Not so with Neil. Neil loved everything about the shul. He enjoyed being called to the Torah. He liked that the rabbi knew his Hebrew name without having to ask him. He thrived in all the attention layered on him by the elders in the synagogue. But even he too eventually drifted away from the synagogue.
Until the accident.
Our shul is a conservative one. Much of the service is in Hebrew. We have a part-time rabbi who only comes to town every other week. The rest of the time we are on our own. Joe Goldman—a Holocaust survivor with a thick Eastern European accent, a big heart, and a smile for everyone—leads the services in the rabbi’s absence. He once brought Neil home a hand-carved chess set from one of his many trips back to his native Poland to visit the Catholic family that hid him from the Nazis. He was also Neil’s bar mitzvah tutor.
Services start at 9:00 a.m. in our shul, but they are a three-hour-plus affair, and the Torah service doesn’t start until 10:00. So it was just before that when Neil and I entered the sanctuary. His hair was long, and he had a full beard and walked with his tall walking stick. As it happened, the Torah portion for that morning was from Exodus and involved Moses parting the Red Sea for the Israelites to pass out of Egypt into Canaan. Because Neil’s Hebrew name was Moshe (Hebrew for Moses) and today he looked the part, there were many winks and nods directed his way as the parshe was read. Neil knew everyone in the room that day, and they knew him too. One by one, slowly, as the service moved on, each member of the congregation came over to Neil, embraced him warmly, and whispered into his ear.
Blessings, or berakhah, are part of the Saturday-morning service. There are blessings for those who are ill, for those who are called to the Torah, for mothers of newborns, for couples about to be married. If you can think of it, there’s a blessing for it in our religion. They don’t all get said at every service, just when appropriate. There is one particular berakhah said for someone who has recovered from a serious illness, has returned from a long journey, or has survived any type of danger. All three definitely applied to Neil. When the congregation recited the prayer in unison, we all cried tears of joy.
Then it came time to recite the Mourner’s Kaddish, when everyone who has lost loved ones stands to remember them and pray for their souls. Neil leaned heavily on his walking stick, pulling himself to a standing position. He bowed his head so that only the top of his blue yarmulke was visible. His long heavy curls covered his face, but his quiet baritone was clear as he recited from memory the Mourner’s Kaddish for Trista. He prayed. We cried.
After the service we all retired to the kitchen for a simple Kiddush meal of bagels and cream cheese, lox, pickled herring, gefilte fish, and, of course, schnapps. The men of the temple hoisted their glasses and sang an old up-tempo blessing in Hebrew that they all knew by heart. They tried to tempt Neil with a shot of the strong stuff. He declined.
Several of the men took Neil aside, their arms draped over his shoulders, heads bowed together in conversation. Mr. Goldman, especially, held Neil for a long time.
While the men of the congregation embraced Neil, the women in the shul embraced me. They were anxious for details of Neil’s road to recovery, but they could see for themselves the most important thing: He was alive. He was here, happy to be back in the arms of his Jewish community. This time I remembered to say it: a silent thank you, thank you, thank you.
28
Hard Work
While Neil’s physical therapy and mental health work began in our home just days after the accident, both continued for the rest of the school year and beyond. When Pat saw that Neil could manage stairs on his own, could transfer himself in and out of the tub alone, and had mastered his own leg-strengthening exercises, she discharged him from her care. But as I watched him walk, especially now that he was using his walking stick, I detected a subtle limp in his gait, a vague listing toward his right side. I sought the help of an outpatient physical therapist. I contacted the office affiliated with Anna Jaques Hospital. We met with Laurie one day after school for his initial evaluation. She worked in a large mirror-walled space where other therapists worked with other patients on beds and tables, bikes, and treadmills. It didn’t take her long to assess Neil’s stride.
“You have to relearn to walk,†she told us. In favoring his injured left leg for so long Neil had basically developed an almost-permanent limp that would take the two of them months to correct.
So after school twice a week, Neil worked with Laurie, stretching and strengthening, working on balance and coordination. She had him ditch the walking stick, feeling it was contributing to his asymmetry. She gave him exercises to do on his own at home, which he did, when reminded.
Neil also worked hard to get his mental health back as well. It took him some time to see that he needed help, but he eventually did. He never quite clicked with his first therapist, Bob, so we looked elsewhere. Jan seemed more compatible with Neil’s personality. I, of course, don’t know all that went on in their weekly sessions, but he seemed to leave them in good spirits. I am proud of my son for working to process all that he’d been through. It would take more than a mother’s love to help him find a way to live with his loss. He needed a professional to talk with, and I was glad he could see that and was willing to put the effort into his healing.
Saul and I also wondered if antidepressants might help his mood, so we found a nurse practitioner a couple of towns away who specialized in medication evaluation. She started Neil on a low dose of Lexapro. Neil was reluctant to take the medication at first, initially unconvinced that he needed it. He eventually agreed to give it a try. I couldn’t really detect any change in Neil’s outlook or personality. Neil’s ways were always quiet, but he was friendly and made friends easily. But since the accident I found myself trying to analyze his moods, the sound of his voice, his eye contact, searching for signs of depression. Was this just typical teenage moroseness or something more ominous? Neil could also be a procrastinator. For me the trait now took on new meaning. Was it just his way, or was it a sign of impaired executive function? It would become a pattern of mine: observing my son and thinking, Is this the injury, or is this just Neil?
29
Present Perfect
On a cold February morning, I brought Neil to his follow-up visit with the orthopedist at Brigham and Women’s Hospital. The doctor was taking out his metal staples that day. Neil wanted to be medicated for the procedure—he never liked the sight of blood. But having taken stitches and staples out of so many children over the years, I knew he could handle it and told him so.
Neil was less than convinced. When the doctor pulled back the gauze from the wound, revealing a colorful mix of rusty-orange Betadine and dark-maroon dried blood, Neil swooned, sweat beading up on his forehead. I held his hand and looked him straight in the eyes as the doctor worked.
“You’re the most amazing person I know, Neil,†I said. “A lot of other people would have just curled into a ball and checked out. But not you. You’ve kept going through everything.â€
Neil was grinning at the barrage of compliments, but he winced with each metallic snap of the staple remover as one after another was bent in half and slid out of his skin. But he never took his eyes off mine as I talked him through the pain.
“Physical therapy. Learning to walk again. Going back to school. You did it all, and I’m so proud of you.â€
The name of the game was distraction. When I was a resident, doing a lot of sewing of little children in the ER, I would often sing to them while I worked. A favorite song was “There Was an Old Lady Who Swallowed a Fly.†Song, fairy tale, story, and joke all rolled into one, it kept the kids still and mesmerized while I sewed. If the cut was small, I’d be done suturing before I was done singing, b
ut the kids were so into it, they’d make me finish the song before I discharged them. Neil might be too old for “There Was an Old Lady,†but he wasn’t too old to need distraction.
After the office visit we stopped for Cokes at the hospital’s hospitality shop, referred as “the spit†by the hospital staff. I told Neil that I had recently put a sand dollar on the top of Trista’s grave stone. It’s a Jewish tradition when visiting a cemetery to place a rock on the headstone of the person you are visiting. There may be some deeper religious reason behind it, but to me it was just a way of showing that I was there. Although we were the only Jews visiting Trista’s grave, others started following our tradition, and soon her tombstone was piled high with rocks.
“When do I get to clean these up?†her father, David, once asked me when we were visiting the grave together. He likened it to the top of his bureau collecting quarters, matchbooks, and odd paper receipts from emptied pockets at the end of the day. “I clean off my bureau from time to time, but what do I do with this?†he asked, gesturing to the rock pile on his daughter’s grave. So I started bringing shells, I told Neil, just to change things up.
“Did Trista like the beach?†I asked as we sipped our Cokes. Neil thought about that for a few minutes, and then answered.
“I don’t know. We haven’t been.â€
He didn’t say “We never went†or “She didn’t go.†Maybe that would sound too final. He said “We haven’t been,†like he could easily have tacked on a “yet†to the sentence. Like there was a possibility that they might still one day get to that beach.
I looked up the definition of the tense when I got home. Present perfect: It describes events in the indefinite past, while leaving room for the possibility of them happening again at some future date. Present perfect: the words themselves suggestive of freezing time, of keeping the present—that perfect present when Trista was alive and their futures were bright and together.
I was glad to be able to talk to Neil about her. Sometimes I felt like I couldn’t. Sometimes it felt like an egg walk.
One day not long after Neil had been discharged from the hospital, he was sitting on the couch working on a crossword puzzle. It was a favorite activity of his, but it had been a long time since he had had the concentration or energy to attempt anything like that. I smiled over at him as I walked through the room, glad for this progress. But as I passed by him, I noticed the picture next to him on the end table. Why hadn’t I seen it before? It was taken outside on our back deck, Neil and Trista framed in green trees. Trista smiling that half-smile that people with braces wear, even years after their braces come off. Neil in his “Dangerous Curves†T-shirt, a souvenir from the guitar exhibit Saul and I had taken him to at the Museum of Fine Art in Boston. His wiry hair and Jesus-like beard framed his own grinning face.
“Oh, Neil,†I blurted out. “Does that bother you? Do you want me to put it away? Or do you like looking at it?†I felt like I was blathering.
Neil looked over at the picture as if noticing it for the first time. Then without a word, he lay down on the couch and pulled the afghan over his head.
I hurried out of the room so he wouldn’t see me crying. I shoved a fist in my mouth so he wouldn’t hear my sobs. I bit down hard on my own fingers to punish myself for acting so foolishly. How stupid I was. This was the first time Neil was awake and alert and engaged, and I had to go and mention the one thing he was trying to forget. I was so angry with myself. So ashamed.
But now, here in “the spit,†he was talking about her. Not in the past. Sometimes in the present. And sometimes like this: in the present perfect. I was also glad he was in counseling. Someone needed to explore this with him. Someone with more background in grief work than I.
30
Our Education
I started taking my first pre-med courses at Clark University in the 1980s. It was right down the street from where we were living practically rent-free in the rundown Main South area of Worcester, in an apartment owned by Saul’s elderly grandfather. Before we moved in, the apartment was uninhabited and uninhabitable. We replaced broken appliances, hung new wallpaper, and painted window casings and ceilings, turning the five rooms into a cozy home.
I was pregnant with Dan when I started taking courses at Clark. Neil was two when I graduated. Saul’s grandfather only lived to see Dan born. He was in his nineties but managed to climb up the two sets of stairs to see the new baby. He chucked him under the chin, calling him Boychick and asking over and over in his thick Russian accent, “How they make ’em so schveet?†(He also used to chuck my husband under his chin and call him “Beardy.â€)
I found a babysitter near the university who would take care of the children while I went to school. I’d walk one or both of them over in a cheap umbrella stroller then head off to class. One of the first courses I took was genetics. I was pregnant with Dan at the time. I learned about the complex double helix, genotypes and phenotypes, and the laws of Mendellian inheritance. Adenosine, cytosine, guanine, thymine—how they shifted and paired, wound and unwound, determined features from height to hair color. One wrong turn in the chromosomal chain could mean the difference between a healthy baby and a fatal abnormality. With 247 million base pairs in its long strands of DNA, it was a wonder to me that any child was ever born whole.
It was a terrible time to be pregnant.
I took courses in biology and calculus, organic and inorganic chemistry. It was all fascinating, but it tested my brain power, stamina, and will. At twenty-eight, a commuter student, the mother of a two-year-old and pregnant with my second, I had little in common with my much younger peers. I was the only student in my physics class who hadn’t taken the course in high school, and I struggled until an engineer friend of mine agreed to tutor me. Things finally clicked. I only made one real friend during those years. Even that friend was years younger than I.
“You know someone’s really young when they’re talking about Cheap Trick’s old stuff,†Saul once joked.
Even with a babysitter watching the kids during class time, my pre-med courses required hours of reading, studying, and cramming for midterm exams. I made time for my studies during naps and after bedtime and whenever Saul came home not too exhausted to take over the child care.
But sometimes the schoolwork just couldn’t be done at home. During my anatomy course I had to memorize every muscle, bone, tendon, and ligament of my preserved, dissected cat. There was no possible way to do that from home, and paying a babysitter for the extra time just wasn’t in the family budget. So I loaded Dan into a pack on my back and walked the six blocks to my anatomy lab. I told myself he wouldn’t recognize the animal I was working on, gut filleted open, stinking of formaldehyde. But when I slid my oblong white box from its spot in the refrigerator and lifted off its plastic lid, Dan pushed up on the metal frame of his back pack, peered over my shoulder, and cried, “Kitty!â€
I felt like the worst mother in the world.
Throughout my undergraduate years, I still worked a few hours a week on the pediatric ward at City Hospital. The doctors and residents there all knew I was taking pre-med courses and applying to medical school.
They were not supportive.
“Don’t you like your family?†one cynical resident asked.
“Do you want to get divorced?†another jaded colleague wanted to know.
Others were even less tactful.
“Are you crazy?â€
True, I’d seen divorce statistics for physicians quoted at around 30 percent. But it varied among specialties and depended on where one was in oneâ€
™s career when one married. And it wasn’t as high as in other professions: massage therapists, for example. Or bartenders. Besides, Saul and I were doing all right. Weren’t we?
There was only one pediatrician, Jerry Durbin, the chief of Pediatrics at City Hospital at the time, who was supportive of my decision. Dr. Durbin always asked how things were going when he saw me on the ward. He answered specific questions I had about the cases we were seeing as well as general ones about life as a doctor. He always waxed enthusiastic about his specialty of pediatrics and his subspecialty, infectious disease. He wrote me a letter of recommendation when I applied to medical school. He would become my friend and mentor throughout my career. I call him to this day for advice on my own sticky cases.
Applying to med school was an arduous task. My advisor at Clark, Dr. Trachtenberg, spent hours with me researching suitable schools, preparing me for interviews, and writing me letters of support. I made long drives to interview at schools I couldn’t afford to fly to, sometimes staying overnight in cheap hotels. I missed my family.
The University of Massachusetts Medical School was my number-one choice. Med school would be stressful enough with two young children. I needed a support system in place. I got into New York Medical College first. I was glad I would at least be going to med school, but I still wanted to stay closer to home. At first I was just wait-listed at UMass, so I started making mental plans to move to New York.
But the envelope finally came. I nervously waited until Saul came home before opening it. I figured if the news was good, I wanted him there to celebrate with me; if it wasn’t, I’d need him to catch me when I fell.
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