Diary of Our Fatal Illness

Diary of Our Fatal Illness

by Charles Bardes

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Overview

This moving prose poem tells the story of an aged man who suffers a prolonged and ultimately fatal illness. From initial diagnosis to remission to relapse to death, the experience is narrated by the man’s son, a practicing doctor. Charles Bardes, a physician and poet, draws on years of experience with patients and sickness to construct a narrative that links myth, diverse metamorphoses, and the modern mechanics of death. We stand with the doctors, the family, and, above all, a sick man and his disease as their voices are artfully crafted into a new and powerful language of illness.

Product Details

ISBN-13: 9780226468167
Publisher: University of Chicago Press
Publication date: 03/21/2017
Series: Phoenix Poets
Sold by: Barnes & Noble
Format: NOOK Book
Pages: 96
File size: 492 KB

About the Author

Charles Bardes is an internal medicine specialist at NewYork-Presbyterian Hospital and professor of clinical medicine and associate dean at Weill Cornell Medical College. His books include Pale Faces: The Masks of Anemia, and his poems and essays have appeared in numerous publications, including Agni, Ploughshares, and Raritan.

Read an Excerpt

Diary of Our Fatal Illness


By Charles Bardes

The University of Chicago Press

Copyright © 2017 The University of Chicago
All rights reserved.
ISBN: 978-0-226-46816-7


CHAPTER 1

Disease has bent me like a bow, the string is tensed, soon the arrow will fly.

* * *

My father said, I don't feel well. The doctor said, Tell me. My father said, My knees hurt, and I don't sleep very well, and I have problems with my blood pressure and my cholesterol and my heartburn, and I pissed blood twice, and I lost weight. The doctor mumbled, Ye gods. My father said, I'm tired. The doctor said, Me too, though not in the same way. When did it begin, and where, and how often, and how bad. My father said, Then and here and always and pretty bad, when I walk or lift or listen or think or rest. The doctor said, Subspecialists for each of these. My father said, What then are you doing, and what good are you. The doctor said, I ask myself the same question.

My father said, I feel old. The doctor said, Did you not know at twenty that someday you would be thirty, and someday fifty, and someday eighty. My father said, Did you foresee always hurting. The doctor said, I imagined turning grey, then white, and feeling sore sometimes, my posture ever erect. My father said, Did you imagine the unsteady gait, the falls and near-falls, the urine-stained trousers, the kindly scorn, the condescension. The doctor said, Nature or disease or divine ordinance. My father said, Has taken away all my pleasures one by one. The doctor said, Till death. My father said, Is welcome.

My father said, pointing, There is the empty place where the elder sat. The doctor said, He was arthritic, deaf, and repetitive. My father said, He is gone.

* * *

81 yo man with chief complaint "I pissed blood." According to his son, a physician, this first occurred 2 weeks ago. According to the patient, a mainly reliable informant, he also had red-tinged urine six months ago and consulted his son, who said it was nothing.

Past medical history notable for hypertension, diabetes, and hypercholesterolemia. He smoked 2 packs of cigarettes daily until age 36, when he changed to a pipe, then stopped altogether at age 63. Drinks alcohol "socially." Retired, worked as an engineer in a manufacturing plant, before then a submarine officer. Married, two sons, the elder a physician, the younger a drifter. Review of systems notable for 10 pound weight loss.

On physical exam, the blood pressure was 128/80, heart rate 76. Exam unremarkable.

Impression: Hematuria, rule out malignancy (bladder, kidney)

Plan: urine cytology, CT, cystoscopy

* * *

I said to my father, Dad, the biopsy shows cancer. My father said, What does that mean, you're a doctor. I said, It can be treated but not cured, managed but not eradicated. Maybe radiation therapy, maybe chemo.

My father said, I shall row, and the father said, Steadfast.

* * *

My father stood at the head of the dinner table, raised his glass and offered a toast, Give each man his due and who will escape a whipping. Hamlet

* * *

The oarsman my father leaned over the gunwale, the boat pitched, the sea roiled, whether from the moon, or the wind, or an earthquake somewhere, or a mass of little fishes, or a flick of the tail of great Leviathan.

* * *

My mother said, What will happen, what is the prognosis. The doctor said, We'll give him some medicine to shrink the tumor, then repeat the scans, don't worry.

My brother said, the Oracle at Delphi once spoke in verse but then only in prose, and later not at all. Had the god stopped speaking; or did the sibyl no longer reach the godhead; or had the age of metaphor passed.

* * *

My father said, I shall stand straight and tall like a soldier. I thought but did not say, As you always told your sons, though your posture has bent these many years.

The father said, When the frigate Birkenhead struck a rock, the soldiers stood in rank while the ship went down, allowing, they imagined, that women and children be saved, and inspiring poets to limn ballads memorializing their discipline.

* * *

81 yo man with recently diagnosed transitional cell bladder cancer, Stage III A, admitted for neoadjuvant chemotherapy. Plan IV hydration, then chemotherapy in AM.

* * *

A man walking down the hall of the hospital hears the long howls of diseases, like faraway coyotes in the night. They sing each to each, whether planning their attack or awaiting their someday chance. They shrill and yelp. He barely makes them out, at first, wondering if the sound is a motor or a dog or an owl or maybe even some noise of his own mind's making.

He walks again, yes, canine; no, no household dog, a wild thing, a disease. Their calls become more distinct. They sound distant but purposeful.

He pricks up his ears. He is older now. The hills surround his own place, and each one sounds and resounds the long call of no human instrument. They begin to call for him. Listen, we are the night's dogs, and you are ours.

He walks again, and there by the nursing station a rustling of underbrush draws his attention, a tawny long-legged dog disappears in a flash. Night falls, and now he does not sleep, listening, unable to disengage. Hath thee in thrall. The voices are louder.

The circles draws tighter, the howls are closer, and now the animals show themselves shamelessly and unafraid, though he is now afraid, and one day the least timid, the one with yellow eyes, runs forward and nips at his leg, he kicks it away, but another comes from behind, he kicks again, and now the whole pack barks, one darting forward, one running back in transient retreat, the whelps of his neighborhood dogs gone wild and interbred with wolves, or coyotes, and now one leaps and has him by the neck, he beats his arms, another brings him down, and now he falls, and now he rises again, he howls, he slathers, he yelps, he runs, his four legs bounding uphill, and now he pauses and pants and lifts his head and stretches his neck and straightens his crooked throat and all together announce and supplicate the cold lucid night.

* * *

In the house of sickness strangers enter your room. In the house of sickness the phone is often left unanswered. Someone makes the bed while you are still in it. Flowers appear from nowhere, grow stale but stay gaudy. In the house of sickness it is difficult to distinguish nurses, technicians, therapists, students, and interns, so often they look and dress alike. It is difficult to distinguish belief from doubt, the one from the many, health from disease. The bed is uncomfortable. The bedrails have bars. Unable to leave, transfixed, as if some hag had cast a spell. The window looks out over nothing. Everyone asks how you're feeling. You are brought some place without knowing how. On a gurney you see only the ceiling. There is much commotion. Smells are hard to identify but always bear traces of sweat, urine, and bleach. Illness is not so ennobling or purifying as you had anticipated when well. You do not catch up on your reading. You scratch. You look around for something to look at. You ask and you hesitate to ask. You beg though you would otherwise never beg. Doctors visit very briefly. Everyone hurries. Quips fall flat. Metaphors illuminate for only a minute. Reassurances seem like impertinent one-liners. Which shall win out, order or disorder. So many songs say my love is far away. Your bottom gets sore. There is ample TV but no music. The news is irrelevant. Nice people do nice things. The people wearing pajamas all look pale. The person who draws your blood tapes the vein but applies no pressure, leaving a large bruise. They say you're getting better when you're not. The moon changes from full to new to full again. They write much about you. Machines beep. You may not eat or drink when you want to. In the house of sickness there is too much juice and too little water. People poke and prod you. Sickness is a full-time job. You can focus on little else. There are not enough blankets. You feel chilled. You feel unable. Your ears follow the footsteps of a tall man who strides down the hall but does not stop at your room. Visitors bringing flowers expect to be smiled at, even by passersby in the corridor. You dream of broken things. The razors are dull and pull your overlong whiskers as if by the roots. The washcloths are rough. Scourge and penance. The bark is peeled, exposing the sapwood. Your years of exercise and abstinence seem pointless. You wait. You do not know how long you will be there. You may see a dead man, maybe for the first time. You may see a man tied in restraints. You may hear a man cry out in pain. You may hear a man shouting, No. Wives and husbands recall their vows. Someone walks who could not walk before. Someone speaks who newly was struck mute.

* * *

The student said, Your patient seems confused. The doctor said, As you should know, this often happens to an aged man admitted to the hospital, given unfamiliar drugs, and unfamiliar foods, and fasts, and sleeplessness, and then the sun sets and the room grows dark and he loses his orientation. We call the phenomenon sundowning.

The student said, I'm a beginner. The doctor said, Read, ninny.

* * *

My father's hospital roommate lay in the bed nearer the window. My people, he said, as his IV pump beeped, ate black bread, and they drank black wine, and they slew a black goat, and spilled his blood in the fosse.

He pulled back the curtain separating their spaces. How can a man so young, he said, examining a pale photograph, Become so old. How does the youth so seeming hale become so ghastly sick.

* * *

No experience quite like this, to sleep in a strange bed, and then to become dully aware, still sedated from last night's tablet, of movement in the room, a band about the arm, tightening, and next an abrupt insulting sharp prick as the phlebotomist commits her morning rounds.

* * *

The roommate announced his giddy exultation in falling sick, something at least at last has happened.

The consultant told him, Did you not think that taking ill would give your life a purpose that it otherwise lacked.

* * *

The hospital fills with sleeplessness, the insomniacs' carnival, where each frolics alone.

The nurse paged the intern, Doctor, you need to order a sleeping pill. She has many years experience, he is a novice.

My father said, Difficult to know whether the sound penetrating my drugged sleep was soft persistent rain, or a distant mechanical pump.

* * *

My father said, Can anyone get a decent cup of coffee around here.

My father said, How about a drink, just one, just a nip, just a splash, just a guss, just a schluck.

My father said, 'Tis Madness to resist or blame / The force of angry Heavens flame.

My father paused a while and said, I was the first of all my family born in a hospital, and once home my mother hired two wetnurses, sisters, named Apollonia and Kunegunda.

* * *

My father said, In Lear there is a doctor, who says, Our foster nurse of nature is repose, The which he lacks. That to provoke in him Are many simples operative, whose power Will close the eyes of anguish.

* * *

My father said, Why do the words of other men Count for me more than my own.

* * *

81 yo man admitted July 9, 2009 with Stage III A bladder cancer. Received neoadjuvant chemotherapy without incident. Hospitalization complicated by intermittent delirium, most likely "sundowning" related to medications, sleeplessness, and unfamiliar hospital environs. Follow-up 2 wk.

* * *

My father said, The hospital disgorges me home, I am to go home, my own footpaths, my own bed, my own woman and wine, but who there will measure and mark my every heartbeat, and sound the alarm should it go amok, and fix it. And wipe my sore behind.

* * *

My father said, As the fleet left port, a launch sputtered among us, and on it a brass band played the jaunty lament, Empty Saddles in the Old Corral, and when we returned after two months at sea, the band played anew, Back in the Saddle Again.

My father said, When our ship lay anchored at Piraeus, I dared not go ashore, lest I succumb to folly.

* * *

My father said, In Naples a steel cable fouled the propeller and would have ended my career, until a skiff rowed up with an old man and his two strong sons. Bargaining with gestures, the ancient donned a worn and doubtful diving suit from the last century, connected by a hose to a long-handled bellows contraption, his only air supply. Over the gunwale he went, and he was down a long time while the young men pumped. Don't stop for a second, I prayed, even to wipe the sweat from your brow, or calamity will double. Finally the old man's head popped up, and then his hands, triumphant, holding a heavy knife in one and a sawn length of cable in the other. The only pay he wanted was the chunk of steel, but we tossed in whiskey and many cartons of cigarettes, having averted the wrath of the Fifth Fleet.

* * *

When you are sick, healthy acquaintances cross the street as they see you approach, embarrassed by infirmity.

* * *

81 yo man status post neoadjuvant chemotherapy for Stage III A bladder cancer. Feels reasonably well. Trouble sleeping. Plan radical cystectomy, although he may not fully appreciate what this entails. Perhaps a bit daft.

* * *

My father said, I have observed two species of doctors, those that feel well and those that feel sick, and the first are proud, regaling the world with their robust constitutions, while the second take alternately strong drink and strong coffee, torpor and acuity.

The doctor said, If you had heeded my advice by pouring kerosene into the swamp to eliminate mosquitoes, such cacophony of frogs, toads, and unknown night sounds need never have disturbed your sleep.

My father said, To read a poem properly you must wake up too early and drink too much coffee, or else stay up too late and drink too much wine. The doctor said, To read a disease is the same, sleepless at either end of the night.

* * *

The stranger saw a girl, Coronis, they dallied, they lay together, the god rose and went away. Time passed, her belly grew round, she felt lonely and afraid. One of the local boys was nice to her, the girl liked him and took him to bed, but this outraged Apollo, how dare she mix mortal seed with his own, he smote her dead. Yet as the flames rose on her funeral pyre the god pitied his unborn son, freed him from the womb, lifted him up, and named him Asklepios.

Dad, I said, Try to focus.

My father said, You try to focus when you haven't slept in three nights. Pay attention, the boy became the Physician, you bozo, the hero the god of Medicine. Born then, born again and again.

He said, Medicine begins when the god pursues a mortal who weds and then defies him, begetting the first physician, human son of an immortal.

Dad, I said, the gods were long ago, there are no gods.

My father said, Medicine begins when human physicians pierce the boundaries between disease and health, mortals and immortals, necessity and freedom. The act is heroic and blasphemous both, worthy a god's homage, worthy a god's outrage.

He said, The gods are the athanatoi, the undying, the deathless, and we by contrast are those who die.

Dad, I said, everyone dies.

* * *

My brother sent a postcard picturing the buried terracotta army of Qin Shi, the first emperor, who ordered that all Confucian books be burnt, excepting those concerning three subjects, being medicine, agriculture, and divination by tortoises.

* * *

My mother said, Your father descends underground. He is climbing down a long, deep stairway. Dim bulbs intermittently light the path. He stumbles forward and always downward. He speaks seldom and with little content. He knows the way and does not know the way.

My father said, I think of Odysseus, but there is no Tiresias to receive the sacrifice; of Aeneas, but there is no sibyl; of Dante, but there is no Virgil, no Beatrice, and no reemergence into the light.

My mother said, My husband is become a miner treading incautiously down the deepest tunnels, seeking some ore he never will bring back.

My father said, The shadows on the cave's wall are the same that mark my room. The doctor said, The descent beckons as the ascent beckoned.

My mother said, Still I am lonely and soon will be all alone.

My father said, I knew a dog who, late in her doggy life, dreamed of bounding over hills, herding sheep, and keeping the wolf at bay. I knew a man who, late in life, dreamed of sailing ships, hoisting sails, watching at night, and braving storms. I knew a man who dove a submarine, deeper and deeper, beyond sound and light, beyond any recall.

* * *

My father said, Naught to be seen but the conning tower, the canny, the cunning, the kenning, the whale road.

* * *

81 yo man bladder cancer chief complaint "Can't sleep." Rx Zolpidem 5 mg 1–2 qhs PRN. Left leg pain; exam normal, doubt metastasis; Rx Ibuprofen 400 mg TID. Mit Schlag.

* * *

My father said, When you visit the doctor you wait a long time. Your time is not your own. The waiting room is a blank space. Upholstered chairs shiny with Stain-Guard.

A man burst in, shouting Glass in my foot, a bone in my craw, a mote in my goddamn eye.

A sick man said, I reached home yesterday just after dusk, and I stirred the lawn with a stick and caused a score of serpents, or small mammals, to fly through the wet grass every which way.


(Continues...)

Excerpted from Diary of Our Fatal Illness by Charles Bardes. Copyright © 2017 The University of Chicago. Excerpted by permission of The University of Chicago Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents

Acknowledgments One Two Notes

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