The Device
by Ute Carson
Vacations: The Good, the Bad & the Ugly, edited by Whitney Scott, Outrider Press, Inc., 2006

During the sweltering summer of her 75th birthday the horizon of Florence Delano's world in Elkhart, Indiana began to close in. Up to that point her life had never been jerky but had flowed like a tranquil river with the satisfactions of work, her bountiful flower garden, gratitude from her patients and her only intimate companion, Snowy the cat. Snowy's name was a stretch for a calico cat with white feet and stockings. Florence figured it must have been the large white tip on his fluffy tail that fanned out like a silky paintbrush which earned him his connection to snow.

Florence had known Edward Vicosa since his rotation as a medical student when she had taken him under her wing on visits to hospice patients. He was a doctor with long, twisted fingers which had probed much flesh rarely touched by the sun during his twenty years in practice.

As always, when she entered his office Ed hugged Florence with a gentle intensity that went through her many layers of clothing right to her heart. Then he led her to a chair and took his seat behind his sturdy wooden desk. He looked at her with sensitive, fawn-like eyes.

Florence pulled her sweater tighter and slipped her hands, small but strong and callused from work in the garden, into the openings of her sleeves. She was a tiny woman with matchstick arms and legs who wore sweaters on top of sweaters to make herself bigger. She also strained after the sun.

"It's freezing in here," she smiled at her friend.

"Old age thins your blood,"

"Then I must have always been old."

Florence was comfortable with growing older. She looked at age as a force that was gradually taking away what life had gradually given. She had seen much shrinking, withering and wilting in her patients and she did not fear decline or endings. She knew why Ed had called her in.

"Your heart, Florence. It's your heart."

Florence smiled. But when Ed's frown lines deepened, her smile froze. She took a breath. Surely, it was no surprise to Ed that of all her organs her heart would fail. Hadn't she always led with her heart? She concluded that it was Ed's reluctance to convey bad news which made him somber.

"How serious, Ed?"

"No way to know. Your faithful old pump could give out any day."

"No rest for the wicked. What do you have to offer?"

"The usual. We tried the pacemaker. We tried medication. Nothing new."

Then he leaned back and wrinkled his fine eyebrows into a crooked line.

"We have a new device, the intraventricular cardiac device. It shocks your heart back to life every time it stops."


"Well, that's the benefit and the problem. It can keep you alive for several more months, maybe even years, but it also makes it difficult to die. Your heart will be shocked back into action every time it quits."

Now Ed was on a roll.

"And it's very expensive. Not just the implantation. There can be postoperative complications, not to mention the medical maintenance."

He caught himself. He had gone too far.

"But Medicare covers the cost of the device and the surgery. And of all people, you are entitled to this one!"

When Ed was breathing calmly again, Florence asked,

"How much, Ed?"

"Two hundred fifty thousand dollars."

Florence could feel her heart speeding up as she heard that figure. She was about to say something when Ed added,

"But if you decline the device, you receive a cash payment of $100,000. And, if you of a mind to, you could donate the money."

Again he caught himself. His attempt to advise Florence about her options and this incentive plan backfired. His well-known kindness which was stamped all over his face turned into blood-red embarrassment.

"Maybe the device is just the thing for you," he added hastily.

When this space opened up in their conversation, Florence briefly thought back to their many lighthearted bantering about hearts.

"This one sounds like an old man snoring," they had observed, or "Ms. Miller's heart sputters like a dolphin blowing water."

Once she had feigned disgust when Ed asked her, "Do you know that Louis XIII's embalmed heart was used during the revolution to make paint?"

Then Florence rose slowly.

"I'll call you. Life and death decisions take time."

"Of course, of course."

Ed hugged her again, this time with a mixture of guilt and relief.


Florence landed in Rome, took a bus to the train station and departed for the city of her ancestors whose translated name she bore. Snowy was panting in his cage. Once in their compartment, she took him out, stroked him and then stuffed him inside her outermost sweater. They were both jetlagged and anxious. Florence had made a life-changing decision, leasing her house to another hospice nurse, cashing in her savings and the incentive money for declining the ICD. Before leaving, she had phoned and informed a stunned Dr. Vicosa,

"I am going on vacation. To Italy." She had snickered behind her tiny free hand.

Next to the entrance to the Florence train station, on a tobacco shop window plastered with announcements and want ads she couldn't understand, Florence peeled off the address of a hotel. The taxi driver took them to a wooden building held up by large beams which seemed to have battled against erosion for centuries. The ample bodied lady owner welcomed them both with a wide-armed gesture. Florence paid for three months in advance.

She liked her room immediately. It was so small and crammed with furniture it reminded her of a rabbit hutch overstuffed with hay. The wallpaper was peeling but had a pleasant flower pattern and the forest-green linoleum floor was covered with overlapping faded yellow rugs. Exhausted, she plopped onto the cozy quilted comforter and even under her feather weight the bedsprings immediately began to bounce and squeak.

The window was wide open and car horns blasted from the streets beyond the small courtyard below. She inhaled the sweet fragrance of bougainvillea and wondered if she would find any of her beloved asters and marigolds in the garden. The windowsill was packed with flower boxes sprouting sage, mint and basil. Snowy relieved himself in the soft dirt.

An hour later the moon sent its enchanted beams over a woman and a cat curled up together in peaceful relaxation.

Once Snowy had learned to balance himself along the edges of the flower boxes, climb down a knotty olive tree and venture out of sight for awhile into lush grapevines, a new hope was born in Florence. For the first time she wanted to live for herself alone, without the obligations of work and caring for others. Her health back home had been dwindling, but here she would set out on a journey with full sails. She forgot all about her heart and instead began to explore Florence with the zeal of an adventurer. When she became short of breath, she stopped and took in the ancient atmosphere of mortar and brick and lives past. Soon she discovered that every cobblestone street, every park, every bridge, even the sluggish River Arno which gurgled along under the Ponte Vecchio, seemed somehow familiar. It was as if knowledge of the city circulated in her blood. Both she and the city were old and both had their dents, pockmarks and scratches. She was not interested in Florence's artistic wealth or its architectural treasures. No Stendhal syndrome for her! She never set foot inside the Uffizi gallery but instead ambled through crowded markets where myriads of odors vied for the attention of her nostrils. She inhaled the scent of fresh mangroves and fingered crisp lettuce leaves. She stopped at steaming food stalls and bought her favorite chunks of skewed roasted pork, spiced with rosemary. Then she walked up and down narrow streets and alleyways where the wind played with the debris and tossed paper in the path of her sandals. She inspected name plates on houses, tracing the colorful letters with her fingers. She found several Delanos. She said thanks in many dim-lit churches permeated with incense and spicy candle smoke.

Florence had been on her feet all her life, tending patients, bending over to pull weeds from flowerbeds, and now her feet were like wheels effortlessly carrying her to the remotest parts of the city. She never tired. She listened to Italians talking and suddenly recalled long forgotten phrases from her youth. It amazed her that she soon loved the sound of this foreign tongue more than English.

She believed and rejoiced in gardens and growing things, so she visited a different park each day. Her favorite was the Boboli Garden where a copy of Cosimo's well known dwarf is displayed astride on an unhappy turtle. She immediately liked the plump little fellow, and soon she had put a few pounds on her own fragile bird-bones. She too had a taste for pasta.

As the city revealed itself, Florence herself opened like a garden. She began to shed layers of clothing and within two weeks she was wearing a blouse with only one light sweater over it. She let her untamable mouse-gray hair tumble down her shoulders and, in memory of her maternal grandparents, she bought a large leather handbag. Her grandfather had come to Elkhart as a skilled leather goods merchant. She stored her knitting and her dictionary in the new purse.

Her landlady asked if she would volunteer in a soup kitchen twice a week and she accepted with joy. There she felt useful and learned more Italian. She also made a friend, Camilla. There was nothing special about plump Camilla but she was kind and had green eyes flecked with gold. The two women met in the Boboli Garden with their knitting on warm afternoons and Sunday mornings. So much for Florence's desire to be alone!

Florence had arrived in late summer, and now lived through a damp fall and a chilly winter that had spread a coat of frost on the ground. With the advent of spring Snowy went missing. For an entire week Florence searched in vain and for the first time since her arrival her heart felt heavy. It was as though a sack of sand had been placed on her chest. She realized that it was time to return to America. The months had been exhilarating, full of freedom and new discoveries. She had sent Ed a few joyous postcards but she had never thanked him for giving her such an unexpected choice. She would write him that letter tonight. This vacation was all she could ever have dreamed of.

It was a balmy Sunday morning and church bells were ringing all over the city. There was a lilac and lavender fragrance in the air. She had gone early to the Boboli Garden and upon entering had picked a crimson bougainvillea bloom from the vine cascading over the old stone wall. She inhaled the pungent aroma and was reminded of her first night in her small quarters and Snowy in the window box. Gratitude and nostalgia filled her heart. She sat down on her familiar bench and carefully peeled back the fragile petals hiding the center of the flower. Gently she put her lips to the blossom's heart. The shadow from her face fell over the tiny calyx and tears light as raindrops wetted its crown. Did she miss her little furry companion that much? Or was she homesick?

As she sat remembering Snowy and waiting for Camilla, she noticed a hole in her Italian mohair sweater. It was a large tear, too big to mend. She would need to find a soft patch, matching the colors of the lapis lazuli yarn. She was attached to this pleasing garment which she had bought on one of her first strolls through Florence.

Suddenly she was hot under the caresses of the gentle sun and felt heat rising from her skin. She removed her sweater and undid the top buttons of her blouse. The front of the blouse jumped with each breath. Florence tilted her face skyward like an animal taking a scent, and briefly wondered what might be growing in her Indiana garden. Then she heard steps approaching along the gravel path. Camilla was at her side.

"Are you alright, dear?"

"I'm having the most wonderful time. Is it about to end?"

Camilla patted her arm.

At that moment Florence's heart began to thud like thunder and each beat sent jolts of sharp pain through her body. Her hands fluttered up like nervous birds.

"I need to go back home to America."

"You are home."

Camilla continued to stroke her friend's arm. An angelic smile played around Florence's lips. She stifled a moan followed by a childlike giggle,

"The ICD is not working. I knew it. I must tell Ed."

She had trouble getting the words out. She felt much pressure in her windpipe.

A gust of wind buffeted the crowns of the gnarled olive trees and shook some bougainvillea blossoms off the branches. Suddenly Florence let out a yelp like a puppy and sweat started to trickle down her face like tickling flies. Then she slumped forward as Camilla tried to catch her.

A moment later everything was absolutely still. The spirits of Florence's forefathers and mothers hovered around her on silent wings.

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