by Ayad Akhtar
“He had syphilis?”
“Some people think he did. Yeah.”
“Is that right?” I’d never seen him so fascinated by anything I’d ever said about Shakespeare before.
“Anyway, I’m just saying—doesn’t it look like a syphilis rash?”
“Could be. Haven’t seen a case since medical school. And the only time I ever see this kind of thing now is with bacterial endocarditis.”
“What’s that?”
“Infection in the heart.”
“And what are the symptoms of that?”
“Fatigue, fever—”
“Haven’t had those.”
“Trust me, you would know you had a problem by the time there’s a rash like this. And that one usually looks smaller anyway,” he said, pondering my palms anew. “Toxic shock sometimes, arthritic complications…”
“I don’t think it’s arthritis. My joints have been fine.”
“Did you write a play about that, too?”
“A play? No. I said a paper, Dad. Like a report…”
He shrugged at the evident irrelevance of my clarification: “What you think is fine and not fine doesn’t matter. You need to get to the emergency room.”
“Can I take the car?”
He shrugged. “I would drive you, but someone has to stay with her—”
“No, of course. It’s fine. I feel fine. I can get myself there.”
“I’ll get you the key.” He stopped on his way back to the door inside: “Just wipe everything off, okay? The steering wheel? If you touch anything else? You know what? On that shelf with the garden tools”—he was pointing now at the sagging plywood shelf on the far wall—“take those gloves. You can wear those.”
“You want me to wear gardening gloves?” I asked, but he was already disappearing inside.
I pulled the gloves he was talking about from under a pile of trowels. The notion of wearing mud-caked gardening gloves over the lesions didn’t strike me as particularly hygienic, but when Father returned with the car key, he assured me—with a dismissive Indo-Pak bob of the head from side to side—that any incidental contact with dirt now dry for years was nothing to worry about. “Just put them on, you know, in case you’re right. So you don’t, you know, get it all over the car.”
* * *
The local emergency room was empty, and I was seen right away. It was a small hospital perched on a wooded hill, one of the first to go up that far west of the city, where professionals didn’t start settling among the farmers until the early ’70s. The attending ER physician was, like so many locals around whom I’d grown up, a particular breed of Wisconsin paradox: tender and Teutonic. Seeing my hands, she suspected at once—as I had—syphilis and asked about my sexual history. Yes, I’d had multiple partners in the last six months—though only one for the last four. Yes, some of that sex was unprotected. Her pitched features sagged with what seemed a disapproving thought as she tore the nitrile gloves from her hands. She explained that though she’d yet to encounter an active case of secondary syphilis in that idyllic suburban enclave where my parents lived, she was aware of the unusual rise in rates of the disease across the country; a good portion of the most recent issue of the Annals of Emergency Medicine was devoted to the subject. The latest clinical thinking suggested administering the penicillin treatment for the illness if it was suspected—barring allergy to the medication, of course—even before the test results came. The good news, she said with a sudden smile, as if announcing an attraction she thought I might enjoy at the upcoming state fair, was that if it was syphilis, and only syphilis—unfortunately, HIV was often a companion ailment, but we would know about that very shortly because a strip test would tell us within minutes—the cure was simple and the prognosis great.
After the phlebotomist took my blood, the attending returned to the exam room with a polyglot trio of young visiting foreign medical graduates in tow: Chinese, Colombian, Ghanaian. They crowded in to introduce themselves and stare at my palms. Only one of them—the Colombian resident—had ever actually seen a secondary syphilitic rash. Here I was, a teachable moment. The attending warned that a test result would be needed to confirm the diagnosis but then addressed the residents with a certainty about the distinctive lesions that belied her note of caution, using a pencil to point out the breaking skin along the largest of them; if it was indeed syphilis, she explained, any of the broken sores they were seeing were actually contagious. I saw the Chinese resident visibly cringe. The attending went on to explain that the palmar rash was often accompanied by another on the soles of the feet and, in some cases, even the torso and back. “Fortunately for this patient,” she said with a smile, “not in his case.” Even so, they pored over every inch of my skin, then watched their instructor stick a needle into my ass and pump me full of penicillin. If I didn’t need to be out and about, the attending said as she stuck a small adhesive bandage to my butt, it was probably best I rest—with minimal contact with others (and none of a sexual nature)—for the next few days.
Something strange happened when I got home.
As I walked into the house, I heard my mother was awake. Her lucid moments were rare now—and not particularly lucid—mostly coinciding with the short windows between her doses. I pulled off the blue nitrile gloves I’d been given in the emergency room to replace the filthy gardening gloves I’d shown up there with—I didn’t want to alarm her—and rummaged in the mudroom bins for something else I could use to cover up my hands. All I could find were two thick rabbit-fur mittens. I recalled Father bringing them home as a gift from a trip to Iceland and Mother laughing at how they looked when she slipped them on. I didn’t remember her ever wearing them again.
In the family room, she was lying propped up on the couch. Father sat beside her; he was feeding her from a bowl. “My hooonnneeeyy,” she slurred sweetly. Her smile was weak, but the brightness in her eyes—above the mass of mostly unmoving gray flesh on her face—matched the delight in her voice.
“Hi, Mom.”
“Yoguuu, yoguuu,” she cooed over Father’s extended spoon.
“You having some yogurt? Is it good?”
“Gooo…Gooo…”
“Can you put her music on?” Father asked, gesturing at the portable CD player on the fireplace mantel. He inserted another spoonful of yogurt into her mouth and watched sternly as I pulled the mitten from my hand to press Play on the console with my index-finger knuckle. The buoyant notes of a polka waltz began, the cheery, syncopated beat filling the room with anodyne joy. Mother discovered the music in the ’80s on local radio stations that played it late in the afternoons and early on the weekends. As she got older, polka became a bona fide obsession. While she was still well enough, packages from Amazon filled with CDs of her latest obscure discoveries would arrive weekly. She abhorred what passed for mainstream in the form, the slick, soulless schlock of Jimmy Sturr, say, and her command of the various schools was truly remarkable. She could untangle the advent of trumpets into the Cleveland-based Slovenian style from the Wisconsin-based strains that leaned Czech in their embrace of a smaller brass sound. Particularly enamored of Bavarian polka, she would call the local DJs to champion tiny bands from backwater towns like Kiel and New Holstein, where German was still a language spoken in the streets. Father never got her love of this music, but I thought I did. It was fun, simple, orderly; it pointed back to an Old World, not her own but old and native all the same, a homespun Wisconsin reminder she was not the only one who’d come here from somewhere else, not the only one still working to keep alive the memory of another place.
Father patted at her lips with a washcloth and stood up. “I luuu youuu, I luuu youuuu,” she burbled.
“I love you, too, Ammi. I love you so much.”
She tilted her face and closed her eyes, offering her barely puckered lips. I hesitated. Of course I wanted to kiss her, and yes, she was dying already, and no doubt it was unlikelier than unlikely she might get sick from the simple peck she wanted,
but all the same, even the remotest possibility of giving your dying mother syphilis is an occasion for legitimate pause. I leaned in and felt the tip of her mouth—still wet from feeding—against my cheek. I turned and kissed hers, too. Contact made, she relaxed back into the cushions and closed her eyes.
I looked up and saw Father glaring at me from the kitchen.
“Outside,” he said curtly. Back in the garage, I told him the attending suspected syphilis; she’d given me the intramuscular dose of antibiotics; test results would take three days; until then, I should lay low. “And don’t kiss your mother,” he added with a grunt as he marched back into the house.
It was then that a discomfort I’d been feeling between my legs for some time finally drew my notice. I had a hard-on, and not of the usual wayward form: mostly firm, somewhat not, amenable to digital adjustment, a cupful of blood lost en route back to the heart. No. This was as fully distended an erection as I could recall, but with not a whit of pleasure or sexual sensation to it. No throbbing need, no promise willed or sought—just a rigid ache.
I went back into the family room and slipped quietly into the armchair by my dozing mother’s side. I watched and listened, her quiet snore belying the evident strain of her breath, the light crease on her forehead, a signal, I thought, of her reabsorption into the narrow black sack of her pain. The image was Tolstoy’s from the late tale about the unremarkable death of a vain government bureaucrat. The Death of Ivan Ilyich was among my mother’s favorite books. She’d given it to me when I was in high school, and I’d read it many times since. As she died, I’d taken it up again, a way to feel closer to her, no doubt, but also to populate her mute suffering with speakable meanings. Reading by her side, I would look up from the pages and wonder if the glorious end of Tolstoy’s tale—when death envelops Ilyich with its simple light—was in sight for her yet. I wondered if her pity had yet turned from her own predicament and to us, still caught up in all the self-deception of the living. On his deathbed, Ilyich came to regret all the time he’d wasted on appearances, on needing to seem worthwhile in the eyes of others. I knew she had other regrets of her own. I knew she felt her life had passed her by. I’d always suspected that she regretted her marriage to my father, though I didn’t yet know about her feelings for Latif. She would sometimes say her cancer kept coming back because it was trying to tell her something. It wasn’t until she died and I read her diaries that I had any idea what she thought the message might have been.
When the tumor was initially discovered, it was already fully interlaced with her spine; no surgery could be performed to remove it. She’d been through chemotherapy three times in thirty years and was resolved not to put herself through that again—which meant she was reconciled to dying of the illness this time around. Sure enough, without the aggressive chemical treatment, her tumor slowly spread into every part of her. By now, as she neared the very end, if the timing of her successive doses of Vicodin or Demerol or oxycodone or morphine—or whatever combination my father chose to give her—were not lined up exactly right, the resulting pain would rage through her entire body. The veins in her neck bulged, her fingers and toes crimped, her face pushed steadily farther and farther into the couch’s cushions, the usual, steady moans now replaced by something that looked like it required so much more from her than she could possibly have to give. Mostly, though, she slept, her pain bearable through a pill-induced haze.
I would sit beside her as she dozed and wonder what, if anything, was haunting her beyond the body’s torment, beyond the pain and the fear of more pain. I wondered what unresolved questions about her life dangled in that narcotic darkness. I read into the subtlest shifts of her expression and sought to redeem her inner life as if it were that of a character in a book. Such was my habit, imagining the inner landscapes of others and drawing their portraits—ultimately—from the model I knew best: myself. I knew I was mostly staring in a mirror as I watched my mother die. I knew it was mostly futile. I did it anyway.
Mostly futile, but not entirely. For all the literary speculation about her secret summations brought me to see how little I really knew her and confronted me with the deepest resentment of my life—that despite the daily demonstrations of love, the doting, the sacrifices, the unceasing maternal care, I never truly felt loved by her. I’d never felt loved because I’d never known who was loving me and never felt certain she knew whom or what she was loving. She complained so often of my remoteness over the years, my difficulty showing affection or speaking about my life and feelings with her—her diaries were filled with observations about how bottled up and laconic I was, how endlessly it frustrated her. I never felt she saw me; or, rather, never felt certain the person looking out at me was really and truly her and was really and truly looking out at me. I saw now that the source of my life’s work—reading, literature, theater—was in part the pursuit of something as simple as my mother’s gaze, a gaze she gave happily to books. Was it a coincidence I, too, had sought the comfort of books as a child? Wasn’t I seeking her attention? Isn’t that what I really wanted as I would sidle up to her warm body on the couch as she read, a book of my own in hand? So many times, I didn’t even read, I just pretended to, wanting to be close to her. I vividly recall one snowy afternoon, the bright winter glare reflected in my mother’s eyes as they scanned page after page, and me, watching her sidelong, jealous of the object that so commanded her being, wishing I, too, could find some way into the rapture of that avid gaze. Is it really a surprise that even words on the page would end up not being enough? That even these I needed to impose on the countenances of countless others by means of the stage? This was not about neglect or disregard. It was about access. I never felt like I had access.
Except when we were in Pakistan.
One of the final proper conversations I had with her while she was still mostly in possession of all her wits—and with her habitual reserve softened by the approaching end—was about Pakistan, or our respective relationships to it. She was sitting up, nibbling on a piece of freshly made laddoo from the sizable new Indo-Pak grocery that had opened a couple of miles west of us, in a strip mall behind the new casino that now sat where, when I was a child, there’d been a middle school. (It was astonishing to me that there were enough of us now in the area to justify the new grocery store’s generous square footage, its aisles and aisles of packaged naans and dals and sacks of basmati, the masalas, the pakora mixes, the biryani mixes, the dazzling mounds of cayenne and turmeric and ground cardamom, the tins of ghee and bottles of bitter pickle, the rows of fresh mint, coriander, methi, of our native fruits—mangoes, guavas, lychees, Punjabi kinu—and, as one approached the registers, the prolonged counter of Desi sweets of every known form, the barfi and laddoo in particular, Mother thought, as tasty as she’d ever had them, even “back home,” and which Father would dutifully fetch a few times every week, the last of her edible pleasures.) She was munching on that piece of besan laddoo, its beige crumble adhering to her lips, when suddenly, she stopped chewing. Her mouth sagged; her eyes welled; her voice quivered with sudden regret:
“I’m so sorry, meeri jaan.”
“For what, Mom? You don’t have anything to be sorry about—”
“You were so happy there.”
“Where?”
“Back home. You were always so happy back home.”
I paused, moved. With her end in view, her emotions had never been so clear, her face never as radiant; in moments like these, her beauty was heartbreaking.
“Why are you apologizing?”
“I never saw you like that here.”
“I don’t know, Mom.”
“No, no,” she said with an endearing firmness. “I never did.” And then, all at once, shifting. “You didn’t know that?”
“What?”
“That you were happier, when you were there?”
I smiled to hold her attention as I considered. The most vibrant of my childhood memories were those of life in my father’s village an
d of the interlocking rooms in my mother’s family’s sprawling Rawalpindi bungalow. I loved being there, but I never pined for it when we returned. Not like she did. As a young boy, I often remarked how much happier she was when we were in Pakistan. I used to pray to God for her to be happy like that in America, too. “I was happy you were happy, Mom. It was nice to be with family.”
“It was, wasn’t it?”
“And it was nice not to be in school.”
“You didn’t like school,” she said, frowning playfully.
“No, I didn’t.”
“I’m sorry.”
“That you made me go to school?”
“No,” she moaned, her face collapsing with sudden despair.
“What is it, Mom?”
“I’m sorry we brought you here.”
“Mom. I’ve had a good life here.”
She stared at me for a long moment, as if confused. “You have?”
“I’m happy.”
Her forehead creased with sudden concern. “I don’t think so.”
“I am. I’ve always been a little serious, right? Isn’t that what you say?”
“Too serious.”
“But it doesn’t mean I’m not happy.”
“Strange happiness.”
“I get to do what I love. I’m a writer. Can you believe it?” I smiled. “I’m happy.”
She studied me for a moment, her head cocked cutely, a loving tenderness pouring into her eyes. “That makes me happy,” she said finally. Then, almost as an afterthought, she added: “I never really liked it here.”
“I know, Mom.”
“You do?” She seemed both surprised and pleased to hear it.
I nodded. Then her expression changed again abruptly, narrow with a troubled thought.
“What is it?” I asked.
“Don’t be mad.”
“About what?”
“You’re one of them now. Write about them. Don’t write about us.”
“But I don’t choose my subjects, Mom. They choose me.”