The nurses lined up to meet a famous baseball player. The children’s hospital always pulled out all the stops. I met a girl there with epilepsy, but half her seizures were psychogenic. In the hospital, she had food to eat, cable TV, and a rotating cast of people like me to ask her how she was feeling. And I felt for her. I had also been a child who did not want to go home. There were stars paved into the floors in the halls, rocket ships painted on the MRI machine, as if we could protect the children from the rest of their lives. On the night shift I did breathing rounds, counted the rising chests of the babies with respiratory infections. A full minute each by penlight.
I met a preschool kid with sickle cell who was working through the semantic differences between similar words. He had been told that he could not go to the game room. He meant, I gathered, that he didn’t care, but what he kept insisting was I don’t matter!
At school as a kid, I learned to write by copying the Bible. For punishment, I copied it in chalk onto the board. We pledged allegiance to the Bible every morning, our hands on our hearts, and to the flag and then to the Christian flag, and memorized long passages of verses for awards. It must have been good for our vocabularies. The school did not teach science or any world history, so when it was shut down—the pastor was caught stealing and suspected of worse—and I fell into the secular school, I was in junior high and behind in a lot of things. Science did not interest me. History was familiar, at least, the war stories not unbiblical, old and new atrocities and carnage a part of the necessary landscape. But I had never heard of the Holocaust before they rolled in a TV to show videos of the liberation of Auschwitz, the sunken cheeks, the bones for arms with numbers tattooed on them. One part told of how the well-meaning soldiers had given the prisoners chocolate and other rations, and the prisoners had been starved so long that eating this actually killed them. In a seat in the dark, I sobbed and sobbed until the teacher pulled me out of class.
And said what, exactly? You see, I didn’t know there were so many brands of apocalypse. We saw a video of the Mayans with their doomsday calendar and learned about, like I said, Ebola in Africa, the Spanish flu, bird flu, pig flu, the San Andreas Fault, Waco, AIDS, nuclear winter and waste and war. And then Columbine, the boys in long black coats, who we heard pointed their guns in students’ faces and asked, Do you believe in God? We had practiced martyr scenarios at my old school, but now I just thought, No, no, no. I became distracted and was sent to the counselor, a social work student who covered every school in the county. She asked me this: Any trouble at home?
In my childhood home, an ongoing fight concerned the location of all the household knives. Someone would always be stealing them for carving projects in the yard or slug dissections in the basement. Scissors were even harder to find. The bathroom door lost its knob, and the scissors were the only thing that fit. You had to choose between no privacy or a room you would never get out of unless a brother came to let you out. Our poor mother, outnumbered six to one. She drank hard twice a year and, before she got sick, would give you anything you wanted.
In the children’s hospital, in the waiting room, a book meant for children asks, Why is the sky blue? And the answer begins: First, understand that colors do not really exist. On a wall nearby hangs a case of objects removed from the noses and ears of actual children, each neatly labeled:
Bean
Beetle
Fruit pit
Marble
Match
Moth
Pen part
Pin
Seed
Spring
Tack
Toothpick
My favorite operation by far was the cesarean. The woman would sit up on the gurney and get a shot that numbed her from the waist down. My job was to pull her toward me, and she would lean forward onto me, and I’d ask her small questions to distract from the large needle headed into her spine. Is this your first, I would ask, or if I got the sense the baby wasn’t joyfully expected, I’d ask about her interests, her job, or her tattoos. Once she was numb, we laid her down and built a paper wall between her and where she would be cut open. The partner, if there was one, came in a space suit and stood with the anesthetist.
I saw a delivery with twins where we couldn’t get a good grip on the infants. I was scrubbed in, calmed by the excitement, holding a bent spatula that kept open the hole we had made, the edges of which were red and bleeding. The first head appeared, wet and scarcely haired, but the surgeon couldn’t get a good grip. Push from below, someone shouted, and someone did, going under the sterile blue paper and doing what, I can’t imagine. The twins, extracted, quiet and blue, disappeared in separate rolling boxes. And I did not follow up, because there was another day coming, and I was tired.
I thought of obstetrics more than anything else, or anything else besides the job I eventually picked. This love surprised me—I had always sort of feared women’s bodies—but in the clinic, I saw young women try to defer exams when they hadn’t found time to shave, and so many, especially the youngest, basically children, knew nothing about their own anatomy and even when pregnant were mortified to talk about discharge or blood. And I did like to be with them, to talk to them, to help take the shame off of bodies and sex.
I was, in a way, a bad obstetrician. As I watched the doctor free those twin blue heads, I thought it wouldn’t be the worst thing if the babies were dead. The seminarian was upset when I said this. He had been coming down from the green suburban hill of his school on the weekends. We would drink wine from chalices he had bought in Rome. There wasn’t much that we agreed on. We did both believe my heart was kind, and I could not explain my feeling about the babies. I just kept saying: I mean, they haven’t even done anything yet.
The summer I lived with him, writing copy, we slept side by side in a twin bed and never had sex. Our relationship existed but could not be called anything. It felt like a third body in the room with us on those weekend visits. I would go on about cell biology or the odd and arrogant rituals of my classmates. He would suggest only by expressions of his face that I lacked generosity or was too quick to judge. He sometimes reminded me that I, too, would be rich when all of this was over. But I had not yet shown him the receipts, all the loans I’d had to take, all I owed for this and what I had done before it.
You’re acting out a childhood fantasy, the Texan said. We were becoming friends, inasmuch as he gave me little doses of the drugs he ordered from local teenagers by text message and sometimes, without context, late at night, would send me links to gay pornography with brief notes like: My favorite. It was always slick young men just bending each other over. I had confessed to him—the Texan—that I did not believe in anything and that this departure from religion, obvious and unvolitional, was the probable cause of my recurrent dreams of praying as I died in freak accidents. He found my celibate union with a theology student odd and repressive but could not help admitting that the seminarian was unusually attractive. A real magazine man, was what he called him. The Texan’s sexual orientation, as far as I could tell, was anyone who would have him. But the point of finding God is not that you want to have sex with him.
It’s not true, anyway, to say I don’t believe in anything. I believe in a blind eye / in a deaf ear / in a lame foot. I don’t believe in this world empty. All of this, of course, is stolen poetry.
The seminarian told me that, in the seventies, a group of divinity students were given LSD and put in a church basement where they listened to a Good Friday sermon alongside a control group dosed with a placebo. One of the men (they were all men) remembered a sense of being absorbed in bars of light, then the physical pain of having all his insides ripped out, then dying and being resurrected. He recalled, at that very moment, the preacher through the speakers said: I shall die, but that is all I’ll do for death.
Almost all of the drugged seminarians went on to become ministers, and not one in the control group did. What’s the point? I asked, sincerely, and we debated what mattered more, the reason for the experience or the experience itself. Some months later, when I took the train up the hill and in his little room we shared a single small mushroom, we did not see God, but we did both see, all at once, that in a portrait on the wall that he had gotten at a junk shop, the brushstrokes built up a shape like a skull beneath the man’s face—an incidental memento mori. And after that we did all the things two people who don’t have sex can do.
The psychiatry attending sent me out for a long lunch. He’d made me admit another woman who had gone off her meds. She was screaming in the intake room, off her chair, on the floor, in the corner, because at home she had a new little baby, and she had just been told her stay with us would be indefinite. Why had that made me cry? The deaths didn’t do that to me. So often, in fact, I was happy to see them off. There was a man with a big belly of ascites, the fluids that gather once your liver has failed. And we kept the surgeons away from him, despite a problem with his heart, because he had shouted and growled he’d for fuck’s sake had enough. When we gave him the drip that took away his breathlessness, the morphine, I felt, as I rarely did, that we had done a good thing. But this brought me to tears: a woman in a room drawing shapes on the floor, saying, I can be better, I can be better, I promise to be better if you just let me go.
There is a story about my mother, about her first pregnancy, a daughter she miscarried. The story—like any old ghost story, it was told only late at night—went that when my mother was eight months pregnant, she went in for a checkup and the doctor couldn’t find the heartbeat. The doctors wanted to induce labor, but my mother refused and instead risked sepsis to carry the fetus to term. A few weeks later, the baby was born dead and rotten and black. And my father was the one who told us this story over and over, a story about grief, about risk without reward. The climax, in his telling, was his horror at seeing the child like that, posed in a crib in a blanket.
A lot of people were dying of the flu that year. You didn’t see it on the news but it was a chill in the air for a few of us who worried or cared directly for the patients who lost their toes and fingers. The treatment did that, the heart and lung machine. They call it dry gangrene. When you’re young enough, strong enough, the overblown immune response floods your lungs and kills you. But you don’t need lungs to live in a place like this hospital. They have a machine that is lungs and a heart in itself. It’s crude to look at, the huge-bore hoses, the buckets and pumps. It looks more fit for mixing paint. And though it can keep the torso warm and oxygenate the brain, it lacks the strength or subtlety to make it all the way out to the extremities, so they grow blue and ache, then numb as the nerves dry, then shrivel and blacken and fall off on their own. When patients are on these machines, you can’t hear the heartbeat, only a pulseless roar in the place the beat should be.
I lose track, sometimes, of why I am telling you all of this. Not to be upsetting, believe me, please. A scrap from someplace, quoted someplace else: I don’t want to be listened to. I want to be believed.
Ada, in her first bed, in the time of the quiet fever. We’d held off the seizures, but things had begun going wrong. The doctors tried not to worry. Most likely, they said, delirium from waiting like she was, kept inside so long. But she was disappearing a little at a time. I’d ask her questions, the basics: Where is your house? What was your lunch? And she would give some answer, sure as ever, with the husband slowly shaking his head behind her. Well, it was fruit, at least, she almost shouted. But she still knew her name and could repeat Today is a sunny day. Even at night, when the drugs for sleep kicked in, I’d still come in and check her lines, look out the window for any signs, and see nothing but the stopped little boat.
The way she disappeared was subtle at first. If you asked only stock questions, you’d never even notice. She could do hello, how are you, are you in any pain? But the thread bent to breaking if you asked her to invent something. Tell me a story, I said one day. A story? she asked. Sure, I said. Just some made-up thing. All right, she said. Once upon a time. And then she stalled and started again. Once upon a time, there was a man. She stalled. And the man was—she looked straight ahead with a thoughtful face, not stern, but like a child at a puzzle. And the man was fractured? She shook her head. She said, I’m not telling it right. And then she was quiet. Empty speech, the neurologists call it. She can speak, but she can’t say anything.
There was still time to do the busywork I liked. I brought warm blankets around a lot or went off to find for a certain patient a certain kind of muffin. I tried to play music for anyone dying alone, though it was always a tough guess what might be the best genre. I asked the families from time to time, but it seemed that they would lie to me. I saw a lot of sons grimacing at the stiff hymns and spirituals their mothers swore they loved and wondered if they might like something sharper. One man left alone had been a singer himself, the lead in a family band that performed in the style of somebody else. On short notice I could find only their Christmas album. It got a lot of laughs, “Good King Wenceslas” in a dying man’s room in the middle of a city summer. He had a beautiful voice, at least, and didn’t grimace at all.
People will surprise you with how much they can stand up to. The poor more than the rich, is my experience. More poor people laugh at death or tell you they saw the ghost of their brother in the hallway saying, Come on with me when you’re ready, I’m holding the door. You could guess they have more peace because they have suffered already enough. When you are poor, you can’t pretend you don’t need your community. The seminarian told me that, or close enough. He gave me a scarf once, wide and cashmere, in the bland checkered beiges I am fond of. And I thought he would approve when I gave it to a woman who was cold on the street. He acted touched, but what he did was run out later, find her, buy the scarf back, and give it to me again. I asked what he had paid for it. Not enough is what he said.
Whenever a binge put our mother down for the count, we children had the run of the house. We overflowed the sinks, lit tissues into glowing ghosts that burned up before they hit the carpet. It was only at night that the fear crept in, the cold sense that we weren’t being tended. We were still children when the towers fell. Our mother sat cross-legged on the floor and watched the scenes on repeat for weeks. I would dream constantly of machines falling from the sky. In a bed shared with one of the little ones, a sister, I would lie awake at night, smelling her doggish child smell and listening in the dark, then grab her if a plane flew low and run out into the yard.