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Authors: Joyce Carol Oates

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Chapter 6
E-mail Record

February 12, 2008.
To Richard Ford
At this moment, Ray is recovering from a nasty cold that morphed into pneumonia without our somehow noticing . . .
Much love to both,
Joyce
To Leigh Bienen
Ray is recovering—slowly—from a severe pneumonia that began as a bad cold . . .
Much love to both,
Joyce
February 14, 2008.
To Gloria Vanderbilt
Ray’s condition improves—worsens—improves—worsens—I have almost given up having responses to it. But the doctors say that over all he is definitely improving—it’s just that the pneumonia is so virulent, through most of one lung.
(I know little of infectious diseases, but am learning rapidly.)
Love
Joyce

Chapter 7
E. coli

February 13
,
2008.
The bacterial infection in Ray’s right lung has been identified: E. coli.

“E. coli! But isn’t that associated with . . .”

“Gastro-intestinal infections? Not always.”

So we learn from Dr. I
_
. Again we’re astonished, naively—there is something naive about astonishment in such circumstances—for like most people we’d thought that the dread E. coli bacteria is associated exclusively with gastro-intestinal infections: sewage leaking into water supplies—fecal matter in food—insufficiently cooked food—hamburger raw at the core—contaminated lettuce, spinach—the stern admonition above sinks in restaurant restrooms
Restaurant employees must wash their hands before returning to work.

But no, we were mistaken. Even as, invisibly, a colony of rapacious E. coli bacteria is struggling to prevail in Ray’s right lung with the intention of swarming into his left lung and from there into his bloodstream to claim him, their warm-breathing host, totally—as totally as a predator-beast like a lion, an alligator, would wish to devour him—so we are learning, we are being forced to learn, that many—most?—of our assumptions about medical issues are inadequate, like the notions of children.

It’s liquidy-voiced Dr. I
_
—or another of Dr. I
_
’s white-coated colleagues—(for in his scant six days in the Telemetry Unit of the Princeton Medical Center Ray will be examined or at least
looked at
by a considerable number of specialists as itemized by the hospital bill his widow will receive weeks later)—who explain to us that E. coli infections, far from being limited to the stomach, can also occur in the urinary tract and in the lungs.
Escherichia coli
are found everywhere, the doctor tells us—in the environment, in water—“In the interior of your mouth.”

Most of the time—we’re assured—our immune systems fight these invasions. But sometimes . . .

Patients with E. coli pneumonia usually present with fever
,
shortness of breath
,
increased respiratory rate
,
increased respiratory secretions
,
and “crackles” upon auscultation.

(Why do medical people say “present” in this context? Do you find it as annoying as I do? As if one “presents” symptoms in some sort of garish exhibition—
Patient Ray Smith presents fever
,
shortness of breath
,
increased respiratory rate . . .
)

Now the exact strain of bacteria has been identified, a more precise antibiotic is being used, mixed with IV fluids dripping into Ray’s arm. This is a relief! This is good news. Impossible not to think of the antibiotic treatment as a kind of war—warfare—as in a medieval allegory of Good and Evil: our side is “good” and the other side is “evil.” Impossible not to think of the current war—wars—our country is waging in Iraq and Afghanistan in these crude theological terms.

As Spinoza observed
All creatures yearn to persist in their being
.

In nature there is no “good”—no “evil.” Only just life warring against life. Life consuming life. But human life, we want to believe, is more valuable than other forms of life—certainly, such primitive life-forms as bacteria.

Exhausted from my vigil—this vigil that has hardly begun!—I slip into a kind of waking sleep at Ray’s bedside as he dozes fitfully inside the oxygen mask and in my dream there are no recognizable figures only just primitive bacterial forms, a feverish swilling and rushing, a sensation of menace, unease—those hallucinatory patterns of wriggling light obscuring vision that are said to be symptomatic of migraine, though I’ve never had migraine headaches
.
My mouth has gone dry, sour. My mouth feels like the interior of a stranger’s mouth and is loathsome to me. The jeering thought comes to me
You must have been infected too. But you have been spared this time.

Waking I’m not sure at first where I am. The sensation of unease has followed me. And there in the hospital bed—my husband?—some sort of disfiguring helmet, or mask, obscuring his face that has always seemed to me so handsome, so youthful, so
good . . .

Something of the derangement of Widowhood is beginning here. For in dreams our future selves are being prepared. In denial that her husband is seriously ill the Widow-to-Be will not
,
when she returns home that evening
,
research E. coli on the Internet. Not for nearly eighteen months after her husband’s death will she look up this common bacterial strain to discover the blunt statement she’d instinctively feared at the time and could not have risked discovering
: pneumonia due to
Escherichia coli
has a reported mortality rate of up to 70 percent.

Chapter 8
Hospital Vigil(s)

There are two categories of hospital vigils.

The vigil with the happy ending, and the other.

Embarked upon the hospital vigil as in a small canoe on a churning white-water river you can have no clear idea which vigil you are embarked upon—the vigil with the happy ending, or the other—until it has come to an end.

Until the patient has been discharged from the hospital and brought safely home. Or not discharged, and never brought home.

Chapter 9
Jasmine

February 14
,
2008.
Today in room 541 there is Jasmine—dark-skinned, Haitian, lives with relatives in Trenton and hates the “nasty” New Jersey winter—a nurse’s aide assigned to Raymond Smith who will bathe the patient behind a screen, change bedclothes and adjust his bed, assist him walking into the bathroom, chattering all the while at him, now at me—
Mz. Smith h’lo? Mz. Smith howya doing?—
voice high-pitched as the cry of a tropical bird. Initially Jasmine is a cheery presence in the room—like the flowers several friends have sent, in vases on Ray’s bedside table—she’s warm, friendly, eager to please—eager to be liked—eager to be
very well liked
—a squat sturdy young woman with cornrowed hair, fleshy cheeks and shiny dark eyes behind thick-lensed red plastic glasses—but as the minutes pass and Jasmine continues to chatter at us, and to bustle about the room, sighing, laughing, muttering to herself—her presence becomes a distraction, an irritant.

Propped up in bed, breathing now through a nasal inhaler, Ray is gamely trying to sort through some of the mail he’s asked me to bring him—here are financial statements, letters from
Ontario Review
writers, poetry and short story submissions—at his bedside I am trying to prepare my next-day’s fiction workshop at Princeton University—still Jasmine chatters, and chatters—our lack of response doesn’t seem to discourage her, or perhaps she hasn’t noticed—until abruptly she makes a hissing sound through her teeth as if in disgust—like a petulant child she takes up the TV remote control and switches on the TV—loud—we ask her please turn it off, we are trying to work—Jasmine stares at us as if she has never heard such a request—she tells us that she
always watches TV in these rooms
—with exaggerated politeness verging upon hostility she asks if she can keep the TV on—
Turned low?
—in her white nylon uniform that strains at her fleshy hips and thighs sitting now in a chair beneath the TV gazing upward at the screen rapt in concentration at antic darting images as if these images were of paramount importance to her provoking her to suck at her lips, murmur and laugh to herself, draw in her breath sharply—
Ohhhh man! Uhhhh!—
until after some time—twenty minutes, twenty-five—as if the magical screen suddenly loses its attraction Jasmine turns back to us with renewed enthusiasm—as the TV crackles and drones she resumes the bright-chattering bird-shriek that makes me want to press my hands over my ears even as I am smiling—smiling so hard my face aches—not wanting Jasmine to be insulted by some lapse in my attention or some failure to respect her personality which in some quarters has surely been praised, encouraged—as Ray shuts his eyes in misery—trapped in the hospital bed by the IV tube in a vein in the crook of his bruised right arm, nasal inhaler clamped to his head—forced as in an anteroom of Hell to listen as Jasmine begins to repeat her monologue of a former patient who’d been really nice to her—really really nice to her—and his wife as well—they’d given her
real special
presents—sent her a postcard
Dear Jasmine!
from the Southwest—really really nice generous people—an older couple—
really
nice—as I listen to these boastful yet accusatory words a wave of dismay washes over me—a stab of fear—is this nurse’s aide employed by the Princeton Medical Center retarded? Is she mentally unstable? Disturbed?
Deranged?

None of the other, older nurses resemble Jasmine in any way—Jasmine seems to have wandered in from another dimension, a Comedy Central TV program perhaps, except Jasmine isn’t funny—Jasmine is deadly serious—I try to explain that my husband is tired and would like to rest—trying to smile—trying to speak politely—in dread of upsetting the excitable young woman—finally saying in a forceful voice
Excuse me—Jasmine—my husband is tired
,
he would like to sleep
—provoking Jasmine to stare at us in astonishment—for a beat unable to speak, she’s so stunned—insulted—a look of exaggerated shock contorting her face as in a children’s cartoon—
Ma’am!—You are telling me to be
quiet?
To
stop talking?
Is that what you are telling me Ma’am—to
stop talking? Jasmine’s shiny eyes bulge behind the thick lenses of her glasses. The whites of her eyes glare. I tell Jasmine that my husband tires easily, he has pneumonia she must know—he doesn’t sleep well at night and should try to rest during the day and if he isn’t able to sleep at least he could close his eyes and rest—as Jasmine continues to glare at me and when my voice trails off she retorts by repeating her account of the really nice older couple for whom she’d worked recently—really nice, generous—
Liked me real well sayin Jasmine you a breath of fresh air always smiling—sent me a postcard sayin Jasmine howya doin
—until at last I cry
Please! Please just stop!

Now Jasmine’s jaw drops, she is so insulted.

Jasmine sits heavily in her chair beneath the TV. Jasmine sighs loudly, muttering to herself. Her fleshy face darkens with blood, her eyes glare whitely. She is sulky, sullen as a furious child. There is no subtlety in her hatred of us who have insulted her by failing to adore her. The thought comes to me
I have made an enemy. She could kill my husband in the night.

My heart begins to beat quickly, in panic. I have brought my husband to this terrible place, now I can’t protect him. How can I protect him?

Whatever happens
,
I am to blame. I am the one who has arranged this.

Outside the room’s single window, it’s night. I think that very likely it has been night for a long time for night falls early in this perpetual winter dusk. I tell Jasmine that she can leave now for her supper break, if she wants to—a little early—this is a good time since I’ll be here for another hour or more.

Jasmine has been rummaging through a large cloth bag on her knees, panting with exasperation. At first she doesn’t seem to hear me—in the friendliest tone I can manage I repeat what I’ve said—Jasmine frowns, glances up—Jasmine pouts and glares—then Jasmine smiles.

Jasmine shuts the large cloth bag with a snap and smiles.

Ma’am thank you! Ma’am that is real nice.

Chapter 10
Vigil

February 14
,
2008—February 16
,
2008.

Those days!—nights!—a Möbius strip continuously winding, unwinding.

This nightmare week of my life—
and yet
—during this week Ray is still alive.

“Don’t worry about that, honey! I’ll take care of that when I get home.”

And: “Just put it on my desk. Next week will be soon enough—I should be home by then.”

At his bedside. Breathing through the nasal inhaler Ray is reading
,
trying to read—one of the books I’ve brought him from home—I am reading
,
trying to read—with what fractured concentration I can summon—the bound galley of a book on the cultural history of boxing which I am reviewing for the
New York Review of Books.
It’s a mealtime—but Ray isn’t hungry for hospital food. It’s time for his blood to be drawn—but the nurse has difficulty finding a vein
,
Ray’s arms are bruised
,
discolored.

The air in the hospital room smells stale
,
used up. Outside is a wintry-dusk February day. This afternoon there is a reading at the University sponsored by the Creative Writing Department—readers are Phillip Lopate and a visiting Israeli writer—of course I can’t attend
,
nor can I attend the dinner afterward with my writing colleagues. A hospital vigil is mostly slow time. Stalled time. In such stasis dread breeds like virulent bacteria.

And then—this happens—Ray begins talking about something I can’t follow
,
in a slow drawling voice—a confused tale of needing to get something from home—to bring to “Shannon’s house”—Shannon is a favorite nurse—Shannon has been friendly with Ray—somehow
,
in the way of dream-delirium logic
,
Ray thinks that he isn’t in the hospital but in a “house” belonging to Shannon—he is her guest
,
and I am
,
too.

So quickly this has happened
,
I’m not prepared. When I’d brought Ray to the ER a few days before he’d said a few things that were baffling to me
,
that didn’t quite make sense
,
but now he’s speaking to me as a sleepwalker might speak and this sudden change in his condition is shocking to me
,
frightening. Quickly I tell Ray no
:
he isn’t in Shannon’s house. He’s in the hospital—in the Princeton Medical Center.

Ray doesn’t seem to hear this. Or
,
hearing
,
discounts it.

His concern is something I am to bring for him
,
from home—to use here in Shannon’s house. He has an “apartment” in Shannon’s house.

Calmly I tell Ray no
:
he is not in Shannon’s house
,
he’s in the hospital where Shannon is a nurse.

“Honey
,
you’ve been very sick. You’re still sick. You have—”

But Ray is irritated with me. Ray will have to argue with me to convince me
,
yes we are in Shannon’s house.

“Honey
,
no. Shannon is a nurse. You’re in the Medical Center. You have pneumonia—you’ve been very sick. But you’re getting better—the doctor says you might be able to come home next week.”

How long we discuss this absurd issue
,
I can’t recall afterward. I am shaken
,
disoriented. This man—this slow-speaking stubborn childish man!—is no one I know.

At the nurses’ station I seek out Shannon—I ask her what has happened to my husband and she tells me not to be alarmed
,
this sort of thing happens sometimes
,
it’s common
,
it will pass. I ask her where on earth Ray has gotten the idea that he’s in her house—in an “apartment” in her house—and Shannon laughs and says yes
,
“your husband who is such a sweet man” has been saying that to me
,
too—it’s better not to upset him
,
just humor him for the time being.

Humor him. For the time being.

How embarrassed Ray would be
,
to know that he is being “humored”—this is very upsetting.

I seek out one of Ray’s doctors—Dr. B_.

Dr. B_ is Ray’s admitting physician. Dr. B_ is better known to Ray than to me
,
a very nice cordial man of early middle age. Dr. B_ will be the
Certifying Physician
on my husband’s death certificate.

Dr. B_ too tells me not to be alarmed—“delusional thinking” isn’t uncommon when a patient’s brain isn’t receiving quite enough oxygen.

My husband
,
Dr. B_ assures me
,
is only “mildly delusional”—the nasal inhaler isn’t working or he’s breathing through his mouth and not his nose as he’s been instructed. That’s why it’s good for me to remain with him as long as I can
,
Dr. B_ says
,
to “anchor” him to reality.

I am relieved—Ray is only “mildly delusional.”

I am relieved—Dr. B_ is so matter-of-fact
,
even a bit bemused. As if
,
if he had but the time
,
he could entertain me with any number of comical delusions of patients he has known—very possibly
,
previous patients in room 541 being treated for pneumonia.

Dr. B_ tells me the condition is reversible.

Reversible?

How casually this crucial term is uttered. Reversible!

Yes
,
Mrs. Smith. Reversible
,
usually.

Dr. B_ orders the nasal inhaler to be removed, the oxygen mask to be resumed. Within a short while—it’s a miracle for which I will hide away in a hospital women’s room, to weep in gratitude—my husband has returned to normal—to
himself.

Days, nights in giddy succession—like a roller coaster—at the hospital, at home—at the hospital, at home—driving into Princeton, driving out into the country from Princeton—this February has been a cheerless month yet this week—the final week of our lives together—our life—overcast mornings are suffused with a strange sourceless sunshine.

This mysterious radiance
from within.

I am relieved—more relieved than I wish to acknowledge—that Ray’s
mildly delusional
state has faded.

Not in a mood to ponder
reversible
,
irreversible
—nor in a mood to consider what is
normal
, what is
self.
Harrowing to think that our identities—the selves people believe they recognize in us: our “personalities”—are a matter of oxygen, water and food and sleep—deprived of just one of these our physical beings begin to alter almost immediately—soon, to others we are no longer “ourselves”—and yet, who else are we?

Is
the self the physical body, or is the body but the repository of
self
?

It’s the most ancient of all philosophical—metaphysical—paradoxes. You do not see a
self
without a body to contain it, yet you do not see a body without a
self
to activate it.

When my mother died at the age of eighty-six she had lost a good deal of her memory—her “mind.” Yet she had not lost her self, not quite.

She’d become severely forgetful, you might say a dimmer and less animated version of herself, as a monotype fades with repeated strikings, its subtleties lost. Yet Mom was never entirely
lost.
In a garden at her assisted living facility in Clarence, New York, we were sitting with her—my brother Fred and me—and Fred asked her if she remembered me—and Mom said, “I could never forget Joyce!”—and in that instant, this was so.

I loved my mother very much. Friends who knew us both have said how much of my mother resides in me—mannerisms, voice inflections, a way of smiling, laughing. I know that my father resides in me also. (Daddy died two years before Mom. Her
mild delusion
was that Daddy was living in a farther wing of the facility: “Over there,” Mom would say, pointing at a specific building. “Fred is over there.”)

Loving our parents, we bring them into us. They inhabit us. For a long time I believed that I could not bear to live without Mom and Dad—I could not bear to “outlive” them—for to be a daughter without parents did not seem possible to me.

Now, I feel differently. Now, I have no option.

Returning home!

What happiness—what relief—returning home!

As if I’ve been gone for days not hours.

As if I’ve traveled many miles not just a few.

Behind a ten-foot fence so faded you would not identify it as redwood—behind a part-acre of deciduous and evergreen trees—our house hovers ghost-white in the darkness—no lights within—but I thought I’d left at least one light on, that morning—I am so very very tired, I am so eager to
get inside
this place of refuge, I feel faint with yearning, I could weep with relief, exhaustion.

This nightmare vigil! The smell of the hospital clings to me—that distinctive smell as of something faintly rotted, sweetly rotted beneath the masking odor of disinfectant—as soon as you push through the slow-revolving front door and into the foyer you smell it—the smell of hospital-elevators, hospital-restrooms, hospital-corridors—the smell of Ray’s room—(what a quaint sort of usage,
Ray’s room
—until it is vacated and
Ray’s bed
filled by another)—this smell is in my hair, on my skin, my clothing. I am eager to get inside the house and tear off my contaminated clothing—I am eager to take a shower—to scrub my face, my hands—my hair that feels snarled, clotted—
But no first
:
phone
—I must check phone calls on Ray’s phone, and on my own—
No first
:
cats
—I must feed the cats, let them outdoors—skittish and distrustful they prefer to be let outside than to eat in their corner of the kitchen—
No first
:
mail
—but I am too tired to run outside to the mailbox, the very thought whirls in my brain shrinking to the size of a dot, and vanishes—
No first
:
lights
—for the house is so very dark—a cave—a sepulcher—like a crazed woman who has thrown off her manacles I run through the rooms of the house switching on lights—living room lights! dining room lights! hall lights! bedroom lights! Ray’s study lights!—I turn on the radio in the kitchen—I turn on the television in our bedroom— can’t bear this silence—you would think possibly I am rehearsing Ray’s homecoming—the entire house lighted as if a party were taking place within—
No first
:
clean
with manic energy I will vacuum the rooms of the house, lingering over the carpets, of all household tasks it is vacuuming I most enjoy for its brainless thumping and the immediate gratification it yields—there is something especially gratifying about late-night vacuuming—vacuuming into the early hours of the morning which one could not do, surely, if one’s spouse were home and trying to sleep—inspired then I will polish a selection of the household furniture—though it doesn’t really need polishing, I am eager to polish the dining room table for it’s at this table that Ray will eat his homecoming meal in a few days—I am not sure which of his favored meals I will prepare—must discuss this tomorrow—what a pleasure to polish the dining room table which can be polished to a ravishing sheen though it’s but mahogany veneer—
No first
:
Ray’s desk
—this is crucial!—I will remove the accumulation of mail from Ray’s desk—both Ray’s desks—I will polish both desks with lemon polish, to surprise him—I will straighten the items on Ray’s windowsills which include such curiosities as semi-used Post-its, ballpoint pens whose ink has long dried up, small boxes of paper clips, coiled-together rubber bands, a small digital clock with red-flashing numerals like demon-eyes glowering in the dark—charged with the urgency of my mission I will gather Ray’s scattered pens and pencils—as an editor, Ray indulges in crimson, orange, purple, green pencils!—and arrange them in some sort of unobtrusive order on his desks; I will Windex his windows, what a pleasure to swab at the glass with paper towels, as beyond the glass-surface there hovers a ghost-woman whose features are lost in shadow—it is very dark outside—moonless—somehow, it has come to be 1:20
A.M.
—no more am I inclined to lie down in that bed in that bedroom than I would lie down in a field in glaring sunshine—as a traveler in even quiet surroundings I am wracked by insomnia—the slightest alteration of my life, I am wracked by insomnia—impossible to sleep while Ray is in the hospital, and distasteful somehow—for
What if the phone rings? What if—
but housecleaning is an antidote to such thoughts, next I will peruse Ray’s closets, bureau drawers—or maybe I should sort books in the guest room, which have begun to spill over the white Parsons table—
No first
:
flowers
—as Ray welcomes me back home from a trip with flowers on my desk so I should welcome Ray back from the hospital with flowers on his desk, must remember to buy flowers at a florist—potted begonias? Cyclamen?—but which florist?—you can buy flowers at the Medical Center but—maybe not a good idea, what if they are suffused with the dread
hospital-smell
—thinking such thoughts, plotting such stratagems drifting through the rooms of the brightly lighted house singing to myself—humming loudly—talking to myself—giving detailed instructions to myself—for when there is no one to whom one can reasonably speak except two wary and distrustful cats, one must address one
self
—in my heightened mood of anxiety commingled with relief—the relief of being
home
—my uplifted sparkly voice reminds me of no one’s so much as Jasmine’s—now I remember
Mail!—
it’s urgent to place Ray’s mail in rows, neatly—for a magazine editor receives many items of mail daily—this mail I will sort: personal, business, important, not-important—all advertisements discarded—like a diligent secretary I open envelopes, unfold letters so that at a glance Ray can absorb their contents; since Ray entered the hospital I’ve been paying bills, a household task Ray usually does, and these bill stubs I will set out for Ray to see, and to record; for Ray keeps assiduous financial records; you will say
But it isn’t necessary to pay bills immediately when they arrive—you can wait—you can wait for weeks!—
but in waiting there is the threat of forgetting, there is the threat of chaos—there is the threat of totally losing control; now in the snowy courtyard there are shadowy hulks like crouching animals, these are UPS and FedEx deliveries for
Raymond Smith
,
Ontario Review
,
Inc.
which I haven’t noticed until now—2:20
A.M.
—it seems to me urgent to haul these packages inside the house, struggle to open them—several are deliveries Ray has been asking about, and so tomorrow I must bring them to the hospital—page proofs, galleys—proofs of book jackets—there is a special pleasure in bringing Ray something he has requested—something attractive, striking—page proofs for the May issue of the
Ontario Review
cover feature on the artist Matthew Daub whose watercolors of small Pennsylvania towns and rural landscapes Ray so admires—something that will be cheering to Ray in his grim hospital room, something we can share—as for more than thirty years we have shared planning issues of
Ontario Review
and books published by Ontario Review Press—in my dreamy state staring at reproductions of Matthew Daub’s watercolors—thinking how much happier visual artists must be, than writers—writers and poets—we whose connections to the world are purely verbal, linear—through language we are beseeching others who are strangers to us not merely to read what we have written but to absorb it, be moved by it, to
feel—
then with a jolt I remember—
Postpone trip!—
this is urgent—I must postpone our upcoming trip to the University of Nevada at Las Vegas where our writer-friend Doug Unger has invited Ray and me to speak to graduate writing students—this trip, long-planned, is within two weeks—impossible so soon; maybe later in the spring, or maybe in the fall, Ray has suggested—
Tell Doug I’m really sorry
,
this damned pneumonia has really knocked me out
—I will send Doug an e-mail for I can’t force myself to telephone anyone, even friends, especially friends—abruptly then another thought intrudes—even as I am preparing to write to Doug on my computer—
No
:
“Vespers”—
at 2:40
A.M.
I am moved to play a CD—Rachmaninoff’s “Vespers”—one of Ray’s favorite pieces of music—sonorous choral music of surpassing beauty which Ray and I heard together at a concert years ago—it might have been in Madison, Wisconsin—when we were newly married—when the great adventure of accumulating a
record collection
together had just begun—beautiful haunting wave-like “Vespers” which a few months ago I’d heard, returning home from a trip climbing out of the limousine in the driveway and smiling to hear this thrilling music from inside the house where Ray has turned the volume up high, to hear in his study, and thinking
Yes. I’m home.

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