Authors: Stephen P. Kiernan
I WOKE THE NEXT MORNING
to a clanking in the house. Dawn was still hours away, and I lay there listening. Had I dreamed it? But then the sound came again: Michael’s weights, from the basement. Changing the circular plates of iron on the bar, that was the source of the clanking. He was lifting again.
Michael had never felt weak to me, even the skinny version of him that came home from the war. But I had fallen in love with a big man, burly and strong. As I imagined him down there beside the furnace and water heater, red-faced under the bench press, or squinting his whole face during a slow bicep curl, I felt supremely glad for him. Maybe exercise would teach his brain how to make endorphins, the pleasure chemicals, once again. Maybe lifting would wring out some of his anguish.
Perhaps his arms would become mighty again too. I rolled onto my back and played an old movie for myself. We were making love on our wedding night, I will never forget, and Michael stood from the bed, his arms hooked under my legs, and he held me in the air while we continued moving together. I was splayed and powerless, hanging against him with my arms around his neck, while he was tireless, as if I weighed nothing. But he did not use my vulnerability to hurt me. He used it to bring me joy. He held me in the air and kissed my throat. I surrendered to him with all that I had.
Thus I did the most unexpected thing, that morning, while he strained and sweated, and the weights clanked from below like the plumbing of an old house: I fell back to sleep.
And woke hours later to a silent home. By then Michael had left on his long march to work. I stood in the kitchen waiting for the coffee to brew, thumbing absently through the newspaper. Flipping it aside, I found one of his paper piles beneath. I leaned over, studying the drawings once again. Who were these people, and what had happened to make them unforgettable? The man in sunglasses, the one with the squiggle beside him, the one with mouse ears. Something was different. I couldn’t see what, but these pages were not like those of the previous days.
I poured a steaming mug, checked emails from Central Office, but kept returning to the table. What had changed? I spread the three sheets of paper out beside each other. I took a sip.
And then I realized. Usually his drawings required four pages. I went to the recycling bin and fished out a fistful of papers. Sure enough, each day: four.
So I counted the faces on the previous night’s sheets. Twenty-nine.
Regardless of what happened for me at the shooting range, something had shifted in Michael too. He spent the early hours lifting weights. He had two fewer ghosts haunting him.
I knew it was a milestone, but there was no one I could celebrate with. Except perhaps Barclay Reed. I wanted, and with urgency, to inform him that he had been right. My going onto Michael’s turf, my willingness to learn a warrior’s weapon, had helped to heal one of his wounds. Or no: two.
I wanted to know what else the Professor would suggest.
First, however, I had to confess that I had been unfaithful.
“He wasn’t an expert,” I explained. “Just a Vietnam veteran who knew military history. So I asked him.”
“Nurse Birch, you disappoint me beyond words.” Barclay Reed furrowed his brow. “Did you not consider this conduct a violation of your promise? Not to consult outside sources before deciding whether
The Sword
was true?”
“I don’t think I broke any promise, Professor. I was making conversation. Besides, he didn’t know anything.”
He folded his arms. “Well, I
am
sure. Furthermore—”
But his eyes bugged before he could continue; he leaned onto his side and threw up. The Professor’s startled expression revealed that he was every bit as surprised as me. It was like a beard of nasty on his chest.
“That’s too bad,” I said. “Let’s get you cleaned up.”
He blinked at me slowly, like an owl, and vomited again.
It was a long morning. Barclay Reed’s body had involuntary work to do. I did what I could to help him, providing a basin, fresh clothes and bedding, a bath at noon. But even after his stomach was empty, it continued to heave so hard that he broke out in a sweat. He was in misery. We could do things to prevent an episode like this from happening again. But for now, the contractions would cease only when his body had finished what it needed to do.
“Should I go to a hospital?” he asked late in the morning.
“You could. That’s a choice you could make.”
“Isn’t my treatment your decision? You are the expert.”
“As you would say, let’s consider.” I wiped his forehead with a damp cloth. “One possible explanation for what you’re doing today could be an obstruction. If you go to the hospital, a doctor will thread a nasogastric tube up your nose and down into your stomach, where it will remain for up to four days. If there actually is an obstruction, you’ll undergo surgery to resect your bowel—basically cutting out the blocked area and sewing everything back together. Plus whatever recovery time that requires.”
The Professor’s face went blank, all emotion suppressed. “I presume there is an ‘or’ coming?”
“Well, yes. Or you can stay here, and wait, and see if the discomfort passes, and you are spared the whole ordeal. Obstructions are usually painful, and you seem to have more nausea than pain. So you have a choice.”
He stared past me. “I accept your recommendation, Nurse Birch.”
“But I didn’t—”
“I accept, I said.”
And he continued to be ill.
Toward evening a gentle misting rain began, easing the humidity and bringing a feeling of calm. I bundled the Professor in a blanket and wheeled him to the sliding doors. As I opened both of them wide, he took a huge slow breath.
The rain made a washing sound against the lake’s surface, which splashed from the raindrops like a million eyes winking. Even so, perhaps because there was no wind, someone was out waterskiing by the point.
“Blasted fools,” the Professor muttered.
“I imagine the rain would sting,” I said.
“And I imagine they think they will live forever.”
We stayed there, me standing behind his chair like a knight’s vassal, while the storm dwindled and grew quiet. He fidgeted with the blanket, tugged on the tuft of hair at the crown of his head, shifted in the chair.
“Yes, Professor?”
“That stomach distress today. I gather there is no obstruction.”
“Apparently not.”
He sighed. “The descent commences. I am going to die.”
A perfectly healthy person would want to die, I thought, after the morning you just put in. But I didn’t say it, or speak at all. I used the pause to think. What door was he opening with this conversation? How could I help?
“Professor Reed,” I said, “has anyone ever told you about the Four Questions exercise?”
“What would give you the idea that I am up to any form of exercise?”
I chuckled. “This isn’t a physical workout. It’s an emotional checklist.”
“Explain.”
“Sometimes people have unfinished work in their lives, in their relationships. The Four Questions clarify what work remains, to help get it done productively.”
“Has today not been uncomfortable enough for your patient? Must we embark on self-actualization as well?”
“We don’t have to, of course.” I studied the back of his head, the white bristling hair. But his posture remained as erect as a soldier at attention, so I ventured one step further. “I’ll just say that often people find that physical symptoms are alleviated by greater emotional calm.”
“If this exercise of yours prevents future days like today, I am willing.”
“I can’t guarantee anything, Professor.”
He gave a papal wave. “Proceed.”
I tucked the blankets snug against him. “Be right back.”
From the kitchen I fetched a clipboard. On the way I remembered the first time I’d seen a patient answer the Four Questions.
Her name was Alaina, she’d been a dancer, then founded a dance school for children. She was eighty-four and suffering. Her breath came in bursts, shallow and pinched, though the chart at the nursing station said her metastatic ovarian cancer had no respiratory involvement. Try telling that to the woman struggling for breath.
This happened early in my clinicals, during a rotation at an inpatient hospice house. The facility served people who were dying, and whose family could not care for them at home: hundred-pound granny can’t turn three-hundred-pound grandpa in bed, spouse of a dementia patient is exhausted, or, as in Alaina’s case, devoted husband injures his knee from too many trips up and down the stairs while caring for bedridden wife.
On that day I was shadowing a seasoned social worker who turned to me in the doorway. “I think she is ready for something beautiful to happen.”
I could not imagine what that might be, considering the skeletal woman in the room whose breath came in gulps. While I lagged with misgivings, the counselor strode in with a cheery hello. Sitting in Alaina’s bedside chair, she took out a pen, raised her clipboard, and asked four questions:
“Is there anyone you need to say ‘I’m sorry’ to?”
“Is there anyone you need to say ‘I forgive you’ to?”
“Is there anyone you need to say ‘thank you’ to?”
“Is there anyone you need to say ‘I love you’ to?”
“Yes,” Alaina wheezed, giving one or two names for each question.
“Six people in all,” the counselor said, flipping to a fresh page. “Who would you like to dictate a letter to first?”
“A letter?” Alaina’s face looked confused. Her eyes searched the room, coming to rest on me. I smiled at her nervously, and she turned to the counselor.
“Lydia. I would like to forgive my daughter.”
The volunteer spoke as she wrote: “Dear . . . Lydia . . .”
And Alaina, there in her dying bed, stopped panting. It was immediate, and not at all subtle. Her breath eased. Her shoulders relaxed.
“Dear Lydia,” she began. “I have loved you from the moment I knew I was carrying you.”
BARCLAY REED HAD ROLLED
his wheelchair closer to the doors. He was leaning forward, elbows on his thighs. I slowed, not wanting to interrupt, but he must have heard me. “Nurse Birch, do you have favorite smells?”
“I think you are enjoying one of them right now.”
He nodded. “It’s fascinating. Although I’m unschooled in neurology, I know that scent and memory are connected in some fashion. Yet while I am seated here, I cannot remember when I last smelled anything consciously.”
“We visited your azaleas not too long ago.”
“True. That was sublime.” The Professor sat back in his chair. “So is this. Rain on a lake. A pity you can’t bottle it.”
“If we could smell this all the time, it might become less special.”
He half-turned his head, eyeing me. “What is this exercise you’ve been plotting? Not another legal form I must sign?”
“Not at all. I just ask you four questions, and you answer them. Maybe there’ll be more for you to say, if you want, but that’s it.”
He tugged on the tuft of his hair. “Do your worst.”
“Is there anyone you want to say ‘thank you’ to?”
His hand came down at once. “I beg your pardon?”
“Is there anyone you would like to say ‘thank you’ to?”
“What is this game, Nurse Birch?”
“This exercise investigates whether you have unfinished business in your emotional life, and maybe it will spark some communication.”
“You wish to know if I have anyone to thank.”
“If you said someone’s name, I would write it down. And after all four questions, you might dictate a letter to me for that person, saying whatever you wanted to express. In some cases I’ve seen—”
“You imagine there is someone to whom I owe a debt of gratitude that has gone somehow unexpressed?”
“I don’t imagine anything,” I said. “I’m just asking a few simple—”
“What the hell else?”
“I’m sorry?”
“I mean, the audacity of this inquisition.”
“It’s not an inquisition. And if you really don’t want to—”
“Don’t you dare try backing out.” He wheeled to face me. “You had some purpose in ruining my reverie.”
“Yes, I did: to help you.”
“By reminding me that every stick of furniture in this house, every page I’ve published, every credential or accolade I’ve ever received was attained despite competition, politics, professional jealousy, and spite? And you want to know if I am grateful? You want to know who I would
thank
?”
“Well, some people do find—”
“I spit on everyone.” His eyes were wild. “I did it alone.”
“OK, OK. I didn’t mean to—”
“What are the other questions? You said there were four.”
I stared at the clipboard, though of course I’d written nothing there. “It’s obvious I’ve made a mistake here.”
“Don’t weasel. You are accountable for this so-called exercise. I want to know the other three. Ask me, Nurse Birch.”
“Professor.” I set the clipboard on a side table. “I intended to do something peaceful, and instead I’ve made you angry. I apologize.”
“Ask me.”
I closed my eyes. How could I have misread him so completely? I opened them, and he was glaring at me like a bull about to charge.