AFTER DEATH, WHAT?

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This is not a philosophical question, or a religious one. It’s a question about what happens to the person sitting by a hospital bedside when the occupant of the bed, someone who was loved and cherished, becomes (suddenly or at last) “the deceased,” dies perhaps even while the sun is still shining brightly through the clean hospital windows, mocking the dark ache in the heart of the solitary survivor.

In the hospital where Bill died early in May, a four-year-old state-of-the-art hospital in upscale Princeton, New Jersey — home of a world-renowned university, of the Institute for Advanced Studies (where Albert Einstein found safe harbor after fleeing anti-Semitism in Europe during World War II), and of Westminister Choir College, whose graduates grace stages in many celebrated opera houses – in this spiffy new hospital, the person blinded by tears who holds the still-warm hand of a new cadaver simply ceases to exist.

A nurse’s aide came to wheel away the equipment that had sustained Bill’s life for the past seven days. I began to gather up my things, thinking they were about to clear the room. “You can stay for half an hour or so,” she said matter-of-factly as she left. “They won’t take him away and remake the bed before that.” People continued to walk back and forth in the hall. I had to get up to close the door.

Not that I had counted for much in the hospital before that, except as a conduit for conveying important information about Bill. In fact, “you can stay for half an hour or so” was one of only five things anyone there said to me the day Bill died. Earlier, Bill’s fourth pulmonologist had come by to report he wasn’t getting better and what did we want to do next, whereupon I told her Bill’s son and I agreed we should let him go. She nodded and said, “I wish more families were as wise as you.” And that was that. She just left. I never again saw or heard from her, although it was me who had accompanied Bill on every outpatient appointment with her and asked at least half the questions. It was also me who had brought him to her office in a wheelchair just before she checked him into the hospital because he was so weak and sick. She knew me. I had thought she was nice. But of course I wasn’t her patient. Her role as a physician ended with Bill’s death. She had no obligation to me, not even a human one. Not even to say she was so sorry.

Somewhat later, another pulmonologist came in. I had seen him briefly just once before, because he was one of four in practice together who took turns doing the hospital rounds for pulmonology cases, so that each was there only every fourth day and you never really got to know any one of them. (Maybe that’s how they keep from becoming too emotionally invested in a patient.) “You’d better notify a funeral director to come get the body afterwards,” he said. “We can only keep it overnight.” As if Bill were a left-behind package needing removal.

After they pulled out the intubation tubes and — still unconscious — Bill was rapidly slipping away, an intensive care nurse came to check that dying was proceeding properly and reprimanded me for looking at the monitor to see his oxygen level. “Don’t look there. Look at his face,” she scolded. (While I still could?) She turned off the monitor. So it was me who first noticed he had died. I held my hand against his cracked and slightly open lips but no faint breath came out. She brought in the pulmonologist who had advised calling a funeral director. He held Bill’s inert wrist for a moment, looked at the clock, and said — not to me, but to the nurse, who was taking notes — “Time of death 2:52 p.m.”

When he, the nurse, the nurse’s aide, and the equipment were gone, I called the funeral director and made arrangements to come to his office next day to pay him for what he was about to do and give him the requisite information for the death certificate. Then I kissed the forehead of the body in the bed that wasn’t Bill any more and stumbled out of the room into the hall and towards the elevator. It was a long hall. I had trouble maintaining my balance. The resident who had seen me every day for the past seven days was at the floor reception desk as I passed him. I gave him a slight nod, but not a flicker of recognition crossed his face. He might have been staring into space. I also crossed paths with the two day nurses and one of the four pulmonologists who had looked after Bill during the seven days he spent in their care. All three looked right through me.

One person noticed how erratically I was walking. It was the respiratory technician, a woman called Antonia who appeared to be in her late fifties; she had been in Bill’s room every day during the last three days of his life to adjust the respirator keeping him alive. Our eyes met, she came towards me and held out her arms. It was a big hug. My eyes began to fill again. “Will you be all right driving home?” she asked, still hugging. I nodded, because it was too hard to speak. “Be careful,” she said. “God bless.”

Of course I wasn’t all right driving home. My hands and arms shook so much I could hardly keep the wheel from going out of control as I tried to make the winding turns out of the hospital complex and back onto Route 1 South. Two other drivers gave me long and frightening honks, as if it were thanks only to them I myself had narrowly escaped being killed.

Resigning myself to the fact of Bill’s death is still very hard. But what particularly festered on the day he died, and does to a certain extent even now, is that his doctors and nurses made it so very clear they didn’t care at all about what I might be feeling. Maybe where there’s so much pain and suffering for their patients, they can’t permit themselves the humanity to be even momentarily concerned with those who survive the patients. Or maybe my experience was unique. Maybe at other hospitals it’s different. I don’t know. All I can say is that nearly three months later, I don’t remember the names of any of the four pulmonologists or the intensive care nurses. I’ll remember Antonia with gratitude for a very long time.

ON CHARON’S WHARF

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[I recently met a woman who recommended I read a book called Broken Vessels, a collection of essays by Andre Dubus.  Dubus  — better known for his short stories — was raised a Catholic and continued in his faith as an adult. As I’m not Catholic, I hesitated. But this is a smart woman.  So I  took her advice.  

Well, there I was, plodding along, beginning to wonder why I’d listened to her — baseball essay, one about trains, another about bullies, a complaint about the justice system (tell me about it) — when suddenly I found myself in territory so gorgeous it took my breath away.  

I had to read it twice, and then some of it once more. It’s a piece called “On Charon’s Wharf”– and if it doesn’t move you, I’d better stop blogging and find something else to do.  I’ve chopped out a couple of pages about an Ingmar Bergman movie which I don’t think you’ll miss, but otherwise was afraid to tamper with it.  It’s about death, and love, and men and women.  Which means it’s about all of us.]

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“On Charon’s Wharf” by Andre Dubus

Since we are all terminally ill, each breath and step and day one closer to the last, I must consider those sacraments which soothe our passage. I write on a Wednesday morning in December when snow covers the earth, the sky is grey, and only the evergreens seem alive. This morning I received the sacrament I still believe in: at seven-fifteen the priest elevated the host, then the chalice, and spoke the words of the ritual, and the bread became flesh, the wine became blood, and minutes later I placed on my tongue the taste of forgiveness and of love that affirmed, perhaps celebrated, my being alive, my being mortal.  This has nothing to do with immortality, with eternity; I love the earth too much to contemplate a life apart from it, although I believe in that life. No, this has to do with mortality and the touch of flesh, and my belief in the sacrament of the Eucharist is simple: without touch, God is a monologue, an idea, a philosophy; he must touch and be touched, the tongue on flesh, and that touch is the result of the monologues, the idea, the philosophies which led to faith; but in the instant of the touch there is no place for thinking, for talking; the silent touch affirms all that and goes deeper: it affirms the mysteries of love and mortality….

So many of us fail: we divorce wives and husbands, we leave the roofs of our lovers, go once again into the lonely march, mustering our courage with work, friends, half-pleasures which are not whole because they are not shared.  Yet still I believe in love’s possibility, in its presence on the earth; as I believe I can approach the altar on any morning of any day which may be the last and receive the touch that does not, for me, say: There is no death; but does say: In this instant I recognize, with you, that you must die. And I believe I can do this in an ordinary kitchen with an ordinary woman and five eggs. I scramble them in a saucepan, as my now-dead friend taught me; they stand deeper and cook softer, he said. I take our plates, spoon eggs on them, we sit and eat. She and I in the kitchen have become extraordinary: we are not simply eating; we are pausing in the march to perform an act together; we are in love; and the meal offered and received is a sacrament which says: I know you will die; I am sharing food with you; it is all I can do, and it is everything.

As lovers we must have these sacraments, these actions which restore our focus, and therefore ourselves. For our lives are hurried and much too distracted, and one of the strangest and most dangerous of all distractions is this lethargy of self we suffer from, this part of ourselves that does not want to get out of bed and once out of bed does not want to dress and once dressed does not want to prepare breakfast and once fed does not want to work. And what does it want? Perhaps it wants nothing at all. It is a mystery, a lovely one because it is human, but it is also dangerous. Some days it does not want to love, and we yield to it, we drop into an abyss whose walls echo with strange dialogues. These dialogues are with the beloved, and at their center is a repetition of the word I and sometimes you, but neither word now is uttered with a nimbus of blessing. These are the nights when we sit in that kitchen and talk too long and too much, so that the words multiply each other, and what they express — pain, doubt, anxiousness, dread — become emotions which are not rooted in our true (or better) selves, which exist apart from those two gentle people who shared eggs at this same table which now is soiled with ashes and glass-rings.

These nights can destroy us. With words we create genies which rise on the table between us, and fearfully we watch them hurt each other; they look like us, they sound like us, but they are not us, and we want to call them back, see them disappear like shriveling clouds back into our throats, down into our hearts where they can join our other selves and be forced again into their true size: a small I among many other I‘s. We try this with more words and too often the words are the wrong ones, the genies grow, and we are approaching those hours after midnight when lovers should never quarrel, for the night has its mystery too and will not be denied, it loves to distort the way we feel and if we let it, it will.  We say: But wait a minute … But you said … But I always thought that …Well how do you think I feel, who do you think you are anyway? Just who in the hell do you think you are?

There are no answers, at least not at that table. Each day she is several women, and I am several men. We must try to know each other, understand each other, and love each other as best we can. But we cannot know and understand all of each other. This is a time in our land when lovers talk to each other, and talk to counselors about each other, and talk to counselors in front of each other. We have to do this. Many of us grew up in homes whose table and living room conversations could have been recorded in the daily newspaper without embarrassing anyone, and now we want very much to explore each other, and to be explored. We are like children in peril, though, when we believe this exploring can be done with words alone, and that the exploring must always give answers, and that the exploring is love itself rather than a way to deepen it. For then we kill our hearts with talk, we place knowing and understanding higher than love, and failing at the first two, as we sometimes must, we believe we have failed at the third. Perhaps we have not. But when you believe you no longer love, you no longer do.

I need and want to give the intimacy we achieve with words. But words are complex: at times too powerful or fragile or simply wrong; and they are affected by a tone of voice, a gesture of a hand, a light in the eyes. And words are sometimes autonomous little demons who like to form their own parade and march away, leaving us behind. Once in a good counselor’s office I realized I was not telling the truth. She was asking me questions and I was trying to answer them, and I was indeed answering them. But I left out maybe, perhaps, I wonder. … Within minutes I was telling her about emotions I had not felt. But by then I was feeling what I was telling her, and that is the explosive nitroglycerin seeping through the hearts of lovers.

So what I want and want to give, more than the intimacy of words, is shared ritual, the sacraments. I believe that, without those, all our talking, no matter how enlightened, will finally drain us, divide us into two confused and frustrated people, then destroy us as lovers. We are of the flesh, and we must turn with faith toward that truth. We need the companion on the march, the arms and lips and body against the dark of the night. It is our flesh which lives in time and will die, and it is our love which comforts the flesh. Beneath all the words we must have this daily acknowledgement from the beloved, and we must give it too or pay the lonely price of not living fully in the world: that as lovers we live on Charon’s wharf, and he’s out there somewhere in that boat of his, and today he may row in to where we sit laughing, and reach out to grasp an ankle, hers or mine.

It would be madness to try to live so intensely as lovers that every word and every gesture between us was a sacrament, a pure sign that our love exists despite and perhaps even because of our mortality. But we can do what the priest does, with his morning consecration before entering the routine of his day; what the communicant does in that instant of touch, that quick song of the flesh, before he goes to work. We can bring our human, distracted love into focus with an act that doesn’t need words, an act which dramatizes for us what we are together. The act itself can be anything: five beaten and scrambled eggs, two glasses of wine, running beside each other in rhythm with the pace and breath of the beloved. They are all parts of that loveliest of all sacraments between man and woman, that passionate harmony of flesh whose breath and dance and murmur says: We are, we are, we are

1977.