Next of Kin ~ a short drama

CHARACTERS

CHUCK
Patient’s same-sex husband.

AUNT BELLA
Patient’s middle-aged aunt.

RESIDENT
Fourth-year Medical Student, part of the patient’s care team. Female. Very young in comparison to other cast.

SETTING

Hospital room.

TIME

Early evening, during visitor hours.

(A hospital room, during visitor hours. A family is gathered around the unconscious body of Jimmy Catalano. Chuck, Jimmy’s husband, is comforting Aunt Bella.)

AUNT BELLA

Why don’t someone tell us something?! We been here 45 minutes and nobody will tell us nothing. Where is James’ friggin’ doctor? That nurse at the front desk won't tell us a damn thing.

CHUCK

She can’t. Nurses are forbidden from discussing a patient’s prognosis with family members. That’s the doctor’s job.

AUNT BELLA

Then where the crapola is James' doctor?

RESIDENT

Excuse me, may I come in?

AUNT BELLA

(Charging the Resident.)

Where the hell is Doctor LeDoux? We been waiting here one hour. I want James’ doctor to get in here and explain to us what the hell is going on!

RESIDENT 

I’m sorry you’ve been waiting so long. Doctor LeDoux is not available right now. She’s in the O.R. That’s why I’ve come in.

AUNT BELLA

And who the hell are you?

RESIDENT

My name is Veronica Melbourne, I’m a Resident. I’m part of the team that’s taking care of Mister Catalano.

AUNT BELLA

A Resident? We want a real doctor!

RESIDENT

I assure you I am a real doctor. I’m in my last year of Medical School, and residency is the final step in my training. As I said, I’m part of the team who’s been caring for…

AUNT BELLA

This is how Tulane treats families? We find James unconscious, unresponsive, with a tube down his throat. But no! The doctor makes us wait and nobody tells us nothing! Except that orderly. He walked by here, looked in and muttered “Oh, that coma guy”. Holy Mother of God! A coma?!

RESIDENT

I am so sorry that orderly said that. That is grossly inappropriate. I will personally follow-up with the orderly staff to find out who said that and make sure it never happens again.

AUNT BELLA

Appalling.

CHUCK

Is that what’s going on? Is Jimmy in a…a coma? Why is he in a coma?

RESIDENT

Sir, what is your relation to Mister Catalano?

CHUCK 

Jimmy is my husband.

RESIDENT

(beat) 

I have some difficult information to discuss with Jimmy’s…Mister Catalano’s legal next of kin. Does Mister Catalano have a…um, wife?

AUNT BELLA

Do you hear what Charles just said, young woman? He and James are married. Just as married as I was to my dear, departed Alonso.

RESIDENT

I understand that. Unfortunately, the State of Louisiana does not yet recognize same-sex marriage as legal. I mean no offense, but..

AUNT BELLA

We are offended! How would you like if YOUR husband was in a coma…

RESIDENT

I did not say coma. And my hands are tied on this matter. As a medical professional, I do have to work within legal guidelines. Does Mister Catalano have any adult children?

CHUCK 

No. We don’t have kids. Jimmy doesn’t have kids.

RESIDENT

I see. Are his parents alive? Does he have adult siblings?

AUNT BELLA

Charles and me are James’ only family. His parents kicked him out when he was 16 for being Gay. Then they died in a house fire—God have mercy on their souls—in their own bed. Now I am James’ only blood relative.

RESIDENT

Ma’am, your relationship to Mister Catalano?

AUNT BELLA

I am his aunt. James’ mother is my sister. James and Charles are practically my own sons.

RESIDENT

Then that makes you Mister Catalano’s legal next of kin. As I said, I mean no disrespect to you, Mister…??

CHUCK

Caldwell. Chuck…Charles Caldwell.

RESIDENT

(to Aunt Bella) And how may I address you?

AUNT BELLA

Mrs. Isabella Lorraine Alfaro. The boys, they call me Aunt Bella.

RESIDENT

Mrs. Alfaro, hello. Again, my name is Veronica Melbourne. Before we begin our discussion about Mister Catalano’s care, what would you like to happen right now? Should I discuss with you alone, or would you prefer Mister Caldwell to also be present?

AUNT BELLA

Are you retarded in the head? Of course I want Charles present! He is James’ husband! You have the moral responsibility to discuss James’ healthcare with James’ husband!

RESIDENT

Alright. As long we all understand that any decisions regarding Mister Catalano’s care can only be made by his legal next of kin. Please, may we sit down?

CHUCK

Is it that serious?

RESIDENT

What I came to discuss is difficult. Sitting down is a good idea.

AUNT BELLA

Sit here, Charles. No thank you. I will stand.

RESIDENT

Mrs. Alfaro…

AUNT BELLA

Please, include us both.

RESIDENT

Yes of course. Mrs. Alfaro and Mister…??

AUNT BELLA

He said Caldwell!

RESIDENT

Excuse me. I’m so forgetful with names when I feel nervous. Mrs. Alfaro and Mr. Caldwell, please prepare yourself for difficult news.

CHUCK

Is it a coma?

RESIDENT

Before I answer that question, can you explain to me what you understand about Mr. Catalano’s condition?

AUNT BELLA

James came here this morning to Tulane for knee replacement surgery. Now he won’t wake up. Got that tube down his throat.

CHUCK

I dropped Jimmy off myself. Bella and I came back now, together, to check on him. Assumed he would need to rest up a couple days, then we’d take him to our home. But we don’t understand why he won’t wake up.

AUNT BELLA

And that chooch in scrubs looked in and called him “the coma guy”!

RESIDENT

Again, that was inappropriate. Mister Catalano’s surgery did go well. Only a couple hours ago he was alert and speaking.

CHUCK

Is he in a coma now?!

RESIDENT

Not a coma, Sir. Please allow me to continue. I promise I will answer all your questions after I give you complete information. As I said, Mister Catalano was alert and speaking. Then the Charge Nurse informed the medical team that he was complaining of shortness of breath.

CHUCK

Oh my god.

RESIDENT

I was part of the team that rushed into the room to help Mister Catalano. By the time we arrived, he was unconscious and non-responsive. We started CPR and then requested a Code Team.

AUNT BELLA

A what?

RESIDENT

An emergency trauma team. They confirmed that Mister Catalano’s heart was not beating, and they took over the CPR.

CHUCK

His heart stopped beating? Why?

RESIDENT

After knee surgery, it’s common for a deep-vein thrombosis to form.

AUNT BELLA

Missy, you better start speaking English. We have every right to understand this. And we can. If you speak language we understand.

RESIDENT

Of course. I apologize for my word-choice. Let me back up a little. After Mister Catalano’s surgery, a blood clot formed in his leg. The clot broke away from the site of the surgery, and travelled in his blood stream to Mister Catalano’s lungs.

CHUCK

You said his heart stopped beating. He had a heart attack?

RESIDENT

Not exactly. The blood clot blocked the major artery between Mister Catalano’s lungs and his heart. We call that a pulmonary embolism. Because of the blockage, his heart could not receive oxygen, and that’s why he had a cardiac arrest. His heart stopped beating.

CHUCK

But Jimmy doesn’t have heart problems!

RESIDENT

It was the clot, Sir. One possible risk of this kind of surgery is the formation of blood clots.

CHUCK

So why is he unconscious? Why the tube in his throat?

RESIDENT

The Code Team did CPR to get his heart beating again. After numerous attempts, they were finally successful. But although his heart did start again, in the meantime, Mister Catalano’s brain was also deprived of oxygen.

CHUCK

His brain? For how long?

RESIDENT

We don’t know for sure. Long enough that his brain suffered anoxic brain damage.

AUNT BELLA

English!

RESIDENT

Brain damage due to the lack of oxygen. That tube you see is helping Mister Catalano breath. The brain controls breathing. But because of the brain damage, Mister Catalano’s body cannot breath on its own.

CHUCK

People wake up from comas all the time.

RESIDENT

This is not a coma, Sir. The damage is more severe than that.

AUNT BELLA

What do you mean more severe than coma?

RESIDENT

We don’t believe Mister Catalano will wake up.

AUNT BELLA

He’ll wake up. Look, he’s breathing. I see him breathing!

RESIDENT

I’m sorry to tell you this bluntly, Ma’am. But what you see is a machine breathing for him. If we remove the machine, his body won’t breath on its own.

CHUCK

He will die?!

RESIDENT

I’m so sorry.

AUNT BELLA

James chose Tulane! He didn’t have to come here for surgery. He did the research. Tulane is supposed to be the best in Orleans Parish for this kind of knee replacement surgery. How could you let this happen?

RESIDENT

We are investigating right now how this happened. The best we can tell, after surgery, Mister Catalano should have received an anti-coagulant medication to prevent blood clots. He wasn’t.

AUNT BELLA

Wait, what? You were supposed to give Charles medicine to prevent THIS! And you didn’t? This is your fault!

RESIDENT

I’m so sorry.

AUNT BELLA

Sorry?? Sorry won’t feed a mockingbird! Sorry won’t wake up my nephew!

RESIDENT

Of course you’re shocked, angry, and grieving. I don’t claim to understand exactly what you’re feeling. But I am here to help you any way I can.

AUNT BELLA

Help us by waking up my nephew!

CHUCK

Bella, please. It’s not her fault. She’s the bearer of bad news. (to the Resident) You tried to save him. You gave him CPR. Thank you for that.

RESIDENT

I did everything I could, everything I know how to do.

CHUCK

And now Tulane rewards you by making you give us the bad news. You’re a very fine young doctor, Miss Melbourne.

RESIDENT

Oh! Thank you, Mister Caldwell. It’s my duty and my honor to be with your family at a difficult time like this. (beat) There’s more for us to discuss.

AUNT BELLA

God in Heaven! Are you kidding us?

CHUCK

Bella, please. Let her continue.

RESIDENT

Mrs. Alfaro, did Mister Catalano ever discuss what he would want if something like this ever happened?

CHUCK

What do you mean?

RESIDENT

How would Mister Catalano, James, want us to care for him? For example, we can keep him on the ventilator. And if he has another cardiac event, I mean, if his heart stops again, we could resuscitate him.

AUNT BELLA

Of course we want that. We want him to live!

RESIDENT

Is that what James would want? If his quality of life is compromised like this?

AUNT BELLA

My nephew wants to live! Tell her, Charles.

RESIDENT

Even knowing that he probably won’t ever wake up? Or if he did, he would not be the James you know?

CHUCK

I understand what you’re saying. Bella, she means withdrawing care. Withdrawing the breathing tube, letting Jimmy…

(Long beat.)

AUNT BELLA

Well, I want him to live! You said I’m his next of kin. His legal next of kin. You have to do what I say. I want him to stay alive!

CHUCK

Bella!

AUNT BELLA

I'm sorry, Charles! But I can't just do nothing. Let them pull the...I can't stand by and watch James... He's my boy! You're both my boys.

CHUCK

(to the Resident)
We cannot possibly make a decision like that. Not minutes after you just walked in here and dropped a bomb on us.

RESIDENT

Of course not. Mrs. Alfaro, you do not have to make any decisions right now. I’m introducing the topic. Begin to think about what I’ve said.

AUNT BELLA

Don’t ask me! You should ask his husband! Charles! Charles is his husband!

RESIDENT

Morally I agree with you. But you are the legal next of kin. Discuss it together then. Decide as a family the best course of action for Mister Catalano. What he would want. What the two of you together think is best.

CHUCK

Jimmy and I watched that whole Terry Schiavo fiasco in disgust. We never imagined it could happen to us.Never talked about what we would want. We both thought the real tragedy was that family’s grief put on display, held up to public scrutiny. Judged by Fox News and Facebook.

AUNT BELLA

Terry Schiavo! No! No!

RESIDENT

I know this is unthinkable, terrible news. But is there anything I can explain better? Do you have any questions for me right now?

CHUCK

No, not right now. Bella, Dear, any questions?

AUNT BELLA

Isn't there any hope?

RESIDENT

I can assure you he's in no pain.

CHUCK

My God! Oh my God! I don't want Jimmy to be in pain! Bella, I don't want him to feel pain!

AUNT BELLA

(Rushes to comfort Chuck) How can you assure us that?

RESIDENT

The most honest answer I can give you is Mister Catalano does not feel any pain. The part of his brain that experiences pain is not active.

CHUCK

Jimmy!

RESIDENT

Mister Caldwell, we also have medications we can give Jimmy to ensure he does not feel pain. Medication and other forms of palliative care...to ease his transition.

(long beat.)

Perhaps I should give you some time to talk and absorb this. I can come back any time you need me. If you do think of other questions, ask for me by name, Veronica Melbourne.

AUNT BELLA

Thank you, Miss Melbourne. We need time alone now, to talk...to grieve as a family.

RESIDENT

Of course. Again, I’m so sorry, Mrs. Alfaro. Mister Caldwell... (Attempts to touch Chuck's arm, hesitates, then exits)

AUNT BELLA

I don't understand what just happened to our family!

(The dam breaks, and Chuck finally has the break down he has struggled to hold back. Bella embraces and comforts him)

CHUCK

Jimmy is my husband!

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