"What happened?" he asked her.
"A burst appendix. You had it for some time."
"How sick am I?" he asked weakly.
"There's a lot of peritonitis. There are drains in the wound. They're draining it. You're getting big doses of antibiotics. You're going to pull through. We're going to swim across the bay again."
That was hard to believe. Back in 1943 his father had come close to dying from undiagnosed appendicitis and severe peritonitis. He was forty-two with two young children, and he had been in the hospital – and away from his business – thirty-six days. When he got home, he was so weak he could barely make it up the one little flight to their flat, and after he'd been helped by his wife from the entry-way into the bedroom, he sat on the edge of the bed, where, for the first time in the presence of his children, he broke down and cried. Eleven years earlier, his youngest brother, Sammy, the adored favorite of eight children, had died of acute appendicitis in his third year at engineering school. He was nineteen years old, having entered college at sixteen, and his ambition was to be an aeronautical engineer. Only three of the eight children had got as far as high school, and Sammy was the first and only one to go to college. His friends were the smartest boys in the neighborhood, all of them the children of Jewish immigrants who met regularly at one another's houses to play chess and to talk heatedly about politics and philosophy. He was their leader, a runner on the track team and a mathematics whiz with a sparkling personality. It was Sammy's name that his father intoned as he sobbed in the bedroom, astonished to find himself back among the family whose provider he was.
Uncle Sammy, his father, now him – the third of them to have been felled by a burst appendix and peritonitis. While he drifted in and out of consciousness for the next two days, it was not certain whether he would meet Sammy's fate or his father's.
His brother flew in from California on the second day, and when he opened his eyes and saw him at the side of the bed, a big and gentle presence, unperturbed, confident, jolly, he thought, I cannot die while Howie is here. Howie bent over to kiss his forehead, and then no sooner did he sit down in the bedside chair and take the patient's hand than time stopped, the present disappeared, and he was returned to childhood, a small boy again, preserved from worry and fear by the generous brother who slept in the bed beside his.
Howie stayed for four days. In four days he sometimes flew to Manila and Singapore and Kuala Lumpur and back. He had started at Goldman Sachs as a runner and quickly went from relaying messages to top dog on the currency-trading desk and began investing for himself in stocks. He had ended up in currency arbitrage for multinational and large foreign corporations – winemakers in France and camera makers in West Germany and automakers in Japan, for whom he turned francs and deutsche marks and yen into dollars. He traveled frequently to meet with his clients and continued investing in companies he liked, and by thirty-two he had his first million.
Sending their parents home to rest, Howie joined with Phoebe to see him through the worst of it and prepared to fly out only after receiving the doctor's assurances that the crisis was over. On the last morning, Howie quietly said to him, "You've got a good girl this time. Don't screw it up. Don't let her go."
He thought, in his joy at having survived, Was there ever a man whose appetite for life was as contagious as Howie's? Was there ever a brother as lucky as me?
He was in the hospital for thirty days. The nurses were mostly agreeable, conscientious young women with Irish accents who seemed always to have time to chat a little when they looked in on him. Phoebe came directly from work to have dinner in his room every night; he couldn't imagine what being needy and infirm like this and facing the uncanny nature of illness would have been like without her. His brother needn't have warned him not to let her go; he was never more determined to keep anyone. Beyond his window he could see the leaves of the trees turning as the October weeks went by, and when the surgeon came around he said to him, "When am I going to get out of here? I'm missing the fall of 1967." The surgeon listened soberly, and then, with a smile, he said, "Don't you get it yet? You almost missed everything."
Twenty-two years passed. Twenty-two years of excellent health and the boundless self-assurance that flows from being fit – twenty-two years spared the adversary that is illness and the calamity that waits in the wings. As he'd reassured himself while walking under the stars on the Vineyard with Phoebe, he would worry about oblivion when he was seventy-five.
He had been driving to New Jersey after work nearly every day for over a month to see his dying father when he wound up badly short of breath in the City Athletic Club swimming pool one August evening in 1989. He had gotten back from Jersey about half an hour earlier and decided to recover his equilibrium by taking a quick swim before heading home. Ordinarily he swam a mile at the club early each morning. He barely drank, had never smoked, and weighed precisely what he'd weighed when he got home from the navy in '57 and started his first job in advertising. He knew from the ordeal with appendicitis and peritonitis that he was as liable as anyone else to falling seriously ill, but that he, with a lifelong regimen of healthful living, would end up as a candidate for cardiac surgery seemed preposterous. It was simply not how things were going to turn out.
Yet he couldn't finish the first lap without pulling over to the side and hanging there completely breathless. He got out of the pool and sat with his legs in the water trying to calm down. He was sure that the breathlessness was the result of having seen how far his father's condition had deteriorated in just the past few days. But in fact it was his that had deteriorated, and when he went to the doctor the next morning, his EKG showed radical changes that indicated severe occlusion of his major coronary arteries. Before the day was out he was in a bed in the coronary care unit of a Manhattan hospital, having been given an angiogram that determined that surgery was essential. There were oxygen prongs in his nose and he was attached by numerous leads to a cardiac monitoring machine behind his bed. The only question was whether the surgery should take place immediately or the following morning. It was by then almost eight in the evening, and so the decision was made to wait. Sometime in the night, however, he was awakened to discover his bed surrounded by doctors and nurses, just as the bed of the boy in his room had been back when he was nine. All these years he had been alive while that boy was dead – and now he was that boy.
Some sort of medication was being administered through the IV and he vaguely understood that they were trying to avert a crisis. He could not make out what they were mumbling to one another and then he must have fallen asleep, because the next he knew it was morning and he was being rolled onto a gurney to take him to the operating room.
His wife at this time – his third and his last – bore no resemblance to Phoebe and was nothing short of a hazard in an emergency. She certainly didn't inspire confidence on the morning of the surgery, when she followed beside the gurney weeping and wringing her hands and finally, uncontrollably, cried out, "What about me?"
She was young and untried and maybe she had intended to say something different, but he took it that she meant what would happen to her should he fail to survive. "One thing at a time," he told her. "First let me die. Then I'll come help you bear up."
The operation went on for seven hours. Much of that time he was connected to a heart-lung machine that pumped his blood and breathed for him. The doctors gave him five grafts, and he emerged from the surgery with a long wound down the center of his chest and another extending from his groin to his right ankle – it was from his leg that they had removed the vein from which all but one of the grafts were fashioned.
When he came around in the recovery room there was a tube down his throat that felt as though it were going to choke him to death. Having it there was horrible, but there was no way he could communicate that to the nurse who was telling him where he was and what had happened to him. He lost consciousness then, and when he came around again the tube was still there choking him to death, but now a nurse was explaining that it would be removed as soon as it was determined that he could breathe on his own. Over him next was the face of his young wife, welcoming him back to the world of the living, where he could resume looking after her.