Love and Death on the Third Floor

On the cystic fibrosis wing of Dallas’ Presbyterian Hospital, an unlikely romance bloomed between two sick patients. The outcome was inevitable.

They first laid eyes on one another in the spring of 1986, when they were both admitted to the cystic fibrosis wing of Dallas’ Presbyterian Hospital. Kimberley Marshall was then sixteen, thin and winter-pale and beautiful, her red hair falling down the back of her pink nightgown patterned with little white hearts. David Crenshaw was eighteen; he wore his usual hand-me-down T-shirt and faded gray pajama pants and oversized glasses that turned dark in the sunlight. David would stand at one end of the hospital hallway, hoping Kim would come out of her room at the other end.

“No way,” the wing’s respiratory therapist, Doug Kellum, would say. “No way she’s going to look twice at you.”

Kim was known among the nurses as the princess. She came from a polished North Dallas family. She loved Tiffany perfume, Lancôme makeup, and clothes from Neiman Marcus. She would sit for hours in her hospital bed, reading romance novels. David, on the other hand, was famous for his bad grammar and coarse jokes. When a female nurse walked past his room, he would lean forward in his bed and shout, “Shake it, baby, don’t break it.” On Saturday nights when he wasn’t in the hospital, he raced midget cars at a local dirt track. “Can you name just one other race car driver in this country with cystic fibrosis?” he proudly asked Kellum. “Let me tell you, there ain’t one.”

“She still isn’t going to talk to you,” Kellum replied.

It was hard enough to imagine a love affair developing between two cystic fibrosis patients, let alone one between Kim and David. A baffling genetic disorder that produces a sticky phlegmlike mucus that clogs the lungs and digestive tracts, CF afflicts at least 30,000 young Americans—1 out of every 2,000 people. Sometimes the disease kills quickly, choking the air out of bewildered little children. Other times it attacks when its victims are in their teens or twenties, causing respiratory infections, pneumonia, dehydration, and gastrointestinal complications. Like a brilliant serial killer, CF is unstoppable: Although an array of pulmonary treatments and medicines now allows patients to live more productive, pain-free lives, few survive into their thirties. As one doctor has said, trying to get rid of the mucus is like sweeping spilled molasses off the floor with a broom.

Nevertheless, Kim Marshall did finally go out on a date with David Crenshaw. Then, six months later, to the shock of their families, friends, and doctors, Kim and David announced their engagement.

“Both of you are sick,” David’s father told him, pleading with his son to reconsider. “You’re sick! You two can’t possibly take care of yourselves.”

“Do you realize what will happen?” Kim’s mother asked her tearfully. “Do you realize that one of you is going to die in the other’s arms?”

Staring down such a death sentence, 21-year-old Kim Marshall wobbled down the aisle of Lovers Lane United Methodist Church in Dallas on October 27, 1990, and declared her love for 23-year-old David Crenshaw—the first known marriage in America between CF patients. To some in attendance, the wedding was a rash, starry-eyed act of youth. “They’ve set themselves up for a tragedy,” a fellow patient told me.

Kim and David, however, insisted that they had a right to be together—“just like normal people,” Kim said not long after the wedding, when I interviewed her for a story about CF. Indeed, three years later, by the time it was all over, everyone had to agree that theirs had been a love story like no other.

On the cystic wing of presbyterian’s third floor, about a dozen teenagers and young adults inhabit private rooms. Just as old people pass the time watching street traffic from the windows of their apartments, the cystics (as they are known) spend hours peering out of their half-opened doors into the hallway. Throughout the day, they receive vast amounts of antibiotics through intravenous injections. Some have thin oxygen tubes running into their noses; others use more-elaborate machines to open their bronchial passages. Respiratory therapists pound lightly on their chests and backs, hoping to dislodge the mucus in their lungs. And always there is the sound of coughing—dry, flinty coughing, spasms of coughing, the sound echoing up and down the corridor like a cold car engine trying to start.

Despite the dreary setting, however, the third floor can feel a little like summer camp, especially for those who have spent months confined mostly to their own homes. It’s the one place, for example, where young patients can experience their first fumbling encounters with romance. “You assume that because CF kids look so weak, they don’t have much of a sex drive,” says Robert Kramer, Dallas’ veteran cystic fibrosis doctor. “Good God, they probably think about it more than regular people. It’s their way of affirming to themselves that they are alive and kicking.” Like characters out of an old Broadway sex farce, a cystic guy and girl, smelling of medicine and IV drips, carrying their portable oxygen bottles, will clumsily sneak into stairwells or empty rooms for make-out sessions—or more. On occasion, two cystics will announce to the rest of the floor that they are dating. “But it’s never real serious dating,” says 22-year-old Kim Cole, a third-floor regular. “I mean, we’d all like to fall in love, but marriage? It just seems so unrealistic.”

When Kim Marshall came to Presbyterian in the mid-eighties, she knew she was fortunate just to be alive. The doctors had been expecting her to die since the day she was born, July 10, 1969, when she took her first breath and immediately began to throw up a black-green mucus. Kim was wheeled into the operating room, where surgeons saved her by removing four feet of her intestine. But Kramer, who was then a young pediatrician—and the first doctor in Dallas to specialize in CF—informed Kim’s mother, Dawn, that it was only a temporary reprieve. At that time, before the advents of more-advanced treatments, 50

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