I came to like being in the hospital—at least after the worst of it was over. As I got older, they put me in the adult ward if there was a free bed. Sometimes, I even had the room to myself. It was cool and quiet, and—because of the drugs—I couldn’t concentrate or think too deeply about anything. Some of the rooms had televisions, all of which seemed permanently tuned to PBS.
A pattern started to emerge: most of my attacks occurred in spring and autumn, fewer in winter. I never had one at camp, which made sense, or when I stayed with my father, which made none. I also tended to be admitted frequently over the holidays—Thanksgiving, Christmas, New Year’s Eve, sometimes even my birthday. I came to like that, too.
But the stress on my body added up. It took me longer to bounce back after I’d been released. I went back to school right away, but I’d be exhausted for days. The medication made me jittery and anxious, and I had trouble falling asleep.
There was a Methodist church on the corner of Highland Avenue and 164th Street that I walked past on the way home if I took the subway to Parsons Boulevard. An adjacent parking lot had been cut into the side of the hill, and a retaining wall by the delivery entrance separated the lot from the church’s front lawn. Starting when I was around eleven years old, instead of heading straight home, I sometimes slid through a hole in the chain-link fence and sat on the concrete ledge with my legs dangling over the edge.
I thought about jumping. Aside from dark circles under my eyes and a slight forward hunch of my shoulders, both of which disappeared a couple of days after being discharged, there was nothing to prove I’d suffered. I wanted to bleed or break. I longed for a scar or any recognizable sign that would force people to notice that something had happened to me, something that demanded a response.
The wall wasn’t high enough to do any real damage. Even so, in the end, I couldn’t make myself jump. I couldn’t overcome my instinct for self-preservation. I didn’t want to hurt myself, really; I just wanted to find out what it would be like if people knew, whether anything would change.
I had a follow-up visit with Dr. Goldman, my pulmonologist, a few days after I got home from my most recent visit to the hospital. I was still tapering off my steroids and, although I was already back in school, I still felt weak and a little shaky.
I sat on the exam table slightly hunched over because my upper back muscles were extremely tight, especially between my shoulder blades. The doctor’s hands were cool. When he grabbed my shoulder and his thumb pressed against my back as he positioned the stethoscope, my muscles relaxed, making me feel faint with relief.
He listened for a few seconds, then asked me to take a few deep breaths. “Your lungs sound good,” he said. “Any problems since you’ve been home?” I shook my head.
“OK. Get dressed and meet me and your mom in my office. I’ve got some good news for you.”
Dr. Goldman was sitting behind his desk writing notes in my chart when I came in and sat next to my mother.
“I forgot to ask,” he said, after he put his pen down. “How’s your cat?”
“Cats,” I said. “We got two kittens.”
His eyes narrowed slightly.
My mother, her voice pitched a little higher than usual and sounding defensive, said, “She gets her allergy shots every week.”
“Well, that’s something.” His voice sounded neutral, but I sensed a tension between them. He checked his notes. “Is the allergist still Dr. Stewart?” She nodded. “I’ll want to follow up with him as well. Now, for the main reason you’re here.”
He opened his desk drawer and pulled out a cylinder, half metal, half plastic. “This,” he explained, “is a rescue inhaler.” He pulled the two halves apart, turned the plastic tube ninety degrees, and attached the other end to the metal half so the whole thing looked like a truncated L.
“Once you’ve reattached the top like this, give it a few good shakes. Exhale all the way and then put the tip of the plastic opening in your mouth—make sure you seal your lips around it—and then push the ends together, inhaling deeply at the same time, like this.” He pantomimed the movement, and when he inhaled it looked like his eyes were bugging out of his head. “You might have to practice that part a bit. When you’ve inhaled all the way, hold your breath for a few seconds, and then breathe normally. That’s it.”
He squeezed the inhaler and a fine mist sprayed through the air. “This is medicine called Alupent. Take it as soon as you feel your chest getting tight.”
“And that’ll help?”
“Yep. It’ll clear you right up.”
“Really?”
“Really.”
I didn’t quite believe him. It didn’t seem possible for the solution, after all this time, to be so simple. I’d learn later that the medication had been around for several years already, but it may have been considered inappropriate to give to a younger child due to risk of overdose.
“Before you go, remember—take it when you need it, follow the directions, keep it clean. And don’t sleep with the cats. The nurse will have it all written down for you before you leave. Now go sit in the waiting room. I need to talk to your mom for a couple of minutes.”
I left the room but didn’t close the door all the way. Instead of heading to the waiting room as I’d been told, I stood very quietly in the hallway.
I heard Dr. Goldman clear his throat. “Mrs. Trump, I obviously haven’t been able to convince you to get rid of the cats, but I cannot stress how important it is that you bring Mary to the hospital at the first sign of trouble, day or night—no matter what time it is. The inhaler will help, but it won’t always work. Again, at the first sign of trouble, you must bring her in. You cannot wait.”
I had never heard anybody speak to my mother like that. If my mother responded, I didn’t hear it.
“Do you have any questions?” Dr. Goldman finally asked.
Again, nothing.
“Then I’m sure I’ll be seeing you both soon.”
I ran to the waiting room before my mother reached the door.
When we got into the car, Mom seemed annoyed, like a child who’d been chastised. I rested my hand on her forearm. “Mom, I really don’t want to get rid of the cats.”
“I know,” she said.
I had stopped rushing to my mother’s room as soon as an attack started. I waited in my room until waiting was no longer an option, because waiting allowed me to postpone the torment of the moment when my mother, ignoring all of the evidence in front of her, said in her tired, apathetic way, for the twentieth or thirtieth time, “OK, get in.”
Having an inhaler would change everything.
The first time I used it, the mist spread through my lungs, dilating my bronchial tubes and opening up my airways. The relief was almost instantaneous and so profound, I cried. I hadn’t allowed myself to believe it could be true. It was like a pocket miracle. Now if I had trouble breathing in the middle of the night, I could stay in my room until morning, sparing myself the added agony of hearing my mother’s normal, steady breathing as I waited for rescue.
I felt invincible. I didn’t have to go to the hospital. When I told my mother the next morning, she smiled. She probably felt freed from the burden I’d placed on her.
Then, one morning after an attack, I was still struggling to breathe. Mom, secure in the knowledge that I had the inhaler, asked if I wanted to stay home. I waited for her to offer another option, but she didn’t, and I knew better than to ask. She left me at home in my bed with a cold-air humidifier, cinnamon toast, and a cup of tea.
The doctor had said to follow the instructions—he had failed to mention what would happen if I didn’t.
Not long after my mother left for the day, I was hanging over the humidifier, my weight on my forearms. My mouth had to be right next to the opening where the cold vapor came out in order for it to do any good. This exhausted me and increased the tension in my back. When I pulled away to give my muscles a break, my face, hair, and pajama top were soaking wet.
I took my inhaler again. I sat up against my pillows, which I stacked against the wall, and kept my breathing as slow and even as I could in order to postpone as long as possible my need for another dose of Alupent.
The air conditioners in our apartment had been installed improperly, and whenever we used them, condensation softened the drywall around them, causing it to bubble. I was too tired to read, so I passed the time poking my fingers through the air bubbles.
I was supposed to wait four hours between doses, but inevitably I couldn’t. I became dependent on the clock, needing to know how many minutes had passed since my last dose, trying to gauge how many more minutes I could possibly last before I reached for my inhaler again. Four hours, then three hours, then two hours, then one. When I was reduced to watching the minutes, I knew I was past help.
Finally, when I rolled over and took a hit from my inhaler, nothing happened.
Nothing.
Weeks later, I hurt my left wrist playing softball. The school nurse thought it might be broken, so when my mother picked me up from school, she suggested my mother take me to the emergency room.
I’d never been there in the middle of the day before. Whenever I came in with an asthma attack, I was rushed in immediately, with urgency. This was the first time I’d been left in the waiting room. After an hour, I wondered what was taking so long.
My mother had gone upstairs to the Women’s Auxiliary offices to catch up on paperwork, leaving me with instructions to have the nurse call her when the doctor was able to see me. Every seat was full, with patients and relatives of patients, and there was no room to walk around. I didn’t want to go outside and risk missing my turn, so after three hours of waiting, I wandered over to the nurses’ station. The two women working behind it were both busy, but one recognized me from my previous visits, even though it was probably the first time she’d ever seen me standing upright.
“What brings you here?” she asked, barely looking up from her paperwork.
I raised my arm so she could see the Ace bandage wrapped around my wrist and hand.
“That’s a nice change of pace.” She went back to her work, but when I didn’t move, she said, “Where’s your mom?”
“She went up to the office. I was just wondering about the wait. It’s been a few hours.”
She slid her chair back, threw some file folders into a box on top of a filing cabinet, and rolled back to her desk. “A car drove through a red light and crashed into a bus full of elementary school kids. It’s chaos.” She shook her head. Every time the swinging doors to the ER opened, I heard the screams.
“That’s awful.”
I had turned back to find a seat when she said, “That’s not the reason for your wait, though.” I turned back and she jabbed her pen at my wrist. “Broken bones aren’t life threatening.”