14

What Was Wrong

Ronnie’s driver’s license photos, showing the growth of his facial features, provided unintended documentation of his disease.

I was reading in bed when my phone rang at ten thirty on a Tuesday night. A newspaper editorial assistant was relaying a telephone message from a woman looking for Ronnie Overstreet’s sister. The caller couldn’t remember my name. All she knew was that I was a reporter. The editorial assistant pieced it together.

It was Ronnie’s landlady and good friend, Maxine Booth. She was frantic. The Vinton First Aid Crew had just taken Ronnie to Community Hospital of Roanoke Valley. He was in grave condition.

I’d never met Maxine. She’d gone away for a long weekend, and when she returned home that Monday afternoon in April 1990, she heard labored breathing from within Ronnie’s bedroom. The door was chain-locked from the inside. After much pleading by Maxine, Ronnie came to the door in his underwear, then collapsed on the floor. For almost ten hours, he refused to let her call the rescue squad. “Hell, no!” he thundered. Finally, just before she dialed the newspaper, he let them come. Maxine was exhausted, and fearful. She didn’t drive at night. “You need to go to the hospital, Mary. He might not make it.”

I threw on clothes and flew out the door. I’d known all along that something was wrong with Ronnie. But I kept my distance and didn’t ask about his health. Before I could see him that night, doctors told me that by the time paramedics reached Ronnie, he’d passed out again. He was dehydrated from days of respiratory distress. His blood pressure was 240/140, high enough to bring on kidney failure or a stroke.

Once he came to, he told the staff he hadn’t eaten for days. In the emergency room, they inserted a plastic tube in his throat to make sure he could breathe. He yanked the tube out a little while later in intensive care. Staff tied his hands and feet and reinserted the tube. In the space for family contacts on his hospital admission form, somebody typed in capital letters, “NO ONE.”

By the time I got there, Ronnie was sleeping and stable, so I went home and napped for a couple of hours. Right before I got back early the next morning, doctors tried to pull the tube out to see if he could breathe without it. His throat snapped shut. Ronnie panicked. I watched terrified through the window of the door as Ronnie bucked like a horse and the team of eight—doctors, nurses, an anesthesiologist, and a surgeon—struggled to reinsert the tube. They gave him Valium, and when he woke up banging his tied arms on the bed rails, more Valium.

As I walked down a hallway, one of the medical residents asked if I knew what was wrong with Ronnie. I said no, that we’d just gotten reacquainted after a lifetime apart. I couldn’t figure out why he’d changed so much since I knew him as a child. It took only three words to solve the mystery. “He has acromegaly,” the doctor said. I’d never heard the word.

Ronnie had a tiny benign tumor, little bigger than a postage stamp, on his pituitary gland. He’d had it for at least twenty years. The condition, acromegaly, had stimulated the gland to produce growth hormones that caused Ronnie’s forehead, nose, mouth, hands, feet, and heart to grow. The disorder led to shrinkage of his airways. It had nearly squeezed the life out of him. Normal growth hormones in an adult measure around eight. Ronnie’s were fifty in the first hospital test and, later that day, seventy-two.

Now it all made sense. After each time I’d seen Ronnie, I’d tried to explain to Mom and my friends how something was deforming him. I’d never seen anything like it.

The doctor said they could have stopped Ronnie’s acromegaly years ago, before it did most of its damage to his body, but no one was there with Ronnie to wonder what was wrong. Where was I in all this? Our mother? She’d seen him in the 1970s, and wondered, too, why he looked the way he did. But we were guarded around him. We hadn’t pressed the issue. Neither had Maxine.

In my first phone talks with Maxine, I zeroed in on her as my scapegoat. She sounded fake sweet. “He’s like one of the family,” she kept saying in her little-girl voice. “My whole family thinks the world of him.” She emphasized that she never went inside Ronnie’s bedroom, just down the hall from hers. “He’s a very private person.” She knew he was living “clean and right,” though, and that’s why she welcomed him to stay on after her husband died seventeen years before.

Ronnie had told me about mowing Maxine’s yard and doing chores around her house. He sounded like a new version of a tenant farmer to me, like our kin. As my mind raced for answers, I blamed Maxine for Ronnie’s troubles. I imagined that she’d held him in some nagging system of peonage, a free room for his labors, and he’d never been able to set himself free. She’d kept him from getting out and making the close friends who might have urged him to get help for his condition.

Finally, with the breathing tube reinserted, nurses untied Ronnie’s hands. He couldn’t talk. His eyes were wild. He mouthed words I couldn’t make out. Eventually, we got him a pen and paper. He wanted me to know that he had health insurance and that he had $20,000 in Southwest Virginia Savings and Loan in downtown Roanoke. He must have thought he might die there in the hospital, because he was most determined to tell me that he had life insurance too and that he had cash hidden at Maxine’s house.

I was keeping Mom posted. That Wednesday, Ronnie’s second day in the hospital, she and Daddy arrived at the ICU. It was their forty-eighth wedding anniversary and the first time they’d seen Ronnie in years.

I was seated in a chair by his bed when they slipped quietly through the door. Over the heaves and sighs of the machines helping him, Ronnie heard his mother’s voice. Standing there in her mauve London Fog raincoat, she greeted him apprehensively, “Hi, Ronnie.” His eyes shot over to her, and to Daddy, standing beside her with his arms behind his back, hanging his head a little. I kept my eyes at the foot of the bed, at Ronnie’s blood pressure readout on the portable vitals cart. It was 200/215 and climbing.

Ronnie was still smarting from the last trip he made to Mom and Daddy’s at Bridlespur in 1976. Daddy had asked him then, “Ronnie, what do you want?” Ronnie thought Daddy was implying he’d come to ask for money, which Ronnie had never done and was too proud to do under any circumstances. The question infuriated and humiliated him. I don’t think he confronted Early about it at the time, or ever, but Ronnie never forgot the perceived slight. I had asked my folks about that day. Both recalled Daddy asking the question. They insisted that what Daddy meant was “What do you want out of life?” That struck me as lame. Whatever Daddy meant, he should have known it would hurt Ronnie. The rip in Ronnie’s relationship with my folks widened even more after that.

Now, in the ICU, I could feel that their presence was so stressful to Ronnie that it could kill him. My brother, who would only present himself to them in an optimal state—finest clothes, shoes shined, hair freshly cut, car waxed to high gloss, statuesque girlfriend by his side—was laid out there at his most vulnerable. He was in no condition to entertain the nemeses of his life. I had to get them out of there. I whispered that we should go. They, as well as Ronnie, were visibly relieved.

That evening, Mom and I finally met Maxine and saw where Ronnie lived. We went to the house, as the doctors had suggested, to retrieve his wallet, his identification cards, and any documentation of health insurance. Ronnie also wanted me to gather whatever cash I could find and to keep it safe for him.

I still didn’t trust Maxine. Why was Ronnie so nervous about leaving money in her house? But she actually seemed like a pleasant woman. She was short, plump, with reddish-brown hair and warm blue eyes. She unlocked Ronnie’s two rooms, which she referred to as his “apartment.” Clothes were piled four feet high around his bedroom. An interior doorway just past his disheveled bed led to the sort of kitchenette—refrigerator, small sink, stove—homeowners installed long ago so they could rent out a room. Ronnie had no bathroom of his own. He shared one down the hall with Maxine.

Mom, still in her raincoat, followed Maxine and me silently into Ronnie’s chamber. Her mouth hanging open, her eyes rapidly blinking, she looked around at the filthy bed linens and the heaps of paper, trash, and shoes scattered around the floor. This was her child’s home, a dysfunctional, dirty mess.

As Maxine looked on, I searched through a stack of down vests I’d spotted in a corner on the floor. Ronnie said he’d stashed money in a vest, but I found no money there. I grabbed the khaki pants he’d worn before the rescue squad came. Back at my house, I searched the contents of his pants pockets. I found his wallet, five driver’s licenses, some small folded papers, and $5,800 in cash. Ronnie had been walking around with more money than I’d put down on my house. That was the night I found the banded stack of Mom’s long-ago letters and birthday cards.

Mom and I returned to the hospital for an evening meeting with the doctors. At a desk in a room down the hall from Ronnie, I lined up in chronological order the pictures I’d just found in Ronnie’s room: Ronnie at three, then at around twenty-five, then his driver’s license photos throughout the seventies and eighties. Snips of hair from Ronnie’s customers had wandered from his hands to his pockets and his wallet, and now they sifted down onto the desk. In the photos, we witnessed a painful march of bone and flesh across Ronnie’s face. One of the doctors quietly mumbled, awestruck, “Watch it grow.”

We saw how the acromegaly gradually expanded his jawbone and lengthened his chin by inches. His forehead bulged; his lips blew up. What we couldn’t see in the photos was that his teeth had separated. His hands were widening. His middle fingers bulbed out at their tips like little lightbulbs. At age fifty-four, his feet were still growing. I made a mental note of the small mountain of old shoes I’d just glimpsed in his bedroom.

A few years before the disease finally sent Ronnie to the hospital, a survey of acromegaly patients found that on average they lived with symptoms eight to ten years before they received a diagnosis. Ronnie had put up with warning signs for at least twice that long. His diagnosis came only when he nearly died.

Usually a man Ronnie’s age had a wife and children to wonder why he kept outgrowing his shoes and why his facial features kept changing. Nearly everyone with the disorder seeks help and halts its progression. That’s why Ronnie, with late-stage acromegaly, was so unusual. The youngest doctors standing beside Mom and me in the hospital that night had only read about acromegaly in textbooks. They’d never seen it in person, much less such an advanced case.

They explained to us that when a person develops a pituitary tumor before puberty, the legs and arms keep growing and the patient might become a giant. Ronnie may have been as tall as six foot five at one point—his height measurements vary throughout his records—but he was not a giant. He was an Overstreet, and we tend to be tall. His tumor came along after puberty, when the long bones of his limbs had fused. Therefore, his overgrowth concentrated in the bones of his hands, feet, and face and in his organs and soft tissues.

Quickly I was absorbing the medical reasons for two of Ronnie’s traits that long had baffled me—that deeper-than-ever voice and his persistent joint pain. Acromegaly reshapes the larynx, deepens the voice, and enlarges air cavities in the cranial bones, all of which gave Ronnie’s voice a deep, gravelly, hollow-sounding resonance, a basso profundo that boomed as from the bottom of a well. Between customers in the barbershop, he would flex his shoulders violently—shoulders in, shoulders out, like a bird repeatedly pushing back its wings. Now I learned that painful overgrowths at the shoulders, hips, knees, and back are common with acromegaly.

* * *

MOM HAD BEEN in such a rush to leave home that day that she’d forgotten to grab her Ativan, the antianxiety drug she’d become addicted to since she was forced off Bridlespur eight years earlier. One of the doctors called in some to my pharmacy so she could sleep that night. With all this terrible news about Ronnie, she was a wreck. She stumbled around my house like a zombie, groaning as though she hurt, and then she blurted out, “Mary Carter, I told you who Ronnie was.” When I was little, she’d revealed to me that he was my brother, but I was too young to understand. She never mentioned it to me again.

Mom and Daddy drove back to Charlottesville the following morning. From then on, it was just Ronnie and me, side by side in the hospital for the next thirty-seven days. In between his medical crises, whenever the plastic tube was out of his throat and he could talk, he spat out more of his story, and I began to deal with my conflicting feelings about him. I was fascinated with Ronnie the story. But what about Ronnie the man?

* * *

I THOUGHT EVERYTHING would get better now that he’d been diagnosed. That’s the way doctors were laying it out for us. That, I guess, was what they were hoping for.

On his fourth day in the hospital, after the tracheal tube came out without complications and he could talk again, I began to share with him what I was learning about his hormonal disease. Doctors had explained the basics to me, and now I was reading about it on my own at lunchtime—at the newspaper and in the library. It was believed that only forty people in a million worldwide had it.

Ronnie stared at me, expressionless, as I explained his symptoms to him and the solution the doctors were proposing.

A pituitary neurosurgeon could take most of the tumor out fairly easily, not by cutting into Ronnie’s head but by threading a slender instrument through his nose or under his upper lip to reach the pituitary through the sphenoid sinus behind his nose. I told Ronnie that once the tumor was plucked, his feet and hands would stop growing. Some of the soft-tissue growth, such as that of his heart, larynx, tongue, nose, and lips, would gradually subside. He would breathe more easily; he would sleep more soundly. His protruding brow, however, and his long jaw and his big hands and feet were permanently his.

Most urgent was the need to get the tumor out and away from his optic nerve. Doctors were warning that the tumor was already pressing on the nerve. A few more nanometers of tumor growth could snuff out the paired optic nerve to his eyes and blind him instantly. Heroic notions swirled in my brain. I was going to make up for all the neglect of his life. I was going to save him. I would compensate for my childless years and become the mother he’d never had.

Ronnie had listened patiently. Then I heard the first inklings of denial welling up in him. “Oh, I’m getting better. It’s not that bad.” Yes, he acknowledged, his shoe size had crept from 12 to 13 to 14, but he thought his feet were no longer growing so quickly. He was pleased about that. It wasn’t easy finding shoes larger than size 14.

Ronnie’s many doctors, especially the gland specialists, the endocrinologists, were in and out of his hospital room for five weeks. They studied his blood hormones; they looked at his tumor through magnetic resonance imaging, and with his permission, they photographed him. To them, Ronnie was a medical star. Ronnie would ask intelligent questions of them. He’d listen to them earnestly. Then, as soon as they were out of earshot, he’d turn a jaded face to me and laugh. “This is all a bunch of bullshit.”

One day, a visiting pituitary specialist came to his room and laid out a plan. I was excited. At that time, no surgeon in Roanoke had the experience to remove the tumor. So their first idea was to send him for surgery at George Washington University Hospital in Washington, D.C.; Ronnie nodded. He seemed receptive to the idea. But as soon as the doctor left, Ronnie smart-assed to me, “Yeah, then Ethiopia, Bangkok, and Zululand.”

Going to some big city for surgery struck Ronnie as a high-flown lark. Out screeched a smart-ass voice of my own: “Slim, they’re trying to help you.”

“Yeah, easy for them to come up with all these cockeyed schemes. Won’t be their ass going up there to be cut on.”

He privately spouted a bouquet of reasons for his symptoms. He simply looked like the people of Appalachia, who seemed odd to city people but whose ugliness was common in the mountains. Or he’d explain away his condition by saying simply, “I’m a freak.” One of his doctors was black. Ronnie said he identified with the man. “I know what it’s like to be the only one who looks like me in a room.”

Then there was Ronnie’s most bizarre theory, mentioned to me more than once: Somehow all his ailments were a conspiracy to punish him for not taking sides in that fall’s vote on a merger of Roanoke City with Roanoke County. Ronnie recalled a female teller at the bank across from the barbershop laughing and telling him, “Well, you won’t be driving long.” Ronnie interpreted her remark as some sort of threat from the Vinton establishment. This was so crazy that I had no comeback.

Nor did I have one for the most heartbreaking explanation he offered for his condition: “I just look like my old man, whoever the hell he was.”

* * *

THAT AFTERNOON, I rode with him in an ambulance to an imaging center a mile away. Doctors needed to confirm that he had a pituitary tumor and to measure its proximity to other vital structures inside his head. The radio waves of magnetic resonance imaging could reveal in detail all the features inside his skull.

As the heavy door to the MRI room closed solidly behind Ronnie and the aide who would position him, the technician invited me to sit with him in the control room. Through a wide, thick window into the MRI room, I watched the aide’s difficulty getting Ronnie to lie flat on the scanner bed. Ronnie yelped in pain. His mangled right hip and leg, healed crooked after a long-ago fall off a railroad trestle, made it agonizing for him to recline on a hard surface. But for images to be captured clearly, he needed to lie there and hold himself still for quite a few minutes. Once Ronnie settled down, a nurse injected him with Magnevist, or gadopentetate dimeglumine, a drug that clarifies images of abnormalities inside the cranium.

At the control panel, the technician wasn’t allowed (or qualified) to tell me what the pictures were showing on the monitor, although he did point out the pituitary. In images of Ronnie’s head taken straight ahead and to the side, I saw an irregularly shaped lump clinging to the tiny gland. After all these years, the tumor was only the size of a Coca-Cola cap. It measured 3 × 2.5 × 2.2 centimeters, large among acromegaly patients.

A few days later, a radiologist’s report confirmed what all Ronnie’s symptoms, his blood tests, and his startling appearance had already indicated: Ronnie did have acromegaly.

* * *

BACK IN HIS hospital room, Ronnie told me he thought he recognized one of the MRI guys as somebody he’d seen in Vinton. The man was yet another character in Ronnie’s conspiracy theory. He seemed to think he’d been kidnapped by the rescue squad and was being held captive at the hospital. Now I was questioning Ronnie’s sanity.

He bragged to me about “riding the MRI.” It was hot inside that tubelike machine. It banged and clattered like a jackhammer. “I did it to satisfy a whim,” he said with teasing annoyance. “Yours.”

He wasn’t buying any of this crap about some mumbo jumbo called acro-whatever-it-was.

“You know they’re just trying to help you, right?” I said.

Ever the wise guy, he replied, “Help themselves to my bank account, you mean.” I was the spoiled kid who trusted people; he was the neglected kid who didn’t.

Ronnie might have been paranoid, but his irreverence often made me laugh. The fervent Christians who swarmed the hospital especially got his goat. A young Baptist preacher grasping a Bible made his proselytizing round on the ward one day, asking Ronnie, “Have you surrendered to the Lord for your salvation?”

“Naw,” Ronnie shot back lackadaisically. “Haven’t gotten around to it.”

* * *

DURING THOSE WEEKS in the hospital Ronnie told me the worst things from his childhood. That was when he told me our mother warned him at age eight, after he arrived in Keswick, never to call her Mama. That was when he told me he had electroshock therapy at Western State. Every night I went home with ever darker information about him and about my family. That I was aghast at all this surprised Ronnie. “I never thought you’d give a damn about me,” he said, giving me the rare look straight in the eye.

“You know,” I told him, “I owe you for all the good stuff that’s happened to me. You were her first kid. She wanted to do better the second time. I got everything you didn’t.”

He snorted. “You got that right.”

* * *

MY OPENING UP like that unlocked his trust, as well as his mouth. Some days he talked to me for five hours straight. When the nurses bathed him or took him away for tests, I’d go to the waiting room at the end of the hall and write down everything he’d said.

* * *

AFTER RONNIE’S FIRST week in the hospital, I’d already listened to him so many hours that I was exhausted. I was home only long enough to feed my cats and sleep a little. I was overidentifying with Ronnie. I’d seen every square inch of him by then, and my feet, legs, all of me, felt like his. We shared the enlarged, arthritic Overstreet knees and the long, thin thighs of our mama and our grandpa. I felt Ronnie’s brow superimposed over mine. He and I shared the same sour smell of our oily skin. Even my sebaceous glands were kin to Ronnie’s.

I was determined not to abandon him in the hospital. Martyr-like, I was appropriating our mother’s guilt in not caring for him. Here was a chance to use my reservoir of nurturing on my mixed-up brother.

At times while taking Ativan for his anxieties, he became docile and even lovable. He expressed sincere thanks to the nurses. “Thank you, dear,” he’d say as they padded in and out. Some of them and the youngest doctors had been afraid of him earlier when he’d pounded those giant hands on the side rails.

One of his many symptoms was a thickening of skin on his heels. It was a wrestling match to get those tight rubber-bottomed hospital socks over his oversized heels. He thanked me for doing that and for bringing him little tubs of sherbet from the fridge at the nurses’ station.

* * *

IT HADN’T YET been three years since I first reconnected with Ronnie, and I hadn’t told him much about myself. In the hospital, I began to fill in the details. For instance, Mom had never told him why they’d left Bridlespur. I explained that Anne McIntyre Black had fired Daddy and evicted my folks from the farm.

“Mom had kind of a nervous breakdown. We couldn’t get her off the couch. She’d lie there for hours and just cry. Remember what a speed demon Uncle Albert was? They took a little trip with him right around then. Mom was in the back seat and could see the speedometer. She had a panic attack in a little town. They thought she was having a heart attack and pulled over. She saw a doctor who put her on Ativan. She’s tried and tried to get off it, but she’s never been able to.” Ronnie was hanging on my every word.

I described the day I was back home to help the folks pack up the farmhouse. Daddy and I were gathering his tools down by the dairy barn when Mrs. McIntyre (we still called her that) and her new husband drove slowly by in their station wagon. “She gave us a little wave from the passenger seat, like Queen Elizabeth parading by the peons,” I told him, gesturing as she had. “I jammed my hands deep in my jeans pockets and glared at her. They drove on off.”

After I’d finished, Ronnie looked me hard in the eye for a few seconds. Then, with the most malevolent face I’d ever seen on him (and I’d seen plenty), he croaked, “Would you like to see that place burn?” He drew the word out so menacingly that it had flames licking off it. It took me a while to comprehend what he was saying. He meant burn down the big house.

I stared back at him, trying to comprehend this dark proposal. Finally, I stammered out, “Good lord, Slim. No.”

I went home that night chilled to the bone. It wasn’t surprising to me, really, that Ronnie could be vengeful. In our barbershop talks, his cynicism had often bled over into vindictiveness. But I’d never heard him suggest anything so evil, and my response to him had been weak. I’d been too shocked to be emphatic enough.

Now I wondered: What has he done in the past? What is he still capable of, even now, even when he’s sick? For all I knew, he’d dial some arsonist thug over the hospital phone that night and put him on the road to Keswick.

I was back in Ronnie’s room extra early the next morning.

“I couldn’t sleep, worrying about what you said.” I didn’t even want to repeat it; it was so awful. “If anything happened to Mrs. McIntyre, I couldn’t live with it. You’re not gonna hurt them, are you? If anything happens, I’ll know it was you, and I’ll never forgive you.”

“Oh, shit, calm down,” he said, half laughing. “I was just running my mouth.”

But then, in a sinister voice, he coolly stated something just as ominous. His eyes turned to slits, and he boasted, smugly villainous, “I’ve righted some wrongs.” He’d gone to a coal mine and burned it up—or did he say he blew it up? Later, I couldn’t remember which word he used. Either one shook me up.

He told me that years before, on Roanoke’s Williamson Road in the days when young people cruised the strip in their cars on Friday nights and people milled in and out of bars and pool halls, Ronnie had spotted an Albemarle County man he’d once known. He’d had a run-in with the guy back in Keswick long ago. He beat the man up and left him for dead on the sidewalk.

“He didn’t even know me,” Ronnie said with a wicked sneer.

* * *

ONE AFTERNOON I was looking out the window of his hospital room. The office buildings of downtown Roanoke sat below. I seldom had time to regard my new home like this. It looked dear to me.

“I love this little old town. I feel so at home here,” I said.

“You could own a piece of that, girl. You could be somebody.”

He proceeded to go on a rant. I shouldn’t be only a reporter. I should be running the newspaper. Or I should have learned to ride horses back in Keswick. I should have married one of those rich men. Then I’d be sitting pretty in one of those mansions. He was getting all worked up about my failings.

“No, no, no,” I protested. “I don’t want any of that.”

“Ya meek!” he suddenly stormed, his eyes blazing into me. “Ya meek! Just like your daddy!”

Several times Ronnie had implied to me that Daddy was a wimp. Ronnie jeered, for example, at the image of Daddy giving up guns. Daddy had long kept a .22 rifle near the back door to kill rabid animals and chicken-throttling varmints, but that was his only firearm. He’d quit hunting long ago, and fishing too. He felt rotten causing a fish to struggle on a line with a hook in its mouth. Daddy’s decision to quit killing wasn’t far from Ronnie’s own turn away from slaughtering wildlife. In his last years in the woods, Ronnie told me himself, he shot far more pictures than animals.

But Ronnie embraced any evidence that Daddy was a weakling, a failure as a man. If Ronnie was ostracized by Mom because of the blood he shared with the man who impregnated her, he was turning that around. I was tainted by Daddy’s blood. Ronnie didn’t understand me or Daddy. I didn’t want to live in a mansion. I didn’t want to be an editor or a publisher. Those people sat at their desks all day. I wanted to be out talking with people. I wanted to hear their stories, just as I was hearing his. And goddamn it, I was somebody.

* * *

AFTER RONNIE HAD been in the hospital a little more than a week, it looked as if he might go home. He sat up in bed grinning. He pressured the doctors to hurry up and let him go. Then, all of a sudden, his airways began to close up again. Cursing his body, he pulled violently, self-contemptuously, on the skin of his nostrils, trying to get air. He burped loudly. White, dried spittle covered his lips. Then he vomited blood. “I hurt so bad,” he said, squeezing my hand. Doctors ran to him. He had a stomach ulcer. The doctors were in a bind. They were desperate to lower his blood pressure and keep him from stroking out, so they kept shoveling drugs into him. His body couldn’t take it.

As aides rolled him to the operating room, I kissed his forehead and his hand. My apprehensions about him melted away; maybe these were the last words I’d say to him. I told him I’d be there when he got back. As they wheeled him away, he rasped, “Bye, baby.”

A few hours later, the surgeon came by to tell me the operation went well. All the new medications and the stress of being in the hospital had burst a long-brewing ulcer in Ronnie. The surgeon patched the internal sore. In the operating room, Ronnie’s larynx had once again gone into spasms. They reinserted the endotracheal tube. Ronnie was back on a ventilator. I came home with the smell of urine and blood stalled in my sinuses and the dread of another long recovery ahead of me.

* * *

HE WAS ALLOWED no water, only three cups of ice a day. I gave it to him on pink sponge-tipped sticks he popped into his mouth and sucked dry in an instant. With his hand on my shoulder, I rested my cheek on it until he fell asleep. I breathed along with him and the ventilator, like a prayer. As he slept, he dropped his hands into his lap, where they twitched in the motions of cutting hair.

I told him I loved him, and he gave me the sweetest smile. At home I’d still smell him, and I’d move my hands like his. My psychotherapist warned that I was merging emotionally with Ronnie and had gone beyond anything Ronnie himself would wish for me. Sometimes Ronnie would seem to be asleep, but then I’d notice him watching me through the slits of his eyes. He was observing me through those thin slices of his wavering irises.

* * *

SOON HE WAS breathing on his own again. He was better but more ornery. He refused to let his nurse reinsert his urinary catheter. As proof that he was peeing normally and able to control his urine, he presented her with a pee jug of clear water, cooler than body temperature—obviously from his water cup.

He believed lying in bed was weakening him, so he insisted on sitting in his chair all day. When the nurse’s aides stood him up, I spotted the edema in his upper thighs and the imprint of the plastic chair on his butt. If he didn’t move around more—bed to chair, chair to bed—he’d develop bedsores. He wouldn’t hear it.

He raged against me. “Damn, woman. If I keep on lying in this bed, I’ll never get out of here!” But as I wearily left his room one night, he pointed to himself, then to me, and squeezed two fingers together. Yes, we were a team, but we were a tense team.

* * *

IN RONNIE’S SECOND week in the hospital, Mom and Daddy joined Daddy’s eldest brother, Albert, and his family at a reunion in Northern Virginia. I’d planned to go, but Ronnie needed me. Mom lied about my absence. She told her in-laws I was working on a newspaper story. As I watched Ronnie’s unwillingness to listen to the doctors and to take loving care of himself, I blamed her. He should have learned self-compassion from her—well, if she had any for herself. He should have stayed in school so he’d understand basic biology. He should have developed more faith in people. He should have learned some manners.

When I made my post-supper visit to him late one night after writing a story on deadline, he greeted me with “Where the hell you been?” He could be brutish and very hardheaded.

It turned out that Ronnie’s health insurance would pay only thirty dollars of daily hospital charges in the thousands of dollars. His bill was at $20,000 and rising. A hospital social worker suggested to me that Ronnie go on disability, but I knew he wouldn’t go through the long process of applying for it. I hadn’t told him yet that scans had shown mysterious masses on his lung and on a kidney. He could be in the hospital for a very long time.

When doctors switched him to a trach with a valve that allowed him to speak more clearly, he borrowed my blusher mirror to see how to put his finger over it to talk. He studied his stubble and his hair standing straight up. “Slim,” he growled, “you’re in a hell of a shape.” He wanted to go back to work and start paying off his medical debts.

To ease his worries a little, I got his keys out of the hospital safe and drove to the Vinton post office to pick up his mail. In his rooms, Maxine and I poked around and found checks so that he could pay some bills. Maxine was becoming my ally. I was calling her Max now, as Ronnie did. In Ronnie’s rubble, I found twenty or more nose sprays—evidence of his long battle against the narrowing of his upper airways from acromegaly.

Mom was feeling guilty that she’d visited her brother-in-law while I was down in Roanoke looking after her sick son. She called me, wanting to come see Ronnie. She wanted to bake him a cake and send him flowers and gifts. I ran it all by Ronnie. Just the thought of her and Daddy coming back to stare at him again alarmed Ronnie and probably spiked his blood pressure. Please, he begged, don’t let them come. Tell them he’d be glad to see them later on, which was probably a lie. But no, not right now. Please.

Mom was incensed. “I see what’s going on,” she snarled at me over the phone, insinuating that Ronnie was trying to turn me against her. She went on, her hard jaw audible: “Well, I don’t want to hear any crap about how Adria was down in Roanoke and didn’t go see Ronnie. Everything I’ve offered to do wasn’t wanted.” In her eyes, he was bad. “Someday,” she warned me, “you will see it.” Where was my charitable mother, the compassionate one I knew so well? She vanished whenever Ronnie appeared.

She and Daddy drove to Roanoke and stayed with me the next night. As payback for my watching over Ronnie, they helped me trim shrubbery and weed flower beds. Daddy was down on his knees in my privet hedges, pulling out poison ivy. In the living room, I was trying to get Mom to talk about Ronnie.

“It’s gotta be hard,” I said gingerly. “All those years you kept him a secret. Makes sense you’re still conflicted about him.”

She snapped back, “You don’t know how I feel.” We returned to yard work.