meditations from a Midwestern hospital
this week i flew to Milwaukee, Wisconsin, taking off on a bright and chilly New York morning, landing a few hours later on a second-hand couch across from my younger sister, Dana. beneath her candy-apple bangs, she wore a familiar expression, her trademark smile-through-pain, as she sucked on a bottle of Gatorade. her usually-olive cheeks were drained a few shades paler than usual, the result of a recent, intense work stint and her pre-operation diet of clear liquids and jell-o. she was preparing for an elective surgery, a procedure that would be both relatively safe and yet substantial in its physical impact, promising acute pain and several weeks of recovery. i was there to support her through the initial, most intense days.
we all hoped the surgery would bring both relief from some of her pain, and a definitive diagnosis after years of chronic, untreated pain.
the next morning we left early, weaving through rush-hour traffic on the expressway to make our way to a nearby hospital. there, after checking in, the hospital staff began the process of transforming my sister from a member of the tribe of Autonomous Well into an Admitted Patient, willingly helpless and entrusted to their care. her wrist they encircled with barcodes and bands, offering her clear plastic bags to stuff with her clothing. they took down numbers, sampled fluids from her body, parked her in a bed next to a window overlooking a half-full, rain-wet car lot. her boyfriend and i sat across from her in uncomfortable chairs, making small talk and craving coffee, conspicuously not-glancing at the door through which The Doctor would eventually appear.
eventually the slow procession began: a train of weary-cheerful nurses, a self-serious anesthesiologist, and finally the straight-talking kindness of her surgeon. their words were a mixture of pro-forma pleasantries and technical jargon, and we mostly understood, nodding along, aware of our reliance, our separation from what would come next. “Into your hands, we commit this beloved.”
she was wheeled away from us, disappearing, bed and all, through a set of industrial metal doors. i was reminded of a factory entrance; i pushed away an image of meat packing plant. her boyfriend and i, assuming the role of Loved Ones, obediently followed directions to the Surgery Waiting Area.
again, we had no reason to believe she would be in any danger, and the likelihood of a useful, positive outcome was high. yet it is still impossible, at least for me, to spend any time in a medical facility without being gripped by its peculiar, encompassing spell.
there is something profoundly affecting about the intimacy and alienation of these liminal spaces. the waiting, the faded magazines, uniform upholstery, the sunless, impersonal hallways. against these generic, neutral tones, we become stark, our bodies and emotions exposed in almost garish clarity in the artificial light. around me husbands, mothers, lovers, each framed by identical, plastic armrests, each an island of private hopes and fears. some looked up with imploring hope as nurses passed by carrying covered trays or pushing carts laden with gleaming metal tools. Others rested their gaze on the floor, their hands, or the muted TV mounted on the wall, staring blankly as advertisements for generic drugs and nutritional supplements played on tedious loop. at the front of the waiting area, a receptionist fielded phone calls from the OR, jotting down notes and then sidling up to one or another of the Waiters, relaying the message in a businesslike whisper.
i wondered which of them had known they’d be sitting here that morning, and how many had landed in this place through some wrenching twist of fate. in our motley group, who was silently battling demons of fear or regret? were any wracking their brain for the last “I Love You” said, or berating themselves for yesterday’s petty argument? Were they envisioning second chances, making unspoken bargains with fate to change, to be “better,” if only, if only… ?
before the surgery began, the doctors asked whether Dana would like to grant permission for them to share the details of her case with us. she said “yes.”and i wondered at this, the way we reach out and choose who to cling to, who to trust, when we are rendered helpless.
perhaps all this introspection was due, in part, to this: i’ve been the one on the otherside of the equation too many times in my relatively short life. i’ve been the emergency phone call, the unexpected catalyst for such anxious hours, spent my share of days as an Admitted Patient.
what is most profound to me, about such moments, is the delicacy of the human organism. for those of us who still spend the majority of our waking hours as Autonomous, Healthy beings, what consciousness do we have that our existence depends each nanosecond on countless, tiny miracles? how quickly this universe of cells can go awry, molecules spinning out of their proper function, tissues ruptured or sliced apart, bones or organs crushed or slowly giving way to decay.
perhaps it is for the best that we live most of our lives in utter ignorance of our constant, countless vulnerabilities. Yet this inescapable fact is made too plain in such confrontations with Modern Medicine, diagramed like some elaborate sentence in the cryptic language of procedures, knives, and needles. we find ourselves adrift in a world in which ordinary things — skin and skulls and urine and memory — come undone, come into question, revealing an elaborate and hopelessly delicate system beneath.
in such moments, we become captives of this mystery, supplicants to our very cells, willing Science or Heaven to have mercy. to answer this riddle of our own bodies, we enlist any number of the formidable army of Specialists. they appear, clad in strange robes, each the bearer, Bradbury-like, of one specific set of invisible knowledge. we Outsiders unsure whether to trust or beseech them, these peculiar beings who may feel to us like the arbiters of Death and Life (they aren’t). we rely on them utterly, to staunch blood or restore breath, to interpret the gleaming, cryptic numbers that confront us like prophecies from so many unblinking screens.
yet there is so much that is unspeakable in such grave reckonings — as Elaine Scarry said, “Physical pain does not simply resist language but actively destroys it.” often, it is the groans, the silences, the helpless, or falsely brave, glances that most capture what these moments ultimately mean. and perhaps, in these pre-verbal utterances, it is possible to meet ourselves and others on a more primal level, knowing intuitively, if imprecisely, the fact of our faltering bodies.
as a Patient, i found this strange equation profoundly humbling, more transformative than many a spiritual ritual. suddenly, everything feels sacred, and tenuous: the ability to walk or run or kiss or piss, the chance to share one more game of Frisbee or al fresco dinner or even one more dreary Monday morning meeting. many of us proud Rationalists slide into magical thinking, bartering with unknown gods, offering repentance or rage.
those of us lucky enough to emerge, even partially, from this liminal state will find our ordinary lives suddenly dazzling — at least for a time. i remember being able to stand on my own for the first time after a life-shattering accident. i recall the wonder and thrill and belief that i would never again take something so marvelous for granted. i remember another recovery, this time from a weeks-long, violent infection, while living in a refugee camp in North Africa. surely, i thought, regarding my paled cheeks in the mirror with eyes at last cleared of fever, surely i would always remember, and cherish the simple ability to think coherent thoughts, to return to once-tiresome tasks rather than wasting on my sweat-sagged cushion that had been my sole dominion for too long.
yet of course we forget, at least in part. we fall under the spell of our own invincibility once again, and forget to murmur awe-struck thank yous each time we rise from a chair or digest our breakfast. we lose sight of the billions-bright constellation of our biological selves, and with the haunting beauty of the spirit we found hovering in its midst. we move on.
until something else begins to ache, or fall off its axis. until a loved one is rushed, broken or bleeding, through steely doors and out of sight.
Susan Sontag famously spoke of this universal, fallible state: “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”
how to live with this awareness without being morbid, immobilized, hypochondriac? how to infuse our love and work with this sense of tenuousness and gratitude, while keeping pace with the demands of each, stuffed day?
over the past few years — as i’ve survived trauma and illness and sought to cultivate the wisdom it seeded — i’ve developed a few tools to remind myself of the bizarre preciousness of this skin-temple. some are obvious: yoga, breathing, body-scans to selectively bring awareness to each member of my body, with gratitude. i also employ a few minor pampering rituals — slowly rubbing lotion on my hands, for example, thanking each finger in turn for its strength, for the endless service of its bone and tendons and nerves. i try to speak to my body with kindness, especially when some part of Her — yes, I use a personal pronoun — is suffering or weakened. i believe, not without evidence, that such tenderness towards ourselves makes “real,” physical difference.
so, i am trying to be mindful, and kind, with this fragile, resilient flesh. she’s got an impressive set of scars already, and they speak of the dense, long story the two of us have shared. i don’t know how far i’ll get in this life, but i do know, wherever i do manage to go, it will be with and because of Her.
***
my sister emerged, loopy and punctured but healthy, a few hours later. thank God. thank saline solutions and respirators, laparoscopic cameras and laughing gas and latex.
so she begins her journey back to the Kingdom of the Well, with lots of love around her.
[benediction]
may those of us who find ourselves already there, today, take due pause for wonder. and may those who find themselves in that darker Kingdom find solace and safe passage back to us, where we are all only happy, half-oblivious sojourners in the end.
Selah.
Silence.
