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WHAT HAPPENS NEXT?
Matters of Life and Death
By Douglas Bauer UNIVERSITY OF IOWA PRESS
Copyright © 2013 Douglas Bauer
All rights reserved.
ISBN: 978-1-60938-183-7
CHAPTER 1
HERE WE WERE AT EXACTLY THIS MOMENT
THE SUNNY BOSTON WINTER SHONE THROUGH THE WALL of windows, casting us in a warm and welcoming morning light. And the sunlight's disposition was the room's in general, thanks to the nurses moving quickly about like focused, happy hosts. At the moment they were happily hosting two other patients besides myself, the three of us here for cataract surgeries. We were sitting comfortably in something like settees that fold down flat, when your name reaches the top of the list on a large overhead monitor that suggests an airport arrival-and-departure screen—if only airports functioned with such brisk efficiency.
I was partly attentive to the movement all around me and especially to the banter among the nurses and staff, overlapping like chatter in an Altman scene. But my mind was mostly fixed on the conversation I'd had an hour ago with my younger brother, Bob, my only sibling, who was calling from his car in Newton, Iowa, where the sun was just then rising and putting a glaze on the crusted snow and where the temperature was uninhabitably below zero. He was sitting in the otherwise empty parking lot of the hospital where our mother had been a patient for a week.
His cell phone had wakened him on her couch; it was where he always chose to sleep when he drove from St. Louis to visit her in Iowa. Answering, he heard a nurse saying that Mom had had "a pretty bad night" and that he might want to get to the hospital as quickly as he could, a distance of roughly twelve miles from her apartment in the tiny village of Prairie City.
Calling from the parking lot, he said to me, "I haven't gone in yet. I wanted to tell you what was happening." He knew I was scheduled for surgery that morning and he'd timed his call for the hour before I left the house, factoring in the difference between Midwest and East Coast clocks.
We agreed we'd talk again at noon, when I'd returned from the procedure and the drugs had lifted and I would be, I hoped, lucid enough for conversation. He wished me luck, I wished him the same, and I hung up feeling an inseparable layering of guilt and relief and guilt for feeling relief, that he was out there, with her, and I was not.
He'd made the six-and-a-half-hour drive after getting word that she'd fallen again, not as she had five months before when she'd lost her balance while fixing her early supper on a hot August evening and broken her left hip as she hit the kitchen floor. This time she'd fallen outdoors, slipping on the ice as she stepped from her car after driving four blocks from her apartment to the local grocery on the town square.
The Midwest winter had been epically severe. Preposterous extremes of snow and cold had completely stopped the days, sometimes several in a row. Certainly, it had kept her "cooped up," as her phrase had it, in her apartment at the northeast corner of the village. She relied on frequent quick excursions as a way of seeing people and mingling with the world. But the winter had made even local trips of a few blocks—to church, to the post office, to the grocery—treacherous, and it made longer ones to nearby neighboring towns—to the bank or the beauty parlor—unthinkable.
So on a January morning, ten days before, she'd stood at her kitchen window with a bad case of cabin fever and looked out to see what she had been seeing—a morning world of undulant white running to the horizon. But she also saw something she hadn't—a high and cloudless sky. At the same time, she was listening to a radio forecast that promised another numbingly cold day, but one with no new snow, and she decided on impulse to get into her car and drive the four blocks to the market, not because she needed food, the grocer made deliveries, but because she needed another nourishment: to get out of her apartment for even half an hour and never mind the temperature.
I picture her getting into her boat-sized Buick and driving the empty, snow-surfaced small town streets at the crawling speed of vigilance. For most of her life she'd had a well-deserved reputation as a lead-foot at the wheel. Growing up, I overheard amused, exaggerated accounts of her daredevil driving—of our blue Dodge zipping through the village or passing someone on the highway as though his car were standing still. She liked to drive and she liked cars. She paid attention when the new models were introduced each year and, as with every other thing under the sun, she held strong opinions about them: which ones were attractive and which were not. She'd absolutely coveted a Ford Thunderbird in its original missile-sleek incarnation.
She reached the store and climbed out of the Buick. The tip of her cane on snow and ice was surely unable to sound the neat, even clicking that it made on the linoleum and thin carpet in her apartment. She negotiated the low curb, stepped up onto the sidewalk, and in falling did no damage either to her new hip or to the one God gave her. Instead, this time, she cracked her pelvis and broke her wrist.
As he'd sat in his car in the frozen dawn waiting to phone me, my brother had been thinking about the similarity of this morning and, except for the weather, the one last summer after her first fall. Then, as now, he'd been waked around four o'clock as he slept on her couch to hear a nurse say she'd had quite a bad night. Then, as now, he'd become alert in a moment. And in the brief time it took him to dress and gulp down his morning Coca-Cola and hurry to the hospital, she had rallied against every expectation. Entering her room, his arrival startled her. In her struggle through the night she'd been somewhere, in some private and primal version of life, and residually that's still where she was. And she had startled him almost as much because of how she looked—her color an unearthly white and her eyes darkly circled; a haggard and spectral kabuki face. Later, a nurse told him that when he was telephoned our mother had had effectively no blood pressure. The nurse said she'd never witnessed someone so close to death returning so quickly and so fully.
How would she be this time? This is what my brother wondered as he'd sat, waiting to call me, and watched the sun begin to light the winter day. How many times can a life elude aggressive failure?
The short, round nurse in charge of getting me ready looked down to consult her clipboard. "So I see it's the left eye we're doing this morning?"
I confirmed it was and she stuck a piece of tape to my forehead over my left eye. This seemed a protocol of spectacularly low-tech efficiency, which both did and did not reassure me.
My mother would be eighty-seven years old in May, when Iowa would be thawed and once more greenly habitable. She'd lived all but three of those years within a fifteen-mile radius of her present apartment, half of a low, blond-brick bungalow, where she moved six months after my father died. All her siblings had died as well. She was maybe two inches more than five feet tall at her full adult height, and she'd shrunk quite a lot over the last decade or so. Among the things she'd survived in her life, in chronological order as I remember them, were these: the removal of her thyroid gland; an operation that required one of her ribs to be taken out so that surgeons could get to the spot on her lung an X-ray had found, a spot that proved to be nothing of concern; quadruple bypass surgery; cancer of the cheek, whose aggressive excavation made it necessary to pull every tooth in her mouth; a mild stroke that caused a gap of several hours when she couldn't remember anything of the belligerent nonsense she spoke to the two or three people, including a favorite niece, who happened to phone her in that time and who'd been naturally alarmed—So unlike your mother—and inevitably a little offended—Still, no one appreciates being talked to like that; two heart attacks within a few days of each other, the second while she lay in the hospital recovering from the first; two bouts of severe pneumonia that put her in the hospital for weeks and left her with a chronic phlegmy cough; and, this past August, the broken hip and the resulting surgical replacement and rehabilitation.
I don't remember her having cataract surgery, but the odds make it extremely likely that she did. Maybe I have no memory of it because it would have seemed the equivalent of her catching a cold in the context of the serious assaults on her body. None of which, nor their accumulation, made her for a moment an invalid. She'd vowed to return the aluminum walker she used while getting accustomed to her new hip, and she had met that goal, graduating to just a cane, the rhythmic click I've described of its tip on her floors like the quick, even ticking of her life's second hand.
I tended to say she was simply too mean to let her body give in to a more than temporary setback, intending it to be an admiring acknowledgment of her flinty resolve. But I'd learned to be careful where I said it, thanks to a conversation months ago, after her first fall, with the manager at her bank who asked me how she was doing. She was beloved by everyone at the bank, and when I gave my customary answer to the manager's question she shot me a look of startled disapproval.
* * *
"What's your history?" the short, round nurse asked me.
"What's my history?"
"Any previous surgeries?" she asked.
Ah. That history. I mentioned a major operation on my left knee to remove a badly torn medial meniscus when I was twenty-one, in those prehistoric days before arthroscopic surgery. I've always liked saying "medial meniscus." It's one of the few terms I know that suggests I have any knowledge of the anatomy. I'm familiar with the knee's anterior cruciate ligament and the shoulder's rotator cuff and the plantar tendon that runs taut like the string of a bow along the sole of the foot. I know these body parts because they're the ones that athletes commonly injure and my interest in sports is an addiction, deep and long. But in general I've been oddly incurious over the course of my life about the way the body works and what holds it together, or doesn't. I suppose this is a symptom of an attitude about my own, the arrogant fantasy that it was uniquely impervious to age.
"Never had your tonsils out?" asked the short, round nurse.
"Oh, right. Yes. When I was really young."
She finished with her forms, then steered me in my upright bed across the room and parked me again. Next she asked me to tilt my head back while she put dilating drops in my eye. When she'd finished, a large, doughy-bodied anesthesiologist wearing surgical scrubs and a plastic shower cap, his black-rimmed glasses pushed up on his forehead, walked with a bear-like shuffle toward me. He asked my name to make sure I was the person, with the history, the overhead monitor said I was. Then, with a minimal shake of his head, he said, "I'm sorry, but you can't be sixty-two." And in that moment was the ignoble essence of where I often found myself at this point in my life—all my vanity in play and hopelessly matched against the contradictions of time and evidence. There I was, a man on a collapsible gurney in a surgical clinic come to have the first of two cataracts removed, and I seized, with the need of an aging coquette, the words of someone telling me I looked younger than I was. Because I used to hear such words, that announced disbelief, routinely, and they verified for me—far more than I'd like to admit—the shallow sense of how I saw myself: nimble and ageless; my body, as I said, insusceptible.
Sad to say, I've continued to wait an expectant beat for that voice of surprise. But for some while now I've heard it only rarely, and whenever I don't my mind stumbles forward through the silent space of the exchange that doesn't happen, like someone pushing against the anticipated resistance of a door that opens freely. But here was this sweetly ursine shower-capped anesthesiologist who'd just said what he'd said, and the size of my gratitude was really pathetic.
He adjusted his black-framed glasses on his nose and took my hand, scanning the back of it for a plump and easy vein. He chose one he liked, his way with a needle was impeccable, and the flow of sedation began. Next he injected lidocaine into a corner of my eyelid to keep my eye still and me from feeling pain. Then he went away and when he returned a few minutes later, he had with him his oxygen on wheels. He gently clamped the plastic tubing to my nostrils. His face looked even fleshier than it had, the bags beneath his eyes grown fat as tiny purses. Which is to say, the sedative was already working; a luxurious lulling was moving in me.
But I was still alert enough—or more likely I was sufficiently sedated—to receive the unbidden coincidence that suddenly arrived. I sensed all at once my mother's presence; I felt it almost palpably; here were the two of us at exactly this moment, in Iowa and in Boston in our hospital beds, attached to our IVs, with slender plastic tubes sending oxygen up our noses. I was not in any way comparing the urgency of our hours, the brief inconvenience of my morning against the horrible struggle she was going through in hers. Simply, it struck me that, right then, we must look the same, with our networks of tubes and their air and their fluids, and I felt glad to have this moving illusion of her company, and with it the idea that she had mine; to be seeing her and me, a split-screen picture, in my mind. It was as if, with my thoughts and senses set free to roam, this was how they'd contrived to reach her.
Then came two familiar, floating moments that I've always thought of as my first memories. In one, I'm a small child lying in the dark in a hospital bed with a crib's slatted sides. I hear the sounds of other small children around me—the rustling of sheets, their soft fussing and steady breathing. I'm very frightened, feeling piercingly alone, and when I call my mother's name she answers from where she sits, somewhere near but not visible, off to the side and slightly behind me in the darkness.
In the second moment I am again that infant, now in her arms, leaving the hospital on a cold winter morning, like this one in Boston and hers in Iowa, and the vivid sensual instant is of her tucking me more securely into the warmth of her wool coat while covering my head with a blanket against a lightly falling snow. It's an even quicker flash than the first, little more than a sensory blink, and as close to womb-return as I can fathom.
Whether these are memories of the time when I was barely three and having my tonsils removed, or whether they're fragments of dreams that have taken up ethereal residence in the same way memories do, this I can't know.
I do know it's inexcusably mawkish to write—in the tone I've just sounded, with the details I've chosen—that these memories or dream-images or whatever they are arrived in concert with the thought that my mother and I were similarly hooked up. But that's what happened. Blame the nurse. She's the one who asked about my tonsils.
With the patch taped over my eye, I made my way down the three stone steps to our condominium door, unlocked it, and hung my coat in the tiny foyer. On the ride home I'd been a fairly dazed passenger alongside my friend, Sam, who'd generously insisted on picking me up.
Inside, I walked down the hallway to the phone and called my brother, leaving a message that assured him at rambling length that my head was clear enough to talk, though I had the sensation as I spoke these words that I had no role in forming them.
Half an hour later, when I got up from bed to answer his return call, he immediately began to tease me, saying I'd sounded in my message like a drunk trying to convince a cop he's sober. Thinking now about his chiding, I'm reminded of a Boston friend, another émigré from the middle of the country, saying that you know a Midwesterner is about to deliver bad news when you're surprised by his phone call and the first thing he does is ask about your weather. And that the news is really bad if the second thing he does is to tell you about his.
My brother was not exactly asking about my weather. I think of him, instead, as wishing to establish an instant intimacy, for we've learned over the years that the private joking insult is our lingua franca, through which we find a quick, fraternal ease.
"How's she doing?" I asked.
"No," he said, all mischief gone from his voice. "No, she didn't make it."
His words took me to a summer night in 2001. I was saying good-night to four friends who'd come to dinner to help me celebrate my birthday when the phone rang and I picked it up to hear my mother say, "Well, Dad didn't make it." She'd gotten right to it. She was too tired and too empty and, despite what seemed the eager purpose with which my father had been failing, too stunned to care about the weather; not mine; not hers; not then.
My brother was phoning from the road. He'd called her neighbor and close friend, Sue, and her sister-in-law, our Aunt Beverly, Aunt B. He'd talked to the funeral director and made preliminary plans for a service and now he was headed home.
(Continues...)
Excerpted from WHAT HAPPENS NEXT? by Douglas Bauer. Copyright © 2013 Douglas Bauer. Excerpted by permission of UNIVERSITY OF IOWA PRESS.
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