ADVANCES IN MODERN CHEMOTHERAPY

by Michael Alexander

While the title of this story might lead you to think it’s a reprint from the Journal of Oncology, fear not: it is indeed a work of fiction, and it marks the debut of an analytical chemist who lives in Oregon somewhere west of I-5. Watch for more from this writer ... and watch out too for those folks sitting around in the ward who appear to be doing nothing.

* * * *

Today’s hypodermic needles are a love.

When I was a kid, there was always a Petri dish of autoclaved needles on the doctor’s desk, drops of condensation hanging on the inner lid. They were fat and sturdy, built for many uses, dull as nails and painful as repentance as they popped the skin. Modern, single-use needles are thin and so sharp they go in with no resistance. When you are getting a lot of pokes this is a real advantage. Less scarring, the veins last longer.

Sitting in the recliner, watching the drip, drip, drip from the bag over my head down the line running into my right arm, listening to the kwee-kabup, kwee-kabup of the infusion pump next to me hooked to my left arm, I could read a magazine, sip coffee, and look around at the other patients in the treatment center. After a while you get to know the people on similar dosing schedules to yours. Alf, the nice old codger getting fluorouracil, irinotecan, and leucovorin for his colon cancer. Mary, carboplatin and paclitaxel for recurrent post-mastectomy breast cancer. Me, leuprolide, zolendronic acid, docetaxel, prednisone, and RGX-364 for metastatic prostate cancer.

After a decent year with testosterone suppression therapy, my prostate-specific antigen levels had begun to climb again and I was moved on to sterner stuff. My oncologist suggested a Phase III clinical trial testing a new compound as adjuvant therapy and I figured what the hell, so as the docetaxel solution dripped in one side, the RGX-364 was pumped in the other. The alphanumeric designation might sound sexy, but it’s just an identifier the pharmaceutical company uses, in this case Rhone-Guiamme Experimental Compound No. 364. I assumed that meant the previous 363 hadn’t panned out. Every three weeks, now on Treatment Number 39.

Side effects. The leuprolide turns off testosterone production to inhibit the cancer cells needing it to grow; it also turns you off below the waist, if you get my drift. You may now leave the monkey house. It also causes loss of muscle and bone mass. The latter will eventually lead to osteoporosis, so you take lots of extra calcium and vitamin D and get monthly infusions of zolendronic acid to minimize the bone loss and prevent your spine from collapsing. Assuming you live long enough. This compound has the interesting ability to produce what is known as “bone flare,” which in its finest form gives you a high fever while producing the sensation that every muscle and bone in your body has been worked over with a brick. It goes away after a while. Ibuprofen works fairly well for the discomfort. The docetaxel, like most anticancer drugs, has a differential toxicity for rapidly dividing cells. This means you try to balance killing most of the neoplasms while sparing as many normal cells as possible. Since your body has other rapidly dividing cells besides the cancer, you end up losing your hair and maybe puking and running for the bathroom. Compazine or ondansetron can help with the nausea. Docetaxel also can cause peripheral neuropathy, making your fingers and toes numb. I had been spared the worst of that particular problem, although I’m very careful walking.

The RGX was an investigational drug targeting specific receptors on the wild cell surfaces in an attempt to produce specific apoptosis. A laudable goal, but, as usual, the compound wasn’t entirely specific, capable of producing an interesting set of, as they say in clinical trials, “adverse events.” “Among reported adverse events” (I’m quoting from the investigator’s brochure here) “are fatigue, fever, and fluid retention. There are reports of blood discrasias and liver enzyme changes, in some cases requiring discontinuation of the drug. Neurological changes have been reported, including drowsiness, slowing of normal mental function, and in rare cases a schizophrenic state including loss of affect, mild paranoia, disturbances of visual fields, and aural hallucinations. These latter manifestations have been controlled by use of relaxants and neuroleptic medications (see Appendix 3a); severe cases may require antipsychotic medications and cessation of RGX-364 therapy.” And so on.

Really, don’t get cancer.

Alf was lying back, eyes closed, a trace of a cannabinoid smile on his face. Mary was reading a National Geographic. National Geographic is the official magazine of cancer treatment centers.

I was enjoying the tail end of my nausea-free time, so I let my head ease back onto the pillow and closed my eyes. I had already read all of the National Geographics. Three times. Know all I want to know about rock hyraxes. I let the different noises wash over me: the television hawking cheap jewelry, people chatting with each other, the noises of a hospital, distant public address announcements. It all settled into a soft, distant murmur in my head. Not unpleasant. My mind seemed to drift away somewhere; I was existing, taking in vague stimuli, an experimental carrot.

hi larry

I cracked one eyelid and looked around. Nobody. I closed my eye and relaxed again to the murmuring.

larry can you hear me

I looked again. Nobody. The nurses were all in the back room. The TV was hawking tanzanite earrings, $49.95 the pair.

Maybe I was developing that RGX schizophrenia. Wouldn’t that be a kick? Something to bounce around with the other patients when we compared all the ways our bodies and souls could find to go wonky. Like the time I had an allergic reaction to the cremophor vehicle for the taxane and my face swelled up and I couldn’t breathe.

Yeah, I can hear you. What part of me is talking to the other part of me, here?

its mary

I snuggled around in the chair; my ass was falling asleep.

Okay, mary. I have to be here for another two hours, so I might as well have some fun. Now, are you the Virgin Mary, perhaps? I went to Catholic school, so I know all about you. Will I be seeing a tunnel of light in a bit? Baby Jesus? Or are you Sister Mary? Shall we do some flashcards?

next to you

I thought about calling over a nurse. I lifted my head and opened my eyes, turned to see which nurse was around, and saw Mary staring at me.

no dont loo—

And the voice stopped. Mary smiled, nodded and resumed reading her National Geographic.

I lay back once more and stared at the ceiling. Then I looked over at the TV. More tanzanite. Ugliest jewelry I’ve ever seen, and people appeared to be buying it. Mary was still reading the magazine. I started to speak, thought the better of it, and relaxed.

Mary was done about an hour before me. After getting unhooked, she came over and patted my arm. “Always nice to see you, Larry.” She glanced at her watch. “I have to run, but we can talk again next time.”

“Uh, Mary....”

“You just relax.” She straightened up, wincing a bit. “See you next time. Assuming, as always.” She picked up her cane and I watched her walk slowly out of the room.

Aural hallucinations.

* * * *

I took the hospital jitney home; don’t entirely trust myself driving immediately after a treatment, even if the side effects can be delayed from hours to days. I was beginning to feel a bit nauseated, but not terribly so. Meaning that two years ago I would have been running for the bathroom as fast as I could move, but now knew that I wasn’t even close to actually heaving.

One of the things about a chronic disease is that you become closely attuned to your internal signals. After the initial wave of hypochondria, where every tiny twitch sends you into agonizing uncertainty, you settle down and tell yourself that as long as you don’t see blood in your urine or spittle or stool, things are probably okay. Considering. In my case blood in the stool would just indicate hemorrhoid problems, and you probably didn’t want to know that. But the heightened perception is still there, and you know almost immediately if that ache is just from yesterday’s gardening or from wild cells finding a new home in your bones.

I decided to try a dry sherry on the rocks. Alcohol is quickly absorbed and a mild drunk on an empty stomach can make any nausea less annoying for me. Putting a couple of ice cubes from the refrigerator in a short glass, I poured a generous dram or three and swirled it, watching the waves of refraction as the melting ice mixed into the liquor. I tried marijuana initially, but it didn’t work for me, although Alf swears by it. All I got was an unpleasant disorientation and enhanced nausea from the smell of the smoke. Me, the Sixties Child, unable to toke. But sherry is an old friend. I know the disorientation of an alcohol buzz and can work with it. I took a Compazine capsule from the bottle over the sink and swallowed it. Sipping slowly but deliberately, I got half the glass down with no trouble. After freshening the drink I walked over to my stereo, put the A side from Brubeck’s Time Out on the turntable, and lowered the needle. I’m old-fashioned.

I returned to my chair and took another gulp to the staccato piano opening of “Blue Rondo à la Turk.” I was finishing the drink as “Strange Meadow Lark” wound up, then closed my eyes and let my head lie back as “Take Five” began, waiting for that Peter Desmond sax riff. Desmond died of lung cancer. You begin to take note of these things, after a while. Still no real nausea. As I said, it can take a while to set in. The Compazine would help.

Brubeck relaxes me. The jazz and the buzz were melding to make me feel pretty damned good, all things considered. Trust me, it’s always “considered.” The docetaxel was getting into my cells, disrupting the tubulin and short-circuiting their division. The RGX-364 was attaching to bits of protein standing out from the cell walls, telling them to kill themselves. Hopefully. I rubbed my bald head and let my mind go blank, nodding along with the music.

I must have dozed off for a couple of minutes. When consciousness returned I could hear the scritchy static from the record player needle rubbing the inner circle of the platter, a bit like the ocean sound you get from holding a shell to your ear. I just sat, eyes still closed, enjoying the nothing. And after a while, the nothing began to sound like something, like a group of people murmuring down the hall, like a theater lobby at intermission, like relatives talking to the doctor when they think you can’t hear. Then I heard my name, the way you hear your name spoken in a crowded room and nothing else makes sense. It went away, then I heard it again.

“Okay, who’s bugging me?” I asked the room, the alcohol. “Hippocampus? Inferior gyrate sulcus? Temporal lobe? The ghost of last night’s chicken paprikash?” I always had a special dish the night before a big treatment, and I make a mean paprikash.

—ear me? i think you—

“Howdy again, me. Haven’t we met before?” I giggled.

...ust relax listen and...

I giggled again, enjoying the drunk. “Larry in recliner, I.V. on the tree; d-r-i-p-i-n-g,” I chanted softly.

...issed a p...

I thought about another drink, decided against it. Not too much alcohol on an empty stomach. “Well, Brain, this is fun, but I really do feel like a nap. If I should die before I wake, let me know, eh?”

—ood idea go to sleep lar—

Psychosis. I found the quilt on the floor next to the couch by touch, pulled it over me and went to sleep. I had sad dreams.

I decided not to tell my oncologist about the voices. I figured it might get me kicked off the clinical trial and I didn’t want that. Not yet, anyway.

“How are you feeling today?” he asked.

“Still on the bright side of the dirt.”

He nodded. “Any problems with your daily routine?”

“No.” He didn’t ask if I was having any problems at work; I had gone on “disability leave” two months before, a nice euphemism for “going home to die.”

“Any pain?”

“Just the usual. The ibuprofen works fine when I need it, so far.” Every treatment day they gave you a form to fill out indicating where you had pain, a drawing of a naked man, front and back. I had put a check on his ass three times before anyone got it.

“Good. Any problems with urinating? Bowel movements okay?”

“Fine for both.” When you get sick you not only lose your health, you lose the illusion of privacy as well. But they always asked about bowel movements; must be Freudian. Sometimes I felt like saying, “Yeah, Doc, the damned things just got up and moved to Majorca.” But I didn’t. “Just the fatigue.”

“That’s normal.”

I always said I had fatigue. It’s like a seven-year-old going to confession and saying he disobeyed his parents. If you offered something there was less likelihood of further probing. It was also true. A flight of stairs was my limit.

“Your PSA is still elevated,” he added. As if I didn’t know. Not only elevated, but climbing fast. I knew the treatments weren’t working much any longer. But what the hell, they got me out of the house.

He made notes on my chart. “Okay. Just remember to keep up the calcium and vitamin D. I’ll see you next month.” Say five Our Fathers and five Hail Marys.

I stood up. “As always. Assuming, of course.”

* * * *

I was the only patient in the treatment room, except for Ed in the corner, and he didn’t talk to anyone, except to say he’d like to make everyone else on Earth and God Himself feel the way he felt. Nice guy. Grow up, Ed.

“Where’s everyone?” I asked the nurse as she felt for a vein. It was getting harder all the time. I would drink lots of water before leaving for the hospital, they would put on a heating pad, but I was just running out of usable plumbing. I didn’t really want a shunt implanted, though. I remembered back to my grad student days and how we would make the ear vein in a rabbit stand up by swabbing the skin with toluene. Grad student days; Christ, that was fast.

“Mary will be in a little late today; she’s getting a CAT scan. Alf...” she let her hand rest on my arm a bit longer than necessary, “moved to hospice this week.”

“Damn.”

“Yeah. He told me he was pissed that he probably wouldn’t have time to finish his book.”

I smiled. “I didn’t know Alf was a writer.”

“Alfred Rees McCutcheon? He’s a well-known art historian, I guess; that’s what Mary said. Something like fifteen, twenty books, she told me. Alf said he was working on something about Olmec art. I think that’s what he said. Whatever an Olmec is.”

“Damn.” Here I had been sitting next to a guy who had actually accomplished something in life and it never once occurred to me to ask what he had done. We had chatted the inconsequential natter of standing in line at the checkout, wet weather, football, politics, drug cocktails. That this ancient, shrunken manikin had been—still was!—working at his profession, racing the hourglass like Ulysses Grant, well....

Suddenly, I felt very fatigued.

Mary came in about an hour later. I was staring at some soap opera on the television. It was in Spanish. I had realized that with soap operas language was optional, and that the women were uniformly gorgeous and foot-stomping fiery. “Hi, Larry,” she said.

I wiggled my fingers at her. “Hi, Mary. How are you feeling? Did you hear about Alf?”

She sat down in the recliner next to me. “Yes, he told me. Didn’t he mention it to you?”

“No, not that I remember.” I reached up and tapped my head with a finger. “Unless chemobrain is setting in again.”

Like fibromyalgia, chemobrain is a suite of symptoms in search of a mechanism. Memory and associational difficulties. Nobody knows if it’s a side effect of therapy, the cancer itself, depression, or what have you. Like a cancer of the mind, it’s as if your personality is being taken over by an invader as surely as your body is. Or maybe just an annoying relative moving in.

A nurse came over to put in a line and do a quick blood draw on Mary; stat creatinine level before starting the I.V. Mary waited for her to leave, then said, “He told me Thursday before last, I think. He knew it would be his last treatment and that he was checking himself into hospice. He was trying to be upbeat, but he was still annoyed, and a little sad.”

“Yeah. I just found out he was—is, sorry—a famous historian?”

“Famous isn’t correct, but well-respected is. I’ve been helping him with some research he can’t do online. When I can.”

“Send him my best.”

“Oh, you already did.”

“Um.” I paused. “When?”

“Thursday before last? Thursday evening. Your last treatment day, anyhow.” You sounded a bit tipsy, but quite sincere.

“I was...how did you know that?”

You said so.

I was looking straight at Mary and suddenly realized her lips weren’t moving as she spoke. She smiled, and it was a beautiful thing in her sunken face.

Welcome to the Last Days Club.

* * * *

Hmph.

Either I was experiencing something impossible, or it was time to start on those antipsychotic drugs. Least hypothesis suggested the latter. “Are you reading my mind?”

No, no. I guess you might say I’m listening to it.

“There’s a difference?”

The nurse looked up from her station. I grinned, made a quick circle with my forefinger against the side of my head. The medical team had figured me out by this time. She made a laughing face and returned to her keyboard. Just try talking without moving anything in your throat, Mary said.

“Jerry Mahoney to your Paul Winchell?” There is an advantage to being of a certain age. Jokes that pass over the heads of younger people can still get a laugh. “‘Eliminate the larynx,’” I replied. That got a look. “Bester. Ever read The Demolished Man?”

No. Any good?

“Yes. The Stars My Destination is better, though. ‘My name is Gully Foyle / And Terra is my nation / Deep space is my dwelling place / The stars my destination.’”

I don’t understand.

“The story of a man who should have died and didn’t.”

Ah. Do you think you shouldn’t die?

I considered for a moment. “I don’t think what I think really matters. It’s what a small patch of DNA decided to do a few years ago that does.”

Mary looked at me. Do you like poetry?

I shrugged. “Yeah, but it doesn’t like me. Lousy memory.”

Do you have a favorite poem?

“Um. A couple.” I thought. “‘Great God, I’d rather be suckled in a pagan creed unborn...gabble gabble...pleasant lea, see Proteus rising from the sea, and Triton blow his mighty horn.’”

I like that one, too.

“‘And kiss her lips, and take her hands...’”

And pluck, till time and times are done...

“‘The silver apples of the moon, the golden apples of the sun.’”

Anything else?

“Um. ‘That time of year thou mayest in me behold...’”

She laughed. I continued. So form a circle round him thrice, and hide your eyes in holy dread...

...for he on honeydew hath fed, and drunk the milk of paradise, Mary finished. She gestured at the I.V. bag. Not exactly what I thought of as the milk of paradise. By the way, did you notice you stopped talking?

I realized that halfway through our conversation my mouth had stopped but the words hadn’t. Okay. This is weird.

Poetry is good practice. We recite it in our heads anyway. Headtalk is one of those things like teaching yourself to whistle. You fool around until things click, then wonder how you ever missed it in the first place.

Okay. Headtalk?

Telepathy sounds so... fifties, she said.

I liked the fifties. Tailfins. Rockets. The IGY. Duck and cover. I leaned back and looked at the ceiling. The Last Days Club?

So far the only people who seem to learn headtalk are terminal cancer patients.

I see. I had already decided that this was more interesting than staring at the television; if I was going nuts, so what? I mean, what did I have to lose?

We don’t know if it’s an effect of the therapies, a combination of new drugs and the disease itself, why it never showed up earlier or what.

Who is ‘we’?

Everyone who manages to find the link. She grinned. Trial and error. It can be hard to make any progress when we keep losing members.

I can understand that. Don’t fall for the three-year subscription. I shifted in the lounger. So. Will I hear anyone else?

When it starts most of us hear a low, background mumbling. I found it helped to actually see the other person at first. After a while you can... I’d have to say ‘call up’ the person you want to talk with. Relaxing helps. And in your case, a bit of sherry seems to act as a lubricant.

I’ll try it again when I get home. One of the nurses walked by. Hey, Mary. Can we talk to regular people with this?

No, not like this. But we can make contact of a sort, sometimes. Some of us, anyway.

Really? Like, how?

Like this. Would you like a cup of coffee?

Um. Sure.

Okay. I’m going to suggest to Lena over there you’d like a drink.

Mary glanced at the nurse typing at her station. Nothing happened for a while, then she looked through the sliding window, got up and came over to me. “Would you like something to drink, Larry?” she asked.

Yeah.

She looked at me, waiting. Oops. “Uh, yeah, thanks. Some coffee, please.

“Black?”

“As usual.”

Lena gave me a thumbs up and headed over to the table holding a couple of carafes and some snacks. The nurses in cancer wards are the best I’ve ever encountered. How they keep it up is beyond me.

Um. Mary, are you telling me we can learn to control other people’s minds? Part of me didn’t like the idea at all, but another part found the concept fascinating.

No, not control. A suggestion. Just like asking out loud. Well, not quite like that. Headtalk seems to allow them to believe they had the idea themselves.

Interesting. Also, unnerving. Can I try?

She looked at me. What do you have in mind, Larry?

“You’ll see.” I fixed my eyes on Lena as she walked over with my coffee. “Thanks.”

“No problem, Larry.” She glanced around, saw Doreen, the other duty nurse, back in the prep room. “Hey, Dor. Can you hold the fort for a minute or two?”

“Sure,” she called.

Lena patted my armrest. “Be right back,” she said and then moved quickly to the door.

That was interesting, I said to Mary.

Just what did you do, Larry?

I told Lena she needed to go to the bathroom. I suppose it could have been coincidence.

Mary looked at me. You seem to be a fast learner.

* * * *

We knocked lightly on the door. “Alf?”

A forearm at the edge of the bed lifted with a brief wave. “Come in. Here, have a seat, the two of you.”

I had offered to drive Mary over to the hospice; she had some data from the library for Alf’s book. We walked in to see him half sitting up, a laptop computer balanced on his abdomen. “‘Lo, Mary. Hi, Larry. What’s up?”

“Not much,” I answered. “How you doing?”

“Been better. My kidneys are finally shutting down. They asked if I was interested in dialysis, but I’ll be done here in a few days at most, so I don’t really see the point.” He chuckled. The counselor asked if I was giving up, or accepting, or whatever Kübler-Ross folderol is in favor nowadays. I just told her I was done with my work and wanted to move on to the next thing.

Mary reached over and handed him a thin sheaf of papers. He adjusted his glasses and then flipped rapidly through the leaves. Uh-huh. Yes, I remembered it correctly. Good, just the right confirmatory footnote. Thank you, my dear.

You’re welcome, Alf.

He looked at me. And thank you for stopping by, Larry. Not that you had to.

Oh, it’s... and I realized I had slipped into headtalk without realizing it. No trouble at all. I guess I feel the same way.

He pursed his lips and nodded. Yes, that seems to be one of the traits of club members, a certain type of acceptance about life.

Not to mention sherry.

Yes, I always liked sherry. Or amontillado. But my favorite was a really good stout. I could nurse a pint for a whole evening. He paused, remembering.

I don’t think I’ve given up, I lied.

Eh? Oh, no, I don’t mean acceptance as going limp. Not at all. Alf spoke with a slight professorial lilt, a sort of British cadence without the accent, if that means anything. Once I knew that my cancer couldn’t be cured, couldn’t be burned out or cut out or poisoned, I decided to accept it as part of me, not some loathsome enemy to be destroyed, but an altered part to be lived with and, if possible, understood.

So, I asked, what do you understand now, Alf?

He shrugged again. That once I dropped all that war imagery, I felt much better. I’m just in another phase of my life now. Looking forward to the phase after this.

Then you believe in an afterlife?

He pursed his lips. No, not really. Has Mary talked with you about the next phase?

I glanced at her. I don’t understand.

I guess not, then. He looked at Mary over his glasses. Would you like to explain, or shall I?

She waved two fingers. Please, go ahead.

Alf spoke as he typed. I wasn’t bothered, just wished I could multitask like that. I have never even been able to play a musical instrument, I’m so right-handed. Besides, I was either having a marvelous hallucination or an impossible conversation. Larry, none of us really understands just what the hell is going on here. So far, we can’t tell if we are the result of some specific type of disease, some particular combination of individual and therapy, or what. There seems to be absolutely no pattern, nothing common, in those of us who get here. The only thing that seems to be a rough constant is that abilities begin to emerge in late stages of the disease.

I thought about it. Alf continued.

Looking back, I think my ability began to manifest itself just as the cancer really took off. Others seem to confirm this. He reached up to scratch his chin, then glanced at me. “How about you?”

I shrugged. “My treatments pretty much stopped working a couple of cycles ago. They’re keeping me in the trial to see if they are still slowing it down.

Well, why not? He shifted his body, looking for a more comfortable position, something basically impossible in a hospital bed. So far you’ve been able to headtalk with Mary and me. Anybody else?

Not like this. But I hear this sort of group mumbling from time to time.

Yes, that was the way it was for me as well. My guess is that you will shortly find yourself with a coven of new friends. Associates, anyway.

I looked from Alf to Mary and back. Have either of you mentioned this to your doctors? Nurses? Any of the clinicians?

Alf laughed, then winced. My dear fellow, whatever for? Either I would be urged to take antipsychotic medications or some eager-beaver researcher would want to hook me up to an encephalograph, MRI, SQUID, or some such nonsense. Or worse, suggest professional counseling.

But new science....

And what are you going to do?

That stopped me. All I really wanted was to head to oblivion with as little pain as practicable. I was done with my life, show over, heading out into the lobby for the last time. Um. For now, nothing. See where this stuff leads, at least for a while. Well, as I said, what else did I have to do? My will was up to date, I had gotten rid of most of my junk, I had my jazz collection. How do I talk to you if I’m not with you?

Just listen. Relax and listen. Distance doesn’t seem to play a role. I have a Misquito friend down Yucatan way, getting traditional herbal treatments from her shaman, who’s as clear as you sitting next to me. And when I’ve had some really potent grass I get odd clicking noises that sound like a grasshopper sending Morse code. I wonder a bit if a creature out Aldebaran way is going through something similar. He winked. Why not? How do you rank your impossibilities?

Mary stood up and patted him on his head. Why don’t you finish this writing up, Alf?

He nodded to her. Good idea. I think my body is beginning to tell me that if I don’t get this done damned soon, it won’t get done at all. Once the kidneys are gone I’ll be comatose in a couple of days, tops.

“I know,” I said, also standing up. My mom went like that. Didn’t seem all that bad. Just tell them to give you antihistamines for the itching.

Until later, then, Alf replied, focusing back on his keyboard.

We’ll be in touch, I said, taking Mary’s arm to offer support. Mutual.

It’ll be kind of hard not to, you’ll see, he said absently.

* * * *

I awoke to Mary saying gently, It’s time, although my subconscious had been keeping tabs for a while. I heard greetings from several people and returned them. Dick Johansen, a used-car salesman on the other side of town; Peter Hayling, a very pleasant fellow in southern England; the Miskito in northern Belize who called herself Chara (or at least that was what I heard), others. Alf.

everyone hi... hi times, feels like mother of all tokes what day

Saturday, Alf.

no no what day I’m in, swinging like benny goodman thank you all for going-away party, forward, backward, want to go forward I’ll try to explain lcr thirty eight four friday

Got it, just let it roll, chap, Peter said, anything that turns up.

I was on the sidelines, letting Alf know I was there. From time to time I would catch something, a description, sometimes a snippet on the edge of the visual. Hallucinations. Here for you, Alf. To anyone next to his bedside he would appear to have been in a deep coma. Was everyone like that?

Make sure you sit by a loved one and talk, maybe they can still hear you.

hey larry, what’dya think... ah, forward, I can really feel it, hey, grayson never expected you got to focus and, hey, see that? it’s—

I tried hard to concentrate, the tail end of a few drinks making my brain cells slippery. There was an image of a flying saucer thing taking off in my head, like the scene from Forbidden Planet.

And Alf was gone.

I looked around my living room. Four in the morning, hour of the wolf. There was a dull ache in my lower abdomen, not too bad. Is he....

Yes, Larry. Go in peace, Alfred. There was a murmur of assent. Did everybody hear the same thing?

Lots of stuff. Still sorting out, writing down whatever I can remember.

Grayson?

Old colleague of Alf’s. Died several years ago.

Was he back or forward?

Couldn’t tell. Be a total rip if he was forward.

Indeed.

Can anyone tell me what you’re all talking about? I asked.

First you tell us what you felt, what you saw, heard, Peter replied.

I saw a college campus.

Any details?

I thought. It felt...small. Mountains in the background, not too tall.

Brighton College, Alf’s old alma mater in Vermont, likely. Anything else?

Um. Numbers. Thirty eight four, and Friday. And letters. LCR. What was that, anybody?

Dick laughed. My guess is that you should check the market report end of next week. Anything else?

A memory of an old fantasy movie, I said.

No, Dick said, real. What an upper. I’m not an astronomer, anyone else?

Cool off, Buzz Lightyear, it was Forbidden Planet.

Huh? I interjected.

The numbers, Mary replied. Try it and see. Assuming, of course.

* * * *

I was looking at the Friday close of LCR Industries on my computer screen. Thirty eight and forty cents, up one dollar twenty.

The week hadn’t been too bad. I was starting to need morphine to get to sleep, but during the day I felt okay once I loosened up. I was enjoying ice cream, on the assumption that before much longer I wouldn’t get any ice cream. And meat loaf, Mom’s recipe.

I just really happen to love her meat loaf. No apologies there.

It was after dinner when I picked up the phone to call Mary. I just didn’t feel like headtalk that evening. Or maybe I didn’t believe in it on even-numbered days. I was still mostly sure this was a bizarre if not unpleasant hallucination on the road to oblivion.

“Hello?”

“Hi, Mary. It’s me. How you doing?”

“You didn’t have to call, you know. And not too bad. Considering.”

“Yeah. Listen, Mary. I did what Peter said last week. I’m looking at the market closing numbers and I’m trying to believe I’m seeing a coincidence and not a prediction of the future.”

“Ah. Alf’s stock tip?”

I sighed. “You know, I’m just about convinced by this telepathy stuff, and now you’re telling me cancer gives precognition. Really, Mary.”

“Not all the time. We’re trying to figure out just why it works with some people and not others. Obviously hard to ask them afterwards. We really need someone to help us formulate a plan to figure things out.”

“Uh-huh. Well, it’s pretty obvious that you need to get some discipline in your methods. You’re all trying to look at everything all the time. Most unscientific.”

“We just wanted you to see for yourself, Larry. What do you think now?”

I sighed. “This is too much. I’m pretty much convinced none of this is real. Sorry. I’m going to the doc tomorrow and asking for something to make my head right again.”

There was a pause. “Please...don’t.”

“Sorry, I’ve decided. Leave me alone, all of you. Just let me die in peace. After a lifetime of working, can’t I have that?” I hung up the phone.

Her voice in my head pulled me up short. Please don’t, Larry.

What is it, Mary?

I’m afraid any drugs will mess up your ability.

Mary...I don’t want any of this. I don’t need any new stuff. I...just want to get it over with and die. Might as well tell the truth for a change.

I’m going to die on Monday. Alf told me. I’d like you to be there.

Not funny, Mary.

Oh, dear Larry. I didn’t mean to bother you. But what is, is.

No, it isn’t.

It is, Larry. It just hasn’t happened for you yet.

No, I won’t listen to this. I held my head for a moment, willing the voice to turn off. Listen, Mary. If you’re real, if you’re not a psychotic episode, don’t buy into this prediction crap. Hang in there. I’ll...miss you if you die.

Why, thank you, Larry.

* * * *

I shut down.

No more headtalk, no more shared hallucinations, no more stock tips, no crap, nothing. I found the amontillado I had put away and opened it, embarking on a weekend of sherry and meatloaf, with ice cream to cleanse the palate. Morphine chaser, dangerous business if you’re not careful. So what. Stereo on loud to cover the murmurs.

Don’t let anyone say you get used to the empty chairs, the empty beds. It just gets worse. Memento mori. And I didn’t want anyone telling me when the black camel would kneel at my door. Or anyone else’s for that matter.

I was sick of cancer, a rotten sea-change. I didn’t like the idea that it was changing me, whether into a pile of dying meat or something new, bizarre, and different; it didn’t matter. What kind of cosmic joke would give you strange new powers while taking away life itself? It was as if Superman needed to cover himself with kryptonite so he could fly a mile once or twice.

Early Sunday evening I looked over at the table next to the couch and saw a bottle of painkillers. They looked luscious.

* * * *

I woke up in the hospital feeling more dragged out than usual. Well, why not? I hadn’t expected to wake up at all. The on-call physician was looking down at me, then back to a clipboard. I decided to do a little prognostication of my own: You’re lucky, we almost lost you.

“We almost lost you,” he said. “You were very lucky.” Arf.

I blinked. “Tell me, Doc, is this one of those new definitions of ‘luck’ with which I’m unfamiliar?”

“You really shouldn’t mix painkillers with alcohol.”

“I’ll remember that in the future.”

“Was it an accident, or intentional?” Cut to the chase.

“Accidental,” I lied. “A little booze, a pill or two, I got swacked and lost count. Won’t happen again.” A thought occurred. “How did you find me?”

He flipped back through the pages. “Ummmm.... Got a call just after one ay-em yesterday.”

“Well, I’m glad for that. Does it say who it was?”

“Let’s see...someone who identified herself as ‘Mary.’ Said you seemed depressed and that she felt you should be looked in on. I believe the EMs had to break your lock, sorry. Know anyone by that name?”

Thanks, Mary. Maybe. “Yes, I do in fact. Old friend, Mary Swinhart. I’ll give her a call and thank her.”

My mention of the name seemed to make him stand up straighter. “Mary Swinhart?”

There was a cold chill. Dear God, I was so tired of cold chills. “That’s what I said. Why?”

He shook his head. “We had a Mary Swinhart brought in last night about ten pea-em; I was on duty in Emergency. Heart failure, secondary to chemotherapy. I’m sorry, she died just after...four ay-em.”

Fuck.

“We have to keep you for observation for twenty-four hours. Policy. Then you can go home and either be more careful or more thorough. Anyone you want to contact? Would you like to speak to a pastoral counselor?”

“No, thanks. I speak directly to God.”

“I see. What’s His take on things?”

“He just keeps refusing to answer.” Looking at the doc, I realized that I wasn’t fooling him at all. I can live with someone who sees reality and doesn’t flinch the way I seem to.

I went home Wednesday. As far as I could tell, all that had been accomplished was the creation of another annoying pile of Explanation of Benefits forms from the insurance company. Although considering what I had cost them the past couple of years, maybe it was even.

* * * *

Larry?

Uh? That you, Peter?

It was the morning after Mary’s memorial service, standing on a highland overlooking the Pacific Ocean. Dick was there, and a kid named Will; Jesus, not more than sixteen. Chara was listening. There were others. Who else? Holding down the fort here. Cool, bit of fog in from the Channel.

I was holding Mary’s ashes, Dick was holding Alf’s. It’s a beautiful day, I told everyone. Sun bright, big breakers down below, good offshore breeze. Anybody want to say anything?

I heard some good-byes and farewells and what I’m sure was an ave atque vale from a voice I didn’t recognize. Dick and I looked at each other, then we each took off the lids and without hesitation gave it the best heave we could. The ashes were caught in twin helical swirls carried toward the sea, heavier grains falling to the beach below. I inverted the can and tapped out a few last bits that I scuffed into the ground cover and held the now empty container toward Dick. “What should we do with these?”

He took it from me. “I’ll find a way to recycle them. They both would have liked that.” He took the handles of Will’s wheelchair. “How you doing down there?” Will let his head fall back and smiled, made a weak wiggle with his fingers. Dick gave him the cans to hold.

We walked back toward the parking lot. Slowly. You gents all right? Peter asked.

Yes, Dick said. Will gave a silent assent that everyone picked up.

Yes. Listen— I paused, continued. I want to apologize to all of you for being such an ass last week. I don’t know what got into me.

A couple of dozen tabs of morphine sulphate, as I recall, Peter tossed in, and there was a rise of laughter.

Very funny. But I felt an infectious chuckle.

In any event, Peter continued, Mary told me that she left some belongings to you.

Me? Really?

Not much. She was divesting herself for the last year. But she said she’d like you to pick up her notes at the flat.

Notes?

Things she had jotted down during our members’ leavings the past few months. We’re trying to assemble things and keep passing them on as possible. We’re just not very good at it.

Dick put his hand on my shoulder. “Y’see, Larry, we’re pretty much convinced all that moving toward the light stuff people report as near-death experiences is a quick look at what we slow diers seem to experience as a loosening of time. No, I didn’t believe it, either. But at some point I have to stop believing it’s all a coincidence.”

“I thought the light thing was oxygen deprivation in the visual lobes.”

“Oh. Not the light. Seeing people and things. It seems to make some sense.”

“Like Mary knowing she was going to die on Monday.”

“Yeah,” Will piped up. I’m heading out a week from Thursday. He seemed excited at the prospect. Considering his condition, he wasn’t being morbid.

“Really? What if I just pushed your chair over the cliff right now and killed you this instant?”

He nodded. Cool experiment. Maybe time would change. Want to give it a shot?

“No. And I don’t want to know about myself, thank you.”

We had reached the car in the parking lot. I paused to catch my breath before helping Dick get Will into the back seat. “Wait a minute.”

“What is it, Larry?”

“Just before I decided to get blotto, Mary told me she was going to die on Monday.”

Indeed? We all knew that.

“But the point is, she didn’t die on Monday. She died early Tuesday morning.”

Ah, well, allow a little windage.

“No, no. What if she was wrong?”

Eh?

“Everyone has decided we’re seeing the future as we die?”

Or the past.

“But what if we see a future? What if there is more than one?”

Hm. I suppose that actually makes more sense than an immutable timeline. Less chance for a paradox or two, I’d say. In your face, Calvin. For a used car dealer, Dick was pretty sharp.

Will got himself settled in the back seat. I got in the passenger side, since I no longer felt safe driving. Taking painkillers more or less constantly, it made me feel more socially responsible. “I asked her to hang in there. I remember that. What if she tried to hang in a bit longer than she otherwise would have?”

Don’t quite see where you’re heading, Larry, Peter said.

What if we can influence the future? I mean, I know some of us can put ideas in other people’s heads.

Oh dear. Did you try the loo thing? I swear, everyone tries that.

Yes, I did. It seemed to work.

Time is all, another voice said.

Chara? Is that you? I apologize, I didn’t know you could speak English.

Alf teach me. I get better.

Blast. I never could learn another language. I thought about it. This is frustrating. We have this ability and don’t seem to have the time to do anything with it.

Bit of a bummer, isn’t it? Peter said. But, I suggest you head over to Mary’s place and pick up anything useful. The key is on top of the—what do you Yanks call it?—the porch light.

I looked over at Dick. “Got it,” he said.

* * * *

Mary’s studio apartment was neat and spare. It reminded me of my mother’s place, at the end. There was a single dinner setting in the kitchen cabinet. One frying pan, one small pot with a lid. Maybe a week’s worth of food in the refrigerator, divided up into single-meal containers. She had known even before Alf’s prediction, I think.

The corners were spotless. Like Mom, a crazy-clean.

There was a slim album of pictures. I didn’t know she had two daughters. Why she had never mentioned them, I didn’t know. Estranged? Dead? Each picture was neatly labeled, person and year. Without any other information the pictures just hung there, isolated in the pelagic sea of time. What do you do with a memory book when the memory is gone?

I found her notes, under the handkerchiefs in the top dresser drawer. After a moment I put them in a bag Dick had in the car, afraid I might be in them. I decided to pass them on to Dick, who seemed a bit healthier than I was.

There was nothing else of interest, save a small bag of knitting, next to the recliner. I picked it up and looked inside. There was a bundle that turned out to be a scarf, a basic, pretty thing with a note pinned to it.

Larry,

Enjoy the scarf. It’s knitted from qiviut, so if you wash it just squeeze some mild soap in cold water through the material and let it dry flat, or else it will felt up and you will have a longish potholder.

Love,

Mary

I picked up the scarf and realized I could barely feel it in my hand, it was so light and soft. I unpinned the note and wrapped the scarf around my neck. The warmth felt like Mary’s voice, the weight like her soul.

* * * *

In the middle of the night my mind woke me up. I listened to the murmur for a little while. Chara?

$%&^%$ Larry?

Did I bother you?

No, Larry. Please talk. Bad night.

Are you being helped?

Shaman bring me herbs, Chara said. Add ocks—ocks—codeine and is better.

Oxycodone. Also ask for morphine.

Thanks to you. Morphine is good?

For me, yes. Alf liked marijuana.

Alf good man.

Very good man. Chara, ask you a question?

Riddle?

Um, no. Can you explain—tell—me something?

I try.

You said Alf teach you English.

He do. Alf friend. Good people.

I tried to phrase my next question carefully. When did he teach you English?

He teach me. Time is all. I tell you that.

By this time you would think I’d be weirded out yet again. Chara. Is Alf teaching you English now?

I caught the feeling of pleasure in shared knowledge. Alf teach me each night. Every? Every.

But Chara.... Alf is dead.

There was serenity in her reply. Old Alf dead, Larry. Young Alf not. You ask him?

I felt cold, hot, I don’t know. I will try.

You funny, Larry. You visit me, we have good time.

I...uh...can’t do that anymore, Chara. But thank you.

You? Oh, funny! You come, see my land. You land tall and cool and green. My land flat and warm and green. How Alf say, we compare notes?

* * * *

“Okay, okay!” I yelled. “The meeting will come to order! Order!”

Chips, please. Dash of vinegar.

“Thank you, Peter.” I stubbed out a cigarette and took a sip of sherry. What, the butts were going to kill me? “As near as I can learn, this has been going on for about two years now. So far, everyone has been supporting each other and making some scattered notes on those we lose.” I found that speaking and headtalking at the same time gave me a bit more volume.

Ja, a newer voice, Werner, in Hamburg, piped up.

“For what? So far it’s all very nice and really cool, but no one has tried to make much of it; just a long chorus of Auld Lang Syne.”

What do you suggest, Larry? Dick asked.

“I suggest we try to actually investigate what’s going on. Not to mention something new that may be starting. Chara—”

Hi-lo, Larry!

“—has been headtalking with Alf.”

That got their attention. The murmur died down.

Laura Singer, a Wiccan in New York, broke in. Chara? Is it true?

Oh, is true. Alf teach me English.

“And I remembered something else, something Mary said to me the weekend before she died. We were talking on the phone, I hung up, and she continued with headtalk. She said, speaking of her death, ‘It just hasn’t happened for you yet.’ I thought she was talking about my own death. Now I wonder if she was talking about hers. From the future.”

There was the mental equivalent of nodding all around. Well, it seems that Mary chose wisely, Peter said.

“Huh?”

We’ve needed someone like you, old chap. Someone who could get our arses in gear and make something out of all this. Hell of a waste, otherwise. That’s why she recruited you.

Recruited me?

Recruited you.

Have you ever heard from Ed? Dick broke in.

Ed? At the center? No, now that you mention it.

You know how you can make suggestions to people? To do something?

Yeah, I said.

You can also make suggestions to people not to do something.

I...see.

As a club we do have some standards, after all.

* * * *

I got everyone into the act. Those who seemed to have any pre-death, as opposed to peri-death, premonitions, those who felt any hint of communication with others out of real time. We established an encyrpted file set on a server where everything could be deposited. Those who seemed unable to probe space or time became bookkeepers and data analysts. Laura turned out to be a former database manager and assumed overall responsibility for care and feeding of the computer material, with two backups. Just in case, although she said that her own premonition was that she had at least eight months left.

We divvied up responsibilities for those passing. Instead of everyone trying to catch everything, there were assignments to individuals with strengths in particular areas; aural, visual, emotional. Instead of trying to write, I had everyone just dictate in real time and transcribe later. Like a space program, we agreed that every probe couldn’t tell us everything.

It was decided to (carefully!) begin experimenting with headtalk to healthy individuals, just as we had been working on not allowing the wrong kind of people to develop their abilities in the first place. Will, before he died, suggested those with the ability to subliminally influence the healthy attempt to influence them into thinking about telepathy. “I know it’s probably kinda unethical,” he had told us, “I mean, what if we end up making everyone telepathic? On the other hand, maybe something is coming for everyone and we’re just the first. Shouldn’t we try to, I don’t know, guide it, somehow?”

Will was a great kid. Wish I’d known him longer.

Maybe. Mom’s old phrase, “You never know,” might be in for a change.

Whether or not anything would come of it, I felt much better doing something; I was dying, but aren’t we all? At least I had something to live for until then. There was less need for painkillers, although I did find myself getting at least lightly buzzed almost every evening with a glass or two of sherry, and after some acclimation, a hit of grass. Flower power. Even as my health declined the club grew, and knowing there was someone I could talk to anytime of the day or night made it better. And I could talk to others as well, lending support and understanding up to the end. Auf wiedersehen, Chara.

* * * *

Nothing hurts, the morphine is working. Dozens of people are around, hundreds, in my head or wherever, telling me I’m doing fine. Things are shutting down, I can feel it, it’s okay, it’s time for the next thing. Not really quite me anymore, still wonder if I’m fooling myself, but that’s okay, too.

Feels like yesterday, like tomorrow, maybe the next day, some next day anyhow. Working on it. Ask people if they want a piece of me, if they want to come along, sing Auld Lang Syne, Guy Lombardo, the happy, it’s time, some time....

No room anymore no bed just me confusing not bad I try to reach out there’s Mary gone back listen everyone I see

oh man Alf was right

I never thought we would—