Jilting Mr. Death

Nick Cariello

So what’s it like, I’m often asked, to be alive more than six years after I’m supposed to have died? Well, one thing’s certain: I’m older by the calendar. But I hope that I’m younger in attitude and outlook. And it’s gratifying to be still walking on planet Earth, knowing my ashes had been scheduled to be scattered in a beloved mountain range near Tucson, Arizona, where I live.

I wouldn’t still be here but for a fortuitous chain of circumstances that meshed to save my life. Call it destiny. Or sweet serendipity. Or just plain luck.

My medical woes began with debilitating chills and fever. The chills would often last as long as an hour, followed by a fever as high as 104 degrees. I was hospitalized three times. Doctors were concerned because of my age (then eighty-two) and were baffled despite many tests.

I had been a combat Marine in World War II and had suffered two attacks of malaria in New Zealand after fighting in the Guadalcanal campaign. The symptoms that I was now suffering were eerily similar. The hospital sent a blood sample to the Centers for Disease Control in Atlanta to see if I was possibly suffering from malaria after all those years. The results were negative.

Finally, the frustrated doctors discovered that I had a bacterial heart infection. It was located on the leads of my pacemaker and on a heart valve. Two highly respected Tucson heart surgeons refused to operate, claiming they had never performed such intricate surgery and knew of no one who could. They said I would probably suffer a stroke or heart attack or even die on the operating table because of the sheer complexity of removing the pacemaker leads buried in my heart.

My son Neal, who is a genetic toxicologist with a major pharmaceutical company, had twice flown in from North Carolina to comfort me and Loraine, my worried wife. Finally the crucial decision was made. With my reluctant permission, I was placed in a home hospice program to grimly await my demise. Outwardly, I tried to remain calm, but inwardly I was devastated. The hospice personnel were most kind. They provided sleeping pills, pain medication, tranquilizers, and, most of all, comfort.

I am not religious. To the contrary, I’m a devout born-again skeptic and wanted to confront this critical situation by myself with the help of only my family. So I told the hospice people that I didn’t want any part-time preacher or full-time minister, priest, or rabbi to come calling. They readily acquiesced.

I grew weaker. Late one afternoon when I was feeling absolutely wretched, I posed a question to the hospice nurse: “What would be my options when my body begins to shut down?”

The pretty nurse, probably in her late twenties, hesitated, looked at me intently, and then said softly, “Well, we can sedate you indefinitely, but you must agree not to eat or drink anything.” I must have been in denial, because those fifteen chilling words, though uttered with utmost kindness, jolted me into the realization that my date with Mr. Death was now very near. I managed to nod to the nurse that I understood. I fell silent and I could hear my weakened heart slowly beating. I thought I saw the nurse’s eyes misting. Emotion was etched on her face, and she soon left after patting my arm in sympathy.

Images began drifting across my mind. They were of the emaciated faces of prisoners at Auschwitz with their haunted, deep-set eyes and ill-fitting, tattered gray clothing dangling from their skeletal frames. I thought, would I look like them when I neared the end? I shook off the unpleasant images as Loraine helped me to bed.

That night a rare rain fell in Tucson. I recalled writer Dorothy Parker’s words: “Oh, let it be a night of lyric rain . . . when my bell is tolled. I have so loved the rain that I would hold last in my ears its friendly dim refrain.”

I also thought of the lyrics from one of my favorite songs, The Rose: “It’s the heart afraid of breaking that never learns to dance/ . . . and the soul afraid of dying that never learns to live.”

I didn’t sleep much that night as I contemplated my mortality. I asked myself with gallows humor: Since I had never died before, how do I approach this rather unpleasant event? How should I handle that final curtain call?

A jumble of bizarre thoughts paraded crazily across my mind, such as “You really get only one chance at dying, and it’s like golf, no mulligans allowed.” I thought about Ernest Hemingway’s contention that it didn’t matter how a man lived but how he died. Should I engage in bravado, I wondered, and be ultra-sophisticated and flippant; should I be regretful and demand to know why life is so unfair, especially to those much younger than I who must face their death?

I mulled over Irish writer Nuala O’Faolain’s words in a novel: “My one and only life has slipped away and I hardly even noticed.”

I heartily agreed and said to myself, “Yes, Nuala, you are so, so right.”

Then I pondered: if, as Shakespeare wrote, “the entire world’s a stage,” then what role do I play now? That of Pagliacci, the tragic clown? Or that of a martyr or a malcontent raging against fate?

I distinctly remember reviewing my philosophical take on life and its aftermath: I don’t believe in gods or goddesses, devils or demons, angels or archangels, hells or heavens, ghosts or goblins, witches or warlocks. And certainly not voodoo, tarot cards, or other such nonsense. Our peculiar universe, I am convinced, is truly indifferent. It doesn’t care if we prosper or perish, are happy or miserable, or are sick or well. The universe just chugs along. It just is.

In my reverie, I suddenly, simply decided to accept whatever came—and the thought had a wonderful calming effect. Like most people, I wasn’t afraid to die as much as I dreaded losing control and any shred of dignity. Later, my daughter-in-law, Adriana, and my grandson, Nickie (then fourteen), flew out to see me for the last time. At one point, Nickie had cried while we were playing whist, and his mother inadvertently hadn’t allowed me to play a certain hand. Nickie, with emotion coating his voice, accused his mother: “This may have been the last hand Grandpa ever could win, and you took it away from him!” I told the weeping boy that I was a born gambler and didn’t want special treatment. Then we embraced and laughed and joked and cried and shared many poignant moments. They departed the next day.

Meanwhile my son, Neal, with dogged determination, collected my voluminous medical records. He and Loraine didn’t let me know what was going on because of the strong possibility of “no hope.” In addition, I was in such a fog that I probably wouldn’t have understood anyway.

After saying what could have been our last goodbye, Neal returned to Durham, North Carolina, where the famed Duke University Medical Center is located. As peculiar luck would have it, a Duke pediatric heart surgeon had recently moved next door to Neal. They discussed my case, and the doctor conferred with his Duke colleagues. Specialists told Neal to bring me in for evaluation because they believed surgery, though extremely dangerous, could save me. So after spending a month in the demoralizing hospice program, I made the flight (although I needed a wheelchair). After consulting with the Duke doctors, I agreed to undergo the perilous operation. Neal and my tearful wife concurred with my decision.

Neal had told Loraine that he would have a difficult time if I didn’t survive, because he felt responsible for starting the process that eventually led to the surgery. The night before the operation, I told Neal that if I didn’t pull through he was not to blame himself, because the choice to risk the surgery was solely mine. He answered with tears flooding his grey eyes, “Dad, intellectually I coul
d handle it, but emotionally it would be difficult.” We embraced. Then Loraine and Neal left. I asked for a sleeping pill, but my sleep that night was fitful and filled with strange, unrelated dreams.

At 5:30 the next morning, a male nurse cheerfully and quickly prepped me for surgery while my wife and son looked on. We embraced one more time, and as I was wheeled away to the operating room I tossed back over my shoulder, “Hey, guys, wish me luck!”

I had had five pacemakers installed over the past twelve years—and six leads remained embedded in my heart. They were all infected. One doctor performed open-heart surgery while another meticulously removed the leads using a newly developed laser technique. Removal of the six leads was a Duke record. I awoke to hear Loraine and Neal saying excitedly, “Hey, they got them all out, they got them all!”

After I left the hospital, we stayed at Neal’s home for five weeks. Loraine, whom I called my own private Florence Nightingale, patiently and skillfully gave me daily intravenous treatments with a potent antibiotic to complete my recovery. She had mastered the technique after being taught by nurses.

Finally we went home. My emotions were churning. It was great to be back and relatively healthy. And the Duke doctors found that I no longer needed a pacemaker. One morning shortly after returning home, I was enjoying coffee on the patio. A two-foot-long, blue and green plastic spinner hangs from the patio roof, and it rotates in the slightest breeze. The spinner became active just as three small yellow butterflies scooted over the back wall. They flew to the spinner and twisted and turned in aerodynamic trickery for about a minute—all without colliding!

I laughed in delight and wondered why those butterflies didn’t crash into each other. Was it “intelligent design”? Or was it because untold generations of butterflies had learned to maneuver tightly after banging their heads together innumerable times?

Ah, I thought, let the theologians and scientists squabble over that difficult question. Then the feeling flooded over me that it’s really a marvelous, magical world, full of wonders and colors and sounds that captivate and dazzle. After my “near-death” experience, I became determined on that glorious morning to really enjoy the brilliance of our red roses against the stark white wall, the lament of the mourning dove, the chatter of the cactus wren, the stunning sunsets, and the luminous moon. And I vowed to enjoy good food, good wine, good books, good movies, great friends, and my exceptional family. And especially butterflies.

Life, I salute you.

Nick Cariello

Nick Cariello worked as a journalist for thirty years. In the past few years he has had six articles published in various war magazines about his combat experiences in World War II, for which he earned a Purple Heart.


So what’s it like, I’m often asked, to be alive more than six years after I’m supposed to have died? Well, one thing’s certain: I’m older by the calendar. But I hope that I’m younger in attitude and outlook. And it’s gratifying to be still walking on planet Earth, knowing my ashes had been scheduled …

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