West of the Rotunda

I was starting one of my usual working days, seeing patients as a family physician. 

I got a call from the sheriff’s office early in the morning.  I was interrupted from seeing a physical to come out and talk to a deputy on the phone.  He was at the scene of a suicide in the northern part of our county.  We discussed the case.  It was an elderly man who had shot himself in his yard.  He had left a note.  His wife had found him, shot in the neck and head with a shotgun.  The deputy described the scene and the circumstances to me.  The man was suffering from some condition with chronic pain. He had seen his physician in Spokane the day before.  He had been denied his usual pain medication for reasons that were unclear.  This was quite upsetting to the man, according to his wife, and he returned home despondent.  The next morning, he shot himself after leaving the note.  His death was pretty clearly a suicide and the sheriff’s deputies felt comfortable handling the investigation. They didn’t think I needed to come to the scene, and I was thankful.

I spent the rest of the day being a family physician.  Later that afternoon, in a clinic we have in a smaller, rural town, I visited with a young high school student. He described vague abdominal complaints to me.  While I was talking with him it seemed like there may be more to the story.

I found him likable, but he had deficits. He was on a regular seizure medication for epilepsy and his features were a bit dysmorphic. That means, “funny looking”.

I asked him if his parents were with him, and he allowed me to invite his mother into the room.  A prolonged discussion ensued. 

He was not doing well in school. 

He had medical problems, but they were stable.

I could see how he might be labeled by his fellow students as not bright.  He spoke slowly; his speech was sometimes slurred.  However, in my discussions with him he seemed to have insight and be cheerful. 

But he was not doing well in school. 

His mother said he didn’t study or apply himself.  When I asked the student what he would change about school if he could he said, “I wish they’d ask me to do more things.”

“What do you mean by that, more schoolwork, or more activities with your fellow students?”  I asked.

“Both,” he said. “They think I’m dumb but I’m not.”

I looked at his mother.  She looked at her son.  She asked, “What do you do when they ask you to do more?”

“I don’t do it,” he said looking at the floor. I could see this conversation had been done before.

“What does he like to do?”  I asked the mother.

She paused for a moment and the two discussed this. It sounded like he likes to play computer games, listen to music, and play sports.  He really does not like to read or do schoolwork.

The mother has tried to encourage responsible behavior by getting him a job mowing lawns.  But she described continually nagging him to get this done. He doesn’t do it on his own.  The two talked with each other in a warm and open fashion, but it was obvious there had been some conflict, maybe even a lot of conflicts.

I asked the mother if she had tried withdrawing privileges.  She said she had tried but it never really worked.  I asked her how hard she had tried.  She seemed puzzled.  “Have you taken all the things that he likes to do away from him?”

“Well, I’ve tried, but that doesn’t really work,” she replied.

“How long did you do it for?”

“Oh, a day or two, and it works a little bit, but then he slips back into not doing his homework.”

I looked at the mother, and then I looked at the boy.  “What we are talking about here is learning discipline. Do you know what discipline is?”

I looked at the young man. “Discipline isn’t spanking or punishment. It’s what we all need to learn to be happy in this life. It’s the duty we feel and the obligation we fulfill to do the tasks we need to do, when they should be done.”

I turned to the mom. “You’re going to have to do it for longer.  He’s going to have to understand that you mean it.”  As I looked at the boy, he looked at me and actually grinned.  I smiled too.  It seemed like he knew this was coming, and he was somewhat relieved by this discussion.

I outlined the plan to both of them. Everything except the bed, his clothes and a lamp were to be taken out of his room. No extra activities until his grades were at a certain level (C’s-B’s, whatever was an agreed, realistic goal). As he achieved these marks the privileges are reinstated. I warned this usually takes a couple weeks. It will not be without conflict or anger. The two seemed quite comfortable and warm with each other, even loving.

I wasn’t sure if the mother had the fortitude to pursue this.  I had never met this family before. This is what I call, as a physician, shooting from the hip.  You try to get a sense of the family and advise as appropriate.

I had a good sense about the meeting. Maybe even a little elation, like I might have actually helped somebody in the allotted fifteen-minute time slot. But then, who really knows. They go home and I see the next patient.

Later that night I got another call from sheriff’s dispatch. Another suicide. It seems they come in bunches.  This one was in the eastern part of our county; out past that rural clinic I had been in this afternoon. A 16-year-old boy had shot himself. 

Usually, I ask the dispatcher the name, so if I know the person I’m not surprised at the scene. A little preparation helps the mind be clear for observation.  I forgot to ask this time.  Then, as I was driving through the night to the small town, a worry came over me.  A deep sense of dread weighed down that this might be the kid I saw today.  I wondered if I had misread the family and things had gone very wrong.

I drove through the small town where the clinic was. The old brick high school on the hill looked down on me darkly. I didn’t get lost this time on the rural county roads and I approached the location where the dispatch had told me the suicide had occurred.  The deputies’ cars were parked off the rural lane and their lights were circling red and blue in the dark.  I approached Brandon, the deputy in charge of the scene and asked him first thing, “Do you have the name of this kid?”

He scowled and admitted he didn’t. He’d forgotten. He got on the radio to call dispatch to get the name. 

As we waited for the reply he launched in: “Let me tell you the story, Doc,” he said.

Then he turned and started to lead me back into the brush with his flashlight to look at the body.  He’s walking ahead with his flashlight, talking, leading. I follow. “It sounds like the parents weren’t happy with this kid’s school performance.  It sounds like they came down on him pretty hard tonight, and he got pretty upset. They were giving him grief, I guess around dinner, about schoolwork, and saying he couldn’t see his girlfriend anymore. He grabbed a gun and ran out of the house.”

I step over branches and brush, following downhill, listening.

“The way the parents talked he was a hot head and had stormed off like this before, so they didn’t run after him. When he didn’t come back for half an hour his little brother went looking for him.  He found him out here in the brush.  There’s a note by him, and there’s a gun. He’s just back here in the brush down off the bank.”

By now, I’m reeling.  I’m following a bobbing flashlight into the black and enclosing brush. As we step over twigs, and they snap and crunch I tell the deputy he has to stop.  I can’t look at this kid until I know his name. I bend over and put my hands on my knees to steady myself. I say out loud, to the ground and the dark warm air, “If this is the kid I saw this afternoon this family will never forgive me.”  And I wonder if I could either.

There are no blood or guts nor dismemberment, no bloated body to see on this dark brushy hillside, but it’s the closest I’d ever come to throwing up or passing out on a coroner call.

This one might not be all right.

I have come to find that most deaths are forgiven. Homicide, suicide, accident. In some way the sense of it fills in and I can come to peace.

The families do or they don’t, and it wears them down, but peace and forgiveness heal. Maybe not this one for me.

 It’s taking forever for dispatch to come up with the name. I stand up and wait for the name over the radio. Brandon is walking on in the dark, leading the way, unaware of my hesitation. He’s talking away into the radio.

I steady myself and follow.

Down the bank I can see the flashlight beam on the shoes. I’m dizzy and cannot brace myself, but I can see the shoes.

They are not the shoes I looked at on the kid in the office today. 

The name that finally comes through the radio is not the name I heard today. 

It’s not the same kid. So, my guilt is assuaged. And I can now recover the distance. The faint I feel fades.

I climb down the bank to look at the face. It is misshapen now with the top of the skull gone and the bones of the face left with little to hold them up.

The buzzing in my head recedes. I can look at the suicide note to his girlfriend and find myself smirking at the misspellings. Distance lets you smirk.

But it’s still a dead kid. Another dead kid.

I look up at the deputy. I can’t see his face since he holds the flashlight. “Kinda makes you not want to lay down the law on your kids, huh?” I say.

“You got that right Doc. I was riding my daughter about her homework tonight before I came on shift. And soon as I heard this one, I called her on the cell and said, ‘You know honey, it’s OK how you’re doing in school’.”

I thought about the kid this afternoon and his mom.

Was this the horror she thought she was avoiding?  Or did she know she could not forgive herself if this happened.

We cannot prevent the tantrum.

A gun makes a tantrum fatal. And our sense of self can be so confused that we feel responsible for the cause or the cure.

And then there’s the gun.

Cause of death: Rifle shot to the head.

Manner of death: Suicide

Apartments full of sleeping students

Draped with white sheets of snow

Over the old apple orchard knoll

Where he shot himself some years ago.

He sat on an old apple tree stump.

Facing south, there was no sun only cloud.

The revolver shiny a few feet from his hand

Now open to the gray overcast shroud.

The clouded-over eyes no longer looking,

Faced upward. The mouth open, teeth dull,

Blood puddled in brown clots on the mud,

Next to the hole on the right side of his skull.

Assume a student, his life unknown pain

Escaping, he thought, days and nights of misery.

With a brief pull of the easy shiny trigger

Died where we left not one apple tree.

Asphalted over his last bloody bed, the mud where he lay.

Awaits my quiet early tread on this sleepy snowy day.

This is one that I’m sure would’ve had a different ending if it was on a TV show.  Not enough drama in the truth.  They gotta give you a wrapped up bad guy, led away with someone, some detective giving them the Miranda litany.  I’ll bet third graders in this country know, “you have the right to remain silent.  You have the right to an attorney…”  Probably up there with, “I pledge allegiance to the flag…”  And just like the pledge means our day of merciless boredom is about to begin, Miranda means another bad guy is being hauled off and a commercial is coming.  But the beauty of any story is that there can be more than one truth.  But stories like that make it hard to cut to commercial. In other words, this shit doesn’t sell.

So, without commercial breaks…

 I got this call early one weekday morning as I was doing hospital rounds.  It wasn’t even nine o’clock in the morning and my pager gave me the number for Paradise Police Department.  I called and they said I was needed for a death at Garfield and Kenwood.  Fifteen years in this little town and I still don’t know all the streets.  “Where is that?  Is that over by the Junior High or by Safeway?”

The dispatch lady answers a couple radio messages in her code “10 99…  10 36” then replies, “it’s by the fairgrounds.  You can’t miss it with all the fire trucks.”

“There was a fire?”  I remembered all the sirens just a half-hour ago as I walked into the hospital.

“Small one.”  She doesn’t want to tell me too much.  She’s busy.  “It’s out now and one deceased.”

“Do you have a name?”  She gives me a name I don’t recognize, but she’s in our two-year-old computer database. But no office visits, no medication refills so I don’t know anything other than a 74-year-old lady.

Sure enough, I didn’t miss it.  The streets around the fairgrounds were blocked with the massive red pumper trucks.  Our all-volunteer fire department is quite handy and enthusiastic.  They were out in force on this cool spring morning.  It had rained and the streets were wet, no ice, no snow.

I had to park a couple blocks away since everyone parked their second or third cars on the street in this residential neighborhood, and between every second car was a driveway cut.  I walked up in my jacket.

The officer keeping the street blocked recognized me and waved me through.  I rounded the corner and came to the nexus of official vehicles.  The firemen were pulling hose and shouting and bustling.  There were two or three detectives there. Almost like the scenes you see on TV.  Except this was a 1960s ranch home with an unkempt yard, no high-rise or brownstone.  But the resemblance to the drama of TV shows might have explained the pulsing testosterone I could sense from the firefighters.  One recognized me and brought me over to a part of the back lawn where cops were standing. 

A blue tarp had been strung across a line between the garage and a pumper truck.  This was an attempt at privacy for the body I was to view.  Heck even the Chief of Police was there, but he just nodded hello in a professional and sober manner.  He was letting his guys do their job, not needing to steal the show.  I recognized the captain of the city police detectives, and he filled me in as we walked around the hanging blue tarp.

Neighbors had called in the fire about 8 a.m.  The trucks had rolled up to see smoke rolling out of the eaves and the front picture window obscured and black.  They’d gone in through the front door to a living room dense with smoke and junk. 

At this point one of the firemen who had joined us behind the blue tarp started describing the masses of piled up junk. They became an obstacle course in the dense smoke and now shallow flame and heat.  They had knocked down some flame and the picture window had shattered.  He described how he beat down the flareup when the oxygen rushed in.

They felt their way around to find the couch, mostly burned and our body, barely recognizable as such in the smoke.  But once that was confirmed they did their best and brought her out, but she was partially cooked into the position I now was looking at behind the blue tarp.

I imagine she was a difficult carry, since, as she laid on her back on the damp lawn her position was still as if seated.  Her legs bent at the waist and her knees at 90°, cooked into a seated position.  Her clothes, if she’d had any, were now incinerated and her skin was quite a bit also.  There were dark black patches, red raw patches, hair gone, but some areas still fairly normal looking.  Maybe she was slow cooked.  Smoked, or baked, not done yet so the joints were still stiff.

The husband had come back while the crew was here. He was down at the station giving his statement.  But the gist was that he had gone out for his usual 7 a.m. breakfast when McDonald’s opened and had said goodbye to her as she sat on the couch for the first or second of her morning cigarettes.  Nothing unusual reported.  The cops weren’t suspicious.  But it seemed a bit funny, a lady sitting on the couch that caught fire and not getting up, so I agreed that an autopsy might be helpful.  There was no obvious injury on her skull, like he might have cracked her one and then set the fire before heading to McDonald’s for his alibi. But there were enough for questions about the scene that more information from an autopsy would seem prudent. I had become more prudent in these years of doing this. I hadn’t always been so.

So, we might want to break for commercial here for dramatic effect: no definite crime, no real question of right and wrong, everybody kind of just shrugging.  Like I said, I don’t think this would make good TV.

I called the lady’s doctor.  I wanted to see if she had any natural history of diseases that would explain why she’d let herself get burned up:  overdose, suicide, maybe a heart attack or stroke on her third cigarette.  I explained the scene to him over the phone and his first reaction was “Oh!”  like now he understood.

“So, Doc, you think of any reason why she’d die suddenly?”

“No. Not really.  I saw her just a week or two ago.  She had high blood pressure, but I can’t imagine she had a stroke or anything.  But she did drink.  And she took a lot of drugs.”

“Really, what kind?”

“Prescription drugs.  She was always calling for refills.  Let’s see.  She was on Xanax and hydrocodone.  From me at least.  She could’ve been getting more from someone else.”

“She’s not getting any from our office.”

“Well, that’s good. She was beginning to show signs of dementia.  I suspected this from the years of alcohol.  But her husband had commented on how forgetful she seemed. And I suspected that she might be forgetting and taking her medications inappropriately.  And she had started coming into the office in her housecoat, looking pretty ragged.  I just thought she might be drinking more.”

“Did the husband seem odd to you?”

“No, why?”

“Oh, just asking.”

So, I relayed this medical history to the pathologist.  Of course, the toxicology levels took weeks to come back but they were inconclusive.  None were in the toxic or lethal range like she’d overdosed, and her alcohol level was not zero but near that.  Her cause of death that he came up with, since this guy never wanted to be too committal, was “conflagration.”

Maybe he was an English Major.

The way he explained that to me was that there was evidence for smoke inhalation, but also severe burns.  And if you give the smoke inhalation as the cause, then the burns were postmortem, but some microscopic evidence suggested some of the burned injury was premortem or near, so you don’t want to commit to smoke inhalation as the cause…  So much hand waving really just meant he didn’t want to get off the fence and call it one way or the other. Here I had an unhelpful pathologist acting like a radiologist. That’s an inside medical joke that would not bring any TV laughs. And why would a dead body be a reasonable joke?

So, I was left imagining it.  Again, this imagining thing doesn’t do too good for TV.  Fade into fuzzy pictures, maybe black-and-white…  You know.  Anyway, the lady has her third cigarette, forgetful, maybe went back and took another Xanax, forgetting she’d taken the first after she’d peed.  Then she returns to the couch for her fourth or fifth cigarette.  It drops onto the carpet; she falls asleep sitting up.  The smoldering carpet fumes giving off carbon monoxide to further sedate her. They all slowly accumulate, drugs, smoke, CO, and she’s so far gone when the heat finally arrives to her legs, ankles, arms and as her nylon housecoat explodes, she doesn’t move. Maybe this is a merciful ending.

Wah-lah. Is this the answer?

So, I called it an accident. That’s my job, I gotta call it.

I did check with the police, and they were comfortable with that.  I had called the husband on the phone the day after the fire to tell him we were doing an autopsy and he could claim the body at the funeral home the next day.  I had asked him if he’d noticed anything unusual.  When he spoke, I recognized his voice.  I had heard him in the halls of our office when he had come to visit one of my partners.  He had a loud, abrasive voice like you imagine a man telling you to get off his lawn as you are chasing your Frisbee.  “Naw, Doc.  She was her usual self that morning.  I said goodbye like always.  She was there on the couch.”

“So, she wasn’t slurring her words, or she didn’t walk differently like she’d had a stroke or something?  She didn’t complain of a headache?”

“Naw, nothing like that.”

“She hadn’t seemed sick or anything?”

“Naw.”

“OK.  Well, I’ll let you know when we get the results of the autopsy.  It usually takes a good three weeks.  If you haven’t heard from me in a month, give me a call.”

“Sure thing.” His rough voice made me think of a chain saw. Not the big ones loggers use, but one of those small ones your neighbor uses to cut up limbs.

He didn’t seem too distraught, real matter of fact.  So, when I heard his voice in the hall about three weeks later my mind was brought back to this man and his burned-up wife.  I thought of his loss, his wife of 50 years, the drinker, smoking away her hours amid a cluttered living room and he off to get his breakfast with his buddies at McDonald’s.  I wondered about how he felt, his awareness of her growing infirmity, losing her mind, her function.  The coming conflicts of care, home, nursing home, feeding, dressing. Had there been arguments?  Was there conflict?  The receptionist said he was asking for me. 

I came around to greet him and invite him into a room for a private talk.  “Ah naw, Doc.  Don’t want to take up your time.  Sorry to bother you.  I just wondered what you found out and all.”

He wore blue jeans with red suspenders straddling the sides of a big beer belly over a cotton plaid shirt.  His baseball cap had the phrase, “You Want Trouble?”  on the crown.  His face was creased, and he walked with the arthritic roll of an old logger, now relegated to Social Security and tales of the woods, where men were men and the government wasn’t keeping anybody from their work of cutting down trees, building roads.  His eyes were hard and dull, like he wouldn’t mind knocking in the skull of a hippie or an Injun if they came into his bar on a Friday night.

“Did you want to step back here?”  I wanted to talk some more with him, see if there might be more. 

Here the TV show would’ve had the bereaved redneck husband come into an exam room and after a few heartfelt, kind questions from the sympathetic coroner he’d have opened up to how hard it was getting for him taking care of the old lady.  How she just sat and smoked all day and never picked nothing up.  How she wouldn’t even have sex no more Doc.  Hell, he’d look into my eyes, anger, and tears, and he’d demur, it wouldn’t be long before she’d be pissing herself. The conflict of true emotion and an unavoidable honesty resolved with my skillful open-hearted questions. And I’d have the forensic evidence from a state-of-the-art lab that showed he’d slipped her two or three extra Xanax’s, then held the pillow over her face, sat her on the couch and left the fire smoldering as he went out to the morning McDonald’s as his alibi.  But this isn’t TV.  This is life; uncertain, confusing, boring life.

“Naw Doc.  You’re busy.  I guess you didn’t find nothing.”  He turned and walked out.  It could’ve been the only way he could show his grief.  It could’ve been a wily cover. And I was just a county coroner.

            Cause of Death: injuries from a fire

            Manner of Death: accident

I often seek solitude, but it’s always temporary. I lived very isolated for a couple years and I got a clear sense what it was doing to my psyche. So, I jumped back into the world. But I still tend to isolate.

This lady was not like me. Or maybe she was in her way. But I appreciated her fortitude. Some call that stubbornness.

I got the call on a cool fall weekend when I thought I could get something done. Maybe I was painting or finishing sheet rock or tearing out walls. I don’t really remember those details. But it was a sheriff’s dispatch call into the county so I paid as good attention as I could to the directions. I made notes. They were long.

I told Martha I was heading out and went to the old Hilux. The differential had been howling recently, but it would make the twenty miles, I hoped. I got gas as I headed out of town.

It seemed more quiet than usual. Maybe there hadn’t been a football game here this weekend, I didn’t know. The sun was heading southwest, and the golden harvested fields glowed. We’d had frost this morning. Might get cold again tonight.

I hadn’t been out these roads. I knew the main roads, but there’s little sense going out all these little back roads unless you live here, or you get a call.

After the second turn I started to worry I was on the wrong road, but the third turn came as the nice dispatch lady had described and now it was gravel. So, I kept going.

That is my nature, to keep going. That is why, when I felt that danger of solitude and I dove off back into people, it was a significant move. I can keep going, even when I think it’s wrong. Unless, for some reason, I don’t. Driving unknown roads makes we wonder these things.

The road narrowed and climbed. There were occasional driveways off into the trees, but mainly just gravel and cutbanks. I knew this direction was toward the mountain that dominated our prairie.

On the turns one rear tire would slip and spit gravel. Everybody else has four-wheel drive. I just wished Toyota gave me a limited slip differential. I downshifted and kept on, now very unsure. I was entering a bit of a canyon. Not like the red rock of the southwest, but what we have out here on the edges of the Palouse. Steep hillside with timber, absent from the windblown rolling hills. These canyons usually have a stream, while the undulating prairie just has mud.

I pledged to do another two or three twists before I headed back.

But there he was, Detective Earl, my hero. I felt relief to see him here. I don’t always get along with all the sheriff’s staff.

I parked behind his rig as far off the road as I dared, given the drop off.

“So, Earl, what have we got?” I walked up toward his Ford Explorer. The rear hatch was up, and he had his camera gear all exposed.

“I’m not sure Doc. That’s why I wanted you to come all the way out here.”

We stood shoulder to shoulder with our backs to the Explorer, facing the uphill cutbank.

“Do you have a name?”

He exhaled and shook his head. “Yeah, but I’m not sure that’s going to help you much.”

He told me what he knew. She was a 63-year-old lady who seemed to live out here on her own. The neighbor would see her walking into town once a week, then walking back. She seemed to always do this on Wednesday. She’d come back with bags in her hands. They didn’t seem to know where she lived, just that she walked up and down this road on a weekly basis. They didn’t know her name, nothing about her.

But a guy had gone down to the creek down below in the draw this week looking for his dog and come upon her. She’s dead. So, we called you.

And that is the definition of the coroner job. Dead, call the coroner.

“So, Earl, how do you know she’s 63? You got ID?”

“Yes, we looked through her stuff and found her ID.”

“Foul play?”

“I don’t think so.”

“Let’s go look.”

He turned and I followed. He hit a trail off the downhill slope that should have been obvious to anyone walking, looking. But left-hand drive vehicles kept the driver away from this perspective going up, and most folks going up this road would be alone in their rigs, no passenger. Going down, you wouldn’t catch it, watching the curves and road. Within twenty yards of where we dropped off, we were near the creek and coming to an overhang.

She had a decent spot. There was the creek down below, running even now in late fall. And the outcrop of granite sheltered her home. I could see her back there in hollow, curled up under a couple blankets. The charcoal fire pit before her was modest. She kept a neat camp.

“We haven’t moved her. I got all the pictures I need.”

I stood on the rocks and looked at the creek, the slope opposite. There was no elk stag looking back, no cougar poised, no drama. Just the dark hillside under trees.  I panned down and up, taking in her panorama. It was quite beautiful if you are OK with closed in places. I prefer a view of the distance. I walked around some before going to her. I found her latrine, quite neat. She had buried her cans and garbage in a couple spots downstream.

I walked back toward Earl. “So, why’d she die?” I ask the detective. 

He smiles his soft smile. “That’s why I called for you, Doc.”

I hesitated to look at her. I kind of knew what I would find. And just how little that would tell me. I stood by Earl and scanned her abode. Small axe and saw, a shovel leaned against the rock wall. There were a couple long gnarled sticks leaned up there too. Walking sticks, maybe, but too short for that. And I saw a pile of rocks build up to cover over stuff on the upstream side. She was keeping varmints out of her vittles.

“She’s got the tools she needs.” I nod toward the implements. “Those are too short for walking sticks.”

Earl smiled. “My wife uses those to dig camas.”

I nod.

I finally go up to her bedroom, under the overhang. As I do I feel the chill of the downslope breeze curling down mountain. It is still light above, but soon will be dark. How many of these sun downs has she seen?

She is close to desiccating. Her eyes have melted, and flies have laid eggs. But they are all gone now. I pull back the dirty blankets. She lies on her side with hands tucked under her cheek. Her knees are flexed, like the Buddha’s in his death pose. Or like you might for comfort as the cold comes toward you. No signs of struggle, no trauma. Earl takes pictures.

“She just died.” I say.

“Hypothermia, you think?” Earl asks as he snaps shots.

“Can’t call it that. The state codes hypothermia as an accident. I think her death was pretty natural.”

“Can’t get much more natural than this.”

“I’ll ask around. Maybe somebody knows her in the medical community.”

“Autopsy?” They always want an autopsy.

“No. I can call it.”

I found her in the hospital records. She wasn’t in our clinic files. She’d been admitted about a year ago, maybe earlier. The hospital records were very uninformative. Suspicion of pneumonia. She’d collapsed in the rural town and been brought in by ambulance. Recovered in a day. The attending physician had ordered a bath. She had left the next day before he could see her. I gave him a call.

“Oh yes, she was very interesting.” This doc was very thoughtful. I liked the way he would consider things.

“Can you tell me anything about her?”

“Well, she told me she had worked as a technician at the vet school over in Pullman for a while. But she had quit that.”

“Did she tell you where she was living?”

He paused. “You know, she was actually pretty evasive about that. She said she lived by herself out near Troy.”

“Did she mention family?”

“Yeah, she did when I asked.” He kind of chuckled. “She said her family didn’t approve of her. She didn’t talk with them anymore.”

I wished I had gotten to talk with her.

“Did she seem paranoid? Delusional?”

He hesitated. “Not really. I just got the sense she liked to be alone.”

I paused, “Thanks.”

At this point, after all these years calling deaths that I knew would not fit the boxes of the Department of Vital Statistics, I knew I needed to make something up. I wanted to submit the cause of her death as solitude, but I knew that wouldn’t fly. And solitude can restore. But most of us take it in shallow draughts, not swim in it.

I’m getting too metaphysical here, I know. Just do your job. Check the boxes, fill out the forms.

No expensive autopsy would add any insight. Nor any dignity to her life or death. So, I faked it. All alone, all by myself.

Cause of Death: Pneumonia

Manner of Death: Natural