Breathe Page 2

  Is this a dream? Can’t be happening, must be a dream.

  (But if we are dreaming together? Can we save each other!)

  Not a floor beneath your feet but a kind of ice-sheet supporting the hospital bed in which your husband lies fixed in place with IV lines in his veins, ice-surface shining-blinding, your eyes blinded unable to see clearly, not daring to see clearly for you are immersed in the opioid dream that shimmers beneath your husband’s bruised eyelids. Shimmering of dreams like reflections in ice. In the freezing water beneath ice. Almost, you can see these dreams. Quick-darting as fish in the luminous water beneath ice. You can feel them against your skinless arms—quivering, thrumming, heat of your husband’s body in its struggle to remain alive even as it is being dragged downward beneath the glittering ice-surface to death and dissolution, to stammered words, grunts, dragged downward by the capricious cruel god of the high desert plateau with the name too terrible to be uttered aloud—Ishtikini. Pueblo-god of toothless laughter, god of eyeless sockets, Skull God, beast-god, scavenger-god poised to devour the body’s organs as soon as life ceases to pulse through them: heart, brain, lungs, kidney, liver, stomach, intestines.

  No one but you will remember—But this man is heroic! Struggling to breathe, to persist in breathing, even as his organs are failing. Slow realization of diminishment, loss. Gradual realization that each day, each hour the patient has been growing weaker, not gaining strength from the liquids dripping into his veins but un-nourished by them, no appetite, no longer capable of walking in the corridor as he’d done initially, not even making his way with a walker, only just able at last to sit upright in a wheelchair you push for him in the hospital corridor in a loop each day losing strength as he was not (re)gaining the weight he’d lost but losing more weight, his cheeks becoming sunken, eyes brimming with moisture when you’d squeezed his hands and assured him that he’d been a wonderful husband and he’d said Wonderful?—but I failed you by dying.

  A wild startled laugh, a child’s frightened laugh—What are you saying? You are not dead, you are with me here. We are both alive . . .

  A spasm of coughing, your husband can’t answer you, too weak to refute you as you insist he has been a wonderful husband, your life with him has been the happiest life you could imagine for yourself, it is the only life you could imagine for yourself, you do not want to live beyond this life. As he lapses into silence you will assure him another time that he is loved, he has been a wonderful husband who is loved, and he is safe because so loved, this is a safe place where he will not suffer needlessly, he will not suffer at all, you will never leave his side. As in the exhausting interminable hours to come you will hear your defiant voice wax and wane, wane and wax, growing fainter, growing stronger, and again faint, and again stronger as the undertow of your husband’s dying tugs at you, tries to pull you under, still you are resolute—Breathe! Darling, please breathe—don’t stop. And the stricken lungs suck at air, pure oxygen seeping into nostrils through a narrow plastic tube attached to the nose. Your own audacity will surprise you, the desperate strength of which you wouldn’t have guessed yourself capable, as a swimmer who has never been tested in deep waters is surprised at her ability to keep herself afloat, to keep from drowning. You are determined that your husband will not give in, will not die and abandon you, not one moment too soon. Though by this time you will be so dazed with exhaustion your eyelids will droop, only barely you will comprehend what is happening in this hospital room, what an ordeal, what horror, why you are begging the man Breathe! Breathe!—please . . . for in this chilled space humming with monitors in this interminable interlude out-of-time there will be only the present tense in which you have gone without sleep and without food for how many hours since before dawn this morning, embracing the man to whom you have bravely joined your life, leaning over his body in the high bed, your neck aches with the strain, your shoulders ache with the strain, your throat aches with the strain of assuring this man tirelessly, defiantly that you love him, that he is safe, he will not feel pain, he will not be alone, how many days have passed, no idea how many days, hours, weeks while outside the hospital room the hot searing New Mexico winds continue to blow through sunlit daytime hours, gusts of wind bearing bits of mica, grit inhaled into nostrils, mouth, lungs, gusts of wind like the ferocious laughter of the desert gods, and after dusk the wind dies down, fades, and night is abruptly chill, no longer a warm terrain but the high desert plateau and you are made to realize how far you have journeyed, how many thousands of (reckless) miles to this place leaving behind your comfortable town house on Monroe Street, Cambridge, walls of books, bookcases in bedrooms and in bathrooms, bookcases in narrow corridors, stacks of books in the basement, books still boxed after the move of twelve years previous when bravely you’d vowed to yoke your lives together, laughing in very recklessness, in yearning and in love. Do you take this man? I do, I do! Do you take this woman? Of course—I do . . .

  Sickness and in health. Till death do we part.

  Recall with horror you’d uttered these words happily. As if till death do we part might be so interpreted: happily.

  Damp with perspiration yet shivering clammy-skinned, anxious in terror of what’s-to-come. In a film, ominous music. In the hospital room, only the sound of breathing.

  Initially, first hospitalized, Gerard had been sharp-eyed, lucid.

  Fits of coughing, bronchial infection, needing to be sedated because he could not sleep because unable to breathe without coughing but clear-minded, coherent, not yet subjected to a battery of tests, not yet invaded by powerful opioids that cloud his mind. Not yet transferred to the adjoining Cancer Center—a transference that dashes his spirits, and yours. Antibiotics, blood thinner, oxycodone. CAT scans, biopsies, fMRI. Initially the prognosis had not seemed ambiguous. Initially the first-detected cancerous tumors (lung, kidney) had appeared to be slow-growing. Even with this sobering news and in his new circumstances Gerard insisted upon working, furious at wasting so much time, goddamned bad luck, eight-month residency at the Institute and already the first month was passing with very little to show for it. Desperate to work, refusing medication that made him groggy, or anyway refusing it for as long as he could, giving you instructions what to bring from his office at the Institute, how you might assist him with the four-hundred-page copyedited manuscript of his next book provocatively titled The Human Brain and Its Discontents; it was Gerard’s custom to answer each query from a copy editor in meticulous cursive script on yellow Post-its affixed to manuscript pages, thus a typical copyedited manuscript of Gerard’s was riddled with yellow Post-its like miniature prayer flags.

  Maybe I can get something accomplished here, maybe my time out-of-time won’t be totally wasted.

  Wanting to think that his hospitalization in the Santa Tierra Cancer Center was nothing more serious than a therapeutic time-out, an opportunity for concentrated work.

  Hope is the poisoned bait. Men eat of it and die.

  Not (yet) realizing that hope is the distraction, the deceit. Hope is what you must not allow to seep into your bloodstream. Hope is what you must never believe. Hope will break your heart for hope muffles the oncologist’s carefully chosen words: Dr. McManus, I have scheduled the palliative care physician to speak with you and your wife but neither of you hear these words, instead you hear CAT scan, biopsy, radiation, “zap” the small tumors, immunotherapy to shrink the urethral cancer, physical therapy, high-protein diet. Amid the succession of tests inflicted upon your husband you come to appreciate the word: patient. For it is patience that is required if one is to become (again) well: if the bloodwork is to become normal; lungs, heart, kidneys, stomach, urethra—again (improbably?) normal. If the fine-tuned organism that is the patient’s body is to function, not thrown off course by a misfiring of neurons, a brittle, thus easily broken rib; blood clots in thigh, lungs, kidney; a fit of spasmodic coughing that undoes days of recovery, like the smashing of fine crystal by an idiot. And when the appetite dims, and ceases; wh
en the patient who has loved food shakes his head irritably—No, not this. No; when the patient is impatient, when the patient is “not himself”—what’s to be done?

  What has been done, that can’t be undone?

  Then, time slows. Days, nights pass inexorably yet time has slowed. Each day, each night is interminable. Each hour. There is the possibility—(is there? or is the wife of the afflicted man imagining this?)—of a blood marrow transplant if the proper donor can be found (in time). (Is Michaela McManus a proper donor? You have begged to be tested, why has Dr. N___ not scheduled a spinal tap?) A bone marrow transplant is one of the most difficult of medical procedures as it is one of the most expensive, you understand. Yet the key words seem to you in time. A donor must be found, the procedure must begin almost immediately, why is everything so slow in the Santa Tierra Cancer Center?

  Skies of sharp-chiseled clouds wounding to the eye, such beauty unknown in the East where the cityscape devours three-quarters of the sky and the air is porous with haze. Running along the Charles River embankment, wiping your eyes of a thin suety secretion, airborne toxins from vehicle exhaust and industrial waste sucked into the tender pink tissue of the lungs, how much healthier to live in Santa Tierra, New Mexico, at a higher altitude though (in fact) it is difficult to sleep here, air and blood are so thin. Head throbs with pain for you haven’t been able to sleep for more than a few fitful minutes at a time for several nights, disoriented, short-breathed, for already the vigil has begun, before you realize what is happening the terrible vigil has begun pressing toward its (inevitable) end like a landslide gaining force and momentum as it descends a mountain. As each night is identical with the others each night feels impersonal, unrecorded. A night when you’ve been at the house, not home (you and your husband have never called this uncomfortable place home, only the house), staggering now down the hill, like a sleepwalker descending the walkway to the Institute grounds and through the Institute grounds to the first street, and to the second street near-deserted at this hour, at last to Buena Vista Boulevard with its tall white lights and now a half-mile marching rapidly, breaking into a jog as you near the hospital, panting, praying the most abject of prayers Dear God let him be all right, let him be alive—one more time . . . indulging in the futility of prayer to a god in whom you have never believed but determined to try all stratagems as a desperate gambler placing numerous bets in the face of catastrophic loss.

  Approach the high-rise beige stucco Cancer Center knowing yourself awaited impatiently in room 771. For Gerard has tormented you with calls that morning: first call at 5:16 A.M., second call at 6:20 A.M., third call at 6:47 A.M. by which time you are fully awake and teeth chattering with dread/excitement on your feet preparing to leave for the hospital without troubling to shower, even to change the clothes you’d worn yesterday which you had not removed when you collapsed into bed, for this is still a time when Gerard could make calls on his cell phone, express bemused exasperation with himself, impatience, not (yet) realizing that no attitude of his toward his medical condition will have the slightest effect upon that condition as no attitude however laudable, however articulately expressed, will have the slightest effect upon whether he will live beyond the next forty-eight hours, daring even to laugh, to apologize—I’m so sorry, Michaela. That this has happened, screwing up our time here in—wherever we are . . . In New Mexico, in such a beautiful place, Jesus!—me in the God-damned hospital . . .

  And you assure him—But you’ll be out soon. Then . . .

  Interminable days slide into a rapid week, a week becomes weeks, one day you stare at the calendar astonished that so much time has passed and (yet) Gerard is not (yet) recovered enough to be discharged from the hospital even to a rehabilitation facility. You imagine yourself a determined swimmer, determined not to drown, determined to swim at slightly beyond your capacity managing to keep your head above the water, managing to keep the sun-warmed water from being swallowed when you gasp for breath, managing to keep the sun-warmed water from being inhaled up your nostrils and into your head-cavity, in a way you are (almost) proud of yourself, your endurance so much more than you might have predicted.

  Yet: flee from the scene, when Gerard is taken away for a scan, an X-ray, an MRI. Once beyond the tall shadow of the Cancer Center feel a shot to the heart of sheer adrenaline, begin to walk very fast, legs rapid as a robot’s rapid-pumping legs. Push yourself until you too are panting for air, for oxygen, breathless in this high altitude where the air is thin as a razor blade for otherwise you are incapable of sleeping at night: cannot turn off your dazzled brain to sleep at night: a brain glaring like fluorescent lighting that will not let you sleep at night: a brain buzzing and crackling like an insect zapper, like the most lurid crackling fires of Hell, that will not let you sleep at night.

  Exhaust yourself until you are literally staggering. Interminable days beginning before dawn, ending after midnight. Collapse onto your bed fully clothed, too tired even to unlace and kick off the pink-and-gray running shoes with the dark-rose laces, Gerard helped you pick out in a runners’ store in Cambridge, Mass., a lifetime ago.

  Falling, fainting. Down down down.

  And then in the morning, waking with a jolt. Is he—? But no, he is not beside you.

  Not in the bathroom running water. Not humming to himself. Not coughing. Not here.

  (Terrified) (in a state of trance) running panting down “scenic” curving Vista Drive, keeping to the far left of the (single-lane) road as vehicles pass you headed downhill, very few at this hour. Scarcely seeing blossoming cottonwoods, cactus. Wisteria, lavender, rosemary grown to a height unimaginable in the Northeast.

  Your first full day in Santa Tierra, walking down Vista Drive into the town with Gerard, holding hands like young lovers. How like a honeymoon this visit would be!—you hadn’t really had a honeymoon when you’d first married.

  The tale you tell yourself. The tale you tell, retell yourself.

  The tale that explains nothing while (seemingly) explaining all. What had been initially diagnosed as bacterial pneumonia turns out in a vertiginous succession of tests to include a blood clot in the (infected) lung, a blood clot in the right thigh, small tumors attached to kidney, lungs; eventually, after an inexplicable delay, a tumor attached to the urethra, at 4-by-14 centimeters too large to remove surgically. A strategy is planned of radiation, chemotherapy, immunotherapy. But what of the patient’s high creatinine reading, is there a possibility of renal failure? (A kidney CT reveals an advanced kidney condition of which the wife knew nothing: the husband had, evidently, ignored prostate symptoms for years.) What of metastasized cancer to lymph nodes? To the brain? What of swollen ankles, wrists, right arm? Though each hour, each day passes with excruciating slowness yet it is all happening very quickly, weight-loss, sunken cheeks, dulled eyes, opioids and delirium, a succession of doctors, a succession of tests, a succession of plastic food trays carried into the room to be presented to the patient, a succession of scarcely touched meals, a succession of untouched meals, until at last one morning you are clasping at your husband’s hand crying Don’t leave me! Don’t leave me!—begging like a child, helpless sobbing like a child, how can this frantic woman be you?—dissolving in tears, and more tears, never an end to tears, in one who’d claimed (boasted) that she rarely cried, hadn’t cried in decades, not since her parents’ deaths, a beloved grandmother’s death, emptied of all tears but crying now whenever she is alone, whenever she is in a private place, trying not to cry in the patient’s presence because that will only frighten and demoralize him.

  All is for the patient. In the service of the patient-husband. You, the wife, will make any bargain.

  At the husband’s bedside pleading Can you try to eat, Gerard? Please, try to eat? The soup today is tomato bisque, it tastes quite good actually, I think you might like it . . . no? The yogurt is blueberry, your favorite, will you try some? Please? As one might plead with a recalcitrant child. Lifting a white plastic spoon to your husband’s mo
uth which he considers for a brief frowning moment then brushes away with a dismissive gesture that chills your heart.

  Please please please try to eat. You have lost fifteen pounds, you must eat . . .

  Hear yourself: beg.

  Risking your husband’s ire: beg.

  The (woman) palliative care physician has spoken carefully to you as the wife of the patient-husband. The (woman) palliative care nurse-practitioner has spoken carefully to you. They are kindly, tactful, soft-spoken, tender. The floor nurses and nurses’ aides have prepared you with their somber smiles and courtesy, the oncologist Dr. N___ under whose auspices Gerard McManus has been admitted to the Santa Tierra Cancer Center has deftly avoided you, your reddened eyes, raw ravaged gaze which is (you will see in time) just another way of preparing you for the worst for to the nattily dressed Dr. N___ who favors colorful linen shirts beneath his white jacket, at times even a bow tie, the loss of any patient is an embarrassment. And the (possible, potential) loss of a patient as distinguished as Gerard McManus of the Santa Tierra Institute for Advanced Research is an acute embarrassment, an occasion for artful circumlocution, awkward jokes and allusions obscure even to Gerard McManus who nonetheless tries to laugh politely when such a response seems warranted.

  You don’t laugh at Dr. N___’s awkward jokes. You stare hungrily at Dr. N___’s mask of a face willing the eyes in that mask to engage with you which very rarely they will do.