Read In the Land of the Living Online

Authors: Austin Ratner

In the Land of the Living (9 page)

   

Before the lords of chaos hurt him in his brain so he couldn’t speak, and he smashed the IV pole to the ground since he had no words, Isidore wrote a letter and sent it into the breach.

Ms. Edith Wainwright
Chief of Nursing
Department of Nursing
NIH

Dear Ms. Wainwright,

As a hematology-oncology fellow I had a brief experience with you in which I found you to be a strong advocate of the patient. Therefore, I am writing to you at present to apprise you of certain complaints generated by my own stay as a post-laparotomy patient in the NIH surgical ICU during the period of August 23–25, 1974.

In comparison with the nursing care delivered to me personally on floors 5E and 4W during a two-month hospitalization, the care in the ICU was an absolute nadir. I was repeatedly made to feel as though I were a nuisance, and the clear preference seemed to be for comatose or semiconscious patients who apparently presented less disruption to the order of the unit than I.

It was, in fact, reported to a nurse on 6E (a friend of mine) by an ICU nurse that I was a “terrible patient”; I was not aware that postoperative (or other) patients were required to conform to behavioral standards defined by the nursing department.

I was ignored when calling for a nurse on numerous occasions when I could see at least one nurse sitting in the nursing station. My earliest response to the ICU nurses’ efforts to help me in and out of bed was fear that this would cause increased pain and I therefore resisted. As a result I was assisted with ambulation but no one had the patience to teach me the easiest way to enter and exit the bed. On 5E I was finally shown how to minimize pain in doing these tasks; I was no less fearful of second-party intervention at that point, either.

Furthermore, my bed curtain was often pulled halfway closed for no other ostensible reason than to obscure my view of the ICU clock. I was using the clock to judge the time for delivery of pain medication and was clearly annoying nurses by reminding them early of my need for it; however, the clock was also the single device by which I was able to orient myself in the most dehumanized and disorienting setting I have experienced. The clock was an essential companion in the face of the extreme dearth of human interchange provided by the ICU nurses. There were, in fact, only three nurses (whose names ever reached me) from your ICU that I would allow to care for anyone who meant anything to me, given any choice. The rest were fit for the care of the half- and near-dead only; i.e. those patients beyond placing any direct emotional demand on nursing.

My experience on the ICU will linger in my mind for years as a nightmare. I am, by the way, not the first person to observe these things regarding these highly trained “angels of mercy.”

Thank you for your attention. Hopefully you will be able to bring some changes to bear in what I feel is a weak link in an otherwise strong nursing department.

Regards,
Isidore Auberon, M.D.

He had said exactly what he had to say. It seemed, however, that nobody was listening.

   

But he did get better, thank God. Better enough to stand up straight like a man on the edge of the thunder hole and breathe carefully, though it hurt, though he weighed a mere hundred and fifty pounds now, which he had not weighed since he was fifteen. He felt better enough to hold Maxwell with a great hope, an expectation even, that he would someday throw a baseball with him (and Mack, as his younger son would later be known, would one day exceed all others in his family at throwing and catching baseballs, he could even pick up a short-hop without thinking). Isidore held the new infant and sang him a song, Sambamba, nobody nothing nemo nun.

The Auberon house was leaning on its nails, but he thought he would get better. He couldn’t open a jar anymore, but he called the new chief of medicine on the phone and agreed to chair the house staff advisory committee next year. And he lifted up a box filled with new dishes that Laura had bought and he said to Leo, “Next year when I’m better we’ll go swimming again. I’ll teach you to swim. I’ll teach you to dive.” It hurt the bottoms of his feet to walk on the cold floor and he hopped and staggered on skinny legs and had to put the box down in the wet sink, where it didn’t belong.

“Whatsa matter?” Leo said. “I’ll help you.” And they both fell on the floor and broke all the new dishes that had flowers on them.

“I’m sorry I broke the flowers dishes,” Leo said. “I’m sorry that you don’t feel good in your arms.”

And Isidore thought that Leo would let him rest, because it seemed that he half-understood, but Leo said, “Play with me, please, Daddy, please.” The boy’s eyes were live as the eyes of a person who’s laughing, eyes struck by an inner fire burning hard at some reserve of love, eyes that burned love and need and wasted the things they sought. Isidore saw that Leo couldn’t understand, and couldn’t wait, not even for a minute.

Isidore left the dishes broken on the floor and played till the wind was gone from his lungs. He tried to lift Leo up onto his shoulders but he was afraid he’d drop Leo down the front steps and crack his head open.

“I’ll crack your head open, Leo!” he shouted angrily, because the boy was climbing on his back and laughing a delirious loud laugh.

Leo said, “Play, play, play, please, Daddy, please.” If there had been any comprehension of lymphoma and chemotherapy, then love burned it off like impurity until what was left was just love, pure, empyreal, uncomprehending, fragile as an ancient bird condemned to saintly extinction.

Isidore was too tired to move his mouth.

“Please, please, please, Daddy. I will help you, I will help you, Daddy.”

“Just give me a second to rest.”

Leo turned his back meaningfully, theatrically, and looked over his shoulder with eyes suddenly smoked up and gray with the grayness of a disappointing sky, of clouds and shadows.

“Okay, let’s get out the truck,” Isidore said, and he went up on his frail, skinny knees and then stood and fell onto the sofa, shaking, eaten up by love. “You can get it, it’s there in the cabinet there.”

His son was a carrion-eater.

Then he woke up in the night with a pain in his mind and Leo and the baby went to Aunt Jenny’s house and Laura and Isidore went to the hospital. He would have said he felt the hole where the clot had torn loose from his heart, but he couldn’t talk. It was a stroke and now he was burned through to a terrible underworld purity, like his son.

When you talked to Isidore he seemed to know what you had said, but he didn’t answer, and it was as if he was too sad to answer, even to answer his own son; he would just look at you with the eyes of a cow going to slaughter, and he didn’t get up anymore since there was no point. He lay in the bed and didn’t even grope for the water cup anymore, even when Leo held it up to him. He was a little bit his old self, but more so not himself, as if he’d been replaced by a wax model. It was the same daddy who’d carried Leo on his shoulders and held him up in the sky at the pool and kissed his belly, but those motions and actions were gone out of him; he didn’t hold up and he didn’t kiss. Then one day Isidore groaned and wailed liked a baboon wailing in a tree while a lion eats her baby underneath it, except that Isidore was wailing not only for his babies but for his own lost future and his fatal powerlessness before the irrevocable harm of this place that’s the universe, and all the doctors went into the room and when they came out he was still moaning, and Leo plugged his ears but could still hear him. Two days later the moaning ended.

Before Isidore died, a great many people and places, or their simulacra, siphoned through him against his will like verses of a sentimental song, jumbled out of order: the crusts of toast and Laura in the garden full of flowers. And ten thousand pounds of doorknobs asail for Hawaii. The sun was like a red gong over the South Pacific sea. He remembered the lightning rinsing down the water mountains and the raw, cold smell of sea wind. He remembered throwing the crowbar in the snow and his garbage truck route when the ragweed pollen was killing his eyes and he wanted more than anything to scratch but he couldn’t touch his face because of his filthy gloves—he and that huge guy Jeffords, the lineman at Wisconsin, would eat on the sidewalk in front of somebody’s house, and if somebody saw them, he and Jeffords would drop their brown bags over an empty trash can and pretend to be eating their lunch out of the garbage! And his friend Mrs. O’Keefe, a patient, looking up from her hospital bed with eyes pushed halfway out of her head by an old case of Graves’ that had ravaged her thyroid and her orbits, and how she’d itched all over, and he’d had to tell about her high creatinine and that she’d need dialysis. She knew it was the end, that once on the kidney machine, there was no coming back off, and the bulging eyes then glowed in the dark face with tears of total defeat, and she got pneumonia soon thereafter and left the hospital straight for the funeral parlor in a bag zipped over her face. He remembered the morning he went off to Harvard—Dennis leaving him there in the house alone because the bells would soon be ringing at the high school, but Isidore was done with high school and he still had an hour before he needed to go to the bus station to ride up to Cambridge, and he told his brother, “You’ll be okay, you know how to handle the old man now,” and though neither admitted it, a certainty had grabbed them both in the guts and they knew that nothing would ever be the same. And there by himself in the quiet living room where Ezer had once slammed Burt’s fingers in the sewing basket, he’d played a Tony Bennett record on the ancient Victrola, and the singer’s voice had seemed to echo forth, faded and diminished, from some obsolete dance hall ages past. And nothing ever was the same after that. They were right.

It seemed to him that the memories dragging through him were not only his soul being ripped out of him; they also screened something even more vital and unremembered, they moved past him like a wind opaque with blowing sand and obscured a sacrifice even more terrible than the flight of his soul to oblivion. The moving memories obscured perhaps the loss not of his past but of his future, not of his mother but of his sons, whose faces, by some miracle of corticosteroids, he could not see, not even Leo’s, who had become in just a couple of years the pith and center of his life. He wanted more than anything to say all that and something more to Leo, or at least to write a letter to his Leo and to Maxwell, too, but he couldn’t speak or write a word. The brain injury was a wall that had bricked him up in Hell.

Then when he was almost dead, he had a morphine dream. He was climbing down a tree and he was very tired, but he had to get to the bottom, there was something very important at the bottom; he saw a pair of worms and the first worm said, “Stop and chat for a bit,” and the other one said, “I need you, I’m having a birthday party,” and he said, “I’m sorry, I have to go.” And he said, “I’d like to stay but I have no time for that now.” He couldn’t figure why, but it was a horrible dream, a dream that stabbed into him like a knife between the ribs, and he wished for the total oblivion of death with all his might.

At last the name Lefty Paradise came to him out of a fog and a great distance, like an ambassador from a magic land. Lefty Paradise: a figure in some story he’d once read or made up. “I loves those combed-cotton sheets of yers (I feel like I’m in a hotel),” he’d once said to Laura. That was a while ago.

  

So Laura wrote the last little paragraph in Leo’s baby book.

He will never be the same and neither will I. Says “I’m sad about Daddy. I’m mad about Daddy.” Says “I yelled at you and you yelled at me. So-oo-oo shut up.” Strokes my cheek. “Remember when Daddy used to do this to you?” At night crying that he was sad about Izzy. When I told him I was too and that he had me and I would always take care of him, said “and Uncle Harvey cause he’s a men.” I said, like Daddy was? He nodded. Swings his arms “like my daddy does.” One night crying he said was afraid if I rocked too hard in the chair the house would break. I reassured him and he said “but who will fix it? My daddy could but he’s not here.” When I cry he often tries to comfort me. One night “soon it will be late and the people I love will come home.” When asked who he meant said “I love my daddy but he’s not here. But there are other persons that I love—like Uncle Harvey and Aunt Jenny—and soon they will come.” Grammy showed him places on the globe. Next day he pointed to Turkey, asking “Who lives in that chicken?” Has developed his own curse words: “I scrumped you off, Bummo.” Talks about being like Daddy who is “the biggest.” Said “if my daddy was here I would play tackle with him.” Said “When I’m bigger I’ll dive in the water and my daddy will watch me.”

Hic jacet Isidorus, Rex quondam, Rexque futurus.

  

In 1984, on the weekend of Leo’s thirteenth birthday, James Helpern came by.

He squatted in front of a fern in his madras shorts and said, “Your mother never could take care of a plant.” He had piston-hard calves that looked as though he’d pulled a rickshaw all his life and a black, somewhat satanic mustache. Leo’s mother and Philip, his stepfather, had gone to buy a new set of glasses before the party. James plucked a yellow leaf off the jade plant or whatever sort of plant it was, dropped it in the pot, and sat down on the gray porch couch, which was slightly damp. He looked at Leo as if he were peering inside him and reading the label on the back of his skull.

“They used to call me Ghost Boy, you know,” James said, lightly stroking his mustache and speaking as if from inside a deep reverie. “I was pretty fast when I was in school. Barry Cohen named me that. Your father knew him. He said,
the Ghost Boy, so fast he wasn’t even there
. I ran the hundred and two hundred. Of course, in those days, we didn’t have good shoes.”

Leo had seen Barry Cohen’s note in his father’s yearbook, a dark-green book on the shelf next to the window where the icicles always hung down. And James the Ghost Boy he had met a few times before. He was a surgeon. Was it Ghost Boy who had given him the doctor’s bag?

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