Camino Winds (Camino Island #2)(36)
A tourist had been killed there, one of eleven, Leo’s final toll on the island. As Mercer and Thomas drove around, taking in the aftermath, they found it difficult to believe that so many people had died. Camino was a laid-back resort community, a tourist attraction, a wonderful place to live and retire, with little thought ever given to sudden, unexpected death. But then, Tessa had died in a horrible storm less than a mile off the beach.
Bruce wanted her to stop by the store for the reopening and autograph books for the crowd. She and Thomas had lunch in a downtown deli and roamed the streets of Santa Rosa, just like in the old days, before the storm.
4.
Sunday brunch was on the veranda, with Noelle in charge of the details and lively with chatter about her shopping excursions throughout southern France. The morning was overcast but the stifling heat had broken, if only for a day or two. It was the first of September, and only four weeks earlier they had gathered in the same place to toast Mercer and her wonderful new novel, with Nelson still alive and Leo a distant threat.
That crowd was not invited this morning because of the delicate subject at hand. The four of them sat at a round glass table Noelle had found somewhere deep in the Vaucluse, and they ate chocolate waffles and duck sausage while relishing the fact that the bookstore was now open again and life was returning to normal.
Bruce had been adamant that nothing about the novel was to be put in writing. The book report would be an oral one.
Mercer began, “It’s five hundred pages, a hundred and twenty thousand words, dense at times, and I’m not sure if it’s a mystery, a thriller, or science fiction. Not really my cup of tea.”
“More up my alley,” Thomas said as he took over the narrative. It was immediately obvious that he liked the book far more than Mercer did. “Here’s the basic plot. A bad company, privately owned by some bad people, operates a string of low-end nursing homes scattered around the country. Three hundred or so, and not the nicer assisted living places or retirement homes you see advertised. These are the depressing places where you stick your grandparents when you just want them to go away.”
“There are two on the island,” Bruce said.
“And a couple of nice ones as well,” Noelle added. “After all, it is Florida.”
“There are over fifteen thousand nursing homes, rest homes, retirement villages, call them whatever you want, from coast to coast. About a million and a half total beds, and almost all are filled, demand is constant. Many of the patients suffer from various forms of dementia and are out of it, completely. Any experience with advanced dementia?”
“Not yet,” Bruce said as Noelle shook her head.
Thomas continued, “Well, I have an aunt who checked out ten years ago but is still alive, barely, still breathing, shriveled up in a bed with a feeding tube and not a clue about what day it is. She has not uttered a word in five years. We would’ve pulled the plug years ago, but the law does not recognize the right to die. Anyway, my aunt is one of half a million Alzheimer’s patients put away in nursing homes, waiting for the end. The care may not always be good but it’s always expensive. On average, a nursing home charges Medicare between three and four thousand dollars a month per resident. Its actual cost—a few meds, the bed, the nutrients in the tube—is much less, so it’s a profitable business. And a booming one. Six million Americans suffer from Alzheimer’s and the number is increasing rapidly. There is no cure in sight, in spite of billions being spent to find one. In Nelson’s novel, the bad company is expanding in anticipation of future demands.”
“And that’s not fiction,” Mercer said.
“Nelson’s writing about nursing homes?” Bruce asked.
“Hang on,” Thomas said. “As you know, the disease is hideous and degenerative with no way of predicting how fast a patient will wither and die. It’s usually several years. For my aunt, as I said, it’s ten years and counting. But once they completely black out, go unresponsive, and live through a tube, they can still hang on for a long time. At three thousand bucks a month. The nursing home operators have an obvious financial incentive to keep them alive, regardless of how nonresponsive they are. Keep the heart going and the checks roll in. This is an enormous business. Last year Alzheimer’s cost the federal government close to three hundred billion in Medicare and Medicaid payments.”
“Does the novel have a plot?” Bruce asked, tapping his fingers.
“We’re getting there,” Mercer said. “It’s sort of a legal thriller with female characters who leave a lot to be desired.”
“I didn’t write it,” Thomas said with a laugh. “I’m just the messenger. Anyway, the protagonist is a forty-year-old corporate lawyer, male, whose mother is stricken with the disease, and he’s forced to put her in a nursing home where she steadily worsens and is soon out of it. The family is torn and goes through the right-to-die debate and all that.”
“Ad nauseam,” Mercer said. “He really beats it to death, at least in my opinion.”
“Your opinion is of the highbrow literary variety,” Bruce said. “Right now it doesn’t count.”
“All you want to do is sell books.”
“And what’s wrong with that, young lady?”
“Here we go,” Thomas said. “The lawyer’s mother weighs ninety pounds but her heart keeps going. And going. It gets as slow as thirty beats a minute, and the lawyer is monitoring this rather closely, then it begins a slow but unmistakable increase. Thirty-two beats, then thirty-five. When it gets to forty and stays there, the lawyer starts asking questions of the doctors. He’s told such a rise is unusual but not unheard of. His mother is totally unresponsive and that won’t improve, but she won’t die because her heart keeps beating. Month after month her rate fluctuates between forty and fifty and she hangs on.”