Mistler's Exit

by Louis Begley

Genres: Historical Fiction; Literary Fiction; Sagas

Synopsis

A PEN/Hemingway Award winner, Louis Begley creates multi-faceted characters that come to life under the spell of his crystalline prose. Returning his readers to the wealthy and privileged world of About Schmidt , he introduces them, this time, to an especially poignant protagonist. "A happy man, as the world goes," Thomas Mistler feels an odd sense of liberation now that he has been diagnosed with terminal cancer. This hard-driving Madison Avenue mogul suddenly has an excuse to live for the moment. But spending time alone in Venice is not the free-wheeling, self-indulgent experience he had hoped for. As growing evidence of his physical decline intrudes, Mistler's sense of control diminishes. With one final impulsive purchase, though, he boldly plans his exit on his own terms. Bitingly candid and sometimes funny, this small gem of a novel addresses the complexities of responsibility, pleasure, and suffering. Narrator Paul Hecht renders the subtle, understated, and intimate prose with amazing ease. The last tape contains an interview with the author.

Release date: December 8, 2010

Publisher: Ballantine Books

Print pages: 224

Sample

I understand, said Mistler.
Really, there was no need to rush the conversation. The waiting room was empty. Bill Hurley had become Mistler?s family doctor fifteen years earlier, succeeding to the practice of an uncle, who died on the tennis court of a ruptured aneurism upon double-faulting in the fourth game of the fourth set of his club?s senior doubles championship, when the score was forty?love. By now, he was also a friend. The secretary had specifically asked Mistler to stop by toward the end of the afternoon, when Dr. Hurley would be through with other patients. Just the same, as soon as Mistler arrived, she began to apologize, because the doctor was running late.
Don?t worry, he told her. For once, I don?t mind waiting.
That was the truth. An interval of empty time seemed vastly preferable to what would follow. In fact, if there was a reason to hurry, once Mistler had reluctantly
abandoned a two-year-old issue of Glamour and found himself in Hurley?s office, the place where Hurley interrogated and decreed, the reluctant flesh having been poked and kneaded into yielding its secrets in the adjoining cubicle that housed the examination table and a reliable scale, the only piece of Hurley?s equipment Mistler was fond of, it had to be that the place was so ugly. With its stacks of manila envelopes containing, Mistler supposed, X rays and EKG tapes, apparently untouched since the time of Hurley?s uncle (if indeed either the uncle or the nephew had ever examined their contents, which Mistler was not ready to take for granted), the fake antique desk, small enough to fit in a college dormitory room, cluttered with pharmaceutical company doodads, and, on the walls, prints of ducks alongside diplomas that traced Hurley?s progress from his New Jersey prep school through the last board certification, this room spoke of indifference and small economies. One would not have tolerated such a thing in any other high-priced service business. Did it ever occur to doctors to have discussions that broke the patient?s heart outside the office, over a cup of coffee, or a drink, if they were unwilling to spend money on furniture? One could, after all, with a minimum of skill, maneuver the patient into paying the check, or bury the disbursement in the statement as a stool test or the like. Most lawyers Mistler dealt with would have considered either a lead-pipe cinch.
Apparently, there was nothing further Bill Hurley intended to say without being prompted. It was up to Mistler.
All right. How much time do I have?
For what?
Before I die, of course. What else could I mean?
You could mean before we get to work. As Mel Klein told you, it may be possible to deal with this thing surgically. Right away. It?s a primary cancer. That?s the good news. Then, provided all goes well, you may also have treatment. That will be up to Mel. Ultimately, you would wait for a graft. They do become available.
But he also said that Dr. Steele thought the odds for this sort of operation weren?t good. Have you or Dr. Klein or Dr. Steele changed your minds?
No. The growth is large and it may have spread. Dave Steele can?t be sure until he opens you up.
And if it has spread?
He?ll sew you up and we?ll do our best to keep you comfortable.
In the hospital?
At first. And probably at the end as well. Hurley?s face remained cheerful.
I think I?ll pass. Can you make a guess about how long I have if I do nothing? I?d also like to know how bad it?s going to be.
It all depends on what is really going on inside you. If the problem is still local, but you have no treatment, not even radiation to shrink the growth, perhaps half a year. Perhaps less. Of that time, the next couple of months should be only annoying. No worse than that. You?ll become more tired and more anemic, and you?ll lose weight. Later, you?ll be in the war zone, especially if other organs are colonized. Every day, this will become a stronger possibility. But even without surgery, X rays and chemo could buy you time. You?d want to talk to Mel about that. Of course, if there is already general involvement, all bets are off. These things don?t run on time, like Mussolini?s trains. Heh! Heh! You know that.
But surely you will arrange matters so that I don?t make it into the war zone as you put it. I count on that.
If you mean to suggest that I?ll kill you, I can tell you right now I won?t. I am here to treat patients. Of course, it?s your right to refuse treatment. You will get all the medication you need for pain, but don?t kid yourself. There comes a point at which medication can?t do the job.
Is that any worse than what will happen if I have the operation and the treatment?
There is a chance that the growth hasn?t spread and can be taken out. Then, with treatment and luck, you could lead a normal life?especially if you get a graft. Otherwise, you?re right, the outcome will be much the same.
Except that I will have had the operation and the treatment and everything that comes with it. I think I?ll leave matters as they are. If you could just prescribe whatever you think works best to give me a boost?vitamins, wild ginseng, tonics. I imagine that?s possible.
Hurley scribbled busily. Here, he said, these may do some good and certainly won?t do any harm. Then he gave Mistler the manly but affectionate look he normally reserved for telling him to cut down on red wine and shellfish, if he didn?t want another gout attack, and, of course, on cigars, and continued: You shouldn?t take that sort of decision before you talk it through with Clara and Sam. If you make the effort to fight, and bring them into it, they will find it easier to accept the outcome. It?s extremely hard to watch a husband and father pass away?especially when it might be much sooner than necessary?because he has decided to die without letting his doctors treat him.
But it?s not me making the decision to die this way and at this time?in fact quite a bit sooner than I expected. His Majesty Mistler?s body made that choice. I am only deciding how I will spend the next few months. If I can help it, it won?t be on hospital gurneys attached to machines that make noises like something out of a science fiction film. I don?t believe Clara or Sam would like that either.
You?d be astonished. The whole world loves a fighter, your family included.
I?ve done my share of fighting, Bill. Believe me. Maybe that?s why I am so sure that now is the time to surrender. Unconditionally!
You did promise you would bring Clara in.
Mistler took note of Hurley?s increasing annoyance.
And so I will. Just give me a little time. Let her have a couple of carefree weeks. There is nothing to participate in, after all, not right away.
After that, he managed a nice smile and shook Hurley?s hand.