Pardon me, Mr. Nocera, Mrs. Gallagher? Are you in agreement? We like to have consensus within the family. Of course, Mr. Nocera, you have the power of attorney. The law says the decision is yours. However, it’s our experience that it’s better if everyone’s in agreement.
The pulmonologist has determined my mother is to be transferred from critical care. Other patients, ones with some hope of survival, deserve this bed. All of this expertise, this attention, cannot be wasted on comfort care. The hospice unit is perfectly capable of ensuring she feels no pain. The hospital has summoned the troops. They’ve been kind enough to provide us with our very own social worker, right out of Central Casting. She’s thin, tremulous, horse-faced. Why is her lower lip quivering? It’s not her mother lying there with her face covered by a thick plastic breathing cup. She oozes empathy and compassion, compensating for the let’s-get-on-with-it demeanor of the pulmonologist.
Regina and I retire to a small waiting room. We’ve been through this twenty times in the past week. She knows I won’t change my mind. She knows my mother’s last wishes. So she fixates on the oncologist, accusing her of having an attitude. She mistakes the good doctor’s dog-tiredness for lack of concern and impatience. I tell her she’s not being fair, that the woman could have chosen the safety and distance of communication by telephone line instead of a face-to-face confrontation with the consequences of the failure of the transplant.
My bone marrow has been swept away by an avalanche of white blood cells.
All further treatment to be limited to keeping her comfortable.
Do not resuscitate.
No mechanical respiration.
No tube feeding or invasive form of nutrition or hydration.
No blood or blood products.
No form of surgery nor any invasive diagnostic procedures.
No kidney dialysis.
No antibiotics.
No codes.
No extraordinary efforts to sustain life.
Do whatever you like, my sister shrieks, running out of the room, battered and defeated, only to reappear seconds later. She insists on a feeding tube. Memories of National Geographic and the bloated babies of sub-Saharan Africa haunt her. She can’t bear the thought of our mother starving to death. I agree and put my arms around her, letting her sob into my chest. I can always change my mind later, if this misguided act of mercy prolongs the agony.
The oncologist hugs me when I tell her our decision. She doesn’t offer any bromides, no it’s-for-the-best, it’s-what-she-would-have-wanted. She leaves that for the social worker. I thank her for being here, tell her it means a lot to us. She wishes she could have done more. She lets me comfort her, knowing the soothing effect my own kind words have on me.
The social worker says my mother should be settled in her new room in an hour. She suggests we get something to eat, we need to keep up our strength. My sister and I trudge down to the cafeteria and forage the steam tables. We carry our plastic trays, scratched and pocked from a thousand forks and knives, and find a table where we sit, silently. I squeeze a dry scoop of mashed potatoes through the prongs of my fork. My sister watches, disgusted. She drinks bottomless cups of black coffee and plays with the salt shaker. Then she starts tapping the table-top with her lacquered fingernails. She knows the rat-a-tat-tat is driving me crazy. I push my plate away from me and set down the fork. She stops drumming the table.
Truce.
“Sorry,” I say.
“Same here,” she says.
I need to piss and she needs to call her husband. Duties finished, we meet at the elevator and ride to the fifth floor. Gina pauses before she enters the room and our eyes lock. We share the same thought: our mother will never leave this room alive. She lies perfectly still on the bed, asleep, no, something deeper, more profound than sleep.
“Mom? Mama?” my sister says.
She pulls a chair close to the bed and holds one of my mother’s hands, talking to her in a low voice, sharing the latest news of the grandkids back in Florida. I don’t recognize the three model citizens in this family update. Neither would my mother if she could hear. My sister will not concede our mother is far beyond the sound of her voice. She’s read a half dozen paperbacks on death and dying and every pamphlet and brochure in the social worker’s arsenal. Mama? Mom? Can you hear me? She swears by the reflexive twitch in my mother’s fingers. See, Andy, she knows we’re here.
My feet are sweating despite this freezing room. I slip out of my sneakers and press my toes against the cool tile. The funky scent corrupts the antiseptic sterility of disinfectant. I look down and see my father’s feet. Middle age, decades of pavement pounding, years of being bound in tight leather wingtips, have taken their toll. When did the tiny nails on my little piggies splinter and crack? I tuck them under the chair, out of sight. My mother, lying prone an arm’s length away, is confirmation enough of my mortality. The blinds are drawn so the sun can’t penetrate the room. The only light is electric and is kept as dim as possible, the darkness perpetuating the illusion she’s just asleep. We keep our voices low and step softly so we don’t disturb her. She needs her rest. We don’t acknowledge an explosion wouldn’t rouse her now.
My mother, by Caravaggio, dark tones suffused with mortuary light, anguish revealed, humanity triumphant.
My legs are stiff and I need to stretch. The staff doesn’t mind my pacing so long as I stay out of their way. It’s three o’clock. The shifts are changing. Bloods are being drawn. Doctors are rounding. One last flurry of activity before evening. Barring a code, the only crisis will be the late arrival of a cold dinner tray. I hear conversations, actual and televised, in the other patient rooms. I reminisce, thinking back to the many Oprah hours my mother and I have shared during this ordeal, comforted and reassured by the tragedies of others. Please, the nurse says, pointing at my bare feet. I apologize, embarrassed. She smiles and says she understands my mind’s elsewhere.
Yes, it is. Where, though, I don’t know. Anywhere but here. I want to leave. I want to stay. Time seems to drag, yet races away. I look at my watch. Almost seven o’clock now. It might be seven in the evening or seven in the morning. It’s all the same, night and day, nothing to do but wait. Thank God for the cold. I feel it, so I must still be alive.
Snap out of it. It’s mashed potato time again. My sister asks me to bring her something from the cafeteria, tuna on white toast, maybe some skim milk.
The cashier is bored and passes the time watching the clock, counting down the ninety minutes until the cafeteria closes. She knows me well by now and smiles. We’ve never spoken, not even hello, not once in the past many weeks. She’s never asked why I’m here or how the patient’s doing. She knows one day I’ll disappear and never return, replaced by another just like me. She and I are familiar, intimate even, and totally anonymous. Like all my relationships. Perfect. Right? That’s what I want. Isn’t it?
I sit in the cafeteria, alone, staring at a roomful of tabletops, counting the napkin dispensers, the salt and pepper shakers. I should have brought a newspaper so I could disappear into the world outside the hospital, where skirmishes break out in unfamiliar parts of the globe, Republicans and Democrats argue, scandals erupt, celebrities mate and separate, box scores are tabulated, highs and lows are recorded, barometers fall. What if someone walks in here? What would they think if they saw me in this far corner, alone, mashed potatoes untouched, gazing into space? They’d grab their coffees and doughnuts and hustle out the door. There’s something terrifying about a man sitting alone. People avoid him, run and hide, spooked, afraid, not because he’s a psychopath or pervert, but because he’s ordinary, just like them, an unwelcome reminder of how alone we all are.
I jump up, nearly knocking over the chair, and walk away quickly, with purpose. I leave the tray and the tuna-to-go on the table. I don’t hesitate as I pass the elevator and pick up the pace as I enter the main lobby. The automatic doors open and I run smack into a brick wall of heat. It kisses my bare skin, taunts me, starts an erection stirring in my pants. The temperature’s a cock tease. I stink. My clothes are dirty. My hair is sticky and matted. I don’t care. I need people. I run a red light. Thank God the cross street is empty and no patrol cars are lurking nearby.