Decline

Eleven Rooms

Chapter 20: Decline

The body declined the way a structure declines -- not all at once, not in a single catastrophic failure, but incrementally, the deterioration distributed across the systems, the decline visible in some places and invisible in others, the visible signs the evidence of the invisible process, the process that had been advancing since the diagnosis in September and that was now, in November, accelerating, the acceleration not dramatic but steady, the way a bridge's deterioration accelerates once the protective coating has been breached and the water has reached the steel and the corrosion has begun, the corrosion patient, persistent, the corrosion doing its work in the hours and the days and the weeks while the bridge continues to carry its load, the bridge functional while the bridge declines, the functioning and the declining simultaneous, the bridge holding while the bridge fails, and the holding-while-failing was Lin's condition in November, the body holding while the body failed, the mind sharp while the body diminished, the librarian still cataloguing while the shelves emptied.

Lin lost weight. The losing was not the voluntary losing of a person who diets, not the controlled reduction of mass that the living pursue, but the involuntary losing of a person whose body was consuming itself, the cancer taking the nutrients that the body needed, the appetite withdrawing, the eating reduced to three bites of turkey at Thanksgiving, two sips of tomato soup on a Wednesday, a quarter-cup of broth on a Saturday, the eating diminishing the way the light diminishes in November, less each day, the reduction gradual, the days shorter, the appetite smaller, the body's intake declining toward the asymptote of nothing, approaching nothing without reaching nothing, the mathematical curve of the decline approaching the axis but not touching it, not yet, the not-yet the duration, the time remaining, the distance between the curve and the line.

Thea tracked the weight. Every Monday she wheeled the bed scale to Room 6 and she weighed Lin and she recorded the number in the chart, the number a fact, a medical fact, the fact that the body weighed this much on this date, and the facts accumulated in the chart the way the letters accumulated in the shoebox, one on top of another, the most recent on top, and the sequence of numbers told a story, the story of the decline, the numbers descending week by week: one hundred and eighteen pounds in September, one hundred and twelve in October, one hundred and six at the beginning of November, one hundred and one at the end of November, the numbers a staircase descending, each step a week, each step six or seven pounds lower, the staircase going down, and the going-down was the decline, and the decline was the body.

The hands thinned. The hands that had catalogued thousands of books, that had held thousands of cards, that had typed thousands of records, that had filed and cross-referenced and organized the knowledge of the Multnomah County Library for thirty-one years -- those hands were thinner now than they had been in September, the bones more visible through the skin, the tendons more prominent on the backs, the knuckles larger relative to the fingers, the hands becoming skeletal, becoming the X-ray of themselves, the structure visible through the diminishing surface the way the studs become visible when the plaster is removed from a wall, the structure that was always there revealed by the removal of the covering, and the covering was the flesh, and the flesh was going.

David saw the hands every day. He saw them when he held them, the holding a daily practice, the practice of the marriage, the fifty-four years of hand-holding reduced now to this: his hand around her hand, his hand larger, thicker, the engineer's hand, the hand that had held pencils and calculators and the steering wheel of the car he drove to Evergreen House every morning, his hand holding her hand with the gentleness that the hands now required, the gentleness calibrated to the diminished capacity, the grip adjusted for the fragility, the force reduced the way a load is reduced on a structure that can no longer bear the full load, the derating that engineers perform when a structure's capacity has been compromised, the engineer reducing the allowable load to match the reduced capacity, and David's reduced grip was the derating, the professional instinct applied to the personal, the engineer's knowledge of structural decline informing the husband's handling of the wife's body.

Miriam saw the decline on Tuesdays. She saw it across the intervals, across the seven days between visits, the decline invisible on any single day but visible across the week the way construction progress is visible across the week, the framing that was not there on Tuesday present the following Tuesday, the wall that was bare on Tuesday painted the following Tuesday, and Lin's decline was the inverse of the construction, the things that were there on Tuesday gone the following Tuesday -- the color in the cheeks, the strength in the voice, the mass in the arms, the things receding, the things diminishing, the body deconstructing the way a building deconstructs when it is demolished, not all at once but system by system, the mechanical systems first, then the finishes, then the structure, the dismantling orderly, sequential, the body following its own demolition schedule, the schedule written not by an engineer but by the disease.

The disease was pancreatic cancer. The cancer that Dr. Shapiro had named in the examination room in September, the cancer that was stage four, metastatic, the cancer that had established itself in the pancreas and the liver and the lumbar spine, the three sites the three fronts of the decline, each front advancing at its own pace, the pancreas producing the pain that the medication managed, the liver producing the jaundice that was visible now in the yellowing of the skin and the whites of the eyes, the spine producing the weakness that had confined Lin to the bed, the three fronts converging on the same destination, the destination that the three-to-six months had specified and that the body was now approaching, the body in month three, the body at the midpoint of the range, the range narrowing as the body declined.

Lin catalogued the decline. She catalogued it the way she catalogued everything -- systematically, precisely, with attention to the primary entry and the cross-references and the subject headings that connected one symptom to another, one system to another, one day to another. She catalogued the pain: lower back, constant, managed by the morphine that Thea administered through the IV, the morphine a liquid that entered the body through a tube and traveled through the blood to the brain and intercepted the pain signals and reduced them, the reduction not elimination but management, the pain present but quieter, the pain a sound turned down rather than a sound turned off. She catalogued the fatigue: total, the energy of the body depleted, the reserves consumed, the body running on the last of its fuel the way a car runs on the last of its gas, the needle below empty, the engine still turning but turning on fumes, on the residual, on the almost-nothing that preceded the nothing.

She catalogued the changes in her mind. This was the cataloguing that frightened her, the cataloguing that she performed with the professional detachment that years of practice had given her but that the detachment could not fully protect her from, because the thing being catalogued was the catalogue itself, the mind cataloguing its own decline, the librarian observing the library's deterioration from within the library. She noticed the forgetting. She noticed that some letters in the shoebox were unfamiliar, that some memories were missing from the shelves where they had been, that some cross-references led to empty entries, the links broken, the connections severed, the system corrupted in places, the corruption sporadic, unpredictable, the forgetting selecting its targets at random, taking a Tuesday in 2003 while leaving a Wednesday in 1987, taking the name of a book she had catalogued last year while leaving the name of a book she had catalogued in 1978, the forgetting capricious, without system, without the order that Lin had imposed on everything else in her life, the forgetting the one thing that resisted organization, the one thing that could not be shelved.

"The shelves are emptying," Lin said to Miriam on a Tuesday afternoon in late November. "Some of the shelves. Not all. Not the important ones, not yet. The Dewey numbers are still there. The system is still there. I can still tell you that 811 is American poetry and 624.2 is bridge engineering and 720 is architecture. The system holds. But the contents -- some of the contents are gone. Some of the books have been removed from the shelves and I don't know who removed them and I don't know where they went. The books are not lost. Lost implies they can be found. The books are gone. Gone is different from lost. Gone is the permanent condition. Gone is the book that has been deaccessioned, withdrawn from the collection, removed from the catalogue, the catalogue card pulled and discarded, the book no longer findable because the book no longer exists in the system. Some of my memories have been deaccessioned, Miriam. Some of the cards have been pulled."

Miriam listened. She listened the way she listened to everything her mother said, with the attention of a daughter and the attention of an architect, the two attentions overlapping, the daughter hearing the grief and the architect hearing the structure, the grief being the content and the structure being the metaphor, the metaphor of the library, of the shelves, of the deaccessioned books, the metaphor that Lin used to organize the unorganizable, to catalogue the uncatalogueable, to impose the system on the thing that resisted the system.

The room held the decline. Room 6 held Lin's declining body the way it had held Lin's arriving body in September, the room unchanged, the room steady, the walls at the same distance, the ceiling at the same height, the floor at the same level, the window at the same angle, the room a constant while the person in the room was a variable, the room's constancy the thing that the decline required, the stable environment that the unstable body needed, the solid walls that the dissolving body needed, the firm floor that the weakening body needed, the room providing the structure that the body could no longer provide for itself, the room's architecture compensating for the body's failing architecture, the walls holding what the bones could no longer hold, the ceiling providing the height that the spine could no longer provide, the room standing while the body lay, the standing and the lying the room's relationship to the patient, the vertical holding the horizontal, the built holding the biological.

David read to her every day. He read Snow Country and they finished Snow Country and he began The Pillow Book, the book by Sei Shonagon that Lin had requested, the book that was a list, a catalogue, a collection of observations organized by category -- things that make one's heart beat faster, things that arouse a fond memory of the past, hateful things, things that have lost their power -- and the book was Lin's kind of book, was the librarian's book, the book that organized the world the way the Dewey Decimal System organized knowledge, by category, by heading, by the principle that the world can be understood if the world can be classified, and the classifying was the understanding, and the understanding was the reading, and the reading was David's voice in the room every morning, the voice steady, the hands shaking, the marriage continuing through the reading while the body continued through the decline.

The decline was not a straight line. The decline had plateaus and drops, days when Lin seemed better and days when Lin seemed worse, the better and the worse oscillating around the downward trend the way a stock price oscillates around a declining average, the oscillation giving hope on the better days and taking hope on the worse days, and the giving and the taking of hope was the family's daily experience, the daily recalibration of expectation, the daily adjustment of the emotional load to match the body's current condition, and the adjustment was exhausting, was the thing that exhausted Miriam and David more than the grief itself, the constant recalibration, the constant reading of the signs, the constant interpretation of the signals -- is she better today, is she worse, does the color in her face mean improvement or does it mean the jaundice is changing, does the firmness in her grip mean strength or does it mean the medication has been adjusted, the interpretation endless, the signals ambiguous, the ambiguity the cruelest thing, crueler than certainty, because certainty can be accommodated, can be catalogued, can be placed on the shelf, but ambiguity resists the shelf, resists the catalogue, ambiguity the uncatalogable thing.

November ended. The decline continued. The body smaller, the voice quieter, the hands thinner, the blanket looser, the threshold state more frequent, the waking hours fewer, the sleeping hours fewer, the between-hours more, the between the dominant state, the between the place where Lin lived now, the between that was not the room and not the outside but the space between the room and the outside, the threshold, the edge, the place where the window was, the glass surface that separated the inside from the outside, the surface that was neither inside nor outside but both, and Lin was at the window of her own consciousness, at the glass surface that separated the waking from the sleeping, the living from the dying, the before from the after.

The room held steady. The room did not decline. The room's walls did not thin. The room's ceiling did not lower. The room's floor did not weaken. The room was the constant, the datum, the reference point against which the decline could be measured, the fixed thing in a world of changing things, and the room's fixedness was the architecture, was the gift the architect gave to the dying, which was not change but stability, not movement but stillness, not the life that was ending but the room that continued, the room that would be here tomorrow and next week and next month and next year, the room that outlasted the person in the room, the room that held and held and held while the person in the room declined and declined and declined, and the holding and the declining were simultaneous, were concurrent, were the room's experience and the patient's experience happening in the same two hundred and forty square feet at the same time, the room holding while the body released, the architecture steady while the biology shifted, the walls standing while the bones softened, the room the thing that did not change while everything else changed, the room the constant, the room enough.