Brian Koukol
Amelia lowered her husband into their double bed—his naked, cachexic body cradled in the polyester sling of their Hoyer lift. As the plush mattress accepted his feeble weight, his contracted legs splayed, exposing a mound of unkempt pubic hair and a flaccid penis, demurely tucked to one side. A musky smell of salted dairy wafted into her face, and she had to work hard to suppress a reflexive cough. Once upon a time, twenty years earlier, this area had been a source of great pleasure for her. Now it was a source of bladder infections and obligation.
When the bed had taken all of him, she cut off the descent of the lift before its cross-brace could crush his scrawny throat. She unhooked the sling, slid it out from beneath him, removed the lift.
Then began the tightrope act of rolling his body to and fro, adjusting limbs and pillows, always a millimeter away from a mistake and a full redo from the top. As she did this, he stared at the ceiling, unable to turn his head and look at her due to a lifetime of muscle wasting. He didn’t talk much out of his wheelchair, a victim of a near-catatonic loss of control. She didn’t blame him. For any of it. But that didn’t stop her from hating him.
After tucking the top sheet and matelasse coverlet over his shoulders and around his neck, she grabbed his BiPAP mask from the bedpost and slipped it over his head, careful not to mess up any of her delicate positioning from earlier. She adjusted the nasal pillows of the mask to nestle comfortably into his nostrils and tightened the strap that ran across the top of his head, then turned on the bedside ventilator.
Amelia slipped into bed beside her husband. She rolled onto her side, away from him, with her butt pressed against his hip and her bottom leg thrust back to support his legs.
It roared to life with a series of beeps and his eyes drifted shut, as they always did. She sighed. Time for bed.
Amelia slipped into bed beside her husband. She rolled onto her side, away from him, with her butt pressed against his hip and her bottom leg thrust back to support his legs. Only her bottom leg would do. They’d tried pillows, but the shape and texture conspired to put his neuropathic feet to sleep.
And then she waited, listening to the inspiration and expiration of his augmented breaths. After a few minutes, his jaw went slack and the snoring started—a horrible crackle of wet air reinforced by the power of positive pressure. Spit spewed from his mouth with every exhalation, bubbling from its corners, dripping down his cheek, his mandible, his neck; aerosolizing, perfuming the air with phlegm, dusting her hair.
The ventilator beeped, indicating insufficient pressure on account of his open mouth, insufficient oxygenation, the onset of hypercapnia. She waited some more. The beeping stopped, his breathing regulated. The snoring and misting continued, but more subdued, tolerable. He was finally, deeply, asleep.
Amelia took her leg back, slid out of bed. She walked to the wardrobe. Her cigarettes were on top, away from the edge, out of any wheelchair-based sightlines. She grabbed them. The cellophane wrapper crinkled; she left it on for that very reason—the crinkle, a call to freedom.
She opened one of the French doors to the backyard, leaned against the jamb, sniffed the tip of a cigarette. It was woodsy, inviting, like a hike on an autumn afternoon. She brought it to life with a flick of the plastic lighter tucked inside the pack and took a puff. The warm smoke, acrid and fiery, filled in the cracks of her lungs. Her shoulders sagged in sated relaxation as she exhaled, blowing the smoke outside.
A shuddering snore from her husband grabbed her attention and she turned to witness a plume of saliva spritzing from his open mouth. He was pathetic. Not the one she’d married, who’d been vital and defiant and loving despite his disease, but this one, this thing that brooded and gave up and ignored her in the face of his innumerable problems.
She glanced through the open door into the dark backyard. His anxieties wouldn’t allow her outside, wouldn’t allow her out of earshot when he was trapped in bed unable to move on his own. She couldn’t blame him.
She took a drag and stepped outside.
The guilt struck her at once, but she pushed past it, into the cool night air. She forced the smoke from her lungs, suddenly satisfied, the concrete cold against her bare feet. Another stride and she was in the grass, staring at the waxing moon, her arms spread.
She heard a distant beeping in the bedroom and ran, not toward it, but away, toward the door into the rear of the garage at the far side of yard. When she reached it, she slipped inside, hit the light, took another drag.
The car beckoned. It was so close, so accessible. All she had to do was slip inside, drive off, leave him to rot. It was that easy. She could drive up the coast, drive forever. She’d never had that freedom. Not with her parents. Not with him. She’d gone from one to the other, with no time for herself.
She left the garage and slammed the door behind her. She couldn’t leave him. Not like this, trapped and alone. She knew the feeling and couldn’t inflict it on another. Even if the other was him.
After snuffing out the cigarette on the fence and throwing it into the neighbor’s ice plant, she slipped back into the bedroom. His mouth was bubbling, overflowing. The room stank. The snores were deafening. The ventilator returned to its beeping.
She stepped over to it, hit the power button. It asked her if she was sure. She was.
With a quick movement of her finger, it all stopped. No more bubbling. No more spritzing or snoring or beeping. Just a soft coo, the only thing his weakened diaphragm could muster.
For a second, two, ten, thirty. She wondered how she would react to it all. To him being gone. She knew she wouldn’t be able to show her joy. Not at first.
Amelia slipped back into bed beside him and waited. On top of everything else, he suffered from sleep apnea. His death, when it came, would be peaceful, unknown to him. Much better than abandoning him alive.
After a few minutes, even the cooing ceased. For a second, two, ten, thirty. She wondered how she would react to it all. To him being gone. She knew she wouldn’t be able to show her joy. Not at first. She’d have to play the broken widow for a while, soak up the sympathies and the praise for two decades of caregiving. The platitudes, the casseroles. And then her life would finally be her own. For once.
He sputtered beside her, gasped. The cooing returned.
Not tonight, it seemed.
She rose out of bed, placed the BiPAP mask back onto his face. A quick adjustment of the nasal pillows. The tightening of the strap on his head. Then she turned it on.
The ventilator roared to life, the snoring returned, the spit flew.
She slipped into bed beside him, stuffed her back leg beneath his, sniffed the lingering smoke on her collar.
They had to get up early the next morning. He had another doctor’s appointment.