Medicine and Masochism
BY JWGoll
“I want you to leave me,” Luisa says. “There was a moment when I would have done anything for you. I’d have surrendered anything, degraded myself, followed you down a hole, but you had no clue the opportunity you had. You were oblivious. You tried to be kind, understanding, you hesitated and now it’s done. You didn’t know the magic words.”
It’s two am and we are heading back to the city after a pretentious party and are pulled over in a poorly lit industrial park. Then you give me a blow job that I hadn’t asked for and barely appreciate. You are nothing if not a walking, breathing mixed message. I close my eyes and drift. I imagine zombies surrounding the car, the archangel Gabriel blocking their advance. I think of Mary Daly’s explanation of hamartiology, that sin only means “to be”. Then I wonder how Charles Bukowski would describe this evening, in particular my willingness to participate and indulge in the farce.
She is right. I never considered the possibility of completely possessing her. It doesn’t occur to me. Seizing opportunities, especially with women, always feels like a trap laid so the universe can ridicule me. I’ve dwelt five years in my head for every year walked on earth which, for all its pleasures, doesn’t lend itself to being fully present for anyone. I mentioned this to a therapist once and he called it poor mental hygiene. But there were boxes and bags strewn in the corner of his office, a grimy window, and he dressed like Peter Falk so I couldn’t take the insight seriously. The researcher Jerome Singer divides daydreaming into two categories; painful, obsessive daymares, and playful, creative reveries. In disaccord with his colleagues, he insists the latter promotes well-being. In disaccord with him I subscribe to the benefits of both. My mind, whatever its flaws, is a comfort zone.
I am thinking of Luisa again as I am standing with the wife of a man in a hospital bed. He’s suffered a stroke and we are waiting on the results of neurological tests that will reveal brain activity, if any. She’s already told me that she plans to demand he be designated full code despite the fact that they’d never discussed it. She wants to provide him with every opportunity for a miracle, she tells me, but asks that I not mention this to the doctors, “because they are all atheists….or Hindus,” she adds. Then she asks me if she should demand a feeding tube. “He was always such a big eater. Even if his brain is gone I know his body is hungry. He was never not hungry.”
My father was a clergyman and his duties included many public rituals. Most congregants, most people in general, myself included, viewed these as the core of his profession: marriages, baptisms, confirmations, communion, funerals, sermons and gospel readings. These were easy for him. They were performance and he excelled at it. They energized him and it was obvious he enjoyed being on stage.
I was deathly afraid of being in front of a crowd and once asked him how he became so comfortable in the spotlight. He understood the question but chose to respond to a different one. He told me that yes, he enjoyed the limelight, but he considered it the reward for the difficult work of council and grief which occurred in quiet places; the kitchen table, at bedside in the home or hospital. It’s the one place where no comforting rituals exist he told me. “Every illness, every death is a unique world. You think there are rules, you think experience can help, but it doesn’t. Sickness is a foreign nation for everyone near to it. It’s by far the most difficult and important work that I do, but I don’t think I’m very good at it. I think it will stay that way. If you think you’re good at working with illness, with death, then you probably aren’t. It’s just not something one can be an expert in.”
I work in a hospital as a patient advocate and am older now than when my father spoke those words to me. I have been doing this for ten years and I don’t aspire to be an expert and don’t think much about whether I’m good at it. Most of the time I feel like a hostage negotiator with my only goal being to bring the event to a conclusion with as few casualties as possible. That’s the professional goal. Otherwise I’m a voyeur, a spectator at the human cabinet of curiosities. I am happy, gratified even, to ease a patient’s anxiety, to minimize a loved one’s stress, to reassure a nurse, to facilitate communication, but that’s not why I am here. I’m here to know about me. I’m here to observe myself, the only thing really worth knowing about, although I doubt I’ll ever be an expert in this either.
Luisa died in Hangzhau, China from a brain aneurysm sixteen years after our last night, which, unfortunately for both of us, was not the night in the industrial park. By that time she had become very rich and was having drinks with potential investors in her commodity futures investment firm. I was no longer in touch but heard through a friend that she’d been sitting at dinner when she tipped in her chair and fell to the ground, probably already dead. This is how it was described to me, but I can’t visualize it. In her professional life, her social life, she was dignified, elegant, and charming. She had perfect posture. I can’t imagine her losing any of that, even in the moment of death. In private of course she was a mess, and between her neediness and my indecision we were a perfect storm. If, after employing her intelligence, grace, and charisma to seduce several newly minted Chinese multi-millionaires into signing contracts she’d died cheating on her husband in a luxury Shanghai penthouse, high on coke and begging to be fucked in the ass, that I could picture. I wish she had lived, but since I didn’t have a say in the matter I’d have preferred her leaping, arms in flight, over the balcony rail, a fitting end that would have provided more felicity and self-respect than an undignified, meaningless flop on a dirty restaurant floor.
On my second day with the patient’s wife she asks again about the feeding tube and I say I’ll talk to the doctors about it. I know they’ll say no, that it would merely prolong his suffering, but it’s something I can do for her, no matter its futility. She begins to cry and tells me about her husband. It turns out his stroke came on the heels of a three day alcohol and cocaine binge. She talks about his struggles, his many relapses, his turning to Christ, and how good a father he was. The tears are real but the story practiced. It’s part of her medicine pouch; a bone, an herb, a bead. I try to coax her into thinking about what CPR would be like if her husband stopped breathing; the pounding, the cracking ribs, the internal bleeding, but she doesn’t hear me and goes back to her faith.
And why should she hear me? I’m just parroting the doctors and I feel guilty for siding, but as she tells me the long story of her own faith, wild early years with rock bands, two abortions, a first marriage ruined by affairs before turning to Christ and I begin to hear the pride and superiority. There is a certainty that echoes the Intensivist’s certainty and I consider perhaps they are a match. There is also a hint of bravado, a wish for an adrenaline rush, which also mimics the doctor’s macha confidence. I wonder if she doesn’t want her husband’s heart to stop, at least temporarily, so she can prove how tough her faith is. I give her credit. Physicians needed six, eight years of training to become so self-certain. She’s come to it on her own.
When I find the doctor she is charting on a computer. I stand around for a few minutes without gaining her attention, but I know enough to understand this is not rudeness. It’s merely intense focus and it’s a survival mechanism, a species trait. When she looks up she is surprised to see me, but quickly reverts to a world weariness. She knows why I am here and I know she knows why I am here. We may as well just shrug and go about our business, but I go through the motions and mention the feeding tube. More accurately, I mention the wife’s request for the tube and then ask about the Neurology test results. She says they’re not back yet in a way that indicates it doesn’t matter. The man’s brain was without oxygen for at least an hour so we both know the test is merely pro forma. Now comes the dance. I am the patient and wife’s advocate and want to make an effort to take her desires seriously. The doctor thinks it’s my job to bring the wife to a place of acceptance, to come to terms with the inevitable. She turns just slightly from the keyboard and I notice that her fingernails are bitten back to the quick. Several of them are slightly red at the edges. I don’t know if she sees me noticing or it’s instinctive self-consciousness, but she quickly closes her hands while she waits for me to make my case. I suggest that the wife just needs time. That’s my go to in these situations. It’s conflict avoidance for sure, but it also almost always works.
When I was fourteen a member of my father’s congregation died in a motorcycle accident. He was eighteen and the adopted child of an older couple who adored him. It wasn’t difficult to see why. He was handsome, smart, and easy to talk to. He also had an edge of the bad boy about him which made him irresistible to girls. And boys as well for that matter. I was too young to be his friend, but that’s what I wanted. I was stunned when I heard he was killed, but more than that I was fascinated by the incident. How did his body look? Did he die instantly or did he suffer? How did the parents find out? Purient perhaps. I wanted to witness the grief. My father visited the parents every day. There was the funeral. My father continued to visit them regularly and I overheard him tell my mother, “Every day is still a year for them. It’ll take awhile”. Later I asked him what that meant. He told me he had no skill, no council, nothing in his grief toolbox as powerful as time. “It’s magic” he said. “ A miracle really, just a slow motion one. The only kind of medicine that works with this kind of pain. But the waiting is tough to endure.” That’s as good a lesson a father ever gave a son, but I was young and it didn’t mean a damn thing to me. It took decades to metabolize and by that time he was long gone.
I lay in bed drunk and enraptured, Luisa’s legs rested on my chest. It is about a month after we met and I am seeing her nearly every day. My apartment was an old second floor banquet hall a few blocks from Wrigley field, close enough to hear the baseball crowds during games. I’m daydreaming again, my default mode, and if I could tell you about what, I would. Maybe it is my cultural homeopathy theory; that less is more and like cures like are applicable to social ills. A little violence, a little corruption can cure. A little evil is an inoculation against great evil. I can’t defend that now, but at the time I spent a great deal of time thinking about bodies as models for everything else; for nations, for families, for economic systems, for entire civilizations. Germs, viruses and immune response, growth and regeneration, mental illness, I thought they could be metaphors for everything. In Medical Nemesis, Ivan Illich says every culture creates its own illnesses and its own cures. I thought if you can create them you can remake them. Just daydreaming really. Just daydreaming.
In my reverie I hear Luisa say, “I’ve never met anyone like you, no one even close really.” Most people go through life never hearing that said to them. We fantasize that we are unique and pray others recognize it, but it’s mostly a movie line. I feel I should be flattered, but instead I hear it as something vaguely unsettling. Her eyes are closed as she speaks and I don’t respond. After a bit she asks if I heard her. I’m afraid to say anything, thinking I’ll break a spell. After another long while she says softly, “I know you heard me.”
Yes, I hear her, but wonder if I should resent it. I imagine she is looking for a response in kind. It would be easy to do. Luisa has a sophistication wrapped in a wide-eyed self-questioning that attracts anyone who encounters her. She is a beautiful whirlpool. I could say I am falling in love with her, that there is nowhere I’d rather be. Instead I say, “I heard you, but you’ll know better soon enough.” Accepting the premise, the compliment, and reciprocating is too mundane. There is nothing healthy about this, but neither one of us is looking for healthy. It’s a pattern that will remain. The pull then the push, the suck and the spit.
On his fourth day in the Intensive Care Unit, the patient’s doctor rotates off service and a new one arrives. This one is younger and determined to move things along to a conclusion. He bluntly tells the wife it it time to extubate her husband to see if he can breath on his own. He does a clumsy job of suggesting this is a positive step rather than a way to bring this to a close, which is what it is. The wife is no fool and flatly refuses.
That afternoon the wife’s daughter from a first marriage arrives to provide support. She’s flown in from Corvallis, Oregon and can only stay 48 hours. She’s got to get back to her tanning bed business. When we are introduced, the wife says, “This is the man who’s helping me fight off those fucking vampires. Thank God he’s here. I’m just exhausted holding off those bastards”. The daughter gives me an unreadable look and nods. The patient’s eyes are not fully closed. The narrow slits make it look like he’s sitting in, spying on us. His fingers are rolled up into a loose fist, the result of muscle contraction. The wife looks her husband and then asks if we can take a walk outside, as though she doesn’t want him to overhear us.
We walk for forty-five minutes, looping around the hospital campus three times. The wife mainly talks about herself, her fear, the loneliness, how her life is in shambles no matter what the outcome. The daughter makes an effort to appear sympathetic. It seems disingenuous to me, but it is more than enough to satisfy her mother, who stops to sit on a curb and cry. We spend several awkward minutes waiting for her to finish. The daughter makes no attempt to console her mother. When she is done crying the wife says, “I will never let him go. Never. I’ll die before I let them kill him.” It’s clear her primary audience is herself. Then she wants to return to the ICU room, “So they don’t mess with his tubes.”
When I buzz them into the unit the daughter turns and says she needs some coffee. I take her to the cafeteria where it becomes clear she has no interest in coffee. She wants me to know that she has no intention of ever coming back once she returns home. “I know you’re trying to help her, but I don’t get it at all. He hit her, he hurt her. He cheated on her all the time. He even stole her money. I think she’s deranged. She tried to get away, she called me all the time, but she could never figure out how. And now she’s looking for a miracle? I think she’s lost her mind.”
I tell the daughter this is news to me. She says her mom is a master manipulator. Always was. “She just met her match when she married him,” she says. The woman stares at her coffee as it gets cold. I’m anxious to get back to work, I’ve plenty of unhappy people to see, but she lingers, and, as I think about how to exit gracefully, she says, “I think she’s punishing him. I think she’s keeping him alive so he can suffer. That would be just like her. She’s always been a victim, but she’s always been a perpetrator too. I just can’t wait to get the fuck out of here.”
The thing to know about our relationship is that it began in a lie, my lie mostly. It was also a betrayal of the first order. Luisa had just broken up with my best friend who adored her. He was hurt and confused, but hopeful for a reconciliation. Our first months are spent hiding from him. She later says she didn’t feel any guilt, she told him straight up and honest, and she only sneaks around for my sake. Well, that is her lie. Even when he becomes suspicious and asks me, I look straight into his eyes and deny everything. The worst he ever called me was a dissembler, which I had to look up. So it began tainted, our original sin. When the relationship begins to rot, which doesn’t take too long, I think I stay on to punish myself. The guilt and the desire are tightly braided. I can’t resist the temptation of Luisa or the need to make myself miserable. I understand this to be a sort of masochism. What I can’t figure out is Luisa’s motivation. Mary Daly calls on us to sin big. It’s a call to cast off domination, but it’s mostly instruction for women. Luisa has never heard of Daly and that’s just as well. She can’t be burdened by philosophy and in any case she is a natural at wrecking anything that might hold her back. Why I’m not quickly placed in that category, I don’t know. I doubt she knows either.
In the days that follow, the situation deteriorates. Nurses begin to tell me things the wife is doing to undermine them, mostly without evidence. This is what happens when nurses believe a family member isn’t acting in the best interests of a patient. Trust dissipates and suspicion grows in both parties. Paranoia introduces itself. Nurses suspect the wife is putting food into her husband’s mouth at night, causing him to aspirate. The wife says that nurses aren’t cleaning him enough, that they are killing him with medicines they won’t identify, that they are giving her nasty looks when they enter the room. I don’t think the first two are true, but I don’t doubt the third. Some nurses are beginning to ask for the hospital ethics panel to get involved. I know that’s a waste of time. The ethics panel is the hospital’s mechanism to show they are making an effort, being diligent. It rarely changes anything, it’s just a cover your ass dog and pony show. Nurses ask what I think. I confidently tell them, sure, that’s the appropriate next step. I’m now the go between. I’m also the brakeman. I filibuster, temporize, stall. Both sides confide in me. This job has turned me into a chameleon, which is a generous way to describe it. Less generously I am two-faced, a false friend, a con man. But I don’t outright betray anyone. I’m just a tightrope walker taking my time to get to the other side. I am made for this job.
On the seventh day nurses find cuts on patient’s lips, tongue and insides of his cheeks. They suspect that the patient is having seizures and use this to argue the patient is suffering. The wife says if they remove the breathing tube he would suffocate and wouldn’t you call that worse suffering? The nurses also tell me they’ve suctioned food from the patient’s throat and are now convinced the wife is putting food in her husband’s mouth at night. She denies it, accuses them of undermining her and continues to demand a feeding tube.
On my 27th birthday Luisa gives me a photography book that she couldn’t afford. It’s Images a’ la Sauvette by Henri Cartier-Bresson. She says a photography book is going to be her present to me every year so that eventually I will have a collection. This is wildly aspirational, but I appreciat the thought. It’s the only one I ever received, but it’s still my favorite book. Years later it was damaged in a fire that destroyed most of what I owned. The book was one of the few things that I was able to salvage from the ruins and its cover is warped and blackened from the water and heat. It still smells like smoke and the rubble of a ruined intimacy.
Louisa and I never live together. She rooms with her sister Lauren in a high rise and they struggle to pay the rent. It had a lake view, but little else to recommend it. Not much about her life is compatible with mine. She wants to be rich and believed it was only a matter of time. She had a robust wealth confidence, a quality alien and incomprehensible to me. I am a painter and do not expect to ever make much money. Self-fulfilling prophesies for us both.
We go to see Leon Golub at the Smart Gallery in Hyde Park. She thinks torture is an uninteresting painting subject, but is impressed by the prices. She suggests my paintings might be more marketable if they were darker. “Rich people like dark”, she says. “They like things that are impenetrable and frightening. They like to struggle with complexity and darkness because it makes them feel they deserve their money.” I say that my work is about faith in all its forms which is dark enough for me. “Well, maybe make it more opaque then. People with money are suckers, mostly. They’ll fall for anything that sounds esoteric enough, that’s incomprehensible enough. They want labyrinthine.” That would eventually become her business m.o. in a nutshell. When I suggest that people without money are suckers too, she ignores me. She is uninterested in people without money. For the time being I am an exception.
We can imagine this man. He is a mechanical engineer for the school district. He has deep HVAC knowledge. He’s experienced with plumbing systems. He’s qualified to maintain electrical circuitry. He even knows a bit about computer systems, servers, wifi. He also likes to hunt. Nothing big, birds mostly; pheasants, duck, grouse. He grew up in the Midwest, near Cedar Falls. He has two brothers, much older, that he’s not particularly close to. His mother has dementia and lives in a memory care facility. He contributes to the costs. His early dreams were to become a pilot, but colorblindness prevented him from going beyond single engine. He joined the military where he gained most of his work skills. He was on a ship in the Caribbean when Reagan invaded Grenada, but he never got ashore. He is a reader, but only historical fiction. He likes James Michener. He was married before, briefly and unhappily, to a woman he met at a laundromat. They honeymooned on the beaches of Panama City, Florida. He loves baseball, football not as much. He likes the Twins in the AL and Cardinals in the NL. He’s never bowled and thinks it’s idiotic. He’d like golf more if he was any good at it. His drink of choice is bourbon, then beer. He was forty-three before he snorted his first coke, proffered by a prostitute. He felt guilty about the prostitute, but the coke was a revelation. He loves his step-daughter, but knows she does not love him. He regrets not making more of an effort when she was young, but thinks it is too late to make amends. He recovers from his deepest dives by talking to his pastor, who he trusts. He’s equivocal about church, but believes Jesus Christ is the son of God and is confident he will go to heaven despite his flaws. He worries about money and thinks his wife spends too much on clothes.
We can speculate that he hit his wife, but just once, for which she never forgave him. He thought of leaving her to ensure he’d never lose his temper again, but was too lazy to go ahead with it. Instead he began having affairs. He felt guilty about those too, but they kept him calmer and made life tolerable. He loves hamburgers, but not chicken; pie, not cake. His musical tastes run to what he likes to call progressive country, which is really just contemporary country. He also appreciates Led Zeppelin, Jimi Hendrix and the Stones, which he picked up from his brothers. He hates prog rock, also from his brothers. He once saw a man cut three fingers off in a power saw accident which made him a safety fanatic. He got over his guilt about prostitutes and treated himself several times a year. The first time he saw one with shaved pubic hair he was so shocked he lost his erection. He got over that too. He once asked his wife to shave when he was drunk and she laughed at him. When he sobered up he laughed at himself.
We can picture the man out walking, enjoying conversations with his neighbors. He likes to chat, but stays away from politics. He’s a bit insecure about his education, but makes up for it with humor and a gregarious nature. On their tenth anniversary he took his wife to Paris and they visited the Louvre and walked in the Tuileries. He appreciated the art and the architecture, but couldn’t get past the anxiety of being so far from home. She drank too much wine at a sidewalk cafe and called him provincial, which hurt him more than he expected. He also took her to San Diego once and loved the beaches. It was one of the best times he ever had with his wife and they had sex once, sometimes twice a day. He hoped to go again but she was uninterested. He thinks about those times now and again and wonders if they are why he’s occasionally cruel, why he sleeps with other women and doesn’t make much effort to hide it. He sometimes wonders if it’s to punish his wife, or himself, but also thinks she should be grateful since it keeps him from hitting her again.
We can believe that this life, all these memories are gone now. A mind that had a billion thoughts, emotions, questions, experiences, now blank. A world disappeared. Or not.
On day nine the wife notices that her husband is moving his fingers. The doctors say is it is just the involuntary twitching of muscles and is in no way connected to brain activity. It’s nearly imperceptible, but the wife believes it’s a signal that he’s in there, that he is trying to communicate with her. She begins logging his digital movements in an attempt to understand what he is saying. She believes it’s a sign he wants to live, that he’s hungry, that he wants to be a better man. She asks me if I know morse code and wants me to confirm her suspicions. I equivocate and say that I’ve seen doctors be wrong before, which she takes a confirmation of her theory. But I feel I have some trust to spend, and gently wonder out loud if it’s also possible that he’s asking her to let him go. She doesn’t speak to me again for two days.
Sick bodies are puzzles. Not open ended puzzles with creative solutions, but more like a Rubic cube, a complex puzzle that one can get good at, especially if one has a certain type of mind. After a while the game gets a bit boring. Ninety percent of hospital patients can be treated with tried and true tactics. Just follow the formula. It’s called state of the art, evidenced- based medicine. By and large it works. Most of the remainder take a few more turns. They’re the challenges that keep doctors interested. The few for whom no amount of turning the cube results in a solution are given a personality disorder diagnosis. His doctors consider this man a finished puzzle with no further moves needed.
Luisa begins her affair with my dealer about the same time I sleep with her sister, Laurel. When the truth comes out there are the expected tears, accusations, recriminations. I say some very nasty things and she responds in kind. Then we revert to form. Luisa draws close, makes promises, begs me to go with her to Buenos Aires, Cairo, Phuket, somewhere foreign and far away. All I can hear is,”Save me. Tell me what to do.” I am flattered but wary. I remain equivocal and indecisive. I am brave enough to walk to the precipice, but never to take the leap. We remain each other’s parasite.
On day nine the wife leaves a message on my phone asking me to visit in her husband’s room. I anticipate accusations of betrayal or lack of trust. It’s something I’ve experienced many times before and I know the best way to respond is with humility and acceptance. Keeping the relationship viable is my only goal. Instead the wife flips the narrative. This is not about me at all. She blames her husband for being selfish for wanting to live. He is taking advantage of her by surviving she says. He is trying to punish her. “If he thinks I will be his caretaker forever he’s very mistaken,” she says with a venom she’d previously reserved for doctors. She wants his breathing tube to be removed, medications discontinued, a Do Not Resuscitate order to be entered.
The current attending Intensivist, the fourth, is uncertain how to respond. She’s seen the notes and is suspicious that the wife is unstable. Instead of moving quickly forward, she puts on the brakes. She tells the wife that she wants to consult with a Palliative Care team, asks that the wife carefully consider the finality of the decision. The wife explodes and spits, “How dare you let him abuse me, how dare you make me a victim again.” The doctor makes an effort to appear sympathetic, but I can see that’s she’s stunned and doesn’t have a response. “You are an enabler just like all the others,” the wife cries. The Intensivist leaves the room. The wife grabs my hand and says, “Help me. Don’t let them treat me like shit. I’m his wife. They have to respect my decisions. I have the law on my side.” I hold her hand silently. “They’ll be sorry if they don’t,” she whimpers. “They’ll be sorry.”
Six years after we broke up I bump into Luisa at the Chicago Art expo. My career isn’t going anywhere but I still make an effort to make the rounds and keep up appearances. It’s demoralizing to chat with gallerists whose eyes are constantly scanning the crowd, but by now I am so used to it I barely care. Luisa has become very rich by telling investors she can save fortunes by promising to lose money. Such is her persuasive power. She invests money in commodity futures that typically move in the opposite direction as the stock market. She pitches it as a complicated hedge and I imagine that many of her clients didn’t understand it. It was certainly well over my head. Luisa was in the Thaddaeus Ropac booth with a Dutch client considering a Baselitz. She is using language I didn’t know she spoke: liminal, cross-pollinated media, visual glitch, gender fluid dissonance. She was a quick study and a shape shifter and I feel oddly proud of her. She does not blend in with the art cognoscenti, she stands out. I could be resentful that she thrives in a world I had introduced her to while I am barely hanging on, but I know my failings are my own. I also know that happiness and contentment will be forever beyond her. We speak briefly, like old friends, but there is a finality to the conversation. Neither of us allude to any pain we caused each other, nothing between the lines, no subtle cuts or acknowledgments of disappointment. Then we say goodbye. Afterward I feel sad, and then confused as to why I was sad.
There are rituals in any hospital, and especially in a critical care unit, that are not apparent to an outsider. When an extubation that is expected to lead to death is planned, the room is dimmed, nurses stick close, the attending alerts the medical director, the body is washed, opiates are loaded to ease the coming struggle for breath, loved ones are cautioned that agonal breathing is not painful or a sign that the patient is suffering, but just a brainstem response. No one believes this the first time they see it and it’s not uncommon for family members to leave the room despite themselves. It’s the main reason loved ones miss the moment of death, after which there is much self-recrimination for not being courageous enough for the patient.
During the patient’s last minutes his breathing stops for long periods. First fifteen, then thirty, then forty, fifty seconds before a deep gasp that is simultaneously brutal and comical. Each time it occurs, a tension builds, only to be released at the next breath. It’s impossible to tell which one will be the last. It’s death theater. The wife sits impassively at bedside. Her smile is indecipherable, a Mona Lisa smile. She looks both angelic and devilish and I cannot intuit what she is thinking.
When the final moment finally comes she slumps in her chair. Nurses keep their distance but the wife doesn’t remain long. She thanks me, a few of the nurses, and the attending Intensivist on her way out, as though we were all colleagues who had just successfully completed a project. The accusations and distrust of the last weeks are gone. Her overall demeanor is one of mild disappointment. It would be easy to believe the disappointment is with the hospital, or with her dead husband, but her face, her body language suggest she is disappointed with herself as well. By the time I get back to my office I realize this is projection.
Many years after Luisa’s death I run into Laurel at an art opening in Chicago. Afterward we go to the Pump Room for a drink where I learn that Luisa survived for ten days in a Hangzhau hospital. Right up until she died the doctors told the family that Louisa might come out of her coma at any time. They said that the brain was inexplicable. At least that’s how it was translated. I also find out that she didn’t fall out of a chair at a restaurant, but was on a dance floor at five a.m. at the Lola Club. She became glassy eyed and dizzy so her friends sat her down. When she became incoherent they brought her to the hospital, dropped her off and left. For four days she was anonymous patient number two until the police, working with the US consulate, identified her. Laurel arrived on day six. Louisa was unconscious but serene, looking like a queen in her bed. Laurel said she’d never looked better and was told that Louisa might come out of it once the drugs left her body. Later a nurse told her it was an aneurism. The doctors were by turns grim, then upbeat. The language barrier made it difficult to know anything for sure. Sometimes Laurel could feel Luisa squeeze her hand. Occasionally Luisa would smile, as though having a pleasant dream. On day ten Louisa went from pale to ghostly white and just like that it was all over. Laurel shook her head and mumbled, “what a waste.” I wait until we separate to smile. I am happy for Luisa. Better, I think. Not what I would have wished for you, not what you deserved, but better.
My father was in his eighties when he died from a brain bleed after a fall. The last words he spoke were “Get me out of here”. The ICU doctors were kind, but never offered a glimmer of hope. Sometimes his body would jerk, his legs kick. After the chaplain prayed with him she told us that he was trying to run. She thought he was trying to escape his body. “He’s running from this world,” she said. “He’s trying to get to the next. It’s taking some time for him to understand he can’t take his body with him.” At the time I wondered what denomination she ascribed to, but now I understand. I say things I don’t mean all the time. I don’t consider it lying. Not at all. Nor is there any guilt involved. I am, as my former best friend alleged, a dissembler, which, if not exactly a healing art, is at least a temporary balm in moments like these.
The body has its own mind, unconstrained by the brain. Wilhelm Reich believed that intelligence was an inferior trait compared to somatic consciousness. He taught that emotion, motivation, spiritual awareness, even language was mostly experienced, recorded and remembered in the body, not the head. I like the idea of the brain as a subsidiary organ.
Reich also thought those energies could only be accessed through orgasm, which is interesting, but suspicious coming from a man who couldn’t keep his hands off of women. For better or worse, in this world brilliance and bullshit are often conjoined, which of course brings me back to Luisa. Neither her substantial talents nor her deeply embedded flaws defined her. I’ve come to believe this is why she was so attractive to me. She was a metamorph, adapting and mutating to the circumstances. She let no one put their finger on her. Perhaps we weren’t so very different at all.
