Twelve Patients: Life and Death at Bellevue Hospital by Eric Manheimer Page A
Authors: Eric Manheimer
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uniforms, a brief pause from the Brownian motion of the eight-hundred-bed hospital a block away.
My cell phone vibrated on my belt. I didn’t recognize the number. When I answered, Dr. Kepal Patel came on the line. He told me the biopsy had come back. I had cancer. Squamous cell carcinoma. We talked for less than one minute. I called Diana, who answered before one ring. She knew what was coming—the diagnosis, that is. But not what was coming over the next year. That was unknowable. Very quickly, I had to tell my family, friends, and colleagues. Autopilot was where I would live for the next three weeks, until the therapy began.
The walk from the diner to my office can take five minutes or an hour depending on whether I take the long loop around the Bellevue campus—not to mention greeting everyone I see and performing the small negotiations and acknowledgments that are at the heart of the small city that is this public hospital. Today I took the long loop, down First Avenue, past the nursing school and the emergency vehicles strewn out on the access road. I had been through many conversations with patients and their families about death and dying. Now I would be having a variation of that conversation with myself. I had lived through the Kübler-Ross fiction about the stages of death, defining for several generations a reality where there were often not stages, just a Munchian scream. The idea of “the good death” had been attractive and provided a lodestar for my own behavior toward my patients. But finally, as Montaigne said, it was useless to “worry about death, it will take care of itself. Worry about life, that needs management.”
I had thought of death often. I had read about it and dreamed about it. My greatest fears were Holocaust survivor fantasies that tormented me and my family, and had been handed down directly to my daughter. Marina’s identification with her chosen tribe went back to the destruction of the Second Temple and the replays of diasporas upon diasporas. “Countries don’t love you,” my mother had warned. “Collect passports, you never know when you may need them,” she addedas a practical note. Her worldview included death, dying, killing, and being both the hunted and the hunter. My way of dealing with the stress of mortality on a daily basis was to bury it for another day. If it wasn’t exactly the elephant in the room, then it was a smell somewhere in the basement that wouldn’t go away.
I believed that everyone feared death. That mortality petrified everyone. That very few would go gently into the night. And that those who did had reached a state of radical acceptance or had their souls stolen by their disease—the one gratuitous positive thing a terminal illness might offer. The soul would be kidnapped slowly, allowing the disease its final victory lap. Now, as I walked the long way around, I was scared shitless. But I had my methodology: I would focus on the here and now. Tasks that had to be completed. Lists to be made and checked off. Supplies to be purchased, people to be notified. My soul would have to wait for another day.
Secured to the radiation table, replaying the events that had brought me here, I became hyper-alert to everything that went on around me, despite the din from the radiation machine. Music is my drug of choice, and my body was rejecting Ol’ Blue Eyes. Dominican
bachata
was my anti-depressant.
Vallenato
from Colombia an intravenous hit of an amphetamine stimulant. Bach meditation in the lotus position. Piazzolla’s jazzy tango journeys to the pleasure of longing and short-circuited desire. Qawwali Sufi chants by Nusrat Ali Khan hypnotically induced trances that erased consciousness. Dylan, of course, aspirin and penicillin, the all-purpose poly-pill appetizer, dessert, or main course. Time ticked by slowly. Trifling delays were magnified. Idle chitchat among the staff about girlfriends and last night’s baseball game annoyed me.
Squamous cell
My cell phone vibrated on my belt. I didn’t recognize the number. When I answered, Dr. Kepal Patel came on the line. He told me the biopsy had come back. I had cancer. Squamous cell carcinoma. We talked for less than one minute. I called Diana, who answered before one ring. She knew what was coming—the diagnosis, that is. But not what was coming over the next year. That was unknowable. Very quickly, I had to tell my family, friends, and colleagues. Autopilot was where I would live for the next three weeks, until the therapy began.
The walk from the diner to my office can take five minutes or an hour depending on whether I take the long loop around the Bellevue campus—not to mention greeting everyone I see and performing the small negotiations and acknowledgments that are at the heart of the small city that is this public hospital. Today I took the long loop, down First Avenue, past the nursing school and the emergency vehicles strewn out on the access road. I had been through many conversations with patients and their families about death and dying. Now I would be having a variation of that conversation with myself. I had lived through the Kübler-Ross fiction about the stages of death, defining for several generations a reality where there were often not stages, just a Munchian scream. The idea of “the good death” had been attractive and provided a lodestar for my own behavior toward my patients. But finally, as Montaigne said, it was useless to “worry about death, it will take care of itself. Worry about life, that needs management.”
I had thought of death often. I had read about it and dreamed about it. My greatest fears were Holocaust survivor fantasies that tormented me and my family, and had been handed down directly to my daughter. Marina’s identification with her chosen tribe went back to the destruction of the Second Temple and the replays of diasporas upon diasporas. “Countries don’t love you,” my mother had warned. “Collect passports, you never know when you may need them,” she addedas a practical note. Her worldview included death, dying, killing, and being both the hunted and the hunter. My way of dealing with the stress of mortality on a daily basis was to bury it for another day. If it wasn’t exactly the elephant in the room, then it was a smell somewhere in the basement that wouldn’t go away.
I believed that everyone feared death. That mortality petrified everyone. That very few would go gently into the night. And that those who did had reached a state of radical acceptance or had their souls stolen by their disease—the one gratuitous positive thing a terminal illness might offer. The soul would be kidnapped slowly, allowing the disease its final victory lap. Now, as I walked the long way around, I was scared shitless. But I had my methodology: I would focus on the here and now. Tasks that had to be completed. Lists to be made and checked off. Supplies to be purchased, people to be notified. My soul would have to wait for another day.
Secured to the radiation table, replaying the events that had brought me here, I became hyper-alert to everything that went on around me, despite the din from the radiation machine. Music is my drug of choice, and my body was rejecting Ol’ Blue Eyes. Dominican
bachata
was my anti-depressant.
Vallenato
from Colombia an intravenous hit of an amphetamine stimulant. Bach meditation in the lotus position. Piazzolla’s jazzy tango journeys to the pleasure of longing and short-circuited desire. Qawwali Sufi chants by Nusrat Ali Khan hypnotically induced trances that erased consciousness. Dylan, of course, aspirin and penicillin, the all-purpose poly-pill appetizer, dessert, or main course. Time ticked by slowly. Trifling delays were magnified. Idle chitchat among the staff about girlfriends and last night’s baseball game annoyed me.
Squamous cell
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