The Life List of Adrian Mandrick
Page 13
He can’t help but wonder (as he has from time to time) if Evan had really escaped a fate similar to his own with their mother, if his childhood had really been as normal and unscathed as it seems. If not, he’s certainly put up a good front.
Evan starts away, taking out a pipe and bag of weed from his pants. “You take your bed. I’ll take Mom’s.”
• • •
Adrian stands in his old room with two garbage bags from the kitchen in his fist. Evan’s room had become his mother’s painting studio when he left home, and when Adrian moved out, she combined their things here in a schizophrenic way. There’s Tom Wolfe, Jack Kerouac, John Knowles, Call of the Wild, The Shining, Time Enough for Love, Birds of New York State by John Bull, a couple of dozen issues of The Kingbird and National Geographic, and the red 1977 Physicians’ Desk Reference—along with Evan’s Rolling Stone, Heavy Metal, and Mad magazines, scattered across the old table Adrian used for a desk. Games rise in zigzagging piles against the far wall: Operation, Life, Monopoly, Clue, Chinese checkers, Twister, Battleship, and Risk.
Adrian’s toy motorcycle collection is piled willy-nilly in a cardboard box on a low shelf under the window next to Evan’s final shop project, a wooden chess set he never used because he wouldn’t (couldn’t) play chess. Adrian’s amphibian-themed childhood sleeping bag (one of the few items other than clothes and his demolished chemistry set Adrian brought with him when they relocated) is slumped over Evan’s first amp in the corner.
Adrian turns back the covers of his old bed and climbs in, the slight grit of the army brown sheets familiar. Startling at the urge to masturbate, he bolts back out of bed and retrieves the laptop from his traveling bag.
He tries to locate himself in the present. In his own life. He balances the computer on his belly, but the room collects around him like a mist as Evan’s even snoring rises and falls from their mother’s room across the hall.
This is when he would usually call home to talk to Stella—hear her voice at the other end of the world. He could see if she’d answer, but he doesn’t want to muscle through the tender possibility of her contacting him first. He shrugs off a momentary prick of desire to call Deborah—though this is surely her territory, dealing with the remains of the newly dead. Maybe he’ll never see her again. He doesn’t know.
He clicks onto Backyard Birder’s chat—just as the lonely man who perches near the water posts—and his throat tightens.
4601 (11/16/09): At about 5:00 a.m. I saw a Wood Stork up on the north side by Yellow River. It is the first time I’ve seen this bird and I won’t soon forget it. It looked downright prehistoric. I looked it up on Wikipedia and I guess I was right because its been around for 10,000s of years All white body, a bald dark grey head and a long dirty yellow bill. At least two maybe three feet tall! From what I gather we get them here but not to often. I had the day off today and I was up there walking around with a thermos of coffee. I couldn’t sleep and I guess I wasn’t the only one.
• • •
“Wood Stork,” his mother’s breath so close and sharp it almost parted the strands of his hair stiff with salt.
The sun was almost down. They had walked down the wooded path from the simple cabin where they would stay the night, just his mother and him, to sit in the sand by the lagoon. She had been reading a fat paperback book with a picture of a rabbit head on the cover, while Adrian covered her legs with little piles of gray-brown mud.
Now she took his wrist, and Adrian hushed—fingers curling and crusty with muck—because across a shallow pool stood a downy figure nearly as tall as himself.
It had a bark-colored featherless head, as rough and uneven as its body was unflawed and silken white. A weathered bill curved down three times the length of its gnarly skull, with a black scarf tied under its chin like an old woman in the sun. Its legs thin, straight driftwood; its feet a subtle pink; its eyes steadied on the pool it waded in.
“It’s fishing,” Adrian whispered, bringing his fingers to his mouth in delight.
His mom shook her head and mouthed an abbreviated shh and then nodded yes, eyebrows rising.
Breast-high in the water, the Wood Stork squawked and plunged its parted beak into the pool.
Mother and son waited to see what was next—Adrian climbing onto his mom’s lap, facing away from her toward the bird, his mother holding him around the waist, her lips pressed into his sun-warmed hair. They waited, giggled, waited, and watched—until the stork’s beak clamped fast like a trap as it was yanked from the water.
“It caught something!” squealed Adrian, and the stork’s body registered the intrusion with immediate movement.
It hopped, splashing up brackish water, and awkwardly and with effort, lifted into the air.
“Surprise!” June laughed.
His head lying back over his mother’s shoulder, Adrian watched the show opening on the stage of the sky. In flight, the bird was something new, as its hidden dark feathers were revealed: a slender white seabird against the backdrop of a bigger, black bird of prey, as if two creatures had merged—with a wingspan five feet across. And under each open wing, Adrian thought he saw a message—lines scratched with black ink across the whitest page.
• • •
Adrian’s hand hovers over his keyboard, fingers trembling. He hears a metallic tink from the darkness of the house. Listens acutely, straightening his spine away from the pine headboard, until he remembers the sound from the pipes behind the toilet.
He focuses back on the post, tears threatening, and clicks comment.
mandrake3: Wood Stork was one of my favorite birds I listed from when I was a kid. I’ll never forget it either. Glad you got to see one.
Chapter Nine
* * *
Very early the morning of his departure, Adrian returns his rental car and waits at the gate at Newark to jet to morning surgery. Luckily, he gains a couple of hours, and he should be able to make it back by 7:00 Colorado time. He and Evan finished the business of their mother’s death without raising their voices again. They gave most of her belongings to Goodwill, took the furniture to the senior center where she volunteered, and shipped her paintings to Evan’s address. Adrian sent the photos of himself, Stella, and the kids to the house in Boulder. There was a simple will in which June left all she had to both sons equally, but Adrian told his brother that when the house sold, he should take the profits.
Now, sipping a double espresso, Adrian thinks at least it’s all over. He can give himself that much. The freedom to let her die. His mother. He will get through this and start again.
He opens his laptop and stumbles about aimlessly. He enters the Backyard Birder’s chat room to see if the man beside the water has posted, and shakes his head, allowing himself a faint smile. He lays his chin gently in his hand.
This is it, he realizes, the one small comfort in his life now—the man’s naïveté, his simple joy in the simplest birds. It’s a lifeline. There are no life lists for him (he can barely put a sentence together) but he reminds Adrian of himself years ago, when each bird was a miracle. The purity of discovery and gratitude.
It is as if Adrian’s consciousness rises then, up and out, like a plane taking off, climbing through thick cloud cover, and breaking through into the blue sky above it all. Or like the very gannet the man by the water describes.
4601 (11/17/09): Just saw a Northern Gannet flying over the water at the beach. He was a ways out but they’re so big you can’t mistake there white wings tips that look like they are dipped in crude oil. They kind of look like a sentinel until they surprise you and dive like a B52. Night training last night. I had to be there late. I couldn’t even think because of the noise. Same old same old.
Adrian knows the Northern Gannet so well. The scene around him in the airport fades as he hits comment and types his few words of response.
mandrake3: Hey.
Once I saw about five hundred breeding pairs of gannets on a rocky coastline off the Scottish Island of Boreray
.
A moment passes, as the sharp intercom alerts of the airport become more distant in Adrian’s ears.
4601: Wow. I can’t picture that I’ll be honest You must be a world traveller?!
mandrake3: Not so much. I haven’t been out of the country, other than Canada, in a year and a half. (Short trip to Indonesia just before that . . .) I’m a doc so I usually can’t go too far from home.
A longer moment.
4601: What kind of doctor? Surgeon?
mandrake3: Nothing too exciting. Anesthesiologist.
The man goes off-line. That happens with chats, of course, and Adrian has other things to do. He waits a few moments more, sipping coffee with his eyes trained on the computer screen, then allows himself to assume they might resume the conversation later on. He knows they will.
He takes a deep, even breath and clicks onto the rare bird site. Oh-so-rare birds, but not-rare-enough birds, birds he’s already seen, birds he’s already listed, numbers he’s already surpassed—and finds that even that, the dynamic tension of the quest for the numbers, is a distant, if sweet-smelling fire far below him now, as he hovers at this new distance, quiet above the landscape of his life. He’ll visit it again one day.
Perhaps forty-five minutes later, just as he is about to board, the man reappears and the exchange resumes.
4601: Anesthesiologist huh? At least you can spell it. (Thats better than I could do)
mandrake3: Funny.
Went looking for a Ruddy Quail Dove.
4601: Nice. Doves are a pretty bird.
mandrake3: This one was very rare for the U.S.
4601: Find it?
mandrake3: Yep. Texas, Rio Grande.
4601: You go wherever the birds take you I guess
mandrake3: Pretty much.
4601: Through wind or rain or sleet or hail.
mandrake3: Right! Well, I guess I’d better go now. My plane’s boarding.
4601: Hey nature calls anyway. Happy hunting
mandrake3: Thanks. You, too.
• • •
Adrian’s flight is uneventful, pleasant even, with no turbulence and no delays. When he arrives back in Boulder, he goes straight to the hospital, passing lightly through the cool, nearly empty corridors, with their cleansing, radiating UVC lights and early morning aroma of ammonia and coffee. He’s thinking about the kids, about seeing them later, about how strong they are, how adaptable and smart.
A text dings in from Stella:
Hope everything went ok. Thinking of you.
“Stella,” Adrian says aloud, stopping in the middle of the hall, and texts back immediately:
Thanks so much for saying so.
He hesitates, then adds:
I’ve been thinking of you too.
She doesn’t reply. When he puts away his phone, though, he tells himself that they will avoid the bitterness and blame that might have come of all this, once the stresses of the last weeks have eased for them both and she’s home from Greeley. Though he was hurt (selfishly) when she still planned to attend her friend Matthew’s wedding despite everything that happened, perhaps, he now thinks, it’s understandable, it’s right. He’s one of her old college friends, after all, and she’s supposed to play the oboe. “Besides,” she told Adrian, she “needs time.” She needs to “find her footing.” But she’s “thinking of him,” even so.
• • •
Trisha Browne lies supine on the table, powder blue on brown, a ringlet of chestnut and gray hair escaping her cap. Here they are, she and Adrian, lashed together by need and demand. They talk casually, Adrian’s voice warm and reassuring; hers, understandably concerned. Her eyes close easily from the sedative, capable-looking hands resting by her thighs, the tips of her fingers twitching just slightly, involuntarily, out of her sway, as if hearing the distant strains of a choir.
He unlaces the front of her gown to expose her chest that has been adorned with EKG leads in a kind of constellation. He covers her nose and mouth with the oxygen mask as she continues falling away from herself, then administers a bolus of propofol into the IV bag with the fat syringe that has been prepared for him in advance. At this point, he moves quickly, before the anesthetic disperses through the system into the blood, heart, and lungs to leave her vulnerable. He removes the oxygen mask, then reaches behind her head and extends her neck so her chin touches her chest, and with his other hand, he opens her mouth, carefully inserting the heart-shaped LMA over her tongue into her oropharynx—the natural, defensive reflexes that might push him out already rendered powerless by his drugs.
Next, he breaks physical contact with the patient and turns on the ventilator to administer the inhalational agents. The attending surgeon, Dr. Faust-Lucking, washes up next door. Jenny, the circulating nurse, removes the gown and blankets to scrub and prep the patient, fit her with an Ioban—the plastic-wrap sterile covering that serves as a sort of sheath over the abdomen, through which the surgeon will cut—and drapes her out.
“Did she get preoperative antibiotics?” The surgeon pulls on his gloves, taking in the operating site like a climber sizes up a rock face: total abdominal hysterectomy for uterine carcinoma.
Adrian responds, monitoring his machines, “Nothing was ordered. Want me to give her something?”
“No allergies,” affirms Jenny, perusing the patient’s chart.
“Gram of Kefzol,” requests the surgeon.
Adrian pulls out the bottle from the second drawer of his cart, draws the antibiotic up into a syringe, and injects it into the IV port. “Kefzol,” he says, “one gram.”
He watches oxygen saturation, heart rate, blood pressure, airway pressure, digital readouts, and waveforms. Strong woman, generally healthy. All is well, he thinks, all will be well.
The surgeon gives his orders to the scrub nurse, centers his scalpel over the abdomen and cuts vertically through the plastic covering and skin, to open her body—
The patient flinches.
“She’s light,” the surgeon tells Adrian, but of course he can see that, and it isn’t unusual for a patient to register an intrusion. Her body felt the cut, though her consciousness had surrendered. Adrian adds an additional bolus of propofol into the IV to submerge her a bit lower, so that in seconds, she will be completely without pain—conscious or otherwise.
“You doing any skiing?” the surgeon asks.
“Hoping to,” Adrian answers. “Didn’t go once last year, believe it or not.” He’s really not one for chitchat during surgery, so he leaves it at that.
He turns back to his monitors. The surgeon works, deft and nimble, cutting through subcutaneous fat, fascia, and muscle in under two minutes—then through the peritoneum, the lining of the abdominal cavity, the sac around all the organs, cauterizing the small arteries in his way.
The bowels swept aside, Adrian focuses a moment on the field: a uterus streaked with blood, its cells friable from the cancer, already being pulled up out of the incision and into the light. Then it’s like an air raid.
Four alarms sound at once.
Blood pressure 64/32, airway pressure gauge rising, EKG heart rate 110. Oxygen saturation dropping like a rock.
“Mandrick?” Faust-Lucking wheels toward the monitors.
“Gotta be anaphylactic,” spits Adrian. The antibiotic—the patient is deadly allergic.
The scrub nurse’s gloves are slick with fluids, holding a retractor and a sponge; the patient’s uterus is in the surgeon’s hand. “Get Sinowitz,” he barks. Jenny lays down her things and vanishes.
Adrian switches off all inhalation agents, puts the patient on 100 percent oxygen, opens up the fluids and squeezes a dose of epinephrine through the IV to boost blood pressure, hoping she hasn’t already lost blood supply to vital organs. (Permanent damage is possible even when response time is ideal.) Steroids, he thinks, and while the surgeon lowers the uterus back into the body, packing lap sponges into the gaping wound, Adrian administers hydrocortisone.
They wait.
&
nbsp; Sinowitz shows up minutes later, pushing open the door with a rush of air, ready to assist.
“He’s got it,” Faust-Lucking tells him. He means Adrian.
Though the patient’s heart rate is still rapid and erratic, her blood pressure is rising steadily. Oxygen saturation improves every moment. Her lips return, a little more as each second passes, to pink from blue. Stabilizing. Everything stabilizing. There will be a tomorrow. The reaction, if not reversed, has been stopped dead in its tracks. Surgery will proceed. Disaster has been averted.
• • •
That evening, before he goes home, Adrian decides to check on Trisha Browne. Earlier in the day, he’d been with her a short time in recovery, then given the nurse the go-ahead to move her to a private room. He’s never visited a patient postoperatively outside recovery before, but he finds he wants to see her, the proof of her, so he stands silent at the door to her room. She’s resting quietly. He leans against the doorjamb and watches her chest go up and down, feeling relieved and at peace like he’s watching waves lap at the shore.
She turns to him, eyes in slits, and as he opens his mouth to speak, she slurs, “I remember you.”
“Hi, Trisha. It’s Dr. Mandrick, your anesthesiologist,” he says low, moving to her bedside. “Just wanted to check in, see how you were doing.”
“Knew that was you.” She smiles a thin smile. “Wanna sit?” she suggests, her eyes closing.
Adrian lowers himself onto the plastic chair beside the bed and she opens her eyes again, pupils reacting slowly to the light.
“They told me ’bout it . . . that terrible allergy you made all right.”
“You came through with flying colors.”
“ ’Cause of you,” she whispers.
“With a little help from Dr. Faust-Lucking.” He smiles. “How’re you feeling now?”
She motions weakly for her water. Adrian picks up the cup and helps the straw find her mouth. “Sore pretty much everywhere,” she says. Her eyes roll back into her head, so she closes them yet again. Adrian takes the cup away. “Went through menopause for fifteen years. Jus’ my luck, minute I get done, they end up taking out the whole damn thing.”