CHAPTER 3

THE TESTS REVEALED THAT PAUL HAD A MASSIVE STROKE, one tailored to his own private hell. In the cruelest of ironies for a man whose life revolved around words, with one of the largest working English vocabularies on earth, he had suffered immense damage to the key language areas of his brain and could no longer process language in any form. Though not visible in the CAT scan’s chiaroscuro world, other vital language areas had also wilted, leaving a labyrinth of fragile liaisons hushed. Global aphasia, it’s called. Paul’s aphasia was indeed global, round as his head, a grief encompassing our whole world. I’d never heard the expression before, and didn’t want to think about the full cartography of loss. Yet I had no choice because someone had to make decisions about his care—informed, clear-headed decisions.

Where was the tutelary angel who should descend at such times and restore the everydayness of things? I felt acutely unqualified. I hadn’t volunteered for this job, and never would have, given how much was at stake. I didn’t want to be responsible for my loved one’s life. Sitting in his hospital room while he was enduring more tests floors below, I could picture him in my mind’s eye, glowing red with warmth as he was wheeled through the chilly haunts of the hospital, could track his travels as if I were a pit viper sensing his heat through tunnels underground. I felt very much alone, scalded by my own ineptitude, and thought: Forget angels. Where are all the grown-ups when one really needs one?

I knew his plight wasn’t unique. Browsing the pamphlets I’d picked up in the waiting room, I discovered that stroke is the number one cause of long-term adult disability in the United States. Paul was now among the 5 to 6 million American stroke survivors, and of those he’d joined the ranks of over 1 million Americans living with aphasia—a void of language, a frustrating perpetual tip-of-the-tongue memory loss, a mute torturer of words, a jumbler of lives. Aphasia doesn’t just cripple one’s use of words, but the use of any symbols, including the obvious ones: numbers, arrows, semaphore, sign language, Morse code. But also the lightning bolt that spells electrical danger, the three triangles that warn of radiation, the intersecting arcs that announce a biohazard, the cross that locates a hospital on a map, even the paper-doll man and woman on restroom doors.

In 1861, French neurosurgeon Paul Broca inspected the brain of a dead patient, known as Tan, who’d suffered from an unusual complaint. Although he understood language, he could neither speak nor write. All he could say was the one syllable—Tan. Broca discovered a large lesion in the lower left front of Tan’s brain, and when he autopsied the brains of other patients in similar straits and found matching wounds, he declared the peanut-sized area the home of language. That was the first patch of the brain pegged to a specific function, and it still bears Broca’s name. Ten years later, German neurologist Carl Wernicke realized that patients with a lesion in the left rear of the brain often spoke incoherently, and he flagged this second area as key to comprehending language.

For the longest time, people believed that the neural pathways of language curved along a Silk Road, journeying from Wernicke’s area to Broca’s, and when Paul had his stroke, that’s what all the textbooks taught and I accepted. But recent strides in brain imaging now suggest that word signals spread widely, detour through mazy souks in the temporal lobe, and strike Wernicke’s and Broca’s almost in parallel. It seems those two classic word-mills don’t so much specialize as conspire to fabricate language, and other artisans contribute to the neural weave.

When we hear a noise, the brain analyzes the incoming stimuli, asking itself: Is that weird yammering human? Is it a syllable, a real word, just nonsense sounds? If it resembles speech, the brain conjures up the memory of how certain words sound, associates them with meaning, and furnishes instructions on how to use the muscles of the tongue, throat, lips, and mouth to dispatch a reply.

In so-called convergence zones, cargo from the senses combines with emotions, resemblances, a tangle of memories, and other mental spices. As neural traders hobnob (wiring and firing together), they grow stronger ties in the process, establishing a quick route for future trade. The brain relies on such guilds of neurons firing in synchrony, but they don’t have to be neighbors. They don’t even have to share the same hemisphere. Still, they forge vast assemblies of cells. One such convergence zone in the parietal lobe, gravely damaged during Paul’s stroke, is associated with drawing meaning and emotion from language, with providing music’s rhythmic enchantment, numbers’ clout, writing’s constellations, telling left from right, directing thoughts outward to the bright spangled world, and deflecting thoughts inward to judge a feeling or hatch a plan. Adding to the carnage, adjacent cells that spur movement can be injured, too. It’s the equivalent of knocking out a state’s electrical grids. After that comes a cascade of silently detonating disabilities.

My mind raced. In an instant, Paul had moved to a land of foreigners, whose language he didn’t speak and who couldn’t understand him. He’d become the unspoken, the unspeakable. In our most talkative of worlds, where lovers coo and confide, friends and family chatter, employers dictate, stores pitch, and all the ready forms of entertainment for the sedentary or sick (TV, books, doctor’s office magazines, newspaper, movies) babble language. Suddenly he could not comment, share thoughts, voice feelings, describe hurts or desires, ask for help.

Over the next day, Paul slept a lot, thank heavens, and, in a stupor, I dragged home to shower and nap, and also cancel upcoming book tour events. I needed to let the venues know so that, with any luck, people might see the last-minute “canceled because of family illness” postings. But I still felt guilty imagining them arriving at events only to find a cryptic sign awaiting them. I emailed editors who expected work to be turned in, and canceled all assignments. My project lay in a narrow bed across the lake.

ON DAY TWO, I swooped up the highway edging Lake Cayuga, a cavernous lake too murky for scuba diving, with a rumored underground passage connecting it to Lake Seneca, and a legend of long-necked monsters. Small white sails battled chop on the steel-blue water. I’d admired the lake thousands of times, and glimpsed it while driving thousands more. It always looked different, depending on its mood, and mine. As I drove, it stabbed at the corner of one eye, shining dimly, not glacial at all, but like some impure metal, with slaggy brown inlets, and at times a glaring surface tense as aluminum. Every landmark I passed held spring-loaded memories.

The hospital is located on a hill overlooking the lake, and just past the Finger Lakes Massage School, Paleontological Research Institute, and Museum of the Earth, which houses over 2 million species of fossils. Paul used to chuckle about the road being an avenue not of pines but of spines, traveling from spiny trilobites to spinal taps, and enjoyed the jazzy rhythm of the fossil syllables: “Cenozoic benthic foraminifera.” Whenever we drove past it, he’d pronounce “mollusk” very slowly and roundly, just for the mouth-feel.

Near the hospital intersection, a roadwork sign warned: BE PREPARED TO STOP AT ANY MOMENT. I felt my jaw dropping. It sounded like a warning, and also a reminder, as if I needed one, that most likely I wouldn’t be hearing Paul say “Cenozoic benthic foraminifera” anytime soon. Or playfully rounding out “mollusk,” either. Would we ever laugh together again? Glancing down to find myself grinding one fist on the steering wheel, I wondered, How long have I been doing that? but kept right on doing it. Parking, then a space walk into the hospital.

When at last I braced myself and entered Paul’s room, I crossed the threshhold into a world that was unfamiliar, with an unfamiliar man lying in it. Although he looked like Paul, he wore a distorted scowl, and seemed to unhinge his whole body in a vain attempt to speak, reeling upright, flexing his shoulders at odd angles and flailing his arms against the bed. Then he switched to just a facial tantrum—cheeks, eyelashes, jowls, and nose writhing as he desperately fought to communicate something. His mouth slouched to the right, his lip curled, and for a moment all I could see was a glint of drool at the corner of his mouth, a thin shiny trail like the rune left by a slug.

“Hi, honey,” I said, trying to rally a small smile from somewhere in the coal-pits of my belly.

He stared at me, his eyes declaring: What on earth are you driving at?

Then he fidgeted about in a vain attempt to muster all the aggregate parts of his being, but only finding a blurred view of what had once moved in unison, he spluttered: “Mem.” When I didn’t respond, bringing down his clenched fist on the bed railing, he repeated it in loud italics: “MEM, MEM, MEM!”

“Easy now, easy, quiet down, it’s okay,” I said in what I hoped was a calming tone, the same one I’d used as a coed to quiet headstrong riding-school horses when I was afraid one might gallop into a tree. But his flare up shook me so much that I had trouble steadying my voice.

Paul would tell me later that he felt different than before, newly embedded in himself, as if trapped in statuary. His room seemed to be full of Hopi dancers and dazzling as Mardi Gras. Almost festive. He felt his teeth blink. Something pagan was going on, with a mad ring to it, like a disturbed vibraphone. People were speaking a foreign language. Maybe Senegalese or Quechua. And they didn’t seem aware of the pandemonium light show and cacophony he was enduring.

When I tried to wrap an arm around him, he threw it off.

“How are you?” I persisted.

He struggled to respond, then he spat a little sound—whgggggggg—as if he were blowing at a candle, followed by a sibilant parade of s’s. On he wrestled, and the more words eluded him, the more frustrated he became, until his temper boiled, his face flushed, his jaw opened and closed in silent damnation, and his eyes darted around the room. At last, he glared at me with pupils tiny and hard as BBs. Suddenly he clenched his fists and thrashed his arms as he shouted: “MEM-MEM-MEM-MEM-MEM!”

I flinched, and seeing that he’d scared me, he quieted down.

“I wish I could understand you,” I said, more to myself than to Paul.

When I reached for his trembling hand, he yanked it away. Thus far, his tantrum hadn’t invaded his legs and feet, which seemed somehow immune to all the turmoil. How strange—his temper stalked only his face and torso, while his lower body stayed calm, free from his rage. I’d once heard that Inuit dancers, to conserve their body heat, danced while seated on fur rugs, using only their upper bodies. Was his brain playing favorites and saving energy in a similar way?

It was an exhausting one-way conversation. I repeated: “How are you?” Not meaning anything by the question except I’m here, I’m sharing your suffering, I wish I could help you.

Paul looked at me with controlled exasperation. All that came back from him was a yawning croak twice, a silent cough three times, and “MEM” barked seven times, and finally murmured almost inaudibly, like the last word from a dying man, as if this syllable alone formed the basis of some life to come. He later told me that he already hated that willful word that sprang loose and clogged his mouth, over and over, no matter what he longed to say. In his mind’s eye, he saw the syllable compulsively scurrying, like a rat in pursuit of a sandwich. If only the right word would present itself, his eyes said, I could still be saved.

“Mem, mem, mem,” I repeated quietly.

“Mem, mem, mem,” he echoed back with a desolation that broke my heart.

Paul fell silent. But the rest of our new habitat was noisy. Remote voices sounded like cats scratching on wood, or monastic prayers, and grew louder as they approached our room, striking a distinct sentence or two as they passed—“Wouldn’t you think?”“I dunno”—before dwindling to sound scraps once more, recognizable only as the distant lilt of human pipes. Low-heeled shoes shuffled past on the linoleum floors. Anonymous skirts and jackets swished like the breath sounds of small whales. Unseen trays and trolleys clanked and clattered through the hallway. Inside the room, the wild tone—that barely-audible background stir we perceive as silence—included purring machines, syncopated pings, the wind shushing behind buttoned-up windows, and faintly humming walls.

“Hawk! Hawk! Hawk! Hawk! Hawk! Hawk!” several crows warned one another so loudly that Paul and I both swooped our eyes toward the windows, searching instinctively for the danger from above of their alarm call, a strident clamor we’d heard often enough in our own backyard. I half expected to see the speckled bloomers of a red-tail perching on the window ledge.

“Must be a hawk around,” I said, mustering a little chat to fill the silence, to help keep up morale.

Paul settled back rigidly on the bed, looking like a sad fallen old idol. Even the crows can communicate, his eyes seemed to say.

WAS I GETTING used to his not speaking? Maybe so, because the next day I began noticing other changes, like his weak, claw-bent hand trying to grip the hospital blanket and tug it up tighter as he settled into a comfortable position. During the stroke, his misfiring brain had told two fingers that something was terribly wrong and to protect themselves by tightening. But the muscles that bend joints are bigger and stronger than those that extend joints, and they always win. Ah, those scrambled nerve signals, I thought, they’re forcing his pinkie and ring finger to contract and stay clenched like this. Poor guy.

Too easily, without warning, my mind kept switching between attention and sensation: the autopilot a parent flies when tending a sick child, and a bedeviled swirling. At home, I thought I heard a unique sound of summer nights in the country: the occasional small sneezes of skunks and raccoons clearing dust from their noses as they snuffle in the dirt and forage through garbage. How we’d loved that sultry July evening when a mother skunk had marched her four kits past the screen door and across the patio. Striped from birth, the young are born blind, deaf, and furry, so we’d assumed they were on one of their first patrols and that mom kept a well-clawed burrow somewhere in the yard.

“They don’t look real, do they?” Paul, tickled with wonder.

I’d tugged at his sleeve in Look, look! excitement. “Each one with a little white cap—perfect!—and an exclamation point down its nose! Sweet.”

“I could use the tails as paintbrushes. . . . Want one as a pet?” He’d sounded half serious.

I’d smacked his hand lightly. “No, no, wild animals stay where they belong.”

“Do we belong indoors?”

“Point taken.”

He’d curled an arm around my shoulder. “Anywhere with you, my lamb.”

I’d baahed quietly. Night was falling then, and humans belonged undercover at least.

Not in the belly of a hospital for any length of time. Lifting his hand now as if it were a large, delicate seashell, I pried open the fingers and wrapped them around a Styrofoam cone lying on the bed for that purpose. This was like a trick I’d used at home with tight knee-high socks, fresh from the wash, forcing their fibers to stretch by wrapping them around flexible plastic hoops. Did it really work on the textiles of flesh and bone? At least it prevented his fingernails from gouging his palm, but the cone kept slipping free, since Styrofoam is slick and his hand, swollen from lack of use, had already grown stiff and inflexible. Again I lifted what had been a beefy, reassuring paw, which didn’t feel like Paul’s hand any longer, but bloated and cool. More like the hand of a drowned sailor, washed ashore on the pebbled beach of the cold lake. The thought gave me goose bumps.

“The nurse said to elevate your hand to ease the swelling,” I murmured as I propped it up on a pillow. Paul looked at me blankly, making it clear that he hadn’t a clue what I was saying, but would peacefully surrender a body part there was no use in fighting over.

A young aide appeared and guided him into the bathroom, and to my horror I watched a strange drama unfolding as Paul tried to groom himself.

“Here you go, Mr. West,” she said, handing him a black plastic comb. “Would you like to comb your hair?”

There was a time, long ago, when raking his thick hair with such small tines would have left the comb gap-toothed. Using both hands, he now held the comb for a moment and considered it as if it were an object from deep space. Then he struggled to wrap his puffy fingers around it, and dragged the comb along the side of his head, smoothing his hair, not combing it, as if he’d forgotten how a comb worked, but remembered where it went and the general motion. Was combing your hair difficult? I tried to remember when I first learned how to hold a comb, and what movements guided what mirror images, which motions led to which results. But I couldn’t travel that far back into the electric mists of my childhood.

The aide repositioned the comb, holding Paul’s burly hand in her small one, steering it gently. I struggled to keep my hopes from plummeting. How much of his difficulty came from sheer bewilderment, I wondered, how much from lack of coordination? The end result was the same either way, and not just with combing. Hamfisted fumbling when he tried to open the water taps at the sink, which he couldn’t manage without assistance. Confusion about how to lower himself safely onto the low toilet, and after that a look of humble desperation as he gripped a wad of toilet paper in one hand, not knowing how to use it, his eyes silently pleading for my help.

“Here you go. Take it slowly. You’ll be all right.” I could only babble reassuringly, though I doubted he understood, and I hadn’t a clue what his future might hold. No one did. Your poor battered brain, I thought, trying to peer through bone on the left side of his head, to where the brain stores the memories of how things are done, how to perform simple tasks. His stroke somewhere in that region had clearly unskilled him. Now his years had come unglued.

Walking back to bed, he veered and tottered, hands jutting out from his sides and then reaching in front of him, as if he were navigating through a dimly lit house. He could see well enough for the short journey, but all of his senses had been rattled by the stroke, it was as if (he later said) someone had reached a hand inside his head and turned the dials up high—everything was too loud, too bright, too fast—and he could no longer trust his eyes. He wasn’t walking the way most adults do, with only one foot on the ground at a time and the legs swinging as a double pendulum. More like stepping over rock fragments at the bottom of a cliff: lifting one foot, putting it back down without moving forward, lifting the other foot, taking a step. And sleepwalker’s hands. It was nothing I had seen before. He didn’t walk like a one-year-old, discovering how. He walked as if he were inventing walking for the first time. Not the breezy strides of a professor across a dappled quad, not the spry shuffle of playing croquet on the lawn, not the march down the driveway to collect the mail.

The bed might just as well have been a rowboat lashed to a dock in a hurricane. Pressing a button, the aide lowered it as far as possible, and turned Paul sideways, planting his weak right hand on the bed rail. But Paul didn’t seem to understand that he needed to lift one leg up while leaning forward in a controlled fall, while simultaneously swiveling onto his side. It wasn’t one motion at all, but three contrary moves. I hadn’t thought about the complexity of climbing into bed before. How can the body forget that? I rushed with tenderness as I watched him struggling with a skill he’d practiced at least thirty thousand times in his seventy-five years. With a half-jump from Paul, a heave from the aide, and a tug from me, he finally landed in bed, on his back, out of puff, and the aide raised the bed once more.

All I’d done was stand nearby, and tug when needed, walk nowhere, say little, lift nothing—and yet I felt winded and tired.

At breakfast, a cheery young man delivered the local newspaper, which Paul had idly perused during his pre-stroke weeks in the hospital, when, exiled across town from his house and haunts, he was desperately in need of distractions. He’d enjoyed its small-town flavor—diner closing for health reasons, hospital planning a new wing, bloody shoes found in a murder trial, zebra mussels invading the inlet, historic building preservations, a man cleared of shooting his mother-in-law with a shotgun on the grounds that he mistook her for a raccoon, citizens sharing pothole alerts. Now the paper lay untouched, and after a while I handed it to him, thinking that, even if he couldn’t speak, maybe, just maybe, he could read a headline or two, or at least look at the photographs?

Paul dutifully accepted the newspaper, and opened it with a crackling flourish, holding it like an oversized storybook or menu. He stared vaguely at the pages, one after another, until his brow began puckering and he grew bewildered. He knew he should be doing something with the newspaper. But whatever the something was, it wasn’t happening. The mossy-smelling, freshly inked letters were just two-dimensional daubs, arranged tidily, but completely without meaning. Paul cocked his head and squinted as he tried to decipher the arcane symbols, flustered, but also a little embarrassed. At last he set the paper down, glanced at me hard as if I’d ambushed him, glanced away.

Oh my god, he really can’t read! I realized, as the enormity of his affliction began seeping even deeper into my ken. Not the signs in the hall—Entrance, Lavatory, Danger—not street signs. Not the thousands of books in our library at home that we’ve painstakingly, joyously collected over the years. Not Shakespeare, Rilke, or Beckett. Not his own work.

On the wall, an oversized clock ticked away the hours, though he couldn’t pronounce the numbers, couldn’t do numbers period. His parietal lobe had been crippled, and in it somewhere, all the accountants had died.

“Do you know what time it is?” I asked, still grasping for the miracle of a right answer, any sign at all of improvement. His gaze followed mine to the clock, and he knew that time had something to do with the moon-faced white object on the wall decorated with cryptic symbols. I later learned that they reminded him of markings on the debris supposedly left by a UFO at Area 51.

Beneath the clock, glaring at him like some Kafkaesque depravity, hung a white wipe-board on which aides wrote each day’s schedule in large block letters. All day long, he faced that roll call of the nurses on duty and the rendezvous with physical and speech therapists that awaited him. Unable to glean even the slightest shred of meaning from the schedule, he floated anxiously, with nerves frayed and scrambled, through blurred time, not knowing who or what would come next.

“But such sensations and noises belonged presumably to no one else,” he would tell me later, “and I took pride in that, while yearning for the quiet I once knew. I, who had been a little slothful, now felt constantly agitated. Yes, it was all a matter of what came next. Life had seemed to me a toss-up between not knowing what came next and a bright insistent message that everything was all right. I had no idea what or who or when. Only where, only here, and even that was hazy.

“I was a case of a man who had come round from delirium to find a cascade of minute changes in his world, which couldn’t be ignored as the big bustle of everyday living took charge. I sensed in the complex fabric of my being that I had been remarkably altered. Changes irrevocable and final. I accepted these hammer blows from creation as overdue, as part of the mystery that people simply have to be dispatched for other people to replace them.”

My own mind returned to the chilling road sign: BE PREPARED TO STOP AT ANY MOMENT. Then, instead of a void or a blockade, I remembered a day I happened upon Paul in our library, humming happily as he rummaged through his treasures. He collected spotters’ guides to world aircraft; lavishly illustrated views of astronomy and the oceans; airplane magazines; British schoolboys’ adventures; accounts of WWII; movie guides; and biographies of composers, boxers, cricket players, gunmen of the Old West, and UFO abductees. On this occasion he was searching through his old railway timetables from countries he’d never visited (just because he enjoyed imagining the trains chugging through the landscapes) for a nineteenth-century schedule of tea trains in Ceylon. Not even for research. He just wanted to thumb through it in the sun and imagine catching a ride.

“I see you’re up to your old tricks,” was all I’d needed to say.

“It’s that, or pack a duffel bag for India . . . ah-hah!” He pulled a moth-eaten pocket-size booklet from a shelf. “This is cheaper.”

What would he thumb through now? Maybe photography books . . .

A green-garbed cafeteria worker swooshed in bearing a tray, plunked it down heavily on a side table, and I helped swivel it into position over Paul’s bed. Hovering, I supported his back with extra pillows so that he could sit up straight, as we’d been soberly instructed to do since Paul was having difficulty swallowing and he’d be less likely to choke if sitting upright. Then I coaxed him to lean forward as he ate, and urged him to take very small bites. Meal trays offered soft food and stiff trials.

“Here’s your spoon, honey.” I handed him the normal cafeteria spoon, which twiddled right out of his fingers and rang as it hit the floor. Next he tried a spoon with a fat handle—more like the Styrofoam cone—better for grasping. I placed it slowly in his hand and locked the fingers around it. He moved it like a snow shovel, plowing at the scrambled eggs until some ridged onto the spoon, then spilling most of it down his gown before it reached his mouth. He closed his eyes in disgust and waited while I laid a towel over his chest to catch further spills. Instead of saying “Mem, mem, mem,” he tried to pronounce something alien and profound, which came out as “Mem, mem, mem, mem,” nonetheless. He meant: What’s wrong with me that a jam-butty can’t fix? Jam-butty: the strawberry-jam-and-butter slabs of bread that highlighted his childhood. If the jam made it to his mouth, that is, without plummeting down his chest.

“That’s okay. Your coordination is a little off. Try again.”

Wrapping his fingers around the log-like handle, I helped him scoop up eggs and aim for his mouth, which he opened much wider than he needed to, offering a gaping target, and I thought he smiled a little as the eggs fell in. But with a rubbery, uncoordinated jaw, his mouth couldn’t trap the food, a dash of which seeped from one corner and onto the towel, creating a lumpy yellow tie. Quickly he wiped his chin with the towel, smeared it really. Paul looked horrified by the mess he had become. Yet he insisted on trying to feed himself again. Up came another spoonful, but soon after liftoff his spoon tilted sideways, spilling the yellow curds onto the lip of his plate. Still holding the spoon aloft, swinging it sideways like a construction crane, he began searching his tray for the fallen egg, unable to find it.

“It’s right here.” I collected the morsels with a cafeteria spoon and fed him by hand, as if feeding a baby, stunned by the new routine. One minute I was crying at home, the next spoon feeding my husband.

It was becoming painfully clear that he would need lots of rehabilitation to be able to return home—if living at home was even possible. If not, I would need to consider the unthinkable, the unspeakable, something so mind-blowing I didn’t dare give it words lest they act as a jinx, something that felt too old, too wrong. A nursing home. How could this be? Was life really so different than it had been only days ago?

Wistfully, I replayed a phone conversation we’d had just a few weeks before. I was on the West Coast, and we’d talked for half an hour or so, about nothing, about everything, including a painful predicament I’d found myself in with a good friend.

“Some mess, huh?” I’d simmered into the mouthpiece of the telephone. “How can anyone not love life, when given enough time it will exercise absolutely all the tender little muscles of one’s heart?”

“You are an earth ecstatic,” I’d heard Paul sigh.

“Was there any doubt?”

“Just don’t get too nutsy about looking for answers,” he’d advised, half seriously. “As Confucius said, enjoy the heist. Don’t buck the current. Try to keep on top of the dung heap. Maybe you’ll find the open-sesame of matter after all.”

I’d laughed and parried: “If I were Herod in the middle of the Massacre of the Innocents, I would pause just to marvel at the confusion of that image!”

“Listen, puddin’ cheeks . . .”

“Puddin’ cheeks?” My eyebrows had leapt up.

“It’s part of my British ethnic revival. I’ve got to get back to work before the secretary blows the whistle on me.”

“Blows your what? Sure you wouldn’t like to step into the darkroom with me and see what develops?” I’d said this in my best Mae West voice.

“Ha-ha . . . something just occurred to me.”

“What’s that?”

“We can go on meeting like this,” he’d said tenderly. “Over and over and over.”

“Thank God.”

Then semi-jokingly: “. . . You know, your agnosticism is much too vocative to take seriously . . .”

“Hey, I thought we just finished that part of the conversation. This is the part of the conversation where we make nice-nice and hang up.”

I tried to push the memory away, but it floated like an iceberg, glassy, blue-streaked, riddled with air bubbles from an earlier age. Was that flavorful part of my life really over?

As the hours splintered and Paul underwent another barrage of tests, my hope died a little with each one. His brain was woefully scrambled by the stroke, and, worst of all, he kept throwing childlike tantrums.

“What shall we do?” I asked Dr. Ann, my voice flattened by despair. “Maybe I should take him to a rehab center somewhere? I looked up some on the Internet, and there’s one at the University of Michigan that sounds like it might be good. . . . I can’t believe I have to think about this. I don’t even know how to. The choices are overwhelming.”

“I’ll help you,” Ann said, wrapping a strong arm around me, a swimmer’s arm. “We’ll figure this out together.”

We were standing at the nurses’ station, out of Paul’s hearing, huddled at a counter in a wash of stark light, as if inside one of Edward Hopper’s lonely paintings. I had little family left, Paul was almost all of it, but, like family, Ann knew our joys and sorrows. Together we mulled over several large urban hospitals offering intensive stroke rehabilitation programs.

“I could contact a friend at Hopkins,” she offered somberly.

“But, at seventy-four,” I thought out loud, “with his heart trouble and diabetes, could he even handle the upheaval of the trip, and cope with living in a hotel, let alone a strange city, all the new faces—he’s so confused!—and completely unfamiliar doctors and therapists? Could his heart take the upheaval?”

“I don’t know,” she said truthfully. “And, you know, he may have to wait a week or two for an opening . . . then we can arrange to have him transferred. . . . Or he could stay here, and maybe go into the Rehab Unit downstairs—maybe even tomorrow, if they have a free bed.”

“There’s a rehab unit downstairs?”

That was a land I didn’t know about and had never visited. In my imagination, it existed as the Land That Time Forgot, a preserve of dinosaur-like patients lumbering over linoleum floors. Or will it be brisker and brighter than that, I hoped, more of a workshop for broken racing yachts?

Over the years, while he coped with diabetes and a pacemaker, the hospital had already become a too-frequent port for Paul. Now it would be a salvage yard, for how long I didn’t know—surely a few weeks. But that made the most sense, at least for now. I returned to Paul’s room.

“MEM, MEM, MEM, MEM?!” he demanded hoarsely, which I took to mean, Where did you go! Don’t leave me!

“I was nearby, at the nurses’ station, talking with Dr. Ann.” Bedbound as he was, I might just as well have been in China.

In a fog, without sleep, I tried to explain to Paul what was happening and discuss where he would be going—instead of home. He understood just a fraction. “Mem,” he uttered first pleadingly, then angrily, over and over.