“Come on, we’re going, and that’s that . . .” Scott insists. I’ve been resisting his pleas to sneak out and grab a few minutes outside, and now he’s taking charge. “It’ll be good for you. Today’s the day.” He retrieves my sneakers and kneels down to help me put them on.
“Scotty, I don’t feel right about it,” I say while he ties and double-knots the left one.
He turns his head to speak over his shoulder to Ann, who sits on a chair behind him. “Amy is a big-time rule follower from way back.”
“Ah, I get it,” she says. “Not like the rest of us.”
“It’s not just the rules—I’m not sure I can walk all the way to the elevator. I haven’t been able to get past the Swan-Ganz lately.” I’m referring to the colorful poster in the hallway that shows the mechanism of the Swan-Ganz catheter—it’s only about ten feet from my door. “And then once I step out into the lobby, how far is the exit?” I’ve never seen the layout of Cedars’s lobby, not even when I was first admitted to the hospital since I was taken straight from the ER to my room on a stretcher. “What’s it like down there?”
“There’s a lovely little courtyard just outside the door. It’s not far . . .”
Scott doesn’t seem to be taking into account that five steps—just five!—make me lose my breath; that’s why I’ve refused his offers to walk in the hallway lately.
“How many steps, do you think?”
He finishes tying the other sneaker and reaches for my hands to pull me to standing. “I don’t know . . . twenty, thirty maybe? You can do it. I’ll be right there, holding you the whole time . . .”
He doesn’t get it—holding me won’t make a difference. I’m not afraid my legs will give out; it’s my heart that won’t last the forty steps. I need a wheelchair, not a firm arm around my waist. But okay, this sneak-out is going to happen whether I’m comfortable with it or not. “This is going to be so good for you,” he repeats, walking backwards and leading me toward the nurse call button.
“Wait . . . I have to take off my telemetry leads.” I reach under my shirt and feel around for the stick-ons where the EKG wires snap in. “One!” I call out, peeling the first one from my chest and handing it to Scott. “Two . . .”
“Hey, Scotty, while you’re doing that, can we go over my role here just one more time?” Ann calls out from the chair at the far side of the room. “I want to make absolutely sure I’ve got it down pat.”
“Of course. First thing—Amy’s going to press the nurse call button and tell them she’s going to take a shower, so they’ll alert the telemetry folks that she’ll be off-monitor for a little while.”
Ann pays careful attention. “Yes, right, got it . . .”
“I’ll turn the shower on before we walk out, and close the bathroom door,” Scott continues, “and you’ll go ahead of us into the hallway, making sure the coast is clear. When you see that we’ve got a safe path to the elevator, you wave us on . . .”
“Okay. I check for nurses. Signal when to go. I will do that. Yes.”
“And then I’ll run Amy to the elevator—”
“Run?” I say.
“I’ll get you there, honey. Don’t worry.”
“Now. Tell me again what I should do if someone comes in while you’re out,” Ann asks. “I will do exactly what you say . . . and, uh, I promise I won’t snooze on the job this time . . .” She raises her giant Starbucks cup and smiles sheepishly. “I’m gonna be sipping one Venti after another today, you can be sure of that . . .”
Ann means to make up for what happened last night: she slept through every one of my pacemaker firings, and this has left her feeling not only regretful but also baffled. As a very light sleeper, Ann assured me that she would be up in a flash whenever I needed her. But when the first scorch of pain ripped across my chest at midnight, I snapped awake and glanced in Ann’s direction, and made a quick decision not to call out to her. Seeing her curled up on the cot in peaceful sleep, it dawned on me that I had woken too many exhausted friends over the past few weeks, and that I should try to rely on myself for once. Ann did not in fact fail me last night by sleeping soundly through the night; rather, she inspired in me a new awareness.
Even so, Ann remains convinced that the mishap was her doing. She is well aware of the protocols outlined in the emails and how her first night in my hospital room diverged from them. As I see it, though, a bit of nonconformity during my sister-in-law’s visit is both fitting and welcome. In contrast to my tightly wound and routine-focused friends and me, Ann is refreshingly spontaneous and intuitive. She goes with the flow and the feel of the moment with an easy confidence that I admire and sometimes try to emulate (with only modest success).
It is because of Ann’s unique influence that I have dared to hold the reins of control more loosely at times and to take an unexpected path every now and then. She’s the only friend of mine who still possesses a few hippie sensibilities alongside her more conservative ones, moving seamlessly between the far-out and the predictable. A modern dancer by profession in her early life and a therapist in her current line of work, Ann operates on the soul level by seeking substance over form. She tends toward platform clogs (comfortable), the do-it-yourself hair dye (less ado), and the calm, balanced mothering of her two Free to Be You and Me daughters (more harmonious). There is a glow of joy in her home that is enviable—an absence of pressure that invites long, serene exhalations. I’ve been fortunate to settle into the rocking chair in Ann’s living room often, where I feel myself floating above it all.
Married for the past twenty years to Scott’s brother Gary, Ann has been a constant and vital presence in my life. By her seamless, worry-free approach to slipups—which she usually laughs off easily and waves away with a swish-flip of her hand—my dear sister-in-law, who is older than I by a few years, reminds me of my much younger self, when not every action had monumental consequences and not every inaction felt like such a great big deal. In her take on life, a missed opportunity only opens the chance for another try at it. I’ve reflected on this quality in Ann a lot lately, contemplating whether I might cut myself some slack—maybe even bend a rule or two. What harm could come and who would know?
Last night in my hospital room, however, Ann set out to do a very specific job that had been perfected and set out in detail by her predecessors. She brought full intention to it and relied on her night owl nature to help see things through, but she knew the minute she woke this morning that all had not gone according to plan: “Uh-oh . . .”
“No, Ann, it’s okay—really.”
“I didn’t, did I?”
“Yeah, you did. But it’s fine. I figured it’s about time I try to get through the pacing on my own a bit. There’s nothing anyone can really do to make the pain go away faster, so—”
“Just can’t believe I slept through—”
“Ann, all the girls would have slept through if I didn’t scream to wake them. But last night, I chose to try to handle it myself.”
She nods thoughtfully. “Okay . . . I understand.”
“And I did okay, see that? Good to know that I’m not a completely dependent mess. . . .”
It strikes me how much I want to put Ann at ease. Things have changed—I have changed—since Jill occupied the cot as my first friend visitor over a month ago. At that time, it was all about what I needed from those around me—most specifically, getting them to understand. But since then, the understanding has come to flow both ways. Where I used to be so hungry to take in empathy, now I am just as eager to give it.
I put my hand on Ann’s shoulder and look into her eyes. “Do you know how happy I am that you’re here?”
She swats at me, half smiling. “Yeah, yeah. But I promise you—I will stay up the entire night tonight so you won’t be tempted to let me sleep . . .” She pauses, smoothes her hair back nervously and sighs, as if doubting her own pledge
Only reparative action would soothe her. So when Scott came in this morning ready to put his sneak-out plan into action, Ann rose to the occasion at once, hell-bent on carrying it out perfectly.
She listens now to Scott’s reiteration of her role with unblinking eyes.
“The shower will be running and the bathroom door will be closed, right? So, if a doctor or nurse comes in, just tell them Amy’s still in the shower and they should come back in about twenty minutes.”
“Right. I got it.”
“Thanks, Ann,” I say, signaling for Scott to pull the two telemetry leads off my back. “I still feel funny about this plan, though . . .”
“What’s the worst that can happen? You get caught and we don’t get to do it again.”
“Again? I say we do this once . . . That’s all I have the nerve for.”
“You got this, Ames. You got this,” Ann assures me.
“Okay, press away . . .” Scott says, handing me the nurse call button.
“Hello, can I help you, Amy?”
“Yes, hi. I’m going to take a shower. My friend is here with me, so I don’t need any help. I’m taking off my telemetry now, okay?”
“Thanks for letting us know. Enjoy your shower!”
“Thanks.”
“All right, here we go,” Scott says. “Ann, you head out first and tell us if it’s safe to come.” He walks me to the door, and I secure a yellow surgical mask over my mouth and nose. Ann steps into the hallway and he peeks out after her, watching as she walks to the intersection where we will turn toward the elevator. “That’s a thumbs-up—let’s go!”
“Holy crap,” I murmur as he clasps my hand tight, leading me out the door.
We reach the sharp left that leads to the elevator. Ann is there, again with a thumb pointing up. She runs ahead of us and pushes the down button in the vestibule—a move that was not articulated as part of Scott’s plan but is terrifically helpful. By the time we arrive, the elevator is already there and waiting for us. “Pressing the button—great idea, Ann. Great!” I say, stepping inside swiftly.
“Good luck, you guys,” she says, and the doors close.
We’re not alone in here, Scott and I. There are a few others heading down with us in the elevator—two nurses, a doctor, and two people in street clothes. I’ve got a mask on, but this is not necessarily suspicious since transplant and chemotherapy outpatients wear masks in hospital settings. So do visitors who might have a cough. What I’m afraid may give me away, though, is the way my mask keeps flapping smack up against my mouth when I breathe in—fast, fast, fast. I’m gasping. Scott notices, and grips the length of my arm from elbow to wrist. He pops his eyes at me—I got you, I got you . . .
We step out into the lobby.
People moving, everywhere! There’s a Starbucks kiosk—Look how long the line is! Everything is fast and bustling and incredibly alive. I hear the street sounds from close up now. And there’s light . . . I’m moving toward natural light!
I take off the germ mask as Scott pushes open the door. We step outside. “And here’s the courtyard,” he says, “just like I told you. See the outdoor sculpture? This one’s a fountain, but they turned off the water because of the drought. We can sit. You want to sit?”
I don’t respond.
“Amy, you all right?”
I nod. I’m still struggling for breath. But this is not what catches my words in my throat. I am overwhelmed. All of this life around me! All this air! And open space! And the sunshine, oh, the sunshine . . .
“Is the sun this bright in New York?” I ask Scott. “I don’t remember sun like this. Oh, honey! I forgot how beautiful . . .” I’m crying.
Scott takes me by the arm and leads me to a ledge where I can sit. I close my eyes and tilt my face to the sky. “Ahhhh . . . so good . . .”
“I told you so. This is just what you need.”
“You were right, Scotty. I feel like I’m dreaming . . .”
“We can’t stay long, though,” he says, taking my hand with tenderness.
“Okay, okay. But I know it’s here. And now I know I can come see it. Feel it on my skin. I’ve been in a hospital room for so long . . .”
“Give me a kiss,” he says, tapping my chin with his finger.
I open my eyes and then close them again, and we kiss.
I feel the strange sensation of a real smile stretching my mouth, my face.
Happiness.
This is all it takes—five minutes under a bright, clear sky and one kiss from Scott, and I am supremely, utterly, immediately blissful.
Scott turns to me again. “This is what you’re doing it for—for us . . . for our life together . . . for little moments of sunshine and blue. That’s all we need to be happy. You’re going to get that heart, Amy. We have to keep hoping . . .”
“Yeah, okay . . . okay,” I say, blinking away tears as he guides me up from the ledge and toward the hospital lobby doors.
“You can do this again tomorrow,” he says, smiling.
“I want to . . . I really do . . .”
“Then we will.”
I secure my germ mask in place, and we step inside the building, leaving all color and light behind us. The lobby is dim and the ceiling feels awfully low. We step into the elevator and Scott presses six. It’s the first time I’ve seen my floor button pressed. I realize with a start: this is what Lauren has done . . . and Jill and Joy and Leja and Robin and Val . . . and Jody and Jack and Ann . . . and my father and the rabbi. And Scott—my wondrous, adoring love and lifeline—who has pushed that button more than anyone, all day long, every day, for so many weeks. How strange to be standing here with him when he presses it yet again, delivering me back to my waiting list sickbed.
But maybe over the next ten days, I hope, a surgeon carrying a cooler with a donor heart packed in ice will press this same button, lift up through this same elevator shaft, and save my life.
Oh, to be able to live. To stand in the sun again with my Scott.
From: Joy Ceterra
Subject: Hello Friend
Date: May 3, 2014 at 9:28 PM
To: Amy Silverstein
Hi Amy . . .
I have to say, you have such wonderful friends. I’m sorry it has taken these past few months for me to get to know them on a deeper level. They are so warm and lovely and supportive even to me these past months—part of me wishes I had stayed in NY and had the opportunity to get to know you all as a group even better. It makes me happy to know you’ve been surrounded by so much love in your life—Scotty of course, but these wonderful people too. Each so different, but all wound together in their amazing love for you.
Today . . . I know you felt the sun—the sun . . . something I take for granted. For me, sun is medicine for my soul—so it made me happy to know you were able to feel its wonderful energy today. But I can understand that that feeling it must also have made you feel cheated—that something so simple in concept as the sun on your body is such a rare treat for you as you wait and wait and wait . . . I wish you could feel the sunshine every day to remind you of this simple beauty that awaits you if this heart were to come.
I’m glad you’ve had time with your wonderful Annie. I imagine she’s been a comforting soul, helping you feel cared for and loved.
I’ll see you Wednesday afternoon. I look forward to our talks. Tonight—please try for just a little more sleep with the Valium. Be kind to yourself, friend.
With love,
Joy
After an intensely caffeinated day, Ann feels prepared for the night ahead. She sits in the chair beside my bed and vows again to stay upright and awake all night long. Nothing I say can dissuade her. “I’ve only got one more night here to do it right,” she tells me. “I’m not going to risk falling asleep again. After last night, I don’t trust myself.”
“It’s me you shouldn’t trust—I decided not to wake you.”
“Did you decide not to wake any of the other girls?”
I pause, but not for long—I can be honest with Ann. “All right. I didn’t have the heart to wake you, no pun intended. Can we please drop it now?”
She shrugs. “Okay. But you should feel free to shut your eyes and go to sleep. Don’t let me keep you up just ’cause I’m sitting straight like a scarecrow here.” She has settled herself into a chair beside my bed with an iPad on her lap.
I turn on my side and face her. “My pacemaker is going to keep me up. Give it fifteen minutes—watch. That’s why I dread going to sleep. It’s the worst part of my day. So I’m in no rush to close my eyes.”
“Want to talk, then? We can chat if you want . . .”
“Yeah.”
“Okay, good.”
“But let’s not talk about waiting for a donor heart, all right?”
She chuckles. “Fine with me.”
“Let me tell you, then, about your sweet daughter Abby. Do you know—she’s texted me every night . . . every single night . . . to say ‘I love you’ and good night? And she sends the goofiest pictures. Got one the other day of her on the toilet, in a bathroom stall at school. ‘Thinking of you, Ames,’ she wrote, or something like that. I laughed out loud.”
“She’s a nut muffin.” Ann smiles. “And oh, she loves her Auntie Amy. Maddy too. Both my girls adore you.”
“I adore them.”
“You know, Ames, I’m going to need your help with Abby’s college applications in the fall. I want to talk with you about some schools that might work well for her—where she can play soccer and get academic help if she needs it.” Abby has a learning disability and has to work hard at writing and organization.
“She can do it,” I say. “I have full confidence in her smarts.” I witnessed Abby’s natural aptitude and study capacities just a few months earlier when she was required to memorize a hefty chunk of Romeo and Juliet for English class. Ann delivered her to my house for a dose of Auntie Amy’s literary memorization technique. I taught Abby my method, and she caught on immediately and with enthusiasm, so we went ahead and memorized all the pages in one sitting. I called Ann and told her she could come pick Abby up early, happy to report that she had the material down perfectly. She’s a memorizing whiz, actually. “And if a kid can memorize, she can do well in any subject. Period,” I said.
Abby earned the best grade in the class on recitation day. Still, Ann was no less concerned with finding just the right college where Abby would be sure to thrive—and then there was the matter of prodding her to complete her college applications on time and with full effort. And now this challenge was close at hand: Abby would be finishing her junior year in just two months, and already there had been college-counseling seminars at her school, as well as assignments in English class that were prompts to prepare for the standard college application essay. “I’ll be handing her over to you to help with some editing in the fall, of course,” Ann tells me now.
If I’m here for it, I can’t help but think.
“Actually, she told me she wants to write her essay about you, Ames . . . about the texts she writes you every night and how much she admires you. She’s so proud of those texts, you know.”
“She should be. You know, when you’re young, you want to run away from people who are scary sick, right? Don’t you remember being little and passing a cemetery and holding your breath? What Abby is doing is pretty remarkable—reaching out to me every single night. I tell you, it’s so much more mature than the way my twenty-five-year-old friends acted when I had my first transplant . . . some of them headed for the hills and we never spoke again. Abby is brave.”
“She loves you.”
“Yes, but she’s got something in her, that girl. She’s—uh-oh . . .”
Heaviness.
A pulling in my chest.
And here it comes . . . the searing pain from shoulder to shoulder.
“Ann—I’m pacing, damn it. Ow, ow . . . Oh my God, ow . . .”
She jumps to her feet. “Should I, uh . . . what can I do for you? I, uh . . .”
“This is worse than ever,” I gasp. “Holy crap . . . ouch . . . ouch . . .” I shift my legs over the side of the bed and push myself to standing, hoping it will make my pulse rise. “Help me, Ann. I’m too weak . . .”
She slips her hand around my waist, and I lean my body weight against her. “I got you.”
“Ow . . . ow . . . it’s ripping through my chest!”
“Should I call the nurse?”
“Uh . . . no . . . well, maybe yes . . . I don’t know. The pacing has been a lot worse lately. Let’s, uh . . . give it another couple of minutes . . .”
“Can you stand it?”
“I have to stand it, Ann. This is what my life is now . . .” I press my lips together and feel my eyes well with tears. “But just for ten more days now. And then, no more. No more.”
Ann blinks long and shakes her head. “Just hold on, hold on to me . . .”
“Oh, Annie!” I cry, collapsing against her shoulder. I begin to weep. “Sorry you have to do this . . .” Up until this moment, I’ve tried hard not to let myself cry during nighttime pacemaker firings because it seemed only to make it so much harder on everyone. Friends have attended to these episodes with a loving but mostly logical, problem-solving approach—each woman with her own method and goal of getting me through, it seemed, and an air of confidence, whether real or skillfully feigned. Ann, though, is not capable of methodology; she has no guile. She is simply present, with wide green eyes, not even attempting to mask the tortured twisting of her facial expression or the lack of self-assuredness upon seeing me so ill. Had Ann come earlier in the spreadsheet calendar, I would have been an easier sight to bear and challenge to rise to. But timing and fate have placed her at the closest point to my end and the furthest point from hope; she is here to catch my near-ultimate fall—and I am so comforted by her presence. Her body movements channel serenity—a dancer’s grace in the way she elongates her neck and folds toward me ever so slowly with a gaze of acceptance. I am reminded of a yoga teacher’s whispery instruction to imagine floating on a lotus flower—There’s no need to change anything . . . You’re just as you need to be in this moment . . .
“I just love you so much, Ann,” I say, gripping her tighter.
“I love you too, Ames.”
After a few minutes, the pain subsides. She leads me back to my bed and pulls the blanket up to my chin. “There you go.” She pulls her chair up close beside me, takes my hand, and holds it for a long, long time—ten minutes, fifteen, twenty. We sit wordlessly, staring with unfocused eyes. I turn my head toward the red blinking light without imaginings tonight; the only good luck beaming toward me is my choice to end this waiting list ordeal.
Out of the silence comes an admission. “I feel selfish,” Ann says, splaying out her arm toward the wall of photo faces. “You say sorry to me . . . sorry that I have to be here with you. But you know what? I am so glad to be here—it’s a gift to me to be able to help even a little tiny bit. Because you’ve given me so much . . . and the girls too. Helping them with things I’m not too great at—the memorization, the writing . . .”
I assure her that it has been my absolute pleasure. Over the years, I have jumped in (often without Ann asking) to help her daughters work toward certain aims—whether a timetable and checklist for college application deadlines, preparation for the Regents Exam in biology, or Shakespeare memorization. My nieces are always appreciative and on-task, acceding to my instructions and study techniques much more readily than my own son. Plus, they’re girls—what fun that is! I give them the short skirts I no longer wear and the cosmetic samples that come with my wrinkle cream purchases. There has been a particular joy in contributing to their lives and watching them blossom over the years. “And Ann, you could have done all of it without me. You will do it without me, if that’s the way it turns out . . .”
“It can’t turn out that way, okay? You’re not replaceable. The way my girls respond to you . . . and admire you. You’re such an amazing addition, a wonderful . . .” She begins to sob, “. . . part of—sniff—my mothering. You round me out as a mother. Yes, that’s what you do, Amy.” She wipes away tears with both hands.
“Ann—” I turn toward her and open my mouth to say something lovely in return, but my thoughts freeze up. In truth, it is Ann who has rounded me out as mother—showing me by example how I might ease up on expectations of Casey and support his seeking of a broad variety of paths in life rather than imposing the narrow, predictable ones that are familiar to me. But what is first and foremost in my mind at this moment is the most essential way in which she completed my experience as a mother: by inviting me to attend the births of both of her daughters.
“Since you’ll never be able to give birth, I thought maybe you’d come to mine so you can experience it,” she told me, eight months into her pregnancy with her first child.
It was, to me, an unimaginably sensitive, kindhearted, and selfless offer to invite me into the privacy and intensity of her first birth. Along with her husband, Gary, and a midwife, I would be the only other attendee, she said, and I accepted with the deepest appreciation and awe. A few weeks later, I drove from New York City to a suburban hospital where Ann, Gary, and the midwife were already hard at work in what would be a very long (and very loud) birthing process that had me immediately aghast at my opting in to this fantastic, horrific spectacle.
Ann was screaming—I mean screaming. The incredible decibel level of it reached me the minute I stepped off the elevator, and it intensified to such a piercing howl as I approached the door to Ann’s room that I couldn’t bring myself to open it. Willing strength through the moment, I stepped inside and witnessed the next several hours of my dear epidural-refusing sister-in-law waiting for her damn cervix to expand, yelling and grunting and, at moments, weeping. The louder and more raucous she got, the quieter and more excruciatingly slow and deliberate the midwife became—and oh, how I wanted to smack that Mother Nature birthing ambassador in her stoic little face! “Aaannn, yoo-hoo, Aaannn,” she cooed, responding to Ann’s shout of “I’m going to break in half!” Then the midwife spied me crying in the corner. “Hey, you,” she said, losing her übergentle-soul facade for a few seconds. “Stop with the tears.”
I did. But I couldn’t bring myself to do much else to help matters. Since I had no experience in dealing with other people in severe pain, let alone the agony of natural childbirth, all I could think to do was stand aside and let the drug-free delivery technique takes its good, sweet time. Gary’s attempts to soothe Ann were met mostly with wails and curse words—another reason, I thought, to steer clear. It wasn’t until the midwife called me to her side and dropped one of Ann’s heels into my hand to hold up in the air (just at the moment the baby’s head was crowning) that I found my place in that arduous scene: it was to observe birth, just as Ann had wanted for me. Ann put me there not to help her, but simply to have a thrilling experience of womanhood and motherhood that I otherwise would not.
I watched baby Madeleine come into the world with a final push and howl—and then silence. A cut of an umbilical cord. A newborn placed on her mother’s chest. A smiling Ann and tearful Gary.
Joy. Pure joy.
The absolute miracle of birth.
But what struck me most that night, and what I carried with me when I floated out of the door that I’d entered in trepidation hours earlier, was this: the incomparable power and strength of women. Watching Ann bring this baby through her and out of her and then letting her go—the first excruciating release in what would be a series of letting-gos over Maddy’s lifetime—seemed to me the most astounding, painful, magnificent feat I had ever witnessed. To see all that Ann went through so that this baby, this child, this human life could breathe on her own and have a life of her own—oh, the sheer mightiness of it. My sister-in-law was a warrior woman. She was brave and daring and persevering. She was, in the most powerfully visceral way, a mother.
And they say heart transplant is miraculous. I say the bringing forth of life beats it by a mile. And I only know this because Ann allowed me a front-row seat—twice.
“You’ve made me whole as well . . . you know, having me there when the girls were born,” I tell Ann now, allowing honesty to carry my thoughts aloud instead of trying to find just the right words.
“I was lettin’ it all hang out. What a sight!”
“I don’t remember any of that. They say you forget the worst of it, right?”
We laugh just a little.
Ann lifts her gaze back to the wall of selfies and sighs. “Ten days, huh? Do you really have to? I mean . . .” She frowns and sighs again. “I support you, Ames, but I’m sorry, I can’t . . . I don’t know how to leave here tomorrow knowing that I’m probably never going to see you again.”
I shrug. “Maybe I’ll get lucky?” I say halfheartedly.
“But, but . . . Abby . . . she’s writing that essay about you . . .”
And Scott’s going to have to summon Casey here in a couple of days.
I cover my ears. “Ann, please don’t.”