From Audrey Hepburn, An Elegant Spirit Audrey had been complaining of stomach pains since her return from Somalia.
Her Victorian upbringing prevented her from telling my brother Luca and me, but Robby was aware of it, and they went to see a few specialists in Switzerland. The results were inconclusive, and so she decided, since she was coming to Los Angeles in October 1992, that she would look into it further at that time….
The doctors in Los Angeles put her through another battery of tests and finally, yet again coming up with the same inconclusive results, they advised that an investigative laparoscopy was in order. We checked her into Cedars Sinair, and the surgery was performed on November 1, 1992. After two hours, the surgeon came out to the waiting room and told us that they had found abdominal (or “abominable,” as she would later say, making light of it) cancer that had spread from the appendix.
No one had been able to detect it because the appendix cannot be reached endoscopically; its angle is too sharp, and you cannot see what is just around the corner. This useless little appendage we still know so little about was killing her. Is the appendix where our perfect body stores all the tiny things that cannot be digested, or is it a place for the soul to collect all the hurts that it cannot digest?
The cancer had grown slowly, maybe for as long as five years. It had not mass, yet it has metastasized as a thin veil, encasing her intestines. We were told that treatment was appropriate and in some cases could lead to remission.
The pain she felt was caused by strangulation of the ileum, the small intestine, which was causing it to spasm as the passage of nutrients became more and more difficult. They removed about a foot of intestine and sewed her up.
Nothing made sense. But we pulled it together and went into the recovery room. As we told her the news, she paused and then quietly said that she knew all along it had to be something more serious than a bug she might have caught in Somalia, for which she had endured a treatment of Flageol, one of the most powerful and destructive antibiotics available. She made me promise never to let anyone ever talk me into taking it.
After having helped to feed millions of children, there she was: unable to eat, herself. To allow time for her to heal, they had to put her on TPN (total parenteral nutrition), a yellowish liquid that provides basic sustenance and is fed to you intravenously so that your digestive system can heal.
She had described to us the basic corn and rice flour meal that UNICEF provides the millions starving in those camps. We had also seen photos of the children in Africa who, on the verge of death, are put on an IV drip because of severe dehydration.
She was now one of them.
We had to wait for the scar to heal before she could receive her first treatment of chemo. We, the family, would take turns during the day; I would usually visit her in the morning and then go to my office under the pretext of work that needed catching up. There I would spend hours reading, researching, and calling every cancer center for the latest treatment or information available. Unfortunately, I was soon faced with the intolerable reality that the only treatment was a particular chemotherapy – 5FU Lucovoril – which had been used since the 1960s. Suddenly the 1960s felt like the middle ages.
After a week we brought her “home” – the home of her best friend Connie Wald, where she would stay whenever she came to Los Angeles….
The day came for the first treatment, and it all went well: no side effects. She was to have her next one in a week, but it wasn’t to be. A few days later she had another occlusion. It caused a pain so severe that the postsurgical pain medication she was receiving had become insufficient. We’d had but a few days of hope, careful walks by the pool and nights of watching television, all of sitting on the floor around her bed, watching comedies, like the British series Fawlty Towers and nature shows on the Discovery Channel. She spoke of how much she enjoyed them. They reassured her that the miracle of nature was still well and alive and that life, with its beautiful simplicity, would continue no matter what.
The doctors wanted her back in surgery ASAP.
December 1, 1992 was the hardest day of my life. We were preparing to take her back to the hospital, and as everyone rushed around, carrying out their respective duties, we had a moment alone in her bedroom. I was helping her to get dressed when it all rushed to the surface and flooded her. She turned around and, with tears in her eyes, hugged me desperately and sobbed once or twice. As I held her tight, she whispered, “Oh, Seanie, I’m so scared.” I stood there, holding her with all my might, as I felt huge chunks of me falling inside.
I reassured her that it was going to be all right, promised that we were going to see this through together; that I would tell her if I thought that things got desperate … to take courage, because we weren’t there yet. This is the only time my mother ever let me see how truly scared she was. As a young boy I had spent hours with her discussing the nature of relationships, of love and life. We were truly friends. We both knew when something was wrong with the other. We were blessed with a spiritual umbilical cord. They say that at some point in our lives we become the parent to our own parents. I had always envisioned it as parents becoming too old and senile to take care of themselves. This was not the case….
And so we again waited on that afternoon of December 1, 1992. This time the surgeon called us in to the prep room adjacent to surgery. It hadn’t even been an hour. He said that disease had developed exponentially. There was nothing he could do. He had to sew her back up. It was going to go rather quickly now. The words were melting in his mouth, the walls went soft, everything slowed down. Robby uttered, “Such a valuable human being.”
I could taste a dry loneliness creeping in my throat. She was probably waking up by now. I took a deep breath and went into the recovery room. She looked peaceful. It was over. She was never afraid to die; she just didn’t want to be in pain unnecessarily. We had made a pact early on. I would always make sure that the pain would be controlled. I sat on the bed. She looked up and smiled and told me that some crazy lady had come and woken her up to know if she wanted to vote. Bill Clinton was winning. I remembered that only a few hours ago – or was it a few days? – I had worried about whether he was going to make it or not. She told the lady that she wasn’t an American and therefore couldn’t vote. A teaching doctor and his class had dropped by as well, and she had woken up again to a room full of youngsters ogling at her incision.
Hospitals have truly become a place of mayhem and confusion. I felt the blood pumping in my throat. But this wasn’t the time for anger.
So I told her; I told her what the doctor had told us, that it was all to irritated to operate. She looked away and calmly said, “How disappointing.” That was it. I held her hand, and felt as powerless as I’ve ever felt in my life.
In a way, that was the day my mother died. And we both sat calmly in that room, holding hands and considered it in silence.
Maybe this is the best thing that modern medicine has to offer: early diagnosis. It gives us a chance to live out fully our borrowed time, instead of having to deal with the shock and grief of a loved one’s disappearance, all the while regretting not having connected, not having had a chance to say “Thank you” or “You were everything to me.”
This was the lowest point of all for all of us. The two months that followed were hard yet beautiful. We weren’t waiting anymore. We were free of doubt, of anguish, of that crushing sense of powerlessness. All we did was love each other, truly live as if tomorrow was going to be our last.
Ferrer, Sean Hepburn. Audrey Hepburn, An Elegant Spirit. New York: Atria Books, 2003.