The Year of Magical Thinking

by Joan Didion

  5.

  There was something else I was taught growing up in California. When someone appears to have died you find out for sure by holding a hand mirror to the mouth and nose. If there is no exhaled moisture the person is dead. My mother taught me that. I forgot it the night John died. Is he breathing, the dispatcher had asked me. Just come, I had said.

  December 30, 2003.

  We had seen Quintana in the sixth-floor ICU at Beth Israel North.

  We had noted the numbers on the respirator.

  We had held her swollen hand.

  We still don’t know which way this is going, one of the ICU doctors had said.

  We had come home. The ICU did not reopen after evening rounds until seven so it must have been past eight.

  We had discussed whether to go out for dinner or eat in.

  I said I would build a fire, we could eat in.

  I have no memory of what we meant to eat. I do remember throwing out whatever was on the plates and in the kitchen when I came home from New York Hospital.

  You sit down to dinner and life as you know it ends.

  In a heartbeat.

  Or the absence of one.

  During the past months I have spent a great deal of time trying first to keep track of, and, when that failed, to reconstruct, the exact sequence of events that preceded and followed what happened that night. “At a point between Thursday, December 18, 2003, and Monday, December 22, 2003,” one such reconstruction began, “Q complained of ‘feeling terrible,’ flu symptoms, thought she had strep throat.” This reconstruction, which was preceded by the names and telephone numbers of doctors to whom I spoke not only at Beth Israel but at other hospitals in New York and other cities, continued. The heart of it was this: On Monday, December 22, she went with a fever of 103 to the emergency room at Beth Israel North, which had at the time a reputation for being the least-crowded emergency room on the Upper East Side of Manhattan, and was diagnosed with the flu. She was told to stay in bed and drink liquids. No chest X-ray was taken. On December 23 and 24 her fever fluctuated between 102 and 103. She was too ill to come to dinner on Christmas Eve. She and Gerry canceled plans to spend Christmas night and a few days after with his family in Massachusetts.

  On Christmas Day, a Thursday, she called in the morning and said she was having trouble breathing. Her breathing sounded shallow, labored. Gerry took her back to the emergency room at Beth Israel North, where X-rays showed a dense infiltrate of pus and bacteria in the lower lobe of her right lung. Her pulse was elevated, 150-plus. She was extremely dehydrated. Her white count was almost zero. She was given Ativan, then Demerol. Her pneumonia, Gerry was told in the emergency room, was “a 5 on a scale of 10, what we used to call ‘walking pneumonia.’” There was “nothing serious” (this may have been what I wanted to hear), but it was nonetheless decided to admit her to a sixth-floor ICU for monitoring.

  By the time she reached the ICU that evening she was agitated. She was further sedated, then intubated. Her temperature was now 104-plus. One hundred percent of her oxygen was being supplied by the breathing tube; she was not at that point capable of breathing on her own. Late the next morning, Friday, December 26, it was learned that there was now pneumonia on both lungs, and that this pneumonia was, despite the massive IV administration of azithromycin, gentamicin, clindamycin, and vancomycin, growing. It was also learned—or assumed, since her blood pressure was dropping—that she was entering or had entered septic shock. Gerry was asked to allow two further invasive procedures, first the insertion of an arterial line and then the insertion of a second line that would go close to the heart to deal with the blood pressure problem. She was given neosynephrine to support her blood pressure at 90-plus over 60-plus.

  On Saturday, December 27, we were told that she was being given what was then still a new Eli Lilly drug, Xigris, which would continue for ninety-six hours, four days. “This costs twenty thousand dollars,” the nurse said as she changed the IV bag. I watched the fluid drip into one of the many tubes that were then keeping Quintana alive. I looked up Xigris on the Internet. One site said that the survival rate for sepsis patients treated with Xigris was 69 percent, as opposed to 56 percent for patients not treated with Xigris. Another site, a business newsletter, said that Eli Lilly’s “sleeping giant,” Xigris, was “struggling to overcome its problems in the sepsis market.” This seemed in some ways a positive prism through which to view the situation: Quintana was not the child who had been a deliriously happy bride five months before and whose chance of surviving the next day or two could now be calibrated at a point between 56 and 69 percent, she was “the sepsis market,” suggesting that there was still a consumer choice to be made. By Sunday, December 28, it had been possible to imagine that the sepsis market’s “sleeping giant” was kicking in: the pneumonia had not decreased in size, but the neosynephrine supporting her blood pressure was stopped and the blood pressure was holding, at 95 over 40. On Monday, December 29, I was told by a physician’s assistant that after his weekend absence he had come in that morning to find Quintana’s condition “encouraging.” I asked what exactly had encouraged him about her condition when he came in that morning. “She was still alive,” the physician’s assistant said.

  On Tuesday, December 30, at 1:02 p.m. (according to the computer), I made these notes in anticipation of a conversation with one more specialist to whom I had placed a call:

  Any effect on brain—from oxygen deficit? From high fever? From possible meningitis?

  Several doctors have mentioned “not knowing if there is some underlying structure or blockage.” Are they talking about a possible malignancy?

  The assumption here is that this infection is bacterial—yet no bacteria has shown up in the cultures—is there any way of knowing it’s not viral?

  How does “flu” morph into whole-body infection?

  The last question—How does “flu” morph into whole-body infection?—was added by John. By December 30 he had seemed fixed on this point. He had asked it many times in the preceding three or four days, of doctors and of physicians’ assistants and of nurses and finally, most desperately, of me, and had never received an answer he found satisfactory. Something in this seemed to defy his understanding. Something in this defied my own understanding, but I was pretending that I could manage it. Here it was:

  She had been admitted to the ICU on Christmas night.

  She was in a hospital, we had kept telling each other on Christmas night. She was being taken care of. She would be safe where she was.

  Everything else had seemed normal.

  We had a fire. She would be safe.

  Five days later everything outside the sixth-floor ICU at Beth Israel North still seemed normal: this was the part neither of us (although only John admitted it) could get past, one more case of maintaining a fixed focus on the clear blue sky from which the plane fell. There were still in the living room of the apartment the presents John and I had opened on Christmas night. There were still under and on a table in Quintana’s old room the presents she had been unable to open on Christmas night because she was in the ICU. There were still on a table in the dining room the stacked plates and silver we had used on Christmas Eve. There were still on an American Express bill that came that day charges from the November trip we had made to Paris. When we left for Paris Quintana and Gerry had been planning their first Thanksgiving dinner. They had invited his mother and sister and brother-in-law. They were using their wedding china. Quintana had come by to get my mother’s ruby crystal glasses. We had called them on Thanksgiving Day from Paris. They were roasting a turkey and pureeing turnips.

  “And then—gone.”

  How does “flu” morph into whole-body infection?

  I see the question now as the equivalent of a cry of helpless rage, another way of saying How could this have happened when everything was normal. In the cubicle where Quintana lay in the ICU, her fingers and face swollen with fluid, her lips cracked by fever around the breathing tube, her
hair matted and soaked with sweat, the numbers on the respirator that night indicated that she was now receiving only 45 percent of her oxygen through the tube. John had kissed her swollen face. “More than one more day,” he had whispered, another part of our family shorthand. The reference was to a line from a movie, Richard Lester’s Robin and Marian. “I love you more than even one more day,” Audrey Hepburn as Maid Marian says to Sean Connery as Robin Hood after she has given them both the fatal potion. John had whispered this every time he left the ICU. On our way out we managed to maneuver a doctor into talking to us. We asked if the decrease in delivered oxygen meant that she was getting better.

  There was a pause.

  This was when the ICU doctor said it: “We’re still not sure which way this is going.”

  The way this is going is up, I remember thinking.

  The ICU doctor was still talking. “She’s really very sick,” he was saying.

  I recognized this as a coded way of saying that she was expected to die but I persisted: The way this is going is up. It’s going up because it has to go up.

  I believe in Cat.

  I believe in God.

  “I love you more than one more day,” Quintana said three months later standing in the black dress at St. John the Divine. “As you used to say to me.”

  We were married on the afternoon of January 30, 1964, a Thursday, at the Catholic Mission of San Juan Bautista in San Benito County, California. John wore a navy blue suit from Chipp. I wore a short white silk dress I had bought at Ransohoff’s in San Francisco on the day John Kennedy was killed. Twelve-thirty p.m. in Dallas was still morning in California. My mother and I learned what happened only when we were leaving Ransohoff’s for lunch and ran into someone from Sacramento. Since there were only thirty or forty people at San Juan Bautista on the afternoon of the wedding (John’s mother, his younger brother Stephen, his brother Nick and Nick’s wife Lenny and their four-year-old daughter, my mother and father and brother and sister-in-law and grandfather and aunt and a few cousins and family friends from Sacramento, John’s roommate from Princeton, maybe one or two others), my intention for the ceremony had been to have no entrance, no “procession,” to just stand up there and do it. “Principals emerge,” I remember Nick saying helpfully: Nick got the plan, but the organist who had materialized did not, and suddenly I found myself on my father’s arm, walking up the aisle and weeping behind my dark glasses. When the ceremony was over we drove to the lodge at Pebble Beach. There were little things to eat, champagne, a terrace that opened onto the Pacific, very simple. By way of a honeymoon we spent a few nights in a bungalow at the San Ysidro Ranch in Montecito and then, bored, fled to the Beverly Hills Hotel.

  I had thought about that wedding on the day of Quintana’s wedding.

  Her wedding was simple too. She wore a long white dress and a veil and expensive shoes but her hair was in a thick braid down her back, as it had been when she was a child.

  We sat in the choir at St. John the Divine. Her father walked her to the altar. There at the altar was Susan, her best friend in California since age three. There at the altar was her best friend in New York. There at the altar was her cousin Hannah. There was her cousin Kelley from California, reading a part of the service. There were the children of Gerry’s stepdaughter, reading another part. There were the youngest children, small girls with leis, barefoot. There were watercress sandwiches, champagne, lemonade, peach-colored napkins to match the sorbet that came with the cake, peacocks on the lawn. She kicked off the expensive shoes and unpinned the veil. “Wasn’t that just about perfect,” she said when she called that evening. Her father and I allowed that it was. She and Gerry flew to St. Barth’s. John and I flew to Honolulu.

  July 26, 2003.

  Four months and 29 days before she was admitted to the ICU at Beth Israel North.

  Five months and four days before her father died.

  During the first week or two after he died, at night, when the protective exhaustion would hit me and I would leave the relatives and friends talking in the living room and dining room and kitchen of the apartment and walk down the corridor to the bedroom and shut the door, I would avoid looking at the reminders of our early marriage that hung on the corridor walls. In fact I did not need to look, nor could I avoid them by not looking: I knew them by heart. There was a photograph of John and me taken on a location for The Panic in Needle Park. It was our first picture. We went with it to the Cannes festival. It was the first time I had ever been to Europe and we were traveling first-class on Twentieth Century–Fox and I boarded the plane barefoot, it was that period, 1971. There was a photograph of John and me and Quintana at Bethesda Fountain in Central Park in 1970, John and Quintana, age four, eating ice cream bars. We were in New York all that fall working on a picture with Otto Preminger. “She’s in the office of Mr. Preminger who has no hair,” Quintana advised a pediatrician who had asked where her mother was. There was a photograph of John and me and Quintana on the deck of the house we had in Malibu in the 1970s. The photograph appeared in People. When I saw it I realized that Quintana had taken advantage of a break in the day’s shooting to apply, for the first time, eyeliner. There was a photograph Barry Farrell had taken of his wife, Marcia, sitting in a rattan chair in the house in Malibu and holding their then-baby daughter, Joan Didion Farrell.

  Barry Farrell was now dead.

  There was a photograph of Katharine Ross, taken by Conrad Hall during the Malibu period when she taught Quintana to swim by throwing a Tahitian shell in a neighbor’s pool and telling Quintana the shell would be hers if she brought it up. This was a time, the early 1970s, when Katharine and Conrad and Jean and Brian Moore and John and I traded plants and dogs and favors and recipes and would have dinner at one or another of our houses a couple of times a week.

  I remember that we all made soufflés. Conrad’s sister Nancy in Papeete had shown Katharine how to make them work without effort and Katharine showed me and Jean. The trick was a less strict approach than generally advised. Katharine also brought back Tahitian vanilla beans for us, thick sheaves tied with raffia.

  We did crème caramel with the vanilla for a while but nobody liked to caramelize the sugar.

  We talked about renting Lee Grant’s house above Zuma Beach and opening a restaurant, to be called “Lee Grant’s House.” Katharine and Jean and I would take turns cooking and John and Brian and Conrad would take turns running the front. This Malibu survivalist plan got abandoned because Katharine and Conrad separated and Brian was finishing a novel and John and I went to Honolulu to do a rewrite on a picture. We worked a lot in Honolulu. No one in New York could ever get the time difference straight so we could work all day without the phone ringing. There was a point in the 1970s when I wanted to buy a house there, and took John to look at many, but he seemed to interpret actually living in Honolulu as a less encouraging picture than staying at the Kahala.

  Conrad Hall was now dead.

  Brian Moore was now dead.

  From an earlier house, a great wreck of a house on Franklin Avenue in Hollywood that we rented with its many bedrooms and its sun porches and its avocado trees and its overgrown clay tennis court for $450 a month, there was a framed verse that Earl McGrath had written on the occasion of our fifth anniversary:

  This is the story of John Greg’ry Dunne

  Who, with his wife Mrs. Didion Do,

  Was legally married with family of one

  And lived on Franklin Avenue.

  Lived with their beautiful child Quintana

  Also known as Didion D

  Didion Dunne

  And Didion Do.

  And Quintana or Didion D.

  A beautiful family of one Dunne Dunne Dunne

  (I mean a family of three)

  Living in a style best called erstwhile

  On Franklin Avenue.

  People who have recently lost someone have a certain look, recognizable maybe only to those who have seen that look on their own faces. I have n
oticed it on my face and I notice it now on others. The look is one of extreme vulnerability, nakedness, openness. It is the look of someone who walks from the ophthalmologist’s office into the bright daylight with dilated eyes, or of someone who wears glasses and is suddenly made to take them off. These people who have lost someone look naked because they think themselves invisible. I myself felt invisible for a period of time, incorporeal. I seemed to have crossed one of those legendary rivers that divide the living from the dead, entered a place in which I could be seen only by those who were themselves recently bereaved. I understood for the first time the power in the image of the rivers, the Styx, the Lethe, the cloaked ferryman with his pole. I understood for the first time the meaning in the practice of suttee. Widows did not throw themselves on the burning raft out of grief. The burning raft was instead an accurate representation of the place to which their grief (not their families, not the community, not custom, their grief ) had taken them. On the night John died we were thirty-one days short of our fortieth anniversary. You will have by now divined that the “hard sweet wisdom” in the last two lines of “Rose Aylmer” was lost on me.

  I wanted more than a night of memories and sighs.

  I wanted to scream.

  I wanted him back.

  6.

  Several years ago, walking east on Fifty-seventh Street between Sixth and Fifth Avenues on a bright fall day, I had what I believed at the time to be an apprehension of death. It was an effect of light: quick sunlight dappling, yellow leaves falling (but from what? were there even trees on West Fifty-seventh Street?), a shower of gold, spangled, very fast, a falling of the bright. Later I watched for this effect on similar bright days but never again experienced it. I wondered then if it had been a seizure, or stroke of some kind. A few years before that, in California, I had dreamed an image that, when I woke, I knew had been death: the image was that of an ice island, the jagged ridge seen from the air off one of the Channel Islands, except in this case all ice, translucent, a blued white, glittering in the sunlight. Unlike dreams in which the dreamer is anticipating death, inexorably sentenced to die but not yet there, there was in this dream no dread. Both the ice island and the fall of the bright on West Fifty-seventh Street seemed on the contrary transcendent, more beautiful than I could say, yet there was no doubt in my mind that what I had seen was death.