by Philip Roth
Terrifying encounters with the end? I'm thirty-four! Worry about oblivion, he told himself, when you're seventy-five! The remote future will be time enough to anguish over the ultimate catastrophe!
But no sooner did he and Phoebe return to Manhattan—where they lived in apartments some thirty blocks apart—than he mysteriously fell ill. He lost his appetite and his energy and found himself nauseated throughout the day, and he could not walk a city block without feeling weak and woozy.
The doctor could find nothing wrong with him. He had begun to see a psychoanalyst in the aftermath of his divorce, and the psychoanalyst attributed his condition to envy of a fellow art director who had just been promoted to a vice presidency in the agency.
"It makes you sick," the analyst said.
He maintained that his colleague was twelve years his senior and a generous coworker whom he only wished well, but the analyst continued to harp on "deep-seated envy" as the hidden reason for the malaise, and when circumstances proved him wrong, the analyst appeared unperturbed by his mistaken judgment.
He went to the medical doctor's office several more times in the succeeding weeks, whereas ordinarily he saw him only for a minor problem every couple of years. But he'd lost weight and the bouts of nausea were getting worse. He'd never before felt so rotten, not even after he'd left Cecilia and the two small boys and the court battle ensued over the terms of the separation and he was characterized to the court by Cecilia's attorney as "a well-known philanderer" because of the affair he was having with Phoebe, who was a new copywriter in the agency (and who was referred to in court by the plaintiff on the witness stand—aggrieved, overwrought, as though she found herself bringing charges against the Marquis de Sade—as "number thirty-seven in his parade of girlfriends," when in fact she was looking too far into the future and Phoebe was as yet number two). At least back then there'd been a recognizable cause for all the misery he felt. But this was his turning overnight from someone who was bursting with health into someone inexplicably losing his health.
A month passed. He couldn't concentrate on his work, he gave up his morning swim, and by now he couldn't look at food. On a Friday afternoon he left work early and took a taxi to the doctor's office without having made an appointment or even a phone call. The only one he phoned was Phoebe, to tell her what he was doing.
"Admit me to a hospital," he told the doctor. "I feel like I'm dying."
The doctor made the arrangements, and Phoebe was at the hospital's information desk when he arrived. By five o'clock he was settled into a room, and just before seven a tall, tanned, good-looking middle-aged man wearing a dinner jacket came into the room and introduced himself as a surgeon who had been called by his physician to take a look at him. He was on his way to some formal event but wanted to stop by first to do a quick examination. What he did was to press his hand down very hard just above the groin on the right side. Unlike the regular physician, the surgeon kept pressing and the pain was excruciating. He felt on the verge of vomiting. The surgeon said, "Haven't you had any stomach pain before?" "No," he said. "Well, it's your appendix. You need an operation." "When?" "Now."
He saw the surgeon next in the operating room. He'd changed out of the evening clothes into a surgical gown. "You've saved me from a very boring banquet," the surgeon said.
He didn't wake up until the next morning. Standing at the foot of the bed, along with Phoebe, were his mother and father, looking grim. Phoebe, whom they did not know (other than from Cecilia's denigrating descriptions, other than from the telephone tirades ending, "I pity this Little Miss Muffet coming after me—I honestly do pity the vile little Quaker slut!"), had phoned them and they'd immediately driven over from New Jersey. As best he could make out, a male nurse seemed to be having trouble feeding some sort of tube up his nose, or maybe the nurse was trying to extract it. He spoke his first words—"Don't fuck up!"—before falling back into unconsciousness.
His mother and father were seated in chairs when he came around again. They seemed still to be tormented and weighed down by fatigue as well.
Phoebe was in a chair beside the bed holding his hand. She was a pale, pretty young woman whose soft appearance belied her equanimity and steadfastness. She manifested no fear and allowed none in her voice.
Phoebe knew plenty about physical misery because of the severe headaches that she'd dismissed as nothing back in her twenties but that she realized were migraines when they became regular and frequent in her thirties. She was lucky enough to be able to sleep when she got one, but the moment she opened her eyes, the moment she was conscious, there it was—the incredible ache on one side of her head, the pressure in her face and her jaw, and back of her eye socket a foot on her eyeball crushing it. The migraines started with spirals of light, bright spots moving in a swirl in front of her eyes even when she closed them, and then progressed to disorientation, dizziness, pain, nausea, and vomiting. "It's nothing like being in this world," she told him afterward. "There's nothing in my body but the pressure in my head." All he could do for her was to remove the big cooking pot into which she vomited, and to clean it out in the bathroom, and then to tiptoe back into the bedroom and place it beside the bed for her to use when she was sick again. For the twenty-four or forty-eight hours that the migraine lasted, she could not stand another presence in the darkened room, any more than she could bear the thinnest sliver of light filtering in from beneath the drawn shades. And no drugs helped. None of them worked for her. Once the migraine started, there was no stopping it.
"What happened?" he asked her.
"A burst appendix. You had it for some time."
"How sick am I?" he asked weakly.
"There's a lot of peritonitis. There are drains in the wound. They're draining it. You're getting big doses of antibiotics. You're going to pull through. We're going to swim across the bay again."
That was hard to believe. Back in 1943 his father had come close to dying from undiagnosed appendicitis and severe peritonitis. He was forty-two with two young children, and he had been in the hospital—and away from his business—thirty-six days. When he got home, he was so weak he could barely make it up the one little flight to their flat, and after he'd been helped by his wife from the entry-way into the bedroom, he sat on the edge of the bed, where, for the first time in the presence of his children, he broke down and cried. Eleven years earlier, his youngest brother, Sammy, the adored favorite of eight children, had died of acute appendicitis in his third year at engineering school. He was nineteen years old, having entered college at sixteen, and his ambition was to be an aeronautical engineer. Only three of the eight children had got as far as high school, and Sammy was the first and only one to go to college. His friends were the smartest boys in the neighborhood, all of them the children of Jewish immigrants who met regularly at one another's houses to play chess and to talk heatedly about politics and philosophy. He was their leader, a runner on the track team and a mathematics whiz with a sparkling personality. It was Sammy's name that his father intoned as he sobbed in the bed- room, astonished to find himself back among the family whose provider he was.
Uncle Sammy, his father, now him—the third of them to have been felled by a burst appendix and peritonitis. While he drifted in and out of consciousness for the next two days, it was not certain whether he would meet Sammy's fate or his father's.
His brother flew in from California on the second day, and when he opened his eyes and saw him at the side of the bed, a big and gentle presence, unperturbed, confident, jolly, he thought, I cannot die while Howie is here. Howie bent over to kiss his forehead, and then no sooner did he sit down in the bedside chair and take the patient's hand than time stopped, the present disappeared, and he was returned to childhood, a small boy again, preserved from worry and fear by the generous brother who slept in the bed beside his.
Howie stayed for four days. In four days he sometimes flew to Manila and Singapore and Kuala Lumpur and back. He had started at Goldman Sachs as a runner and qui
ckly went from relaying messages to top dog on the currency-trading desk and began investing for himself in stocks. He had ended up in currency arbitrage for multinational and large foreign corporations—winemakers in France and camera makers in West Germany and automakers in Japan, for whom he turned francs and deutsche marks and yen into dollars. He traveled frequently to meet with his clients and continued investing in companies he liked, and by thirty-two he had his first million.
Sending their parents home to rest, Howie joined with Phoebe to see him through the worst of it and prepared to fly out only after receiving the doctor's assurances that the crisis was over. On the last morning, Howie quietly said to him, "You've got a good girl this time. Don't screw it up. Don't let her go."
He thought, in his joy at having survived, Was there ever a man whose appetite for life was as contagious as Howie's? Was there ever a brother as lucky as me?
He was in the hospital for thirty days. The nurses were mostly agreeable, conscientious young women with Irish accents who seemed always to have time to chat a little when they looked in on him. Phoebe came directly from work to have dinner in his room every night; he couldn't imagine what being needy and infirm like this and facing the uncanny nature of illness would have been like without her. His brother needn't have warned him not to let her go; he was never more determined to keep anyone.
Beyond his window he could see the leaves of the trees turning as the October weeks went by, and when the surgeon came around he said to him, "When am I going to get out of here? I'm missing the fall of 1967." The surgeon listened soberly, and then, with a smile, he said, "Don't you get it yet? You almost missed everything."
Twenty-two years passed. Twenty-two years of excellent health and the boundless self-assurance that flows from being fit—twenty-two years spared the adversary that is illness and the calamity that waits in the wings. As he'd reassured himself while walking under the stars on the Vineyard with Phoebe, he would worry about oblivion when he was seventy-five.
He had been driving to New Jersey after work nearly every day for over a month to see his dying father when he wound up badly short of breath in the City Athletic Club swimming pool one August evening in 1989. He had gotten back from Jersey about half an hour earlier and decided to recover his equilibrium by taking a quick swim before heading home. Ordinarily he swam a mile at the club early each morning. He barely drank, had never smoked, and weighed precisely what he'd weighed when he got home from the navy in '57 and started his first job in advertising. He knew from the ordeal with appendicitis and peritonitis that he was as liable as anyone else to falling seriously ill, but that he, with a lifelong regimen of healthful living, would end up as a candidate for cardiac surgery seemed preposterous. It was simply not how things were going to turn out.
Yet he couldn't finish the first lap without pulling over to the side and hanging there completely breathless. He got out of the pool and sat with his legs in the water trying to calm down. He was sure that the breathlessness was the result of having seen how far his father's condition had deteriorated in just the past few days. But in fact it was his that had deteriorated, and when he went to the doctor the next morning, his EKG showed radical changes that indicated severe occlusion of his major coronary arteries. Before the day was out he was in a bed in the coronary care unit of a Manhattan hospital, having been given an angiogram that determined that surgery was essential. There were oxygen prongs in his nose and he was attached by numerous leads to a cardiac monitoring machine behind his bed. The only question was whether the surgery should take place immediately or the following morning. It was by then almost eight in the evening, and so the decision was made to wait. Sometime in the night, however, he was awakened to discover his bed surrounded by doctors and nurses, just as the bed of the boy in his room had been back when he was nine. All these years he had been alive while that boy was dead—and now he was that boy.
Some sort of medication was being administered through the IV and he vaguely understood that they were trying to avert a crisis. He could not make out what they were mumbling to one another and then he must have fallen asleep, because the next he knew it was morning and he was being rolled onto a gurney to take him to the operating room.
His wife at this time—his third and his last—bore no resemblance to Phoebe and was nothing short of a hazard in an emergency. She certainly didn't inspire confidence on the morning of the surgery, when she followed beside the gurney weeping and wringing her hands and finally, uncontrollably, cried out, "What about me?"
She was young and untried and maybe she had intended to say something different, but he took it that she meant what would happen to her should he fail to survive. "One thing at a time," he told her. "First let me die. Then I'll come help you bear up."
The operation went on for seven hours. Much of that time he was connected to a heart-lung machine that pumped his blood and breathed for him. The doctors gave him five grafts, and he emerged from the surgery with a long wound down the center of his chest and another extending from his groin to his right ankle—it was from his leg that they had removed the vein from which all but one of the grafts were fashioned.
When he came around in the recovery room there was a tube down his throat that felt as though it were going to choke him to death. Having it there was horrible, but there was no way he could communicate that to the nurse who was telling him where he was and what had happened to him. He lost consciousness then, and when he came around again the tube was still there choking him to death, but now a nurse was explaining that it would be removed as soon as it was determined that he could breathe on his own. Over him next was the face of his young wife, welcoming him back to the world of the living, where he could resume looking after her.
He had left her with a single responsibility when he went into the hospital: to see that the car was taken off the street where it was parked and put into the public garage a block away. It turned out to be a task that she was too frazzled to undertake, and so, as he later learned, she'd had to ask one of his friends to do it for her. He hadn't realized how observant his cardiologist was of nonmedical matters until the man came to see him midway through his hospital stay and told him that he could not be released from the hospital if his home care was to be provided by his wife. "I don't like to have to say these things, fundamentally she's not my business, but I've watched her when she's come to visit. The woman is basically an absence and not a presence, and I have no choice but to protect my patient."
By this time Howie had arrived. He had flown in from Europe, where he'd gone to do business and also to play polo. He could ski now, skeet-shoot, and play water polo as well as polo from atop a pony, having acquired virtuosity in these activities in the great world long after he'd left his lower-middle-class high school in Elizabeth, where, along with the Irish-Catholic and Italian boys whose fathers worked on the docks at the port, he'd played football in the fall and pole-vaulted in the spring, all the while garnering grades good enough to earn him a scholarship to the University of Pennsylvania and then admission to the Wharton School to earn an MBA. Though his father was dying in a hospital in New Jersey and his brother recovering from open-heart surgery in a hospital in New York—and though he spent the week traveling from the one bedside to the other—Howie's vigor never lapsed, nor did his capacity to inspire confidence. The sustenance the healthy thirty-year-old wife proved incapable of providing her ailing fifty-six-year-old husband was more than compensated for by Howie's jovial support. It was Howie who suggested hiring two private duty nurses—the daytime nurse, Maureen Mrazek, and the night nurse, Olive Parrott—to substitute for the woman he'd come to refer to as "the titanically ineffective cover girl," and then he insisted, over his brother's objections, on covering the costs himself. "You were dangerously ill, you went through hell," Howie said, "and so long as I'm around, nothing and nobody is going to impede your recovery. This is just a gift to ensure the speedy restoration of your health." They were standing together by the entra
nce to the room. Howie spoke with his brawny arms around his brother. Much as he preferred to appear breezily superior to the claims of sentiment, his face—a virtual replica of his brother's—could not disguise his emotions when he said, "Losing Mom and Dad I have to accept. I could never accept losing you." Then he left to find the limo that was waiting downstairs to drive him to the hospital in Jersey.
Olive Parrott, the night nurse, was a large black woman whose carriage and bearing and size reminded him of Eleanor Roosevelt. Her father owned an avocado farm in Jamaica, and her mother kept a dream book in whose pages, each morning, she recorded her children's dreams. On the nights when he was too uncomfortable to sleep, Olive sat in a chair at the foot of the bed and told him innocent tales about her life as a child on the avocado farm. She had a West Indian accent and a lovely voice, and her words soothed him as no woman's had since his mother sat and talked to him in the hospital after the hernia operation. Except for the questions that he asked Olive, he remained silent, deliriously contented to be alive. It turned out that they'd caught him just in time: when he was admitted to the hospital, his coronary arteries were anywhere from ninety to ninety-five percent occluded and he'd been on the verge of a massive and probably fatal heart attack.