April 3. Entering his room about midnight, I notice that he is sleeping too soundly on one side—he should move frequently—and have a foreboding that all is not well. Has the substitute nurse, unaccustomed to his restlessness, given him too strong a sedative? V. is deeply asleep, too, however, and I do not disturb her.
April 4. Palm Sunday. We can hardly wake I.S., and his breathing is very labored, in spite of which the nurse, another substitute, dresses him, and actually wheels him about the apartment. It is soon obvious, in fact, that he again has pulmonary edema. Mid-morning the nurse calls Lax, but apparently does not describe the condition as an emergency. Even worse, she does not call R., who would know enough to give Lassix or another diuretic immediately, along with dijoxin; which is what she does do, happening by at about two-thirty, but by this time his pulse is dangerously rapid, and his breathing is like a fish out of water.
When at last the doctor arrives (after three o’clock) we reject his recommendations in favor of the hospital—an unthinkable trauma for I.S. now, convenient as the removal would be for the medical functionaries—and insist that the intravenous apparatus be installed here, and that an intern or doctor remain in attendance during the night. The I.V. equipment is delivered surprisingly quickly, but a weak vein is chosen, the needle slips out, and a full hour is lost before it is reinjected and the clysis begins to flow. Lax, meanwhile, trying to explain I.S.’s chances to V. and myself, seems oddly drawn to anecdotes about the last days of his one-time patient Bela Bartók. ” ‘One of the most important things that I learned from Stravinsky,’ Bartók said, ‘was daring.’ ” But is Lax deliberately hinting to V., or, as I think, is he so disturbed himself that he cannot eject the memory of the other composer’s death from his mind?
Two large green torpedoes of oxygen are trundled in, but the twin-pronged nostril-clamp feeder can be kept in place only by stretching a rubber band around the head. We cushion I.S. from the pull of the elastic with large tufts of cotton on either cheek, where they look like Ibsen’s sideburns (and bring to mind Ibsen’s “to write is to judge one’s self”; but surely a simpler use of writing, calling down no judgment, if not exempt from it, is the writer’s mere desire to remember?). I.S. is frightfully anxious, squeezing and kissing our hands, crossing himself and ourselves, but still and always panting like a stranded fish. And his body is not responding. The Lassix is not mobilizing the fluid, he does not pass any urine the entire afternoon, and the lungs are no less audibly congested.
Worst of all, his pulse is wildly irregular and the signs of heart failure are alarming. About 8 PM Dr. Lax and the night-watch intern decide that morphine must be given to slow the heartbeat, even though it may perilously retard the other functions as well. Just before the injection, I talk to I.S., his big eyes studying my face as I promise him that he shall have music tomorrow; and he responds with a smile. “Do you want Beethoven?” I ask. But he does not answer. “Well, then, Stravinsky?” But at this he makes a sour face and firmly shakes his head to left and to right.
About an hour later, when he is still not reacting to the medications—would he have if he had received them five or six hours earlier?—R. disregards her nurse’s uniform for the first time in two and a half years, and says, “Robert, you must hope that he dies now—for him. And I will tell you that already this afternoon we thought he would.” But I do not want him to die—or, of course, want him to suffer; but if the choice were mine, it would be for more suffering, cruel and egoistical as that may be (or surely is); but I would take the responsibility for it on my own conscience for all future time—in so far as any future without him bears thinking of—because I know there is more life in him still, and life of the most precious kind. At this point V. enters the room, seems not to comprehend the gravity of it, yet, after gazing at him a long time, says: “He is tired and would like to sleep ‘forever,’ but his mind is still making distinctions and he is afraid that ‘forever’ and ‘death’ are the same.” We take turns moistening his open mouth and lips with lemon water—“like Christ and the vinegar,” she remarks.
Then a little later, strangely, ominously, and for no reason except that the record is on the turntable—only two days ago I had been listening to it with I.S.—I start to play the Symphonie Pathétique. Two days ago it delighted him; “Tchaikovsky’s best music,” he called it. But again I have no idea why we played it, for we have never listened to it together in all of our twenty-three years. Now, at the first sound of it, the last movement, V. runs from the room, begs me to turn it off, says that to Russians it predicts death.
April 5. No change occurs during the night, the diuretics are having no effect, and no urine is passed. His breathing, too, is still like that of a runner after a race, and the sound of it is more and more like a death rattle. The intern, on his way out, at 7 AM (after a reasonably good night’s sleep on a pile of pillows near the bed), tells me that in his opinion nothing can be done, and that it cannot last more than an hour or two. But Dr. Lax, on his rounds, finds some accumulation of water in the bladder and he summons Dr. Slaughter (sic) to catheterize him and Dr. Brown to take blood for a B.U.N. And Lax tells V. that “it is not one hundred percent hopeless. His strength is incredible and he is a man of surprises.”
The catheterizing is accomplished without complications, but by about 1 PM his life signs are failing; the pulse is weaker and even less regular, the lungs are still congested, and the catheter has drawn only 44 cc.’s of urine. The blood pressure drops below 80, at one point, while the pulse climbs to 140, and the respiration continues steadily at 40. Nor can morphine or dijoxin be given again for at least two more hours. Three times when we are very briefly out of the room, R. calls us back to his bedside for what she apparently fears may be the end.
Then suddenly a great change comes over him. His inspirations sound less labored, and his lungs begin to clear. At the same time his blood pressure rises, and his pulse falls (but only to 120). He responds to R.’s directions, too, turning from side to side when she explains how important it is for him to move—but fighting her like a wildcat when she attempts to insert a nasal suction tube. And whereas he was holding my hand loosely an hour ago, he clasps it now with a powerful grip and will not let go. Finally, in the late afternoon when the B.U.N. report comes back not too unfavorable, it is clear that the outcome rests entirely with that mighty heart, which is so much more than a muscle in I.S.’s case, but which has already endured more than forty hours of almost superhuman strain.
He seems much improved in the evening, and Dr. Lax is noticeably less tense. Yet when I sit by his bed, he kisses my hand and holds it to his cheek as if he were saying good-by; and when V. sits on the other side and he slowly strokes her cheek with the back of his left hand, which is bandaged to keep the I.V. needle in place, that is obviously what he means. His eyes are aware of some new change, moreover, and he always was and still is ahead of everybody. But V., after dabbing his face and neck with eau de cologne, goes to bed slightly relieved, or at any rate more hopeful than last night, and soon falls into an exhausted sleep. And R., with whom every few minutes I have been lifting him to change his position (with his help, too, for he has great strength in his arms), actually returns to her room at the Essex, “for some real sleep if I am to work well tomorrow,” a disastrous decision but evidence that she, who knows him best, believes in the rally and in his recovery.
April 6. While the new intern and new nurse adjourn to the living room to play a few hands of cards (before turning in themselves), I pace the floor, looking in at him every two minutes, hoping and praying for a change in that terrible breathing. But it does not come. And an elderly relief nurse who remains in the room with him confirms my fears that it is, if anything, more labored. I go to the intern, but he tries to assure me that the breathing will soon begin to ease as a result of the last morphine injection. Unallayed, I go to my room, not so much to pray as to beg, then go back to him, find him looking weaker but perhaps more peaceful (Eliot’s line, “his life is light, waiting for the death wind,” comes into my mind), hold his hand awhile, and again return to my room. This time I doze off until awakened by L., who says he is sinking. I run to him in a half-stupor and see him die—a simple cessation, without struggle.
The intern stethoscopes the chest, says he hears nothing, removes the intravenous tube (with all the feeling of a filling-station attendant removing a hose from an automobile tank), and remarks, “Gee, he went just like that.” While he leaves the room to call Lax and certify the time of death as 5:20, I wake V., but cannot directly tell her the truth: “He is very bad…. Dying…I think…. No…he is dead.” Then I go back to I.S. and hold his still warm hands and kiss his still feverish cheeks and forehead, during which I am certain that life is in his eyes for an instant, and in that instant he knows me. V. comes, kisses him, and leaves the room crying.
The brutal “Loved One” business begins immediately after the eyes have been closed and the sheet pulled over the head. First, the room is disinfected, by which time R. arrives from the Essex House and inserts his dentures, brushes his hair, replaces his rings. We are then obliged to decide questions relating to the two funerals and burial, such as whether the casket is to be sealed for the New York service—which it should be, we agree, for V.’s sake, though contrary to the barbaric Russian Orthodox rule. Fortunately R. takes over the macabre job of selecting burial clothes (it is especially painful to think of his Venetian-made shirts with “I.S.” stitched on them to distinguish them from mine in the laundry), and of choosing the casket and flowers. His gold cross and silver medal go with him, but V. gives me his wrist watch, which I can hardly bear to look at, remembering how he had to lift his sleeve halfway to the elbow to find it and tell us the time, his arm had become so thin.