"What worries me is not when but how," my friend Basil said over the phone. He was speaking of the when and how of his death. He had just been told he had a lung tumor that was malignant and inoperable. Ignoring my shocked "no," he said chemotherapy had already been scheduled to begin later in the week with radiation to follow.
Basil's matter-of-fact tone and the attitude it reflected did not surprise me. They were very much in character for the man who had been my closest friend for the 50-plus years since we were classmates at the University of Pennsylvania Law School in Philadelphia. In recent years, before and after his wife's death, Maryland's Eastern Shore had been his home. During the week he lived in Washington, where he was in private practice and I was a government lawyer. We saw each other at least once a week, usually over lunch.
Two months passed after his call before Basil and I got together in person. In that time, he underwent a course of chemotherapy in an Eastern Shore clinic. We talked on the phone every day or two in conversations that amounted to little more than base-touching as he grew progressively weaker from the chemo. Then a break in his treatment opened the way for a visit. Since I am blind (I lost my sight in Italy during World War II), my wife, Enid, drove me over to Basil's condo in Easton. Then she and Basil's companion, Nancy, went off to lunch, leaving us alone to talk.
After updating me on how he felt -- much better with the suspension of treatment -- Basil brought up his "not-when-but-how" concern. It was, he wanted me to know, based not on the fear of pain and dying but on the loss of dignity and control. Then without waiting for me to comment, he brought up the question of suicide.
Was there any stigma to going that route? he wondered aloud. No, we two nonbelievers quickly and emphatically agreed. What would be the best means? Our consensus was pills, and Basil volunteered he had a supply of the sleeping variety. How many would it take? We weren't sure but felt the 20 or so he had accumulated would be more than enough.
As we continued talking and eating the sandwiches Nancy had left for us, I kept expecting the conversation to turn to -- well, to what? I wasn't sure. Thoughts and feelings I had often had since that first call streamed through my mind -- my affection for him, how much our friendship had meant to me over the years, how I would miss our no-holds-barred conversations. If Basil was experiencing similar thoughts and feelings, he gave no sign of it.
In the face of his silence on the subject I felt utterly incapable of bringing up anything that might suggest approaching death. I was afraid of slamming a door he still wanted kept open despite our facile talk of suicide. Such were my ruminations as I struggled to keep up my end of the conversation until Nancy and Enid returned from lunch.
On our trip back to Washington, Enid said Basil looked surprisingly well. He had lost some weight but was not gaunt. What's more, he did not appear to have lost any of his white hair or mustache.
In the weeks that passed before our next visit, Basil and I again talked on the phone almost every day. Although free of serious pain and nausea from his resumed chemo, he was now suffering from the most enervating fatigue he had ever known. He could barely make it to the bathroom. His voice was so weak I could only pretend to understand him. Yet, once or twice, he came close to sounding optimistic, particularly the day the oncologist said, "That tumor has definitely shrunk since I last measured it." "When" and "how" were never mentioned.
Nor did they come up during our second visit to the Eastern Shore several months later. With another suspension of chemo, Basil's voice sounded firmer and more distinct than it had in weeks, and the debilitating fatigue was gone. Before long, however, the thoughts and feelings of the first visit began to nag at me again. Could I, should I, cut through them this time and say how I felt? To do so, I knew I would have to speak out before Enid and Nancy returned from the local museum they were visiting.
Suddenly, to my surprise, I heard myself blurt out, "Well, I guess real men don't, you know, don't say how they feel about, about . . ." I could not find the right words to go on.
After a long moment of silence, Basil said, "I know what you mean."
The right words never came. Indeed, I was still searching for them when Enid and Nancy returned. Our abortive exchange that day was as close as Basil and I ever came to expressing our feelings for each other.
We had only two or three brief conversations on the phone after that. His voice suddenly grew so weak I could catch only a word or two here and there. I was reduced to simply murmuring reassurances whenever he paused.
Then came the call I had been expecting, dreading. In a composed voice Nancy reported that Basil had died peacefully in the middle of a conversation with her, and she apologized for not calling sooner.
That was almost three years ago. Today, the memory of him is as vivid as ever, often prompting me to address the unseen picture of him hanging in the study where I am writing this.
Some months after Basil's death, I was talking to another old friend, Peter. Remembering that his wife, also a Nancy, had had a long bout with several types of cancer, I told him about my stalemated talks with Basil. "I know exactly what you are saying," he said after I had finished. "Let me tell you what happened with Nancy."
An Episcopal priest, a friend of one of their relatives, came to visit Nancy at a time when the family was divided over whether she should undergo yet another round of chemotherapy. "Well, not long after this guy arrived, he turned to Nancy and said, 'Do you know what's happening to you?' Well, to say I was appalled would be putting it mildly," Peter said. "We had all tiptoed around the subject, just like you did with your friend, and then this character comes out with that. I was still trying to think of what to say, you know, to blunt the question, when she replied matter-of-factly: 'Yes, I know what's happening to me. I'm dying.' "
Peter then went on at some length, describing how the question and Nancy's answer had opened up everything. For the first time in her long illness, they were able to speak frankly about her condition and impending death, about the rewarding marriage they had shared, about their two children, and about his life after she was gone. There was no further talk about chemotherapy, and she died a short time later.
In the following year, I lost two more close friends -- one, Ken, also to an inoperable lung tumor; the other, John, to ALS, Lou Gehrig's disease. I talked regularly by phone with each of them right up to the end.
And, right up to the end, our conversations followed a familiar pattern. Neither Ken nor John spoke of dying and their silence kept me from doing so even as I remembered Peter's experience with Nancy. Did we all dread facing up to the finality of it, I wondered, or were we simply trying to spare each other? Was it better that way? I'm still wondering.