Hostname: page-component-745bb68f8f-lrblm Total loading time: 0 Render date: 2025-02-11T07:20:58.009Z Has data issue: false hasContentIssue false

Quinlan, Texas

Published online by Cambridge University Press:  24 January 2018

Daniel E. Epner*
Affiliation:
University of Texas MD Anderson Cancer Center, Houston, Texas
*
Author for correspondence: Daniel E. Epner, University of Texas MD Anderson Cancer Center, 1400 Pressler, Houston, TX 77030. E-mail: depner@mdanderson.org
Rights & Permissions [Opens in a new window]

Abstract

Type
Essay/Personal Reflection
Copyright
Copyright © Cambridge University Press 2018 

The man had received all the chemotherapy and radiation he could tolerate, yet lung cancer continued to consume his body. He even tried immunotherapy to no avail. He vowed to never give up the fight, and he even hoped to try experimental therapy if he could regain enough strength to resume light work. But now he was too weak to even sit up in bed, let alone return to work. He struggled on every breath of high-flow oxygen. He was dying.

His doctor nodded politely to the throng of visitors in the hospital room and addressed his patient's wife: “How is everyone holding up?”

She looked up from her well-worn Bible and removed her reading glasses.

“We always keep our faith,” she said.

“Faith is the strongest medicine,” the doctor replied.

As the nurse's aide approached the man's bed to shave him, his older daughter gently took the razor from her hand and said, “Don't worry, honey, I've got this.” The man was meticulously groomed, propped up in bed, and covered with crisp bedding and a homemade comforter. A respiratory apparatus hissed in the background. Several friends and family members maintained a prayer vigil at his bedside. The room pulsated with life and love, faith and optimism, despite the man's grave prognosis.

The man's wife slept on the recliner by his hospital bed night after night. They hadn't spent a night apart in more than 50 years. During this hospitalization, she had a recurring nightmare in which her husband was a young man dressed in hiking gear, standing alone on a rocky trail. She called out to him in the distance, but he gazed back in silence, like an apparition. She was always relieved when dawn arrived, when she could arise from the recliner, shower, apply makeup, and dress in the bathroom of his hospital room. As she did, she often imagined an old photo they kept on the mantle at home in which her husband was a young cavalry man, wearing black face paint and a flak jacket. He posed with his arm over his best friend's shoulder in the jungles of Southeast Asia. War paint could not hide the primitive fear in his eyes, just as makeup could not hide the fear in hers.

The doctor awakened the man to ask how he could help him feel better. “I want to go home,” he said between labored breaths. He was too weak to even eat. The fluorescent light in his room could no more restore him to health than it could coax the cut flowers around him to grow. He and his flowers would be gone within days. The doctor fiddled with the hem of his crisp white coat as his face contorted into a half-grimace, half-smile. He was desperate to get the man home to avoid the indignity of another sterile hospital death, but he knew he would be unable to wean the high-flow oxygen. Nonetheless, the man had but one request: “I want to go home.” And each day the doctor replied “Let's see if we can make that happen.”

On his fourth day in the palliative care unit, the man lay still and silent at the precipice of death as his blood pressure drifted downward. The doctor discussed the usual medical issues, and then, not knowing what to say next, asked “Where are y’all from?”

“Quinlan,” his wife replied, “about 40 miles east of Dallas.”

“What do you do there?”

“He worked as a mechanic in Garland for over 30 years before he got sick, and I was an elementary school teacher in Mesquite before I retired to look after him. His granddaddy settled in Quinlan to work for the railroad.”

The doctor glanced at photos lining the windowsill. In one photo, taken many years before, the man smiled broadly as he posed in front of the open hood of a vintage pickup truck. His thick black hair glistened in the sunlight; grease covered his forearms. He held a filthy rag in his right hand and a threadbare baseball cap in his left.

“What do you do for fun around Quinlan when you're not working?” the doctor asked.

“Not much of anything,” she continued. “We spend a lot of time at the lake.”

The doctor glanced back at the photos lining the windowsill and noticed one taken a couple of years before in which the man smiled while holding his young grandson in the cockpit of a sail boat, both sporting orange life vests. Wind swept the boy's bangs back to reveal his smooth forehead. The doctor gazed back and forth between the vibrant man in the photo and the withered body lying before him. Spring was in full bloom outside, but the man would never again enjoy the fragrance of Asian jasmine, feel the humid coastal breeze, or trim the sails of his boat.

His wife continued. “There wasn't much to do in town, so we just hopped in the truck and went to the lake for the weekend.”

As the man's wife spoke, the man lay in bed silently, seemingly unaware; yet, he followed the conversation through a haze of delirium. As his wife spoke of trips to the lake, the man imagined a field they always passed on their drives there, recalling how he would pull the truck to the side of the two-lane road, climb down out of the truck without explanation, and walk to a rusted barbed wire fence at the field's edge. He would gaze into the distance silently, as his family remained in the truck, wondering why he would engage in this odd ritual. The man himself never quite knew why he was so drawn to that field. As he lay dying, he remembered the tiny wooden house that sat alone and empty in the field and remembered wondering what stories it held. When was it built and by whom? What did its occupants dream? What did they fear? What secrets did it hold? After so many years exposed to the elements, the house leaned under the relentless pull of gravity. All but a few flecks of paint were gone, revealing only lifeless wood. Nails that once maintained the house's right angles were rusted and deformed. The metal roof was mottled, beaten relentlessly by the elements. Weeds infiltrated the sides of the house, and over the years bushes grew up through its foundation. Finally a sapling broke through a hole in the roof. Death replaced life, which rose again from decay in an endless cycle. Perhaps the man was drawn to the decaying wooden structure over and over because he saw it as a kind of prophecy. Perhaps it symbolized to him the destruction he witnessed in Southeast Asia so many years before.

His wife continued describing their excursions around Quinlan: “We would hike all day in the woods around our cabin. I remember times when I would break a sweat during a hike and then stop for lunch in the shade of pine trees, and feel chilly in the middle of an August afternoon. During the winter he and our son would go hunting during deer season, but he was never interested in shooting anything. He liked to take the grandkids out there to fish and hunt crawfish. He just enjoyed time with friends and family.”

As the man listened to the melody of his wife's voice, the voice of his heart for more than half a century, the man imagined himself huddled against the cold with his son and grandson in a deer blind on a crisp, clear November morning. He then imagined cradling his young grandson in his arms as they felt the power of the wind in their sails, gliding across the lake on a breezy, spring day. And finally, he stood once more gazing at the field and its decaying wooden structure, reveling in the beauty of life emerging fearlessly from death.

Acknowledgments

The author thanks Ricardo Nuila, MD; Burke Nixon; Linda Epner, MD; and Margeaux Epner for feedback and suggestions.