all three doctors, smiling quietly.
Marci looked back at the records, and then looking up at the doctors, "Did everyone find the document pack? Good. The text in question on each document is highlighted for easy identification. On the first page, dated Friday, October 18th, I'd like you all to read through the highlighted text.
(quote) Progress Note: post radiation therapy, a non-small cell adenocarcinoma of the left upper lobe treated with two cycles of Platinol and VP-16 combined with radiation therapy presents for left upper lobe lobectomy. However, due to an abnormal bone scan, surgery will be cancelled and further evaluation of the bone scan will be undertaken.
According to the patient, for the past six months he has had complaints of left shoulder pain "bursitis." He had an injury to his left scapula area with the ball used in handball, and subsequently he has had complaints of discomfort of the left upper back region and inability to raise his arm to full range of motion. Dr. Emory Sidler (unquote)
"This was written by you, Dr. Sidler, did I miss anything?"
"What's your point?" Sidler now glaring at Marci.
"My point?" There was a quiet pause as Marci's gaze bore down on the oncologist.
"My point. Well, Dr. Sidler, my point is that this document is nothing more than a mish mash of unrelated and misleading information that has been cobbled together to make it look as though there was a rational sounding and logical sequence of events that help explain away the patient's newly discovered scapula cancer – a wonderful smoke screen to divert attention away from the very real possibility that the disease originated with you, your colleagues and your misguided treatment protocols.
. . . (the meeting continues) . . .