January 2004

Once again, I was left to pick up the pieces. Because she was dead, however, this time it seemed different—more final. Since our divorce nine months before in March 2003, my young daughter Emily and I had progressively seen less and less of her, she being rarely sober. I had never stopped loving her, but ultimately found the disease too much to bear. I was functionally a single parent anyway, left to arrange nanny after nanny, while trying to hold down an exhaustive job as a cardiologist, complete with night and weekend call, and working sixty to eighty hours a week.
A few years before the final call came, Emily and I were visiting during Tina’s latest episode of gastrointestinal bleeding, due to a cirrhotic liver and continued drinking. She was in DT’s and didn’t even know we were there. Emily sat on my lap outside her mother’s door in the intensive care unit at Palms of Pasadena Hospital, a small 307 bed hospital in St. Petersburg, Florida; both of us staring at the yellow heartbeats racing across the dark screen. She was petite for ten years old, but full of energy and her long red curls caught all of the nurses’ attention, as she bounced on my lap, fidgeting with strands of thin paper used to record patients’ heart beats. Emily’s mood became somber.
“I wish she would just die already,” she said to me with little emotion or expression. We were both exhausted from this routine.
“I know that’s how you feel sweetie, but that is up to God and your mom,” I said, tempted to agree with her.
When Tina’s end finally came, I was at another small hospital, St. Petersburg General, in the intensive care unit, seated at a nursing station, reviewing a patient’s chart. The patient was a ninety-year-old woman who had had a heart attack and was probably not going to survive. Although she had a living will, the family was having a hard time letting the matriarch die and was torn about how much more they should do to keep her alive. My mobile phone rang, and I saw Tina’s condo phone number flash on the caller ID. Momentarily frozen, I was unable to respond. She had stopped calling me weeks ago, and I had a premonition of terrible news. As a nurse stared, expecting me to answer it, I finally hit the connect button. My mouth dry, I stared at the dull grey tiled floor before I spoke.
“Hello.”
“Tina’s dead,” her mother, Helen told me, in between sobs.
“How? When?” My stomach tightened and I started to bite my cuticles, a habit which afflicted me when I had to deal with unpleasant tasks.
“Sue came over to visit her and found her dead on the couch.”
I didn’t ask for any more details, as her exact mode of death seemed unimportant to me at the time.
“The paramedics need the name of her doctor and…” Helen’s voice faltered.
“I’ll be right there. Tell them not to leave.”
Quickly hitting the end button, I immediately called my office, explaining what had happened, and saying I could not finish work that day. Rising out of my chair, the same nurse approached me.
“Are you okay, Dr. Mokotoff?” I must have looked pale.
“Yes. I’ll be fine. Thanks,” I uttered, not wanting to go into any particulars. Even though the news was not unexpected, I felt stunned and saddened. I wasn’t ready to share the news with my colleagues.
Driving the short seven-miles to her condo, my window down and A/C off, the cool January Florida air streamed in as I squinted out at a mix of high cirrus clouds and angled sunlight. January is one of the coolest months in West Central Florida. Most tourists envision eighty-degree weather and warm water, but the highs for this month are rarely above seventy, and the Gulf of Mexico water temperature often hovers around an uninviting sixty degrees. My only thought was how Emily would take the news. I remembered very little else, and upon arriving at the condo, I saw the EMS truck and local police cars were outside. Two of her sisters, Sue and Janey, were holding each other weeping. After giving them both hugs, I noticed a scruffy looking thin figure in the background of the growing crowd.
“Who’s he?” I asked
“Billy Barber. You know, her old boyfriend,” Sue said subdued.
Wearing a long, worn black leather duster, boots, an open shirt, one-day-old beard, and long unkempt graying hair, he reminded me of the homeless men who held up signs begging for cash on the local street corners. Approaching, I did not reach out my hand. He smelled of cigarettes and stale beer, and had coke circles around his nose.
“I’m her ex-husband. What happened?”
Head partly bent, and with little eye contact, he hesitated a bit, then said, “She got sick last night and started to throw up blood. I asked her if she wanted to go to the hospital and she said no. I helped her to the bathroom, and then made her comfortable on the couch.”
He stopped, made eye contact briefly, to see if I would judge his story believable.
“And then?”
“Then I left to go to the beach. I came back this morning and found her.”
I knew he was lying.
The stench of death hit me as I entered the golf–fairway condo. Being a physician, I had long ago grown accustomed to it. However, the sight and smell of stale blood and vomitus was omnipresent. January 8, 2004. I remember every detail in the room like it was yesterday. Her mother, Helen, standing off to the right in the kitchen sobbing, and two EMS technicians, in yellow jumpsuits, were taking notes on clipboards, and trying to look sympathetic. Specks of dust danced in the filtered late day winter sun, illuminating the living room where my ex-wife lay motionless on an overstuffed couch, a fine rivulet of dark blood hanging down one corner of her mouth. She was bloated, clothed in a stylish sweater and skirt and leather boots, and I could neither move towards or away from her.
“This is your ex-wife, Tina Mokotoff, is that correct sir?” One of the paramedics asked.
“Sir?”
“I’m sorry,” I said. “Yes.”
“Are you her doctor?”
“No.”