Chapter 1: Living with Lead May 30, 2019 I awoke to the sound of muffled coughing and the smell of bile and feces permeating my room. As I lay in the early morning darkness, half-asleep, I listened to the quiet murmurings of a nurse telling the patient at the far end of the room that it would be an hour or more before fresh bedding could be arranged. The window shade to the left of my bed was open, revealing the lights of a city still asleep. Through the darkness and curtains that separated us, I could hear the soft voice of a wife quietly attempting to calm and console her husband. I lay in a four-man room with three other veterans in the Veterans Affairs Medical Center in La Jolla, California. The day before, I''d had surgery for a total hip replacement, one of almost a dozen surgeries I have received as a result of a very active military career. I was recovering in a room, staying overnight, and would be discharged later that morning. Dozing in and out, I listened as the hospital slowly came alive.

Later, my surgical team stopped by to check on my progress. They informed me that I would be going home as soon as the discharge paperwork was processed. This was not so for the older veteran next to me on the other side of the curtain. He was dying. Disturbed, I listened curiously as hospital staff told him that they were discharging him. He replied that he "lived alone" and had "no one to care for him." They persisted, providing options for twenty-four-hour care and in-home hospice services. I asked myself, "Aren''t they listening? He wants to stay.

He doesn''t want to go home to an empty house, alone, to await the end." After breakfast, I overheard conversations identifying my other two roommates, who were dying as well. Two beds down, one of the veterans and a chaplain were discussing the end. In a one-sided conversation, the chaplain was telling the vet how to come to peace with and prepare for his death. At the far end of the room, I listened as a doctor apologized to the other man in the room and his wife, the ones who had awoken me before dawn. The doctor told him he was sorry, but he wasn''t on the medical team that had been working with him before. "Instead," he told the patient and his wife, "I''m here now and can work with you on how to proceed in the coming months." I listened as he continued, "You need to concentrate on how to proceed now, instead of focusing on why you weren''t diagnosed earlier.

" I learned the patient was a retired Navy captain. He and his wife were attempting to cope with the fact that the VA had failed to identify and treat his cancer earlier. The doctor told him, "By the time we caught it, the cancer had spread to a point that treatment will have little effect," and explained, "I''ve had other similar cases where people have lived for up to four months, or not." "God," I thought, "I can''t wait to get the hell out of this room and away from this hospital." Later, as my wife wheeled me out after lunch, I recognized the retired Navy captain as an officer I''