The Little Way of Ruthie Leming: A Southern Girl, a Small Town, and the Secret of a Good Life (13 page)

“I’m telling you now,” Abby growled. “Either you make an appointment with Tim Lindsey, or I’m doing it for you.”

This time Abby wasn’t taking no for an answer. When Ruthie protested that she couldn’t do that because her Zachary doctor had all her X-rays, Abby shot back, “Then he can send them to Tim, or Tim can take his own set.”

She set her jaw and stared Ruthie down. Ruthie blinked.

Defeated and resigned, Ruthie said, “I’m going to do it right now.” She went back into her classroom, picked up the phone on her desk, called Dr. Lindsey’s office, and scheduled an appointment.

It was on his thirteenth birthday that my sister’s new doctor, Tim Lindsey, decided what he wanted to do with his life. When Tim should have been home having cake and ice cream, he lay in a bed in the West Feliciana Parish Hospital, waylaid by pneumonia. He was scared and he was miserable. But he knew he was going to be okay when he saw Dr. Patricia Schneider, a familiar face from church. To Tim’s young mind, she was not a technician; she was a friend. She told him he would be fine, and she made him well.

As he recovered Tim thought about how much it meant to him to see a familiar face when he was so sick, and to put his trust in her hands. He thought about how the doctors whose children attended Wilkinson County Christian Academy, the religious school in nearby Woodville, Mississippi, where Tim was a student, helped out in the school community. How they would be on the sidelines at football games. How they could be ordinary dads as well as doctors.

He decided then, in his hospital bed, that he was going to be a small-town doctor. And he resolved that he was going to do this in St. Francisville, his hometown.

Tim doesn’t remember the first time he met Laura Seal, but it must have been at WCCA. He was in first grade when Laura started kindergarten. WCCA was so tiny they knew each other throughout their childhood. They began dating during his senior year. Their first Christmas together Laura gave Tim a silver ring engraved with a cross. Two decades and five children later, he still wears it.

After graduating from high school in 1993, Tim enrolled at LSU, less than an hour from home. Laura, who comes on her mother’s side from a big West Feliciana family, joined him the following year. They became engaged in 1997. Tim graduated from LSU that December and applied to medical school. Laura finished her degree in elementary education the following May. She was a June bride. They were both twenty-two years old.

In August they moved to New Orleans so Tim could start LSU Medical School. Laura took a job teaching first grade in a public school. He and Laura decided together that learning to be a good doctor was not the same thing as making the best grades in the class. They were not going to miss a family event, a vacation, or an LSU football game so Tim could study. Nor would they miss having dinner together every night. If that meant he wouldn’t be at the top of his class, Tim was prepared to make that sacrifice. It was a matter of priorities.

After graduation and a three-year residency in Chattanooga,
Tennessee, Tim returned to St. Francisville to practice medicine. It was 2005; Tim and Laura were starting to have children and were eager to return home. Tim worked out an agreement with Dr. Chaillie Daniel, a young physician who had started a successful clinic in town five years earlier, to join his practice. Tim would also have a certain salary guarantee from the West Feliciana Hospital for two years, but not beyond.

It was a risky move, Tim thought. West Feliciana isn’t a big place and there might not be enough business to go around. Tim quickly discovered that he enjoyed being a country doctor because he was able to get to know his patients personally before they became his patients. Treating people he knew as a baseball coach or a Sunday school teacher allowed him to practice medicine in a personal, emotional, and even spiritual way. For Tim healing was not only about fixing the body; it involved helping patients discover how they could bring their emotional and spiritual lives back into balance. He found that at times he anticipated that particular patients would be coming in to see him, simply because he had heard through the community grapevine what was going on in their lives.

Tim did not know Ruthie well. She was older than he, and had gone to a different school. Ruthie’s and Mike’s paths began crossing Tim’s and Laura’s when my youngest niece, Rebekah, and Mary Margaret Lindsey, their daughter, became best friends in first grade.

There were other connections. Tim and Laura were leaders in Young Life, the teenage parachurch Christian fellowship, whose meetings Hannah started attending when she was fifteen. But for the most part the Lemings and the Lindseys were little more than acquaintances until Abby succeeded in convincing Ruthie to walk into the Daniel Clinic.

Ruthie showed up there at the end of the workday. Her shortness of breath startled Tim. She could barely complete her sentences without gasping or succumbing to her raspy cough.

Her previous doctor had called it allergies. Then he said it was bronchitis, or maybe asthma. Nothing he prescribed had worked. Given Ruthie’s shocking degree of physical distress, Tim knew something critical had to be done for her.

He ordered a chest X-ray. The results came back on a Friday, and they were grim. Splatters covered her lungs. Fearing cancer, Tim ordered a CT scan for early the next week. He phoned Ruthie at home to tell her the news.

“I’m not going to lie to you, it’s not good,” Tim said. “We have to rule out cancer. I’m not saying it’s cancer, but I am saying we have to rule it out.”

Ruthie took the news calmly. But when Abby called to hear the results, she found Ruthie in tears.

“There are spots on my lungs, and they don’t know what it is,” she cried. Mike was overnighting at the fire station and she didn’t want to deliver the news by phone. She swore Abby to silence and said she wasn’t going to tell anybody else just then. She didn’t want to worry them.

“I’ve got to pull myself together,” Ruthie said. “I’ve got to go pick up the girls.”

“Do you want me to get them for you, Ruthie?”

“No, I can do it. I’ll be fine.”

“Ruthie, we’re going to figure this out,” Abby said. “We’re going to get through this. Okay?”

“Okay.”

Ruthie climbed into her SUV to head out to pick up her children, but the burden of this news paralyzed her. She realized that she couldn’t, after all, keep it from Mike until he finished his shift on Saturday. She sat in the Ford under their carport, and dialed his number on her mobile.

“I have some bad news, Michael,” she said, and began to cry. “Tim
called and said they found spots all over my lungs. I’m so sorry. I know you didn’t need to hear this.”

Mike swallowed hard. This was worse than they had anticipated. A lot worse.

“Try not to worry too much,” he said to his wife. “It might be nothing serious. They still have to do more tests. I love you. I’ll see you tomorrow.” Ruthie kept the news from Mam and Paw.

Days later the radiologist called Tim to discuss the results. “It’s crazy, but I don’t know what this is,” he said. “It could be fungal, it could be an infection. She doesn’t have a defined mass, and her lymph nodes are fine. This one has me stumped.”

That’s when Ruthie disclosed her condition to me. I was driving home from work at dusk and called her as I motored home along the wooded road headed for a ridge along the Schuylkill River. As I sat in traffic waiting for the light to change, I heard my sister say: “There are spots on my lungs. But listen, don’t worry about it. If this were cancer, my lymph nodes would be messed up. They’re normal. This could be some sort of fungus from those peppers I inhaled. You can’t tell Mam and Paw, though. You know how they worry.”

This really is cancer,
I thought. But I dropped that notion like a pie tin of hot coals. Ruthie’s tone was so matter-of-fact and reassuring that it was easy to trust her. Besides her lymph glands were fine, and we all knew that forty-year-old women who have never smoked don’t get lung cancer. Anyway there’s crazy stuff in the subtropical air in Louisiana; maybe a hurricane or a storm kicked up something last fall that got stuck in her lungs. It was probably a fungal thing.

It took three weeks for Ruthie to get an appointment with a pulmonologist. The doctor examined the first CT scan, found it puzzling, then ordered a second scan. This one was dramatically worse, and her lymph glands were enlarged. It looked for all the world like an extremely aggressive form of cancer.

“The truth is, it was a terminal illness from the moment I saw her.” Tim sighs. “I know that. But in my mind, as a doctor who wants to fix things, I thought about that three weeks, and wondered if we could have found this earlier.”

The pulmonologist ordered a bronchoscopy, a procedure in which surgeons snake a tubelike instrument through the mouth or nose into the lungs to examine the condition of pulmonary tissue and retrieve tissue samples for biopsy. It did not go well. Ruthie’s lungs were in terrible condition, and hemorrhaged badly.

“I’ve never seen one like this,” the pulmonologist told Tim. “The only thing we can do is figure out what kind of cancer this is so we can treat it.”

Ruthie’s doctors scheduled surgery for February 16—Mardi Gras, 2010. Fat Tuesday, the high holy day of south Louisiana revelry. They would go into her lungs to excise and biopsy the growth near her heart. In the days leading up to the operation, Tim tried to comfort Ruthie and Mike, but he was discouraged by how rapidly her health was declining. Meanwhile Ruthie was quietly researching medical possibilities.

Was she frightened? Yes. But she stayed calm. She knew that Mike and the girls were watching her closely, and taking emotional cues from her behavior. If she kept her head and stayed upbeat, maybe they would too. She had to be strong, she figured. She couldn’t let Mike and the children be afraid.

The annual Spanish Town Mardi Gras parade rolled on the Saturday before her surgery. Though Carnival celebrations are more common in New Orleans and Louisiana’s Cajun country, Baton Rouge’s funky Spanish Town neighborhood held its own popular parade, which had become a Capital City tradition. Ruthie and Mike joined their friends in a krewe—a Mardi Gras parading club—called the Krewe of Updog (“What’s ‘Updog’?”—get it?) in the parade. Ruthie rode an Updog float, tossing beads and doubloons into the crowds below. She
told friends who asked about her health that she was going to have a little outpatient procedure done on Tuesday, but it was no big deal.

Ruthie and Mike awoke at five on that morning, dressed, and drove to Baton Rouge for the surgery. All the girls knew was that Mama was going to the hospital to have some kind of operation done to determine what was causing the cough. Ruthie had kept all knowledge about the severity of her condition and the seriousness of the surgery from the three children. Because it was a school holiday in Louisiana—Ruthie, for whom the universe was south Louisiana, had been surprised to learn that schools elsewhere didn’t have Mardi Gras off—Mam took the girls to Laura and Tim’s house for the day.

Mam stopped off in Starhill to pick Paw up, then drove on to Our Lady of the Lake, the big Catholic hospital in south Baton Rouge. As the waiting room at the Lake filled with friends and family, the lead surgeon made an incision above Ruthie’s breastbone and began to burrow into her chest cavity.

CHAPTER SEVEN

The Bright Sadness

What the surgeons found that February morning was so frightening that one of them telephoned Dr. Gerald Miletello, a veteran Baton Rouge oncologist, directly from the operating room. The surgeon’s voice was shaky and scared as he described what he had seen in the patient’s lung. It was a large, angry tumor that gripped the superior vena cava, the vein that carries deoxygenated blood from the upper half of the body to the heart. They had tried to cut the tumor out, but found it impossible.

The surgeons were upset. Ruthie should not have had this tumor. She was young. She had never been a smoker. She had no family history of lung cancer. Nothing about this diagnosis made sense.

Still in scrubs, one surgeon gathered Mike, Mam, Paw, and Abby into a small room adjacent to the waiting room. He began to tell them what he had seen inside Ruthie. Everyone was tense and afraid.