Max was my “first best friend,” as he likes to say, back when he was Judy. Max was born intersexed, and the doctors performed an immediate sexual assignment surgery after his birth, then told his parents to raise him as a girl. So they did. And that girl, Judy, was my constant companion from kindergarten through junior high. Judy was a wonderful friend. Unlike other girls, she was never catty, cliquish, or cruel. She accepted me unconditionally and we didn’t squabble or compete, like I did with other girls. Her family invited me over every year to decorate their Christmas tree. We had frequent sleepovers. She was creative and brilliant. In first grade, we wrote satirical “newspapers,” skewering our teachers, families, and general issues pertinent to a suburban 6-year-old. She liked Root Beer. She had a T-shirt with the iron-on initials JEB, so I called her Jeb. She introduced me to Mad and Cracked magazines. We memorized the dialogue of “Star Wars,” (the first one, the real one) and would recite it to each other.
When I got back in touch with Max, he told me he had cancer. Vaginal cancer, but he seemed to be in a remission and was working fulltime, raising a family. This didn’t last long. The cancer spread to his lungs, and probably elsewhere in his body, and did not respond to treatment. He is terminal, with a life expectancy at this point of 3 to 4 weeks. I wanted to be among the faces he saw in these final days, so I flew to Atlanta for a weekend visit. I took a cab from the airport to the home of Max’s friends, Jennifer & Dale. They put me up in their third-floor nanny’s quarters and had generously also offered to chauffeur me around. Upon arriving, I learned that Max had been hospitalized that day because of constipation. He hadn’t pooped in nearly 2 weeks and was in significant pain. So the plans were going to change around a little, but I didn’t mind. That first night another of Max’s friends picked me up and drove me to Max’s house so I could meet his family. I visited a little with Tamara, Max’s wife, and met their kids. We ate ice cream and I helped her give baths and read books. Then she packed them in the car and drove me back to my accomodations.
I slept somewhat late the next morning, then showered and went downstairs to deal with the day. I played with the kids for a while, and had a couple cups of coffee. I was in no hurry to get to the hospice, even though this was the stated reason for my visit. I knew it was going to be rough and was procrastinating. Dale offered to drive me to the hospice and pick me up when I was ready, and finally we headed out. On the way, we stopped to get some supplies that Max had requested like “decent coffee” and some Vitamin Water.
The hospice looked like a regular doctor’s office from the outside. It was by the side of a road, not far from a strip mall, just kind of unassumingly sitting there. We buzzed to get in and found Max’s room right away. He looked horrible. Like someone dying of cancer. Gaunt. Gray. Weak. I put down my things and hugged him. He grabbed ahold of me hard and held onto me for a long time. Dale excused himself and left. I pulled up a chair so we could face each other and talk. We had about 15 or 20 minutes of conversation about how he was feeling, his current medical issues, and some other facts like that. I was handling the topics well, albeit clinically, and felt like I was on solid emotional footing. We talked about his parents, his kids, and his plan to come back as a red-tailed hawk.
Intermittently, Max would wince with abdominal pain. His belly looked distended and he told me about his constipation. He also told me that he had a “fistula.” Fistula is kind of a general medical term, but in this case it refers to an opening that had developed between his rectum and his vagina. More like a tear, really, from all the strain. And since Max’s vagina was created in the operating room, it was not meant to withstand much pressure. Consequently, anything that came out of his rectum also came out of his vagina and vice versa. It also meant that enemas were useless to resolve his problem as the fluid just looped back around came out the va-jay-jay. I could see that he also had double nephrostomies, which are tubes that go through his back and right into his kidneys to drain his urine. His insides are so full of cancer that it is choking off the ureters that lead from the kidney to the bladder. The urine backs up into the kidneys then. So they put these tubes in and his urine drains out the back into two little bags.
After talking for a while, Max told me he thought he was going to “get some action,” and would I help him to the bathroom. He cautioned me that he had trouble moving his legs and would need assistance getting out of bed. When he drew back the bedcovers, I could see that his emaciated upper body sat atop distended, bloated hips and elephantine legs. It was as if he was wearing the back end of the horse costume in a cartoon. He had severe edema in both legs, left over from his chemo, and was probably carrying 40 lbs of water in just his lower half. Amazingly, he steadied himself on these pilings, and shuffled to the bathroom. He was wearing a Depends, which I helped pull down, and I seated him on the toilet and left to get him some rubber gloves, as he was going to have to perform a manual disimpaction on himself.
Just after I had my first son, I had some pretty severe constipation and ended up passing out once on the toilet. I was afraid this might happen to Max, so I pulled a chair up to the door of the bathroom, which I kept ajar, then asked him if it would be okay if I sat there to be sure he was safe. He was fine with that. As I read the issue of Mad magazine I had brought, I could hear him grunting, straining, moaning, and ultimately succeeding in moving his bowels. After that first passing, the floodgates were open and he began to have explosive and unrelenting diarrhea. Every time he tried to get up and clean himself, it would strike again. We called for the nurse several times to help him get into the shower and rinse off, but then he would soil himself in the shower as well. So there I was, sitting in the visitor’s chair outside the door, talking to Max while he painfully shit his brains out all over the bathroom. Shit coming out of everywhere. The stench, I might add, was staggering. Occasionally he would ask me to get him something, and I would deliver it to him while he sat on the can: Some water, a tissue, a washcloth, etc. In all the years we were best friends, I had never seen Judy on the toilet. But Max did not hold to these formalities.
After about an hour of this torment, Max was ready to get back to bed. He rose from the toilet, blue-lipped and shivering. I helped him to bed and wrapped him with extra blankets, like I would my child. I lowered his head a little as he said he was dizzy. Then I brought the chair close to the bed and held his hands, which were like ice. He closed his eyes and said to me, “I’m okay with this. Are you okay with this?”
“This is the reason I came to see you,” I answered. “There is no place I would rather be right now.”
“I love you,” Max said.
“I love you, too, buddy. And I always will.”
Then we talked a little about what brought us together as friends. Then Max told me, “I have to go to the bathroom again, but I’m too weak to make it. I’m just going to go in this diaper. I hope you don’t mind.” He did that several times and then fell asleep. I kept holding his hand. He dozed for about 15 minutes, talking unintelligibly in his sleep, then awoke. I went to get the nurse to help him get cleaned up. She got him back into the bathroom, where he endured another bout of this painful, uncontrollable expulsion. Again, I sat outside the door and talked with him while he moaned, bleeted, and sweated through this episode. This time he went into the shower afterward and was able to get back into bed. Once comfortably settled there, he asked for a few items from the store. I made a list and ventured out to the Publix market about ¼-mile down the road. It felt good to be outside in the fresh Georgia air, not breathing in the stench of old shit, but I was still bracing myself, kind of talking myself through it. Once I had the Chap-stick, Gatorade, ginger ale, toothbrush and toothpaste in hand, I walked back to the hospice. This time, Max’s door was shut. When I opened it, I saw two nurses at the bedside with Max rolled on his side. By the smell it was obvious that he had soiled himself and the sheets. They asked me to wait outside, so I went to the TV room and watched American Idol Rewind.
About 20 minutes later, the nurse let me know they were done. Once again, Max was all tucked in, but totally exhausted. By now I realized he really wanted to sleep, but was trying to stay awake for my benefit. I held his hand again and let him know it was okay to close his eyes. I eased his head back onto the pillow, and he began to breath rhythmically. Thinking he was asleep, I began to cry. Tears of pure grief. I felt his other hand gently pat my head, and his whispered voice saying, “it’s okay. I love you.”
I told him, “I wish I could say something deep right now that would really help, but I can’t think of anything.”
“Just love,” he said.
“I will always love you and always remember you,” I blubbered. “Whatever happens, Max, I hope it doesn’t hurt.”
Again we sat in silence, holding hands, and Max dozed off again. He talked in his sleep, but nothing I could understand. Except for one clear and distinct, “Wow!” I decided it was probably time for me to get going, so I phoned my hosts and Dale started out to pick me up. We agreed that he would call me when he was outside so I could say my good-byes in private. For that last 15 minutes, Max and I talked about our friendship, how we never had a fight, why we grew apart, and how pleased we were to have found each other again. I told him I would think of him always. Part of me couldn’t wait for the phone to vibrate in my pocket, letting me know my liberators had arrived. Another part of me dreaded the thought of walking out the door. When the time came to do it, I hugged Max one last time, told him I love him, and forced myself to walk away.
As soon as I hit the fresh evening air, tears came. I buried my face in my hands, walking toward Dale and his red mini-van. Next thing I knew, he scooped me up into a big bear hug and let me weap and sob all over him. I barely know this person, having spent an hour or two chatting with him for the first time that morning, and now I am dissolving into a vulnerable heap right before his eyes. But he handled it, and I thank him for that. It takes a unique person to surf that kind of emotional tsunami, especially from a stranger.
I’m kind of exhausted just from typing all this out. Not sure I have a point, exactly. I just needed to purge it. If you’re still with me, thanks for reading it.
