Ewing Cook—Merle Lagasse

Ewing Cook—Merle Lagasse describes the relationship between a physician who treated Merle’s emphysema and a patient who adored him. Its defining tension is between Cook’s unvarnished understanding of her illness and the personal warmth Merle brought to their appointments: he told her there was little to be done, but she dressed up to see him, and he greeted her with an affection that could take the form of a macabre joke. The relationship ends as a treating relationship when Cook retires, leaving Merle’s later hospitalization and cancer care to another doctor.

Identity and Course of Care

Cook had treated Merle for emphysema until his recent retirement. His care took place against a chronic and weakening illness: Merle needed oxygen at home and sometimes went out with a portable tank. Although Cook had been her doctor, the account distinguishes that established care from her later treatment after a new diagnosis of lung cancer. A little more than a week before Hurricane Katrina, her new doctor, Roy Culotta, admitted her to Memorial Medical Center after she reacted badly to a pain-medication patch. Cook’s role in the relationship is therefore specific: he was the physician who treated her emphysema, not the doctor managing this final hospital admission.

Their encounters had a recognizable social ritual. Merle would dress for appointments at Cook’s office, arranging her appearance with arched brows, mascara around her eyes, and bright lipstick. The book compares the effect to an Elizabeth Taylor aura. This detail makes the visits more than a sequence of clinical consultations: Merle came to them as someone who cared about how she presented herself, even while living with a disease that had made her weak and dependent on oxygen. Her preparations also show the importance of the relationship from her side; the narrative explicitly says she adored Cook.

Frankness, Affection, and the Joke

Cook did not offer Merle false optimism. He was sober with her from the beginning about the emphysema and the limited options for treating it. The account records this frankness alongside her attachment to him rather than presenting the two as opposites: the physician who acknowledged how little could be done was also the doctor whose appointments Merle approached with care and anticipation.

Cook’s greeting gave that candid relationship a strikingly dark refrain. Smiling broadly, he would say, “Merle,” he’d say, “you’re gonna make a beautiful corpse.” The remark irritated Karen, who heard its blunt reference to her mother’s mortality. Merle, by contrast, heard only “beautiful.” The exchange captures a difference in how mother and daughter received the same words, but it does not erase their shared circumstances: Cook’s joke existed alongside a serious prognosis, and Karen’s objection alongside Merle’s evident affection for him. The book leaves the contrast intact rather than explaining it away.

Oxygen, Weakness, and Unanswered Possibilities

Cook prescribed a home oxygen machine for Merle and she chose the longest cord, allowing her to walk freely through the house while using it. She also sometimes went out with a portable tank. The practical arrangement suggests a limited but meaningful form of mobility: oxygen was necessary, yet the long cord let her move about her home rather than remain tethered to one place. At the same time, Merle was weak, and Karen wondered whether physical therapy might help. That question marks a limit in the account of Cook’s care: it records Karen’s wish for a more proactive approach, not that physical therapy was tried, recommended, or refused.

The later lung-cancer diagnosis changed the medical situation, but it did not turn Cook into the doctor overseeing Merle’s hospital treatment. Her cancer was not the curable kind, and by the time she was admitted to Memorial, her care belonged to Culotta. This transition matters to the relationship’s boundaries. Cook had treated the emphysema and had spoken candidly about its limitations; the evidence does not attribute to him Merle’s later hospital decisions or procedures.

Retirement and the Relationship’s Limit

Cook’s recent retirement provides the point at which his role in Merle’s care recedes. The narrative recalls him through the accumulated details of their relationship—her dressing for visits, his large smile, his frankness, the oxygen prescription, and the joke that divided Karen’s and Merle’s reactions—while the hospital crisis unfolds under another physician’s care. The chronology is consequential: Merle’s worsening illness continued after Cook’s professional relationship with her had ended, but the account does not claim that he remained involved in her treatment.

Taken together, these details present a relationship shaped by both medical limits and personal attachment. Cook could prescribe equipment that helped Merle move through her home, but he had been candid that little could be done about emphysema; Merle could adore him without hearing his dark joke as her daughter did. The relationship’s significance lies in that unresolved combination of blunt prognosis, everyday adaptation, and affection, not in a later intervention by Cook. His retirement closes his role as Merle’s emphysema doctor just as her illness enters a new and more acute phase.