Dr. Barnardo was especially concerned about Janis when Bellow was first intubated, but “she held up pretty well.” He describes her as “a very strong factor in him getting out of the hospital as quickly as he did.” Bellow “didn’t have a voice….We had him very heavily sedated.” Janis was his voice. “Because he was so overwhelmed,” Dr. Barnardo remembers, “I wasn’t sure he was interested in all the torture we were going to put him through, if he’d known about the tube [the ventilator] and so forth.” In addition to intubation, the torture included lumbar spinal taps, endoscopies, cystoscopies, MRIs, CAT scans, catheterizations, and “interminable medications,” to deal not only with blacked-out lungs but bladder infections and heart failure. Only after Bellow was extubated could the doctors “tell he was pushing himself to get back. I remember vividly he was sitting there with a pile of books at his bedstand doing research. I said, ‘What are you doing?’ He said: ‘I’m writing.’ ”
Bellow’s memories of his time in intensive care were sparse and confused, a product in part of delusions or hallucinations, in part of retrograde amnesia, both caused by heavy sedation. In a speech of April 13, 1997, in Chicago, at a medical conference (“Contemporary Health Care and the Ethic of Medicine: What Is a Physician to Do?”), as well as in a memoirlike story of the same year, “View from Intensive Care,” he remembered being certain of only three things: “someone pounding me on the back and ordering me to breathe”; being turned over “many times”; and Janis’s presence. “While I struggled to breathe, she would lift the oxygen mask and swab the inside of my mouth….My divided consciousness recognized at all times that she was present and that she was determined that I should live.”8 He had no idea where he was. Often, in his delusions, it seemed to him that he was underneath Kenmore Square in Boston. In “View from Intensive Care,” he recalls thinking he was in a vast cellar with soiled brick walls “as white as cottage cheese” (p. 74). One especially vivid delusion, recounted in the medical-convention address, caused real-life physical pain:
Before my release from ICU I climbed out of bed, thinking that I was at home in wintry Vermont, and that one of my granddaughters was skiing around the house. I was annoyed with her parents for not having brought her in to see her afflicted grandpa….It was a winter morning, so I thought. Actually it must have been the middle of the night. I climbed over the bed rail without noticing that I was attached by needles and tubes to hanging flasks and intravenous needles. I saw, as if they were someone else’s, my bare feet on the sunny floor. They seemed unwilling to bear my weight but I forced them to obey my will. Then I fell, landing on my back. At first I felt no pain. All I was aware of was my helplessness. An orderly ran up and said, “I heard you were a troublemaker….” I had been out for many weeks [pp. 1–2].
Bellow was on heavy doses of heparin, a blood thinner, at the time of the fall. He began bleeding internally, and his “hugely inflamed” back looked, he was told, “like a forest fire.” The nurses decided to put him into a restraining vest, so “I asked my grown sons to call a cab; I’d be better off at home, soaking in the bath” (p. 2).
A version of this delusion appears in “View from Intensive Care,” as does the unfriendly orderly, whom the narrator says he’d “taken notice of” earlier (noticing being “part of my job description”). As the orderly hangs Christmas tinsel and mistletoe from the wall fixtures, the narrator notes “his sloping shoulders and wide backside” (p. 75). Later in the delusion, the orderly kicks him out of the hospital, saying, “We need the space” (p. 76). The narrator identifies himself as “a tabloid publisher” (but if so why is “noticing” part of his job description?). For those with knowledge of “All Marbles Still Accounted For,” the novel Bellow was at work on in St. Martin, it is tempting to see the narrator as a depiction of Bellow himself under a toxin-induced or sedation-induced delusion: that he was Hilbert Faucil, the novel’s hero, a tabloid publisher.
In another delusion recounted in “View from Intensive Care,” the narrator’s ex-wife appears. Her name is Vela, which is the name of Chick’s ex-wife in Ravelstein, a character modeled on Alexandra. In the delusion, Vela is described as having left the narrator on his seventy-fifth birthday, after ten years of marriage. She “declared and also silently asserted that she was a real beauty. And something else, which may be rendered, translated or explicated as: ‘Judge for yourself what sort of match I made in marrying this deficient person—nothing but a tabloid publisher’ ” (p. 77). A companion joins her: “a Spanish-looking and very elegant male person in his mid-to-late twenties” (a cross between Maggie Simmons’s young French lover, Jacques, and the elderly Argentinian mathematician Alberto Calderon, whom Alexandra married after Bellow, and whom Bellow suspected she’d been seeing during their marriage). Vela explains to the narrator: “Until now I never had any experience of glamorous sex and I figured, in what you always call the sexual revolution, I should have a sample of it—to find out once and for all what I was deprived of with you” (p. 78). Later, Vela and the narrator are in a bank and she suggests to him that he freeze himself for a hundred years, through cryonics, while she “did lewd things with the Spanish boyfriend.” At the end of “View from Intensive Care,” the delusions seem to give way, though the narrator’s wife is not so sure. “ ‘That meeting in the bank you believe in,’ my wife, the real wife, later said, after I described this moment to her. ‘Why should it be always the worst things that appear to you so real? I’ll never be able to talk you out of being sadistic to yourself.’ ” In the story’s last sentence, the narrator identifies this real wife as “Trudi” (p. 81).
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IT TOOK A MONTH, Bellow recalls in the medical conference address, for the pneumonia to be defeated, the sedation to be reduced, the delusions and hallucinations to recede, and for him to be transferred from ICU to a regular room, “ ‘on the floor,’ in hospital lingo” (p. 2). Dr. Barnardo and another doctor from ICU came to visit, bearing gifts. The other doctor brought “soup from her own kitchen”; Dr. Barnardo “made some lasagne and meatballs and brought it in and [Bellow] actually ate them.”9 At this point, with his lungs cleared, everything else that was wrong with Bellow needed addressing. “My body was wasted—unrecognizable. My sphincters were haywire. I could not walk. I had lost the use of my hands. The extent of recovery possible could not be estimated; I would soon be eighty years of age.” Among smaller problems, “my upper lip was (to put it in my own way) lame. Even when I spoke or laughed it was strangely immobile or partially paralyzed” (p. 3). When given paper and pen and asked to draw something, he couldn’t. He couldn’t sign his name or eat his soup.
In the intensive-care unit, Bellow had been dimly aware of resisting death. Now he had to decide “whether I should or should not make efforts to recover” (p. 4), a decision that required he be “as clear as possible, or as frank as I had the strength to be,” about what he could expect. For example, “I could not expect to recover the powers of a sixty or seventy year old” (p. 5). Janis’s determination to keep Bellow alive figured heavily in his calculations, “so that in addition to what 19th century old timers called aviditas vitae, I had to keep going in order to deserve a wife who put up such a fight for my not-so-precious-life” (p. 4). The doctor in charge of Bellow’s recovery was the senior neurologist at the hospital, Daniel S. Sax, who “overwhelmed” Janis with questions but refused to speculate on Bellow’s long-term prospects. When Dr. Sax learned that Bellow played the recorder, he encouraged Janis to bring it in for Bellow to play: for the good it would do his fingers and paralyzed facial muscles as much as his spirits. Sometimes Bellow asked Dr. Sax larger questions, about tenacity and the kind of life worth living: “He steered me towards other subjects—books, music, anything except my dilapidated biological foundations. But he came several times a day to see me, at odd hours….He asked me a great deal about a course I was giving in the next term. He wanted to hear all about the reading list. Before I
knew it he had me outlining lectures….He brought me back to the subject again and again with great cunning” (p. 6). Bellow “longed” to be told he would regain his strength (p. 5). Only in retrospect, when writing up notes for the medical-conference speech, did he come to appreciate “how much tact there was in the doctor’s conduct and to see that he knew perfectly well how much I needed him to see me through” (p. 6).
It was Dr. Sax who made the diagnosis of ciguatera, almost a month after Bellow had been admitted to the hospital. That his colleagues at the hospital doubted and disputed this diagnosis, Bellow suspected, may have had something to do with the frequency of his visits (it may also have mattered that his patient was famous, though Bellow says nothing of this). “I was able up to a point to separate [Sax’s] professional motives from his other interests. The fact is that he knew I needed his ‘personal’ visits, his daily presence—that I depended on it” (p. 7). When asked about Dr. Sax, Dr. Barnardo described him as “a classic neurologist who was trained in the old school: clinical history and physical examination told you everything; then you get the CAT scan, then you go to the technology. He was a neurologist who got his information from his patients and developed everything around what he heard and what he sensed from his patients first.” Under Dr. Sax’s care, Bellow gradually recovered the use of his hands and fingers; he was able to pick up a ballpoint pen, though “the best I could write was a cramped small circle.” Sax set him long-division and multiplication tasks, the sort that reminded Bellow of the challenges thrown to David Copperfield by his stepfather: “Nine dozen cheeses @ 2 pounds, eight shillings, four pence. It shouldn’t take you more than three minutes.” Soon Bellow was adept enough with the pen to sign checks “and began to pay hundreds of bills.” In his early days “on the floor,” when he failed to name the day of the week, Dr. Sax was tough with him: “Now don’t tell me you live on a superior plane and don’t have to know exact dates….From now on you’ll know the date, like any normal person. You’ll check it out every morning and you’ll be sure from now on to know the day of the week and the exact calendar date.” Soon after, Sax came in “and pinned a calendar on the wall for me. The doctor had observed that my days were a morass of negligence and I was demoralized and drifting and losing heart in slackness and disorder” (pp. 5, 8).
In the medical-convention speech, Bellow refers to Dr. Sax as Dr. X, because, he explains to Sax in a letter of January 5, 1998, three years after the event, “I was unwilling to use your good name without permission….In any case you are the Doctor X who brilliantly diagnosed my disorder—a case of cigua-toxin; from which, with your help, I am still slowly recovering.” In the speech itself, he praises Sax more fully, while also considering the differences between medical virtues and those of his own profession:
I am deeply grateful to the doctors and nurses who saved me within intensive care. But I wonder if I would have been able to come back without Dr. X. And I have given Dr. X a lot of thought. And what I see for him goes something like this. The doctor’s outlook, if you prefer, his ideology, is humane. But his training is in science. And science does not see nature as having a soul. But the neurologist, Dr. X, whether he was aware of it or not, did have a soul. He was capable of compassion. So he came early in the morning or late at night, and on the weekends. Nothing is more disheartening or killing than a sickness late in life, when your capacity for recovery is low. I often think that Dr. X understood my condition in the widest sense—beyond blood pressure, beyond the loss of muscle mass (one of his terms), beyond the nerve damage. I can’t say [what] he understood of his understanding and that he was “conscious” of it. But that is the difference between his kind of work and my kind of work [p. 11].
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ON JANUARY 5, 1995, after over a month in intensive care and almost two weeks on the floor, Bellow returned to the apartment at 73 Bay State Road. The class that Dr. Sax had taken such an interest in would start two weeks later. It was on Joseph Conrad and, understandably, had been canceled when Bellow was in ICU. After rescheduling, it was held in the apartment, and Bellow taught it alone. The class was small. Chris Walsh, who was auditing, remembers Bellow as “hollowed out by his illness. Mentally altogether there, physically drained but trying to husband his energies, and slowly rebounding.” The day after the first session, on January 19, Bellow wrote to John Silber to thank him for “saving my life”: “The doctors agree that if I had not been rushed to the hospital on Thanksgiving Day, I would not have lived through the weekend.” Silber wrote back, on January 22, to say that all he’d done was to contact the dean of the School of Medicine, who ensured that Bellow was immediately put into intensive care, “where you belonged”: “The person who really saved your life was Janis.”
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HALF A YEAR LATER, on June 18, 1995, a week after his eightieth birthday, Bellow wrote to his friend John Hunt to tell him of his illness. While in the hospital, “I wasn’t certifiably unconscious but neither was I in any ordinary sense conscious….‘Recovery’ was a euphemism for infantile weakness. I had to learn to walk again, to go to the toilet like an adult, to tell time, etcetera.” He was now better, but still not “normal.” “I take huge doses of blood-thinners, and I am warned that to swallow two aspirins may be fatal. I do now and then write something, and I can read again….All the granite I depended on has turned to loose sand and gravel. This is the dérèglement de tous les sens [disordering of all the senses] Rimbaud was sold on.” A week later, Bellow received a letter from Alexandra—Vela in his delusions, also in his fiction. She had heard of both his illness and his recovery: “Now I hope you will go on to enjoy the years ahead and to prove that there is life after eighty, just as you proved that there was life after the Nobel Prize. As always, ergodically yours, Alexandra.” On July 28, Bellow reported to Saul Steinberg that he “was again caught in an undertow—one of the drugs I was taking had swollen my tongue and my palate to such an extent that I was unable to swallow.—I was, in short, choking to death. And once more, rallying, I pulled through.” On September 30, he apologized to Martin Amis for not having written. “For the better part of a year,” he had been convalescing, “unable to pull myself together.” Often he felt “that I never shall recover—I’m too old to do it.” Despite medication and a pacemaker, the persistent fluttering of his heart produced “unbearable sluggishness….I have just enough stamina to write for an hour or two, and then I go back to bed for a siesta! I take a good many drugs—‘beta-blockers’—and these affect the brain weirdly. I am easily depressed. The days fly away, the weeks are uncontrollable, the months and the seasons are like the merry-go-round.” “Derangement and drift,” he tells Amis, mark his days, relieved only by the pleasure of “being in Janis’s company, and in the weather, the summer blues and greens.” Only toward the end of the letter does Bellow rally slightly, with something of his old bite. Debility is not all loss. “I haven’t been well enough to see the shoulderless Atlas—that’s an unmixed benefit—a very considerable plus.”
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JAMES ATLAS WAS NOT the only person to rouse ill-feeling in Bellow after his release from the hospital. Rachel Schultz was rebuked for urging the doctors to prescribe Versed: “Uncle Saul hated the way it made him feel. He said he was a person who really worked hard to remember things and he was angry that he was given a drug that was meant to make him forget. He said he struggled to remember while they were giving the drug to him and that it was quite a battle. He was angry at me when I told him it was my idea to switch him from the Valium (which also does the same thing as the Versed)….He gave me a real earful!” But Rachel stuck to her guns, explaining to Bellow her fears about weaning him off the ventilator had he not switched sedatives. He forgave her “grudgingly,” recognizing that Versed “was the lesser of two evils.”10
There were problems with Greg as well. As Greg writes in his memoir, shortly after Bel
low “was wakened from his induced coma, Janis made it clear that she was in charge and, despite appearances, had the strength for the job.” After two weeks “hanging on every medical detail…I had no reason not to trust Janis. I told her I had no wish to be burdened with his physical care or to make decisions.” Greg gives no indication of why Janis may have thought otherwise, adding, “Silently I thought that a man who had left three sons in the custody of their mothers could not expect them to care for his day-to-day welfare.”11 Some months after Bellow left the hospital, Lesha visited him in Vermont, a visit Greg describes in his memoir:
With Janis sitting quietly by, Saul, in a rage at his sons, told her that while he was in a coma, Adam, Dan, and I expressed a desire for our father to die so that we could inherit his estate. Lesha shot back, “That’s ridiculous, the boys came to Boston to help.” Further angered, Saul challenged Lesha to check it out for herself if she didn’t believe him. Shocked and frightened by the damage that could result, Lesha called me. Angry about a report I knew to be false, I grudgingly repeated the entire chronology that I had relayed to her over the phone from Boston while Saul was in a coma.12
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