The reality of life
May 17, 2006
It’s twelve-thirty in the morning. I’ve spent the past hour going over in my mind my wife’s death, as she lay beside me, warm and soft, and very much alive. I’ve reviewed her final moments, her final few breaths. They won’t be in a hospital, I’ve told myself. Not if I can help it. They will be at home, in her beautiful sleigh bed, its mahogany warmth curling around her, nestled in her billowy down duvet. Where should our daughter be? Should she be beside her, snug against her breast, as close as she could physically be to the one thing in her brief life that has most signified love and life? Or would it be more appropriate for her not to be there, but at one of my wife’s friend’s, playing with our friend’s children, removed from her mother’s struggle to avoid dieing and be left with remembrances, though they may be vague as she grows older, of her mother’s very vibrant life? Where will I be? Will I be strong enough, emotionally put-together enough, to be close by? Will I have to be far removed, insulated physically and, with a few valium, chemically?

Trish, my wife, is not dying, not in the sense of an impending doom, not in a way that wouldn’t naturally and slowly exhaust her life in another forty-five or so years. She is the epitome of health, very seldom sick. She seldom complains of an ailment even if she is ill. But she turned forty-four last month, and a week ago she went for a mammogram.
Trish dreaded the procedure, the indignity of having a stranger cup and shape her breast into a cold, mechanized eye, painfully scanning her for signs of physical failure, cellular mutations against which she is largely unable to defend herself, and utterly, and perhaps blissfully, ignorant of. Until that machination of man’s inquisition suggested otherwise.

I was home from work that day and we — our daughter, Ella, who is eighteen months old, and I — dropped Trish off in front of the hospital. We had moved to one of Maine’s larger cities just eight months earlier from Nashville, a city known, regionally at least, as much for its advanced medical care as its music. Trish was a nurse and had worked for more than twenty years in a Catholic hospital that specialized in high-risk cardiac care. Trish worked with the sickest of the sick, in critical care, tending heart transplant patients and patients with heart-assist devices back to health. She was good, very good. Her smile, charm and quick wit made her popular among her patients; her devotion to those patients, her hard work and her ability to excel in the worst scenarios earned her the respect of other nurses and physicians.

One hesitancy we had when we decided to move to Maine, when I was offered a job there, was the lack of the highest level of health care. There was no level-one trauma unit in case I fell off a cliff, no cadre of pediatric sub-specialists if Ella got sick. But the beauty of the state and the challenge of my new job won us over. It was a completely new world for us, almost as far north, and away from our Southern roots, as we could get. But when I dropped Trish off at the hospital for her exam I took comfort in the hospitals lack of complexity, it’s small, intimate size. There was no long line of cars waiting to drop people off, no immense parking deck to get lost in, no variety of entrances to choose from. It was simple: drive up to the front door, pull over and let Trish step onto the curb and into her appointment. The doctors wouldn’t have the experience, the case loads or the publications that Nashville doctors had, but they would have Yankee sensibilities and small-town manners. We found Mainers’ restrained sincerity a refreshing alternative to the South’s ebullient exteriors.

Ella and I waved goodbye, then headed off to Home Depot to kill some time. When we returned, an hour later, the radiologist had finished early and Trish was waiting for us. It had not been too uncomfortable; the clinic had a new machine and the technician was kind. But there was a lump, a cluster of calcium that the digital camera detected. It was probably nothing. Benign lumps are not that uncommon in women, especially in women who had breast fed in the previous year, and the new highly sensitive imaging devices detect the smallest distortions, often leading to unnecessary, but still worrisome, false positives, things that need to be checked out through what medicine calls “invasive” procedures. Trish hadn’t felt a lump. She knows her body well, and takes good care of it, which was certainly one thing that attracted me to her almost six years earlier.

Trish and I met in a dog park. It’s a story that, when we tell it to people for the first time, extracts several sighs. “Awwww, just like in the movies.” We were living one block apart without knowing each other. I had two dogs, two boys, Duke and Tiger, and she had a girl, Abby. I had just changed to a job with reasonable hours, and so had she, and we found ourselves in the dog park for the first time. It was our dogs, really, who met first. But when I saw who my boys were leading me to, this new canine friend and her very attractive owner, I quickly caught up.

We hit if off well, but took things slowly. On one of our early, informal “dates,” we went for a hike in Nashville’s large, hilly public park on the edge of town. We could do the two-mile route or the more strenuous six-mile route. I was trying to impress her, and didn’t expect her to call my bluff when I suggested we combine the two. “It could take several hours,” I said. “OK. Sounds great! Let’s go.” And she was off. That’s the way Trish is. When she decides to go somewhere or do something, I have to put it in gear because she’ll be halfway there or have it half done by the time I usually catch up to her. Midway on our hike she was still outpacing me. We came across a big oak tree with a large vine hanging down. She dared me to swing on it. This was a pivotal moment for me. I was single and in the dating scene. I had a lot of pride to lose if I fell on my face. But Trish was different that the other women I had been seeing. It wasn’t a measure of my machismo so much as a test of my humility. She knew she was in great physical shape, and I, well, I kept up. She wanted to see how much fun I could have. I ran and grabbed the vine and swung back and forth a few times, and landed near her. She leaned into my chest and I looked down at her, and the thought of kissing crossed both of our minds. But I wouldn’t let it happen. I pulled away, and at that moment I told myself that Trish, she’s different. I didn’t want to ruin a potentially meaningful relationship by letting any sexual urges intervene. That, in itself, was a moment of remarkable, and unusual, clarity. (After we were engaged Trish revealed that she had practically been stalking me, and wondered what my problem was, why I was so slow to engage.)

Today, Trish called me at work. The clinic called with results. Treatment guidelines say that when there are specific number of calcium deposits in a certain amount of tissue, in close proximity, it’s too tough to make a call, so closer look is necessary. The calcium in Trish’s breast were right on the border, and the radiologist called for a biopsy. Trish sounded worried. She’s known several women who have had breast cancer. My brother’s wife battled the disease a few years ago. But in plenty of women, calcium deposits are normal and harmless. Lumps are benign. I reminded her of this. “Yeah,” she said. “Angela has had to have these biopsied many times.” But she wasn’t thinking of her best friend, or other women she knew who didn’t have cancer. She was, uncharacteristically, thinking of herself, and she was afraid. The clinic could take the biopsy Monday morning, almost a whole week away, she said. Ella awoke from a nap, and Trish said she had to go.

Trish’s normally positive perspective makes her a good nurse. She gets it from her mother. When she’s not positive about something she works at it, a trait from her father, until she is. I’m the one who worries, who stays awake nights fretting about my job or whether or not we should paint the den. Where some people have water-tight valves in their consciences to regulate the flow of uncertainties, I have a tired, rusty faucet, letting doubts and fears seep around the seems and dampen otherwise blissful days and nights.

I tried to file the information at the back of my mind. It was no big deal, this happens all the time. I let other tasks fill my forethoughts. I busied myself with work. But what will I do if the calcium turns out to be cancer? My mind was off and running, skipping over the imagined hurdles on an unrealized track. We’ll have to move back to the South, closer to Trish’s family in Kentucky, closer to her friends, where she would be comfortable. We would have to find a small house, something affordable, because I couldn’t spend a lot of time working. I would call an old boss and ask for whatever job was available. Trish would die, and we would have enough money from insurance and from her investments, to sustain us for a while. I wouldn’t remarry, I’d be a widower dad, a bachelor father. I was making the vow now, twenty minutes after hearing there was a slight problem that required an additional test. But, how do I take care of my daughter, alone?

In the course of the afternoon, between phone calls, setting up appointments and answering emails, I had fast forwarded through my wife’s cancer surgery, chemo, radiation, her death and the funeral and wound up taking my then five-, eight-, ten-, twelve-year-old daughter (I played this out like a disaster drill, preparing for all possible scenarios) to soccer practice by myself, cooking her dinner by myself and then sitting myself down beside her at the kitchen table to do homework, surrounded by photos of Trish. It would be a tough struggle, but we’ll make out okay; we’re happy, we have each other. This gets me through the afternoon.

But tonight, in bed, I couldn’t bypass past the maudlin thoughts to a happier time. I rolled over and put my arm around my wife, placed my hand on her small belly, made soft from pregnancy. We’ve been married only four and a half years. She waited until late in life to marry; I waded through a first marriage and a divorce and dating until I found someone I fit with. Trish loved our wedding. And she loved becoming a mother three years later. Becoming pregnant had been a dream of hers, since she was a little girl. It didn’t come easily for us. After eighteen months of fertility treatments we had given up hope. We took a vacation and, like so many other stories we eventually heard, nature took its course. Trish’s lean body gradually plumped. Her small breasts grew round, filling out shirts she never had before, much to her — and my — delight. Her stomach had been taught, toned, a flat stretch of muscle any image-obsessed Hollywood actor would kill for. It grew slowly, oblong from top to bottom, the skin stretching tighter, a miracle of the human body and a metamorphosis of body and spirit. Trish loved being pregnant. She never had morning sickness and worked until the day before her C-section (Ella was breech). She was a glorious new mother. Her breasts delivered milk, and our baby latched on right away. I often think of the image in the final scene of “The Grapes of Wrath,” and marvel at how a woman’s body sustains life, provides fluid for survival, containing everything necessary for a human body to grow until it can care for itself. I know Trish believes deeply in her duty as a mother, and I know she feels a deep spiritual appreciation for the blessings of being a mother. She thanked God that her breasts wept, that hormones flowed through her body in new and different formulations. I remember now that she had also said being pregnant would reduce her risk of breast cancer.

When Ella was five months old Trish went back to work at the hospital, pulling twelve-hour shifts on Saturday and Sunday so Ella wouldn’t have to go to daycare. I quickly learned how difficult being a parent really is. That first morning, Trish left the house at six-thirty. Our daughter woke up around seven. I retrieved her from her crib and sat her on a guest bed in her room so I could gather the items to change her diaper. Two seconds later I turned around to see her tumbling off the bed. I got a hand under her, but she landed on her shoulder and started wailing. This was the beginning of my attempts at flying solo as a father. A few weeks later she started crawling. One weekend morning, after Trish left for work, Ella crawled through our house saying her first word — “Mama?” — from the kitchen to the living room, into our bedroom, around to Trish’s side of the bed. It was the most pitiful, and determined, sight I had ever seen. If her mother was in the house, this little girl was going to find her.

“Mama,” and the newly arrived “Mom,” will probably always be Ella’s favorite words, and Trish’s, too. Most days, Ella doesn’t let her mom out of her sight for five seconds without asking for her. If Trish walks out of the room, “Mama?” If Trish steps outside, “Mama?” When Ella wakes up, in the middle of the night or after a long nap, her first utterance is, “Mama?” As long as she knows where her mom is Ella can very happily play by herself. She’s very outgoing; she recently entertained an entire plane full of people when the aircraft was delayed in Philadelphia. We haven’t had many babysitters, simply because we prefer to be together. Our daughter says two words clearly; one is “mama,” the other, a recent acquisition, is “dada.”

I unwrapped my arm from Trish’s waist and turned back to my side of the bed. Everything’s just fine, I said. Everything’s going to be fine. There are no problems. Trish is completely healthy. She would not allow herself to be ill. She can’t be. Even if the lump in her breast becomes rapidly reproducing, mutant cells, I’m going to be one of those husbands who remains positive. If we have to go through cancer treatment, we’ll go through it. I’ll shave my head, like my brother did when his wife went through chemo. I won’t dwell on the mortality statistics. I know cancer oncologists. I know breast cancer surgeons. Some of the best in the world. People like them would not let Trish die. And I will not, after her cancer is killed, let my mind be preoccupied by the nagging worry that nobody is ever “cured” of cancer, that remittance is always a possibility. I won’t go there.

But it’s my little girl’s voice saying “Mama?” that seeped into my fears tonight, that finally cause me to sob. I bite my lip to keep the cries from leaking out, but I can’t keep my shoulders from shaking. I breathe deeply to keep up with the sobs. Those pictures I imagined, the ones in which I’m strong and defiant? Now my little girl is in them, and she’s asking for Mama. When we’re at home, and Trish is in the hospital, she’s constantly wanting Mama. This is an incredibly powerful fear I have, this fear of being without Trish, alone as a parent. And there’s a separate fear of what Trish would have to struggle through. Anxiety creates demons that otherwise don’t exist. I have fought them often since I was a young child. The fearful anticipation of the demons is almost as bad, almost as debilitating, as being in the demons’ presence. It occurred to me recently that I might have passed on the tendency toward anxiety through my DNA to my daughter, hence her need to be held close to her mother more than other toddlers, her need, still, to awake in the middle of the night and cry, or plead, endlessly until her mama rescues her from the isolation of her crib.

And, so, the natural progression of these fears, these physical, mental and emotional energies wasted on the impossibly unknown and the improbable, led me to imagine what it will be like after Trish dies. The death, the funeral, are bad enough. What about the life ever after? What about the quiet morning two weeks after we have scattered Trish’s ashes in a garden, when my daughter awakes gripped by the choking realization that her mother will never again hold her, that when she pleads for her mother her cries will never be answered to her satisfaction.

I’ve been through enough therapy to understand that this isn’t about our daughter, or about Trish. In fact, I’ve amazed therapists, very skilled professionals, with detailed clarity of self awareness and the ability to name my fears. I know what this is all about. But I also know it’s not entirely about me, that my daughter is her own person and that she has, and will have, her own distinct fears. You know what? It doesn’t help. Not much.

Perhaps as a distraction, I allowed myself to think of the deaths of other people I’ve been close to. My mother’s step-father was my first hero. He was a former Marine with the globe-and-anchor tattooed on his forearm, who fought at Guadalcanal and forever battled his own demons. I remember the last time I saw him, how I was playing coy, as a little boy of nine, shying away from telling him goodbye at the nursing home. Early the next Saturday morning the phone rang. I was too sleepy to answer it in time, and when I finally picked up the phone I only heard a dial tone. A few minutes later it rang again. This time my mother answered, and within seconds was saying, “No! No! No!.” I pleaded to know what was being said. “Will’s dead,” she said. I screamed. For at least a year I grieved, very heavily. I blamed myself for not telling him goodbye that last time I saw him, for not hugging him as I normally did. I had been silly one afternoon, and that had been my last chance to love him.

Twelve years later, when I was still a struggling college student living at home one summer, my grandmother died. She had been the quiet matriarch, the mortar that held together the fragments of my family — my depressed mother, my raging sister, my aloof brother, my aunt and cousins and my sister’s small children. We were poor, poor pieces of people living poorly in a small town, my grandmother’s hometown. My grandmother’s Social Security checks, and her financial shrewdness, helped us all survive. But age and illness fogged her mind. She had written a bad check and a notice of insufficient funds came in the mail. I was a co-signer on her account, and I scolded her over it. I was her favorite, the youngest of her grandchildren. She adored me, spoiled me, called me Son. And, most often, she had the only welcoming lap I could crawl into as a little boy. She looked at me very simply and said “alright.”

The next morning, a Saturday, my young nephew, who lived with us, woke me up and said, clearly, calmly, almost as if he’d expected it, “Grandmother’s dead.”

I had been out late the night before, and when I came home I passed by her bedroom. I could see her sleeping. I thought I should go in and apologize for being firm that afternoon. I should tell her I love her. But I didn’t.

Sometime in the early morning my grandmother had gotten out of bed and collapsed dead on the floor. It was probably an aneurysm that struck her down, quickly and mercifully.

Shortly before my grandmother’s death, on another Saturday morning, my mother woke me and told me a friend of mine from junior high, who had moved away when we were in high school, had died. He and I stayed friends, but our interests diverged. I visited him once. I went with other friends to his funeral, and when I saw his father, a kind and soft-spoken Southern Baptist preacher, the man seemed surprised. He said, “Why, if Steven had known you would be here,” and he broke down crying. If my friend had known I’d be there, what? He wouldn’t have died? Was this yet another missed opportunity to exercise some magical power I had to deliver a kind word and extend someone’s life?

More recently there was my dog, Paco. Paco and I had a lot in common. We had both escaped my mother’s short leash. He was sporting and playful but he had his own anxieties; he barked incessantly if he was left alone outside. Paco took ill the day after the fourth of July, 1998. His illness puzzled his vet. We transferred him to the vet school an hour’s drive from our house, but by then it was too late. A rare auto-immune disorder gripped his throat, immobilized the muscles that contract to swallow. Paco aspirated his own fluid and died of pneumonia.

I was driving to pick him up on a Sunday afternoon to bring him home so our vet could euthanize him on his bed, in his house. But the car had a flat tire, and the spare was flat. A family in a minivan stopped and picked me up. I told them the situation and they drove me right to the hospital. By the time I got to him Paco was too weak to move. I held him — he at least was on his bed — and he looked up at me, his eyes vague, watery, as if pleading with me to end whatever it was that had taken control of his body. Days before, he had looked like he wanted to come home. On his last day, he simply wanted his life to end. I hugged him as the vet injected his body with morphine. Like in the movies, he took one last deep breath, sighed heavily, and was gone. That was it. I had Paco cremated; he’s sitting in an urn in my book cabinet. I mourned that dog more than I had mourned any person.

I ran through these death encounters as if fast-forwarding through old home videos. At the end of the tape I again heard my daughter, “Mama?” I wondered how much I should lean on Trish’s family, her sisters, for support in raising our daughter after Trish dies. Would Trish want me to involve them more or less than I would? Would she want me to involve her girlfriends, some of whom she’s known and loved for twenty years? Would she want me to remarry? Does she think I could handle raising our daughter alone? What are her fears?

I felt Trish roll over toward me. She knew I was awake. She knows me well, knows the demons I fight off, knows where they come from. I convinced myself that the best thing to do at the moment was to get out of bed and write this down. I call myself a writer, but these days I don’t write much of anything that’s of any significance. But this, this could be the most horrible event of my life. I know of no other outlet, at twelve-thirty in the morning, than to write. If I stay in bed I’ll only keep Trish awake. She has enough to worry about.

So, three hours later, I feel like this exercise has helped. I have jumped years ahead, fallen back a few decades, revisited parts of my life that include others’ deaths. Parts of life are very sad. Parts are unrealized sadness. Many parts, for me, are fears. But fears, anxieties, hearing my daughters’ cries when she’s fast asleep and seeing myself at a memorial for Trish in the beautiful catholic cathedral where we were married, while she’s sleeping soundly beside me, those are not unlike the fog of imaging on diagnostic tests. It’s best that those images, or imaginings, are penetrated, extracted, examined, to determine what’s real. And whether what’s feared is alive and threatening, or benign, it will be dealt with, just as every day ticks off minute by minute, until it’s tomorrow, until it’s a memory, sweet or sad.

At the moment, Trish lies sleeping in our comfortable bed, in our comfortable house. We have three dogs, asleep in the basement, and, for now at least, our daughter sleeps peacefully. And that, for now, is the reality of life.