One well-known book suggests that first you cry, but I didn’t. After I hung up the phone, I walked to our apartment window and looked down at the street. The vendors were out: the Korean fruit stand couple, the African sellers of purses and sunglasses, the proprietor of the umbrella-shaded Halel stand where smoke escapes in steamy wisps. A row of yellow cabs was lined up outside the Warwick Hotel, and when a man jogged past wearing a red jersey, it occurred to me that I should open the window and shout to him-about his red jersey, maybe, or about where he thought he was going. My ears felt hot. I heard a high-pitched buzzing. A mosquito? It was mid-March, and besides, I was five floors above the ground-ground that, I now realized, was spinning. My father once told me that the best thing to do when the room starts spinning is to sit still for a moment.
Just a few minutes before the doctor’s call, I had been on a three-mile run in Central Park, carrying in my head some lines for a poem about kangaroos I had begun a week before, shortly after returning from the Routine Procedure, as I would continue to refer to it over the next few months. If you are anywhere near my age, you are familiar with the Routine Procedure, that unpleasant, potentially demeaning event every conscientious internist urges you toward as you approach your fiftieth birthday.
The gastroenterologist, who came highly recommended, was a handsome, walnut-colored man with a deep, soothing baritone voice. My husband accompanied me as I had accompanied him a few years earlier for his Routine Procedure, because as the pamphlets advise, you may be drowsy afterwards and should not plan to drive yourself home or, in my case, to flag down a cab. Having had bad reactions to anesthesia in the past, I reminded myself that this was only mild sedation—Sublimaze or Valium, maybe. Just something to relax me. Maybe it wouldn’t make me sick.
The walls of the examination room were pale blue, the gowns were blue, and the nurse’s eyes above the paper mask were blue. Tranquil, watery blue. The better to take me under, I thought. I attempted a few groaners to break the tension only I seemed to be feeling. “What you see is what I got.” “I’m tired of being the butt of your jokes.” And finally, as the nurse positioned me onto my side and parted the flaps of the gown, “This isn’t my best feature.” She started the IV, and still I yammered on, assuring the doctor that I was clean as a whistle, thanks to the gallon jug of purgative he had prescribed, but that I wasn’t fond of the cherry flavor, and had he considered patenting a Scotch or bourbon concoction, it could make him a wealthy man. His eyes behind the mask seemed to smile. Then I got sleepy. I hope I said nothing stupid. I hope I didn’t drool.
When I surfaced Donald was waiting for me in an anteroom, where I stumbled into my clothes, feeling mildly but not unpleasantly drunk. There was a knock on the door, and the doctor entered. He wasn’t carrying a clipboard, which I took as a good sign. He looked first at me, then at Donald. “May I speak freely?” he asked, and I immediately thought, no you may not, and squeezed Donald’s hand.
“Certainly,” I answered.
The doctor looked down at his hands then back up to us. Why was he stalling? Get on with it already.
“We found something,” he said, then went on to explain that there was no reason to think the worst but that I should call his office the following Monday for biopsy results. Which is what I’d been planning to do when I got back from jogging that morning, the phone ringing, ringing.
“Ms. McClanahan?” The smooth, modulated baritone sounded familiar, but I couldn’t place it, and when I did my first thought was how nice of him—most doctors don’t call personally.
“I have the results of the biopsy.”
I looked around the room, my eyes darting from one object to another, resting on the wind chime my sister-in-law had given us years ago.
“Ms. McClanahan, are you there?”
Actually, it is more than a wind chime. It is a musical instrument. Perfectly calibrated, perfectly tuned. Nine double strands of chimes. The slightest touch can set it to singing.
“I’m afraid I have some not-so-good news.”
Beside the wind chime is a small, gold-faced clock and two black-and-white photographs. One shows Donald’s thickly tressed mother, now a decade dead from cancer, kissing her toddler son. The other is World War II vintage, my parents in profile, locked—there is no other word for their passion—in a kiss. The force of the kiss seems to suggest first, but it might also be interpreted as last. That’s how it is with images frozen in motion, in time. Impossible to know what came just before the flash and what came after.
“when i have fears that i may cease to be . . . ”
Denial is a highly developed survival skill that has gotten a bad rap lately, and one of the best ways to deny denial is to plunge headfirst into the experience. Start by making a list. The longer the better. More items to check off.
Locate a surgeon, check. Get precertification, check. Buy new socks—colorful ones with funny pictures on them—to keep your feet warm in the hospital. Go online to research survival rates. Contact the sponsors of the readings and workshops you must postpone. Don’t forget students, who will be wondering why you are canceling all those classes. To simplify things, compose a group e-mail.
“How brave you are,” one friend types back. “To face it head-on like this.”
“If I ever get cancer,” a student asks, “may I take lessons from you?”
“Of course,” I type back, feeling lighter with each key stroke.
Within a few days I regret the group e-mail. At the time, I thought I was being selective, but later I realized I should have told only those I know so intimately that I could have predicted their reactions. Had I done that, I would not have been ambushed by responses that, though well-intentioned, were not helpful: the colleague who knows three or four people who have had this surgery, and they’re doing perfectly fine, so not to worry, this is no big deal. The friend who suggests that I plan a memorial service for the section of the colon the surgeon will remove, since it has served me so well all these years. The student who asks if she can phone me and pray aloud to God while I am on the line.
It humbles me to confess that I seriously considered the student’s offer. Her e-mail arrived on a bleak morning when I had tried several times to pray on my own. My own folded knees, folded hands, my own thin, faltering voice. “Dear God,” I had begun, “dear God, dear Father, oh Jesus, oh shit I am so afraid, mother of God, brother of God, sister, is anyone there?”
Only the frightened pray for courage or feel the need to display it. My father, the bravest man I know, cries easily. Is anyone more sentimental than an ex-marine fighter pilot? All those wars and rumors of wars, all the decades of holding it in, holding it back. Now he cannot phone without crying. He is sorry I have to go through this. If there’s anything he can do. Anything at all. “This isn’t helpful,” I tease when his voice begins to break. “Put Mom back on the line.”
My father recovers himself for a moment, and wishing to lighten the air, I decide to tell him about yesterday’s appointment with the surgeon. I don’t tell him my fears about the surgery—how long I will be under, what I pray they will not find. I don’t tell him about all the papers I signed—there in the surgeon’s office and later at the attorney’s—giving myself over to the anesthesiologists, the surgeon, and, if things do not go as planned, to Donald, my designated attorney-in-fact who will execute my wishes.
“So I said to the surgeon, ‘You’re saying I’m going to have a semicolon?’ ” My father groans but I keep on. “And when he told me I might have to wear a colostomy bag I told him I hope not because it’s so hard to find shoes to match.”
My father gasps as if I have told an off-color joke, and maybe I have. Maybe this time I have gone too far. He probably thinks my comments show disrespect-to myself, my disease, to hospitals and surgeons. He has always shown respect for the institutions of healing. Twenty years past heart valve surgery, he wears his scar with pride. I sense, in my father, a reverence for the memory of what he calls his hospital stay. I don’t like calling them stays. The same way I don’t like calling airports terminals. I don’t want to terminate at an airport, and I don’t want to stay in a hospital. We should call them visits.
Terrifying as my father’s stay was, he seems reluctant to let it die. He even saved the socks the hospital issued him, the kind with the nonskid patches. He wears them in the morning while he works the crossword puzzle. And once a year he stands in front of a premed class and removes his shirt while the students take notes. Maybe I wouldn’t be making jokes if it was my heart that was in trouble.
Hearts inspire respect. Diseases of the bowel (or the colon, intestine, gut-name it what you will) do not. I have read Illness as Metaphor, so I realize my logic is wrong headed. Intellectually, I agree with Sontag that “the healthiest way of being ill is one purified of metaphoric thinking.” Still, I can’t shake the notion that some diseases are more dignified than others. So I am trying to think of something beautiful to make from this experience. A poem, a song, something to lift me up. But just try to find a good rhyme for bowels.
“Anything you want,” Donald says. “Anything.” With major surgery looming in two weeks, a wiser woman might have lobbied for a post-recovery Caribbean cruise or massage coupons or at least a new silk robe. Donald gets off easy: a walk to the bookstore, where I steer him toward the reference section, and sure enough, there it is. A beautiful, affordable, leather-bound copy of Gray’s Anatomy with gilt-edged pages and a satin ribbon secured to its spine. Though the book is only a reproduction, I like the way it feels in my hands. Heavy, substantial. I like the weight of history in its pages, suggesting that perhaps the body is not a complete mystery. There are those who have studied it, taken it apart, put it back together. Some of them belonged to the Royal College of Surgeons of England; why does this cheer me so? Also comforting are the black-and-white line drawings that isolate and abstract each organ, muscle, tissue, and bone. The phenoid is a monarch butterfly preparing to lift off; the choroid, an artichoke perfectly peeled, articulated; the osseous labyrinth laid open to view is part saxophone, part shell, its tip a curled wave breaking. Look, the Gland of Blandin is bristling with ducts. And just listen to the beautiful words: capsular, synovial, navicular, subclavian.
Even the lowly intestine has its music. True, the poetry of the small intestine is easier to hear, with its trio of duodenum, jejunum, ileum, but the large intestine claims a few notes of its own. Iliac fossa. Vermiform. The caecum, I read, means “blind pouch,” which translates to cul-de-sac. But the real poetry of the colon lies in its movement. “The large intestine, in its course, describes an arch,” is only the beginning of the story. This remarkable organ not only commences, it ascends, it bends, it flexes, it traverses, it convolutes and bends again before it descends. My tumor resides in one of these bends, the transverse arch, more specifically the splenic flexure, so named because of its proximity to the spleen. “Lucy,” I imagine Ricky Ricardo saying. “You got some spleenin to do.” Maybe I should try that one out on the surgeon.
When I was young and my father was stationed stateside, from time to time he would announce that he was going in for “a lower GI,” or, sometimes, “an upper GI.” I knew that GI stood for government issue, which was another name for soldier, but I didn’t know what an upper or lower one was, and I never asked. Not until the nurse practitioner called with instructions for my pre-op testing and directions to the “GI ward” did it dawn on me. Gastro Intestinal. I was a GI, too.
We all have ways of preparing for battle. Some drink, some cry, some sleep, some put on—in the words of the New Testament writer—“the whole armor of God.” My armor is words. Fourteen years ago, during the darkest months of separation from Donald, I frightened my analyst by grabbing up every book on her list and reading it through to the last bitter syllable. She kept warning me not to overdo it. “Most people read a chapter or less, that’s all they can take in the midst of it,” she said. Obviously, she didn’t know with whom she was dealing. “More books,” I growled like the Neanderthal recruit I had become.
So within days of receiving the diagnosis, I started stockpiling words. Books, journals, online articles. Buddhist texts on suffering. The brave, tender poems of Jane Kenyon facing cancer straight on, and losing. Even a new book by a surgeon confessing everything that can, and does, go wrong on the operating table. I placed a toy action figure on my desk, the kind that can morph into different shapes. I can do this, I thought. Bring it on.
the creation of adam
In a hallway off the Imaging Center, where I have come for pre-op testing, I stand beside a tall woman, both of us clutching the tops of our gowns and staring up at the huge mural where Adam is caught in mid-flash. I have seen dozens of versions of Michelangelo’s fresco-on stationery, aprons, even on computer mouse pads—but never one like this. This is a radiologist’s view, Adam’s x-rayed body open to our view. Winglike clavicle, xylophone ribs, the outline of lung and heart. The other woman is silent, her head cocked sideways as if expecting some message from the ceiling. I turn to her and smile awkwardly, careful not to let my gaze wander downward. Beneath the thin gown, she too is naked, as I am, but who wants to be reminded of that?
The door of the x-ray room opens, and the technician’s head swivels around the corner as if mounted on a periscope; the rest of him stays behind. “Next,” he says, and though I was first in line, I motion to the other woman to go ahead. I want to spend a few more minutes with Adam. The mural is actually two murals, the famous image split down the middle so that God and man are separated by even more distance than usual. God takes up most of the right-hand side, fully gowned and surrounded by a staff of plump, pink angels. Only his hand reaches into Adam’s territory—or perhaps it is Adam who is reaching—their fingers not quite touching. Or maybe they have already touched and are just now breaking away from each other. The air between them seems alive. A spark, an electrical charge, the Frankenstein juice that is about to jump-start Adam. Is it God energy, divine love, that has lit up Adam’s chest, his shoulders, his heart? Then why not give us a glimpse into God’s insides, his hidden motives, the whys and wherefores, the God heart pumping?
every second of every minute
Leaving the Imaging Center, my back to the East River, I am thinking about my mother, who is probably just now packing for her trip from Indiana to New York. At first I had resisted offers of help from friends and family members. “When Donald goes back to work,” they said, “you’ll need someone there.” When they finally convinced me that this would be no picnic, that the hospital stay would be nothing compared to afterwards—“You’ll be weak as a kitten,” one friend warned—I relented. So now my seventy-eight-year-old mother, the daughter of farmers, grandmother of fifteen, and president of the local quilting club (whose members, seated around the frame at last week’s meeting had warned her of the city’s dangers, advising her to pin her Social Security card and cash inside her brassiere) is packing, suiting up for battle.
I pass the subway entrance on Sixty-eighth Street, opting to walk the two miles to our apartment. I choose the residential route, row after row of townhouses where miniature gardens are locked behind wrought iron. In one garden, acuba bushes are pushing up against the gate, their raucous green and yellow streaks sending my mind back to the old house in North Carolina where we lived when we were first married, the massive bushes no amount of neglect could kill, how they just kept growing, pushing up against the house, and here in the next yard comes another life, this one hidden in Japanese pieris, those same delicate clusters that softened the entry to the first home we mortgaged our future to buy, and in their blooms are all the years we spent there, planting, cooking, sleeping, loving, and what if, what if...? Now I am moving faster, my heels clicking on the sidewalk as I hurry across the avenues—First, Second, Third, Lexington, Park, Madison, Fifth—getting dizzier with each step, and now finally here is the park where I can sit a minute.
Most of the benches that line the South Pond bear commemorative plaques. There is one from Barbara to Marty in celebration of their wedding anniversary, another from a family reminding us that even in the aftermath of 9/11, we can still find refuge among these trees and flowers. Many of the inscriptions are simple and clear-cut as gravestones, marking the parameters of a life: “For our beloved brother, son and friend, 1958–1996.” A few are enigmatic. “For Noodling,” reads one. “Entirely of possibility,” another. My favorite bench, the one on which I have once again landed, proclaims, “Every second of every minute. August 7, 1997–.” I like that there is no closing date, that the inscription celebrates a beginning. A baby was born on that date, perhaps, or a love affair started, a marriage begun. Or maybe that was the day someone’s life took a turn. A divorce decree was finalized, the lab tests came back, a son buried a father, all the things we call endings that could also be seen as beginnings. The way liberated prisoners claim a new birthday. The way, on some board games, you can place your marker on any space. Choose: start here.
dream after reading gray’s anatomy
Inside the gilt-edged hospital, we wear the shape of our diseases. In the cardiac ward, the valentine woman. In the circulatory ward, the highway-map man. And here in the GI ward we are navy, lima, kidney, all manner of beans coiled into ourselves. Cul-de-sacs. Pink kangaroo nurses hop from bed to bed, adjusting their pouches.
the waiting room
Patients-in-waiting are easy to spot. We are the ones wearing gray nonskid socks and large cotton robes over loose pajamas, so as to cover all bases. Except for our bare, nervous hands, we hold nothing in our laps, our belongings having been stashed in official brown paper bags marked with the hospital’s name. I was ordered to report midmorning, and I have been waiting nearly two hours, Donald to the left of me, Mother to the right, a television mounted high on the wall in front of us. A noose is looped around Saddam Hussein’s neck, and a tiny marine is climbing onto his face and draping it in an American flag.
I know I should be more interested—this is, after all, history in the making, a regime tumbling—but my gaze keeps wandering to the window where, a dozen stories down, the East River is flowing and a barge is making its slow, determined way. Does it move on its own power? Or do the currents help it along? Now it is passing under the Queensboro Bridge, now beneath that little cable car in the sky that floats its passengers to and from Roosevelt Island. Six years ago, when Donald and I were planning our move to New York, we briefly considered living there, but decided no. “It feels like a hospital,” Donald said, and he was right. Decades ago the whole island comprised institutions, including the New York City Lunatic Asylum where Mae West was briefly incarcerated after appearing in what was then judged to be a lewd play. As the story goes she convinced the powers-that-be (how she convinced them is not recorded) to allow her to wear her silk underwear beneath the prison garb.
I walk to the window and look across the river. Roosevelt Island. Named for a president who never let his legs show in published photos. Only in candid shots with family and friends did he allow the camera its full range. What was he afraid of? That he would lose power if the public got a good look at the whole man, folded into a wheelchair or leaning on the arms of those he loved? I pad across the room, feeling the grab of the sock treads against the floor. I had tried to sneak out of the changing room wearing the bright pink flamingo socks I’d bought last week, but the attendant had sent me back for the official hospital footwear. Mom smiles up at me, and I take my seat between her and Donald, crossing my arms on the stiff fabric. Here, one size fits all, every robe extra large: another attempt to cover all bases. In a pathetic attempt at style, I have rolled up the huge sleeves and the long pant legs, and sashed the robe twice. I should have insisted on silk underwear—Mae West had the right idea—embroidered with my name, perhaps. Some small comfort, something of my self to keep on “my person,” as the attendant called what was left of me after I stepped out of the changing room. In an ideal world a patient would be allowed to bring along all the accouterments that make up her person. A gardener could pack a shovel and her best petunia bed; a grandfather, photographs of the grandchildren; a writer, all the books she has read and the ones she has written. The body of her work. Her corpus.
Instead, they strip you bare, and last to go are the rings that link you to the one you love. During my father’s hospitalization, my mother wore his wedding ring on a chain around her neck. Donald and I never had wedding bands, but he surprised me with two diamonds, one for our fifteenth anniversary and one for our twenty-fifth. Before we left the apartment this morning, I planted both rings in an envelope in his dresser, tucked inside a letter marked “special bequests” detailing all the little things that didn’t make it into the official documents we signed last week. By the time we left the lawyer’s office, my hands were trembling, my mouth dry. Marriage vows are nothing compared to death vows, signing yourself over. Terror more binding than any “I do,” this power to connect, disconnect.
Donald nudges me, and I look up at the television. The statue is tipping forward, yanked from its moorings by tiny men with ropes, a scene out of Gulliver’s Travels. “End of an era,” the reporter announces, and the huge body topples.
the pain guys
Three young men, joined at the clipboard, appear at the foot of my stretcher in the area where patients are held before surgery. “We’re the pain team,” one of them announces. In all my planning, my careful research, I must have missed something. Are they telling me this is going to hurt?
“No team shirts?” I ask. They are too young and far too handsome. They could have been movie stars or fashion models, but no, of course they wanted to be doctors. Feeling suddenly old I tilt my chin and flash them my best smile. “The nurse has already been here,” I say, lifting both hands to show where she has “introduced” IV lines. One is hooked to a drip bag; the other, capped and taped, has been readied for the anesthesia.
One of the pain guys checks the clipboard, the second checks my IV sites, and the third starts explaining the epidural they are about to administer. Epidural? Isn’t that for women in labor? My sisters had epidurals.
The third pain guy asks me to sit up, then positions me so that my legs are hanging off the side of the bed. “Lean forward,” he says. “That’s good.” He starts tapping on my vertebra as if looking for a tender spot. He asks the second pain guy for his opinion. This does not inspire confidence. Maybe I was wrong to come to a teaching hospital.
“Can’t you just knock me out?” I say. “A hammer will be fine.”
He pushes my head down gently. “Just lean over a little more. That’s great,” he says. “That’s good. Just hold that position. You’ll feel some pressure now.”
I tell them there’s no need for this; I don’t plan on using the epidural.
“Right,” the third pain guy says.
“I don’t do well with drugs,” I say. “Never have. They make me stupid. And nauseous. I won’t be using this.”
“Time will tell,” the first guy answers, moving around the stretcher and standing in front of me. He probably wants to check my mouth, to measure it for the endotracheal, the tube that will breathe for me while my chest muscles are paralyzed and my mind is who knows where. Three hours, four, five. And what if the anesthesia is more than a dream? What if I don’t wake up?
I open my mouth as wide as I can. He just stares at me. Then he smiles and says, “We’re the pain team. For afterwards.”
Later, after they have gone and the nurse has come yet again to check my blood pressure and IV, she shows me the magic button that I can push when the pain gets too much.
“Now?” I smile, pretending to scramble for the button.
She narrows her eyes. Most nurses are great kidders, but this one is an exception.
The afternoon drags on. Mother and Donald take turns sitting on the little plastic stool. Gurneys are wheeled in and out. The minute hand on the big school clock stutters and jumps. The nurse keeps saying, “Just a little while longer” and “They’re readying the OR right now,” and finally at nearly five o’clock an orderly appears. “Cocktail hour?” I ask Donald. The orderly is a moonfaced woman with round eyes and plump hands. She places a blue paper cap over my hair, checks my ID bracelet, and leans to unlock the wheels. Mom reaches over and touches my forehead, Donald kisses me on the cheek, and I lie back, blinking against the brightness of the ceiling lights. Now we are moving, the IV pole rolling beside us, really moving, out of the holding room, through the swinging double doors, into a corridor, another, and now we are wheeling down a long hallway, window after window flashing past. I turn my head to the right and see a slice of silver water, another slice, another. “Slow down,” I say. “I want to see the river.”
The orderly not only slows, she stops.
“Take a good look, honey,” she says softly.
I am not prepared for such kindness or for the dazzling water, hundreds of white lights winking back at us. What a stunning sight, and what if, what if, but it is too late for that now, we are moving again, down the long hallway where a brawny nurse is waiting beside a short, dark man outside the OR doors. He asks me a few questions, points to a clipboard, and tells me to sign here, and here.
“Wait,” I say. I saw this on a documentary once, and it made sense. “Tell me my
name. Tell me what operation I’m having.”
He answers correctly on both counts. I ask him the name of my surgeon, just to be sure. Again he answers correctly.
“Okay,” I say and sign on the dotted lines.
“thou preparest a table before me . . . ”
I remember how big and white the room was, how bright the overhead lights shining on all that metal, and how small the table looked. The table spread for me, on which I would be spread. The anesthesiologist, another young man—why are they all so young?—leaned over and asked me how much I weighed. Then he asked me to open my mouth. He sighed, and I wondered if he was thinking how small my throat was, how hard it would be to insert the tube. I wanted to pray, but nothing original would come. “The Lord is my shepherd,” I began silently. Green coats were gathering in my peripheral vision. I heard feet shuffling, hushed voices.
“You’ll feel a cold sensation,” the anesthesiologist said. What a terrible job to have, I thought. What could be worse than putting someone under? “May I count?” I asked. When I was small the dentist always told me to count backwards starting with ten. But that was a long time ago. “One hundred,” I began. “Ninety-nine. Ninety-eight. Ninety-seven.”
Twin bed, single bed, the terms are used interchangeably, but between them lies a vast difference. Twin is what you sleep in when you are young. Across the room in the other twin bed is your sister, so close that you can reach out and touch her if you need to, and on some nightmare nights you do. Twin suggests that half of you exists in another. You are a matched set, your separateness chosen rather than required.
There are no twin beds in hospitals. Each one, narrow and white and tagged with a name, is a single.
Even if you are lucky enough to have a husband and a mother standing beside you when you wake in the recovery room.
Even if you are lucky enough, as I was that first night, to be wheeled from recovery into a semiprivate room where a wise woman lay in the other single bed. A woman whose name escapes me at the moment; another side effect of the anesthesia. I, who have always prided myself on my memory—what a strange phrase, to pride oneself, as if there were two selves, one who does the boasting and the other who accepts the compliment—now find that I often begin a thought that I cannot finish until much later. Sharon, her name was, or something like that. A pretty name, easy on the ears. A name spoken from behind the curtain that separated us, in a voice that came as close to soothing as any voice could have, considering my pounding head, the convulsive trembling and post-anesthesia nausea, the wretched dry heaves.
“I’m sorry,” I managed after another violent bout of gagging and heaving.
“It’s okay,” the voice behind the curtain answered. “You’ll be better tomorrow. You’ll turn a corner.”
Sharon’s corner had already been turned; the doctor would sign the papers tomorrow so that she could go home. In the meantime there was this night to get through. Anyone who thinks you can rest in a hospital has never spent a night in one. If you manage, through the mercy of pills or exhaustion, to doze off for a moment, you will be roused by a blood-taker, an IV-checker, a catheter-emptier, or a Voice crying out. I capitalize voice because the Voice seemed larger and more terrible than any body to which it could have been attached. The man’s cries, issuing from somewhere down the hall, came in waves, every two or three hours, followed by a woman’s voice—his wife’s, I imagined—cooing and crooning to no effect. Nothing, it seemed, could ease his cries. I have never heard such agony and hope never to again.
“Bless him,” Sharon whispered from behind the curtain. I did not yet know the seriousness of her prognosis, what she was facing. Had I known, I like to think I would have tried to comfort her, though, in the state I was in, I cannot be sure. If there is a scale of suffering—and I am certain there is—it is impossible to gauge your place on that scale when you are in the midst of suffering, however minor, in retrospect, your suffering may appear. All that long night and the next day, before the anti-nausea drip was installed, I could not lift my head, but I could turn it on the pillow and watch Sharon move past my bed and to the bathroom. Amazing, I thought, to lift your body from the bed, to move on your own power, without IV lines and catheter. To sit on the toilet. To flush. How amazing. I heard the spray of the shower through the walls, and when the bathroom door opened, a fresh, clean smell emerged and clung to her as she moved toward the window or out into the hallway, where she began yet another slow circle around the nurses’ station.
By the end of the second day, I could smell the sourness of my sweat and sickness, my rancid breath. Every few hours the nurses’ aide would appear at the door, announcing that I needed a wash, that this was her job, and that I should let her do it. She was a light-skinned black woman with short red hair and an attitude so outwardly crusty that I knew she was hiding something soft inside. I wanted to please her. I wanted a bath, but I could not lift my head without the room spinning and the bile backing up in my throat. She would stare down at me, shake her head, then turn and walk out of the room, saying to the air, “That one won’t let me do nothing for her. Nothing at all.”
Sharon had brought her own robe from home, and terry cloth slippers that shuffled and scuffed as she moved herself along. On her own power, I kept thinking. Someone moving on her own power. I wondered why no one was there with her. Would she be going home alone? Her stomach was huge, the sash of the robe tied high between breasts and belly, the way you tie a maternity dress. But she was older than I was, too old to be pregnant. It wasn’t until later that evening, when the doctor came to sign her out, that I learned the nature and extent of her disease. I wasn’t trying to listen, but semiprivate means just that. Close as you are in your single beds, no secrets can be kept. So I learned that her cancer was far advanced, that she had been in the hospital more times than she could count, and that she would be back again in a few weeks. “Not that it will do a lot of good in the long run, you understand that, don’t you, Renée?” the doctor was saying.
Renée. Yes, that was her name. It is coming back to me now. I wish I had learned her last name so that I could send her a letter of thanks. If I could trace her. If she is still alive. There is a Japanese artist at the edge of the park who can write your name on a grain of sand. That is what he claims. I have never stopped at his booth, but I believe he can do exactly that. Maybe that is why I have never stopped.
By the end of the third day, I could sit up on the bed, legs wrapped in compression boots, head held over a plastic tub while I brushed my teeth—has anything ever felt so good? I could sip water through a straw and suck on ice chips, which soothed my throat, still raw from the intubation. The anti-nausea drip had kicked in, so I had even slept a few hours. This isn’t so bad, I thought. This is manageable.
That was before the anesthesia wore off and the pain from the incision began.
That was before I was told the pathology report wasn’t in yet.
That was before the second roommate was wheeled in, a thin woman with prominent cheekbones and a voice like a saw. All day, all night, it scraped and rasped and scraped some more. Even my mother and Donald, both eternally patient, began to chafe against the sound.
The next morning the rounds began.
“The incision looks good,” the surgeon announced, “but you don’t. I heard you had some trouble with the anesthesia.”
The internist stopped by. “Why aren’t you up? You need to start moving. Have you passed gas yet?” I knew that this was my ticket out. If I did not pass Gas, I could not collect two hundred dollars. I could not be released. And God knows I wanted to be released.
The three pain guys showed up. “How often are you pushing the pain button?”
“It makes me sick, I told you that.”
They shook their handsome heads, made a note on their clipboard. “You know if you don’t use the button, you will experience—”
“Pain,” I snapped. “I know.”
The resident team appeared at the door, a multicolored clump of men and women. One of them turned and spoke to the others. “Caucasian woman, aged fifty-two, presenting with . . .” Presenting with? Where are my tap shoes, my top hat and cane? And now, folks, from behind the curtain, here she is. Now presenting . . .
A body that has not been bathed in three days. A head of oily, matted hair. Feet that must belong to Petunia Pig. Tubes for arms, a catheter tail. Newly rearranged bowels that have not passed gas. A swollen belly stitched together, hanging by a thread. Jesus, what a body of work. Body of work, my corpus.
your name on a grain of sand
That evening, after Donald and Mother left for home (which in my pride and stubbornness I insisted they do), the roommate’s sawing began in earnest and did not let up. She talked to the air, to herself, to her missing daughter, to the faces at the window, the faces she claimed were peering in at her. Imagining what Renee would have done, I spoke. “It’s okay, it’s okay. There’s no one at the window.” Behind the curtain the woman gasped. I had not meant to frighten her. Then from down the hall, the Voice cried out. Agony no one could ease. No matter how you try, you cannot get inside someone else’s pain. And no one can get inside yours. Lying there, exhausted and terrified—though the surgeon reported that the site had looked clean to him, the pathology report was still not back, and I was starting to imagine the worst—I tried every mind trick I knew, every technique I had been taught in hospice volunteer training all those years ago. Techniques I enthusiastically passed on to the patients as if I knew what they were feeling. I tried visualizing a beautiful place. A waterfall, the meadow behind my grandparents’ farm, the view of Central Park’s South Pond from my favorite bench. I tried going back in time, but moments were slippery and would not hold. I tried reciting the dozens of poems I knew by heart. Or thought I knew. Emerson, Roethke, Hopkins, Yeats, where had they gone? I could not even call forth my own poems. Words and phrases would emerge in my mind’s periphery then float past before I could grab their sense. Nothing makes sense, when you stop to think herself, “She was a suicide,” but not, of someone who has had cancer, “She was a cancer.” Why do we pray for negative pathology reports and fear positive ones? “On the verge,” we write, but how can we tell when we are on it? And a “sleepless night”? The night is not sleepless. Just us, wrapped too tightly in it. Shirley, Goodness, and Mercy shall follow me, and who are they anyway, and why are they following me, little sheep nipping at my heels?
And now here come the single words, lonely, discrete, each appearing on the screen in my mind’s eye, then breaking apart, the connective tissue tearing loose until only the skeleton of the word is revealed, lit from behind.
about a bout (the battle we fight)
knowledge ledge of know (over which we tumble)
Look, a moth hidden inside mother. Virginia Woolf’s moth, dazed and exhausted,
beating its wings against the window.
And now, from down the hall, another wave is breaking, and the Voice is crying
out. Suffering no one can ease. Not the nurses who hurry past my door, or the doctors who answer the summons, or the wife’s voice echoing his cries, singing back in a language composed entirely of vowels. Their voices break, rise and fall, crash against the rock of silence then break again, an opera of shared pain.
shirley, goodness, and mercy
God, we are told, is a god of mercy and compassion. I must believe this, and I do. But this belief lets no one off the hook. Not God, not us. Scratch its surface and you unearth its smaller, harder core: that the unmerciful exists in the first place. If suffering did not exist, God would not be forced to be merciful and compassionate. He could use his energies in other ways. He would not have to be on call, day and night, minute by minute.
For, finally, that is the promise. Not that he will relieve the suffering, but that we will not have to do this alone. We will have company. Not Michelangelo’s plump, pink angels, perhaps, but company all the same. The night nurses whose backlit forms appear in the doorway. The aides who remove catheters and collect toilet samples and sponge you down and strip the bed. The technicians who take blood, who poke and miss and poke again: “Sorry, I didn’t mean to hurt you.” The food workers with foreign accents who bring the trays with Jell-O and juice, Jell-O and juice, Jell-O and applesauce and juice. The two teenaged volunteers, beautiful Asian girls, who roll the cart of library books to the foot of the bed and are so intent on making me smile that, though words have still not returned, I choose three books anyway solely for the bright colors on their covers. A husband who brings news from home, cards and flowers, who watches for the IV’s final drip and presses the call button. An aging mother on whose arm I lean as I hobble past the nurses’ station, holding my incision, letting out little kitten whimpers I hope no one will hear, because I have nothing to whimper about, I who will be released in a day or two because I am now a virtual whoopee cushion, my body of work reduced to a series of punctuation marks, exclamation point after exclamation point, each more welcome than the next. I have been bathed and freshly powdered; I can hobble on my own power, dragging my IV pole, past the nurses’ station, past the room of the Voice that is now too quiet, down the corridor to the window where the East River flows and thousands of lights from thousands of windows blink back.
Barn’s burnt down—
I can see the moon
Each day I grew a little stronger. That first day home, Palm Sunday, I staggered into the apartment and fell into the sheets Donald had turned back for me. Hours later when I woke, a phone was ringing somewhere in the distance, and Mother’s voice was answering but not in words. It was as if I were underwater, just below the surface. All was tone, music, lilt and fall. I tried to lift my head, but my friend had been right, I was weak as a kitten. Later I woke shivering, and someone came in to arrange the down comforter over me. When I woke again I was sweating, but I could not move the comforter—it was too heavy—so I mewed (the three little kittens have lost their mittens) for my mother, and she came to lift first the comforter, then me.
Today the door to the living room is open, and the view from my bed is too much to take in. The photographs of my nephews and nieces. The lamp with the pink shade lighting the watercolor painted by my aunt, who, in her ninety years on this earth has survived betrayal, divorce, subsequent happiness, widowhood, innumerable surgeries and recoveries. The bookcase with its colorful spines of books, two rows devoted to the twenty, count them, twenty gilt-embossed dictionaries—how can one alphabet take up so much space? And there, in the leather reading chair, is a section of my mother. I cannot see all of her from here, but I trust that she is complete. The phone is ringing again. I see her hand pick up the receiver, press it to her ear. I like that the phone rings, that someone out there somewhere wishes me well, but I am too tired to talk.
To keep my mind occupied, and in an attempt to jump-start my brain, I have gathered books around me. The novels and biographies serve mostly as props, but the poems, with their open meadows of white space, are almost navigable. Yesterday I began with haiku, Issa and Masahide, and today I am moving, syllable by syllable, through my standard favorites. “I learn by going where I have to go.” (Roethke). “When I have fears that I may cease to be.” (Keats). And some lines by my dead friend, William Matthews:
Anyone proud of his brain should try to drag
his body with him before bragging.
Mother appears at the door, saying it’s time I had a real meal, that she is going out to buy makings for chicken and noodles but not to worry, she’s just going across the street. She means “across the avenue,” but I don’t correct her; only New Yorkers make the distinction. “Here’s the phone,” she says, handing me the portable. “In case of emergency. But I won’t be long.”
But she is. Fifteen minutes go by, thirty. What was I thinking to ask her to come, my little Protestant mother from Indiana, her purse stuffed with twenty-dollar bills because everything costs so much here, and how will she navigate the Jewish deli, the aisles of matzos and gefilte fish and corned beef? Where is she? She might have fallen, turned her ankle on a pothole, been knocked down by a bicycle, a taxi making too sharp a turn. I pull my body out of bed, drag it across the room to the window. From this vantage point, five stories up, I can see the fruit stand and the Halel vendor, but I cannot see the avenue she will be crossing or the sidewalk directly below, where she should be walking any minute now.
The tall office building across the street, a monolith of steel and glass, sends back a clear reflection. There is our apartment building, looking smaller and older than the other building, a bit shabby. Moving my eye down I can see the sidewalk below, the clumps of people hurrying past in a purposeful rush, as if being propelled by some swift, invisible hand. Tall, three-piece-suited men, short women with briefcases, teenagers with cell phones, mothers pushing strollers, and where are they all going in such a hurry? And where is she? She doesn’t know our ways here—what was I thinking to let her go out? I will have to call Donald or the police, and then suddenly, into this puzzle of steel and glass, this crisscross grid of square black windows, a small figure enters. A woman, aging and small and slightly bent from the double burden—a grocery bag in each hand—moving into the reflection. Stopping at the green awning, setting the bags down, reaching for something in her purse. A key, it must be a key. And letting herself in.
Years before his death, my friend Bill, whose poems I returned to during my recovery, spent months nursing his critically ill wife back to health. He didn’t know she was going back to health. He thought the cancer would surely kill her; in the meantime, as he told me in letters, she was “soldiering on.” Strange how things work out. She is still alive somewhere, and Bill is six years dead. In his absence his poems are present. The lines I quoted earlier are from “Recovery Room,” a poem that turns, as many of Bill’s poems turn, on a phrase, in this case its final line:
Welcome back, somebody said. Back? Back?
Because of course the speaker of Bill’s poem knew—as Bill knew, as anyone who has ever gone through the valley of the shadow knows—that there is no back. When you return, if you return, everything is changed. The light, the music. It is too bright, perhaps, or too noisy. Too something. You feel exposed, unprotected, so what else to do but re-cover? Cover yourself over, again. You can’t stay naked forever, stripped bare, all your fears revealed, your insides lit up.
I have the x-rays to prove it. And the excellent negative report from the pathologists. A year past surgery, I am writing these words with a pen that bears the name of the hospital. A souvenir from my stay. I now understand why no one calls them visits, for no matter how long since my release, part of me is still back there. I am beginning to understand why my father still wears those tacky little socks, still opens his shirt for the premed students. I threw my hospital socks away, but I did save the pen and one memory that, try as I might, I can’t shake. It was the fourth day after surgery. Donald and Mother had just left for lunch, and at my request the privacy curtain had been arranged on its metal rings so that it formed an enclosure around my bed. Inside that enclosure I was lying on the sweaty, rumpled sheets, my oily hair plastered to my forehead, my eyes closed against the overhead light. I heard the squeak of metal, and there she stood. The light-skinned aide with the short red hair and the crusty manner. She was carrying a small plastic tub into which she had placed a washcloth, a hotel-size bar of soap, and sample-size containers of baby powder and lotion. Over one arm she had draped a towel. “I’m not taking no for an answer,” she said. She removed the items from the tub, arranging them neatly on the night table. Then she carried the tub to the sink and filled it with water, returning to place it on the table. She helped me out of bed and placed a stool in the space beside my bed. “Sit,” she said.
The rest was accomplished mostly in silence, an awkward dance of stretch and lift, untie, remove, soap and rinse, cream and pat and powder, and all the while my tears were falling—into the plastic tub, down my cheeks and breasts, onto the surgical tape that held my swollen belly together. She handed me a sponge and motioned for me to do the rest. There are limits even for bathers, parts of ourselves only we can be responsible for. When I was finished she held up a clean, stiff gown, and I found my way into it. Then, while I sat on the stool, cradling my incision, she stripped the bed of its sheets, the pillow of its white casing. This is what they do when someone doesn’t wake up, I thought. But I had woken up. The bed looked so empty, and for an instant—very quickly, then it was gone—I felt a sting, a pinch of grief for the one who had so recently lain there. The tears started again. I had not cried like this since I was a child. She just stood there and let me do it. I started to thank her, but I knew that if I started thanking, I would never stop. As if sensing this, she held up both hands like a cop directing traffic. Then she reached for a clean sheet, flung it over the bed, and tucked in the edges, taking extra care to center the top sheet and the freshly cased pillow, which she fluffed and fluffed, looking my way.
Rebecca McClanahan has published The Riddle Song and Other Remeberings (essays, 2002), four volumes of poetry, most recently Naked as Eve (2000), and three books about writing, including Word Painting: A Guide to Writing More Descriptively. Her work has appeared in The Gettysburg Review, The Best American Essays, The Best American Poetry, the Georgia Review, the Kenyon Review, and elsewhere. McClanahan, who received a Pushcart Prize in fiction, the Wood prize from Poetry, and the Carter prize for the essay from Shenandoah, lives with her husband in New York City.
“Back” appears in our Autumn 2005 issue.