Moral Hazard (12 page)

“I beg of you, return him to the nursing home.”

“He will die,” said the doctor, “if we do that.”

I changed my tack. “Palliative care. Don’t you have palliative care?”

“No need for that.” Stern.

“We have living wills. Healthcare proxies. No extreme measures.”

The doctor turned away, flicking me from his consciousness as if I were lint.

Bailey kept on hemorrhaging. The transfusions continued apace. His skin became translucent: cold, colder, coldest. Around seven in the morning, he stirred. He opened his eyes and smiled shyly. “Cath,” he said, “the party’s over.”

I searched his face, shocked by his lucidity. Did he know what was happening? A few minutes passed in silence, and then he gestured at the other patients on gurneys—firemen suffering from smoke inhalation, an electrocuted electrician, a construction worker with a crushed leg, a couple of asthmatics—and said, with utmost seriousness, “Do
all
these people have invitations?”

Bailey was admitted to a ward in the hospital. Interns gathered around his bed, white-coated ghouls strung with stethoscopes. “What year is it?” “Who is the president?” Solicitous at first, then, when he didn’t respond, loud.

“He’s not deaf. He has Alzheimer’s.” Fluttering at the edge of the group.

“Who are you? His daughter?”

“His wife.”

Raised eyebrows. The interrogation continued. “Where are you?”

“In a hotel on Madison Avenue,” said Bailey.

“No! You’re in a
hospital
.” Loud
and
impatient.

Bailey pulled back into his pillow, terrified.

“He needs his medication,” I told them, “or you won’t be able to control him.”

“The elderly are overmedicated.” Accusing.

Within an hour, Bailey had pulled out all his tubes and drips, spraying the room with blood. The nurses berated him, cleaned up, reinserted everything, only to have him pull them out again. He heaved himself out of the bed and fell to the floor, where he lay, beached. They strapped him to the bed.

The next morning, to prevent bed sores, he was removed from his bed and placed in a restraining device called a Johnny chair. Gwen, who came when she could, was sitting with him. I greeted him in my usual way, my cheek against his concave, stubbly one. No answer. He didn’t recognize me. From time to time, he had forgotten my name but never who I was: his protector. Gwen looked stricken for me.

That day, all he wanted was to get free of the chair. The angle of it, the confinement, hurt him. He banged and pushed at the chair’s railing, snorting with frustration. When that didn’t work, he began to examine its construction with fierce absorption, to no avail.

The care in the hospital was minimal and grudging. It became even less so when the hospital aides learned I had Gwen. I arrived one morning to find his bed a swamp, his body smeared with excrement. Beyond rage, only wanting him clean, I went to find a nurse. They sat with the interns at computer terminals, tap-tapping. Irrationally, I felt what was happening was my fault. I found a basin and towels. Gwen arrived and together we cleaned him. He was oblivious to our ministrations. An animal determination to survive gleamed in the back of his lusterless eyes. Pinpricks of life surrounded by dullness.

Tests were conducted and botched. The cause of the hemorrhaging was never found, and Bailey was returned to the nursing home, where flu was raging. He caught it, developed a lung infection, and, for the second time in a month, hung on the edge of life. He was dosed with quantities of antibiotics, again without my permission, and recovered. Pneumonia used to be called the old people’s friend. Not any longer.

It was customary at the home to line up residents far gone in their diseases near the nursing station, where they could be watched with the least trouble. They sat strapped into wheelchairs, lolling, slumped, empty-eyed, indifferent to their surroundings, some silent, some gibbering, occupying a slope of hell. Bailey joined the line for the first time, sitting upright and stiff, but as vacant as the rest. His last wits had been shocked out of him. He had forgotten to remember. Finally, reduced to a nub. Seeing him in the line, I gave up.

Reconstructing those last months, I suspect—I know!—I was not in my right mind. All the same, my mind—my wrong mind?—was made up, Scar on my soul be damned. He’d asked me to take care of it when the time came. Now I would. Mrs. Death. Not an assisted suicide, though. A mercy killing. Merciful for him. And merciful for me. I was on a life raft, Bailey was in the water, going down but holding my hand with an iron grip, pulling me after him.

I arranged that in the event of another emergency he be taken to a hospital that might be more respectful of our wishes. Then I obtained the pills for an overdose from a doctor who was part of a guerrilla network willing to help in these situations; many have trodden the same path. To reveal more would be to incriminate others. Accessories to manslaughter, if not murder, according to the laws of New York State.

I
can
tell you that the doctor’s office was one of those thousands of windowless shoeboxes that the medical profession inhabit on the ground floors of apartment buildings on the Upper East Side. Pin-tidy. An arrangement of silk flowers. A huge computer, which she consulted occasionally. She’d done her homework on Bailey, on me.

After we ran through Bailey’s medical history and recent experiences, we discussed ethics. I’d read Peter Singer, Ronald Dworkin, and Sherwin Nuland early in Bailey’s illness, consulted books with titles like
The Moral Challenge of Alzheimer Disease.
I knew about slippery slopes and the argument that what healthy people want in the last stages of life might not be the same when they get there. That is, if Bailey had a mind, he might tell me he had changed it.

She asked me if I had fully considered the risk I was running. Truth be known, I was past questions of risk or morality, boxed in, as animal in my instincts as Bailey. All I knew was that living wills and healthcare proxies could be blithely ignored, that common sense concerning the final stages of disease is often absent. All I knew was that it was time. Stand in judgment if you like. If you must.

The doctor handed over the pills in a small turquoise box. A Tiffany box. Put her arm around my shoulder as she walked me to the door that let out into the street.

The hedge fund was duly disemboweled, dismembered, and Mike’s tally of derivatives-related scandals leapt into the stratosphere. “All the king’s horses and all the king’s men aren’t going to put that hedge fund together again,” he joked. He was wrong. The banks resurrected the fund. The excuse given was that its bankruptcy would imperil the entire financial system. What they meant is that it would imperil them;
their
losses would be “unsustainable.” In the best tradition of Wall Street, they were saving their own bacon. The heck with moral hazard.

The events surrounding the rescue are well documented. My view of the shenanigans was limited to glimpsing Horace throwing on his jacket as he ran through the Niedecker lobby on his way to the New York Fed building, where the bail-out negotiations were held. He was not so much running as scuttling. Horace, scuttling! This
is
major, I can remember thinking. These guys
never
run, unless for a plane. As the drama unfolded and the rationalizing and the spinning of facts began in earnest, my incipient conservatism collapsed. I was back where I began, only more so, cynical as an old-time, hard-bitten newsroom journalist. And as outraged as if I’d been sold the Brooklyn Bridge.

When it was over, someone had to take the bullet. Another Wall Street tradition. At Niedecker it was Mike. He wasn’t even allowed to clean out his desk. Over at Merrill, Dan Napoli took extended leave. Other risk managers and a slew of traders were given their marching orders or quietly disappeared from the scene. A couple of senior executives had their power bases undermined. The CEO said to Mike, “God, man! I needed a big whiskey after I looked at their books.” (At Merrill, their CEO was saying, “When I saw their positions, my fucking knees were shaking.”) Not quite the fiscal hygiene, the flushing out, Mike had in mind.

Banks drew up lists with titles like “Ten Lessons We Learned from the Hedge Fund Disaster.” A so-called blue-ribbon panel, the President’s Working Group on Financial Markets, found causes, suggested remedies. Congressional Banking Committee hearings were held. To date, no follow-up. Nothing.
Nada.
As if afflicted with Alzheimer’s, the Fed remains adamant that banks can police themselves. Deregulation rackets along like a runaway train, banking lobbyists clinging to its side, climbing into the cab, waving from the windows, hollering in their exhilaration.
Hoo-ha.

Several weeks after the hedge-fund negotiations came to an end, I was with Horace in his Town Car going uptown for a speech when his cell phone rang. The call was from the disgraced head of the hedge fund, who had invited Horace to dinner on a Friday. As he was a strict Catholic, the meat dish would be fish. Would Horace mind? When the conversation was over, Horace said, “I feel sorry for him.”

“You do?”

“He lost billions. Most of it his own money.”

I’d given up tugging my forelock for Horace. “I don’t. He’s not penniless. He’ll be back in business. A question, though. Why’d you bail him out? I thought you believed in the efficiency of the markets. The markets were saying, send this hedge fund to the bottom of the ocean. And if other funds or banks join it in the briny, so be it. That’s what the markets were saying.”

Horace interrupted before I could expand. He hated being interrupted himself. I’d learned to wait patiently until he reached the very end of a thought, the furthermost reaches of an idea, even if I knew the conclusion. “We didn’t bail him out. It was an infusion of money, an
investment.
We expect excellent returns. People forget how much money the fund made for them over the last five years.” He shook his head at the fickleness of investors and returned his attention to customizing the speech he was about to give. No rattling or straining in executive Town Cars. The ride is fluffy, as if the suspension were made of beaten egg whites.

While Horace worked, I looked out the window without seeing. I would like to tell you that the Tiffany box was sitting in the middle of my mind, as difficult to banish from my consciousness as a tarantula, but it wasn’t. Having made the decision, I felt empty, numb, but resolved. Instead, a Steve Earle bluegrass tune was going through my head:
I’m just a pilgrim on this road, boys / This ain’t never been my home.
We were nearing our destination—an Economic Club function—when Horace put away his papers and asked, “Cath, are you okay?” He knew about Bailey. His secretaries kept him informed.

“No, I’m not okay,” I blurted, startling myself. “Do you remember the retired couple down in Florida that made the news? Married more than fifty years. She had Alzheimer’s. He killed her. With a shotgun. Couldn’t bear it any longer. Went to jail, I think. I understand why he did it now. I understand what would drive someone to that kind of action.”

Horace was alarmed, perhaps sympathetic. He tore off a piece of paper, scribbled something on it. “I want to do something for you,” he said. “This is the number of a psychiatrist, a good friend of mine. Please go and see her. Tell her to send the bill to me.”

Horace had his own problems. He and the CEO were at odds. Oil and water, those two. Always gentlemanly, Horace professed esteem for his colleague. The CEO was not as circumspect. Behind closed doors, he regularly referred to Horace as a horse’s ass. “Horace. Horse’s ass. Get it?” Most would laugh, a few wince. The problem: The CEO wanted to sell the company, cash in on the fashion for financial mega-mergers. Horace wanted Niedecker’s “proud tradition” to continue.

I took the piece of paper, thanked him warmly, genuinely touched. Threw it away when I returned to my office.

An afterthought. It was almost an afterthought. If thinking is what I was doing; I was about to go to bed, mentally checking off the things I had needed to do to be prepared for the next day. Clothes ironed, shoes polished. And then I remembered: One more task.

I had already bought the drink. Nantucket Nectars. Orange mango. I decanted the pills from the Tiffany box into a breakfast bowl and ground them with the back of a teaspoon. I eased the powder into the drink, shook the bottle. What didn’t dissolve was disguised by the sediment in the bottom.

The day passed as any in the office. Around six, I closed down my computer and caught a taxi to the home, up the FDR Drive, along the river, by the bridges. Swooping, soaring.

I chose that night because it was his bath day. He would smell sweet, the odors of incontinence, folded flesh, rotting teeth and gut disguised by lotions, powder, soap. To bathe him, Gwen and another aide lifted him into a high plastic chair and wheeled him to the shower room. In the early days, they giggled, flirted, teased, but no longer. When I arrived, he was already in bed, his face upturned, unapprehending. I kissed him, nuzzled his hair, and then went over to nip dead leaves and spent blossoms from the geranium plants on the windowsill. More alert now, he followed my movements not with the incuriosity that had encased him these last months but approval. Or so I thought.

The time for last words, for ceremony, had passed years ago, so I got on with what I had come to do. I supported his head while he sucked at the straw. He always did have a sweet tooth.

I drew up a chair by the bed, took his hand, and read him Elizabeth Bishop’s “Invitation to Miss Marianne Moore.” This wasn’t planned; the trip along the FDR Drive had reminded me of the poem: