“My sister’s. She was never going to walk again. So why go through that every day? The special sock? The special shoe? And then the brace? Like, it was pointless. And sometimes she didn’t want it, and she’d fight it, and my mom and dad would go through all the work of getting this brace on and off every single day, or else her staff would.” Now the words are literally choking me, and because Mick and Ron keep making the same point about noticing what you feel from one moment to the next, I notice the tension gathering in my face, the air pressing up against my eyes. “It was totally hopeless, right? The best outcome was like in ‘The Gambler.’ You know, Kenny Rogers? The country singer.”
“What happens in ‘The Gambler’?”
“You just hope you die while you’re asleep.”
“Oh, fuck, yes,” says Ikiru.
“And that’s what happened to my sister. She died in her sleep. How’d your mom die?”
Ikiru wipes a hand across her eyes, smudging her sparkling green shadow. I can’t tell if she’s crying.
“She was in palliative care at the end. She didn’t even know me for almost a year. She made no sense. We used to say her last meal was a word salad.”
I stifle a laugh. Someone in another group looks over at us. I cover my face.
“Love the black humour.”
“No other kind.”
“Did that resident you were working with ever find out your mom died a few weeks earlier?”
“If he did, he never said anything.”
“Did you think about telling him?”
Ikiru looks at the back of her hand, notices more smudges of eyeshadow. She traces them with a long, delicate finger. A surgeon’s hand.
“Actually, I’ll tell you something, but you’ll think I’m a horrible person.”
“I doubt it.”
“I heard his dad died. Maybe two years after that. I saw him in the hall. He looked really shitty, shittier than usual. I was going to say something to him, but he walked right by me and looked through me, like I wasn’t even a person. And I just thought to myself, Now it’s your turn.”
“Schadenfreude.”
“Yeah. Ugly, though. It’s not like I wished his dad would die.”
“But you hope he learned from it, right? Like, maybe it made him more human.”
“I think the only thing that would make that guy more human is a personality transplant.”
“Why do you think he acts like that?”
“Somebody told me once he used to be a really nice guy, everybody in his med school class liked him, that he always joked around. But he started to change during residency. By the time he was a fellow, he treated everybody like dog shit.”
“I don’t think I buy that he started out that nice. Although it is classic Stanford Prison Experiment.”
“I’m split on it too. Except, do you think women just direct more of that stuff inward? Because it’s unacceptable to behave like an asshole if you’re a woman, right? But all that rage has to go somewhere. I mean, I’d never be an asshole to a patient under any circumstances.”
“But you’d be one to yourself.”
“Yep.”
Is that why she has a pierced eyebrow and a hole in her sweater? Is that why 80 percent of what I ate for two years was almonds and black coffee? Jill, we’ve traced the call. It’s coming from inside the house.
“I feel like this is a really important idea.”
Get out of the house! Get out of the house!
“It’s funny, because I kind of assumed you wouldn’t even want to talk to me because you’re older,” she says, her voice sounding almost shy. “And then we have this huge thing in common.”
“Which one?”
“Ha. I just wish my mom could have seen me graduate.” Ikiru’s voice is distant now.
I’m picturing her walking across a stage in her cap and gown. Her father, maybe some siblings somewhere in the audience. The emptiness of the moment as Ikiru reaches out to accept her degree from the chancellor, or the generic dean. Another name called before she is even finished pausing for the picture, a photo for which the university will charge her eighty-nine dollars, a photo she’ll show her mother in her hospital room a few weeks later. When she points at her own unsmiling face and explains what’s happening in the photo, her mother will gesture at the bald, round head of the chancellor and say a single word: Egg.
“There’s always this void,” I tell her. “Losing a mother is totally different—I wouldn’t even presume to know. But in general, it’s difficult not to focus on what’s missing.”
“I think about it like an amputation. It’s kind of the inverse of the story Mick told about being shattered but still whole. You can still have a great life, a meaningful life, but you can’t look at the situation and say there isn’t something missing that used to be there. But then you find there are a lot of other people who have had amputations, and at least you don’t feel alone.”
“I completely get that.”
“You know how I ended up doing this Zen Buddhism meditation stuff? It was a quote I read somewhere. ‘The universe doesn’t exist to make you happy.’ For me that was a tiny lightbulb moment. None of this is personal.”
I have the feeling I’m looking in a mirror, the way it sometimes used to be with the students. Like I’m handing a letter to a younger version of myself, like I’ve come to this place in order to tell that version of me something I wish I could have heard then.
“This is really weird, okay? But I have to tell you. I wrote this song once. It’s kind of exactly what you just said.”
“You write music?”
“I used to, but then it kind of died on the table.”
“Well, that’s not okay.”
I pick up a pen. I write down the words for her in my notebook. I tear the sheet out, and she takes it from my hand.
There should have been birthdays and nephews and nieces
Instead of these shards of a life torn to pieces but
Life doesn’t owe us anything
Life never owed you anything
Life never owed me
Anything
She reads it twice. “This is exactly what I meant. Like, life never actually failed to do what it said it would do, because it never said it would do anything.”
“Because it’s just a construct that it made a deal with us.”
“It lets the hurt just be hurt.”
“Manslaughter instead of murder one.”
“Can I keep this?”
“Sure.”
“Will you play this for me someday?”
“You can’t afford me.”
It’s the first time I’ve really seen her smile. She has a beautiful, wide grin. Perfectly straight teeth. A vulnerability about her, a loveliness I missed when I was composing a narrative, the one that was only in my mind.
“Why do you have the piercing?”
“Why do you have blue hair?”
“Okay, but it doesn’t hurt when you dye your hair.”
“This didn’t hurt much.”
“But why choose anything that hurts?”
“It was kind of an impulse. People make assumptions about Asian girls, right? You’re so nice, you’re so polite, you’re going to follow all the rules. You know about the culture of cuteness? Kawaii?”
“I thought that was a piano.”
“A super cute piano.”
“Maybe medicine needs more kawaii.”
“No, medicine needs more of the last part. The ai.”
“What does that mean?”
“Love. Or, like, aisuru is ‘to love.’”
“That sounds like your name.”
“Only the -uru. It’s the verb.”
“So what does ‘Ikiru’ mean?”
“There’s a movie,” she says, looking embarrassed. “My mom loved it. She had a background in film. It’s black-and-white. I doubt you’ve heard of it. It’s called Ikiru. Don’t laugh if you think it’s cheesy.”
&nb
sp; “I won’t laugh.”
“It means ‘to live.’”
“You definitely have the best name of anybody here. Even if I’m going to withhold judgment on the eyebrow.”
She rolls her eyes. “You sound like a mom.”
The weight of those words fills the space between us. Our eyes meet. Now Ikiru’s eyes really do fill with tears. They roll down her cheek, leaving trails.
“I am a mom. And your mom would be so proud of you.”
“Well, I’m a sister, and your sister would be so proud of you.”
“I don’t know if she would be, actually.” Here my voice catches, and I break her gaze. “She didn’t have a chance to do all the things I did, and I’ve screwed up so much. I’ve wasted a lot of time. You never get that back.”
“What would you have done differently?’
Now I’m the one wiping away tears. “I wouldn’t have thrown myself under the bus for so many years.”
“Like, how?”
“Like, just the way I treated myself during residency. I’d have been nicer to a dog.”
She nods slowly, emphatically. Her voice is gentle. “What else?”
I drum a finger on the floor, thinking. “Probably joined Costco earlier.”
She laughs out loud. “What is it with doctors and Costco?”
“So efficient.”
“You’re a crazy lady,” she says, shaking her head. She wipes away her tears, punches me in the shoulder like we’re old friends. “We don’t get time back. But maybe going through all this teaches us how to spend it properly.”
“Or what it’s actually worth.”
“Or both.”
She gives me another shy smile. “I’m glad we met.”
“Me too.”
Another long, drawn-out minute passes between us, the kind of space people rarely leave between one another.
Ron and Mick can’t end this moment with a bell. It was always here, like a secret door you’ve been trying to kick in for years. And then, in the midst of this trial, as you hang your head in defeat, you notice that around your neck you are wearing a key.
21
Silence
For the rest of tonight, after a session with Ron and Mick, we’ll be in silence. Supper is in silence. Evening meditation: silence. In the morning, we’ll eat breakfast in silence.
But first we talk about silence. We talk about how it has many meanings for us. We have often experienced silence as punitive. A parent or lover who froze us out in anger. A teacher whose long, ominous pause before answering our question spoke to the depth of our shortcomings. The stunned silence of rooms where we’ve decimated lives with news of masses, failing bone marrows, the ominous results of scans.
Mick is giving us a “send-off.” He says it might not be easy. That not everyone responds to silence in the same way. He tells us not to make eye contact with each other, that many people find it invasive in silence. We may notice the intensity of our own thoughts in ways we’ve been able to mitigate and dilute before. He says we’ll need to sit with these things, just let them be.
Part of me bristles at these instructions. I’ve lived through tough things in my life. Mick’s framing a period of silence as if it’s learning to perform brain surgery. It feels pretentious, like he’s making a big deal out of a tiny laceration.
But why do I bristle? What constitutes a problem in my universe? Well, brain surgery. It’s not easy to compete with that. And yes, I know this definition is a form of extremis, and even a tiny laceration can become a life-threatening problem if you don’t sew it up properly and watch for signs of infection and tend to those signs if they arise.
I catch Roy’s eye. We look at each other for a long, quiet moment. Ikiru is still sitting next to me. I feel connected to her, as though a bright silver filament is fluttering in the air between us. I look around the room and locate Greg and Jodie and Joss. I’m going to miss talking to these people until tomorrow. I know more about them than I know about doctors I’ve worked with for the last decade, people whose offices are steps from my own. I’m not going to want to say goodbye to any of them on Saturday. I feel a curtain of anxiety come down over me, like I’m swimming at slow speed in very cold water. I don’t usually notice these sensations, or these emotions. I just plod through the cold and the darkness, heart pounding, breath shallow. It hits me like a wave of sickness: I don’t want to leave here. I want to see my children, my husband, my family, my friends, but I don’t want to leave these people. I don’t want to go back to the way things were before.
Do I have to go back to the way things were before?
The stillness in the room is electric. Fifty people, not speaking, breathing. Noticing.
I’m thinking of my children, how I loved them before they could speak. How their cries could tell me whether they were tired, or sad, or hungry, or wet, or afraid. Listening for different notes in their brief utterances, watching the way corners of mouths turned up or down, how eyes widened or closed. A look, a glance. A squirm, a particular kind of sigh. A song without words. I came to know what they needed. Even when they didn’t know.
We sit in complete silence. Occasionally someone sniffles, or lifts a hand, wiping away tears. I turn my attention to my breath. Every time I notice my mind wandering, I try to come back to the temperature difference in my mouth and chest, cool air entering my warm body, lungs expanding. I notice how each breath displaces me, lifts me up higher on the cushion, nudges my shoulders and rib cage skyward. My mind still wanders. It never stays with the breath for more than a few seconds.
But maybe I can shepherd it back to the breath when it’s only gone as far as the backyard. Maybe I don’t need to let it get as far as the freeway, or the airport, and then I won’t have to spend days walking back, retracing my steps to the place where I find my breath. Maybe this is a way to conserve energy, an alternative to holding court with everyone I know. Talking to Stan, Mr. Ripple, the Dutchman. The students. My parents. My sister. My friends, my enemies.
None of the people I talk to in my head are actually here. This seems so obvious, and yet it isn’t obvious at all—that I spend half my waking life interacting with what are basically holograms I’m generating myself.
And what is it that I’m saying to them, trying to get them to understand?
Mick uses the mallet and strikes the metal bowl. The sound is a slow, resonant quiver.
The quality of the energy in the room changes. People stretch, yawn, sigh. We stack our cushions in the corner. It’s getting dark outside, and our movements are reflected in the opaque glass.
Slowly, we form a silent procession up the stairs, our feet padding on the rug, our eyes cast down. We splinter at the top of the staircase, going our separate ways.
I wouldn’t have imagined that you could get a group of fifty doctors to follow all these crazy rules. But here we are.
At the top of the stairs, despite the instructions, Roy looks me in the eye. I meet his gaze. It is mine to decipher. As with my children, I know he is asking me for something in that moment. I nod at him silently. I can hear the music in his head. A song, without words.
22
When You Walk Away
We meet by the blank deceitful Zen head, as if we had planned it. Roy’s sitting on the bench, wood stained with dark rainwater, wearing his windbreaker and knee-high rubber boots.
“I wanted to talk to you,” he says.
“I know.”
“You didn’t dress for the weather.”
“Snow’s my forte.”
“I’ll give you my windbreaker.”
I sit down next to him. He takes it off, drapes it over my shoulders. We’re under a massive tree with long, spidery tendrils. I didn’t really notice it yesterday.
“I saw you talking to that Japanese girl.”
“Ikiru.”
“It looked intense.”
“It was intense. Who were you talking to?”
“A psychiatrist from Northwestern.”
“How was that?”
“Helpful. I told him to bill for it.”
“What did you talk about?”
“A pregnant woman who died of a pulmonary embolism a few years ago. My resident misread the perfusion scan as normal, and she presented to another hospital in cardiac arrest.”
“That’s awful.”
“The kind of case that makes you want to steer your car into a tree on the way home.”
“I’ll bet.”
“What was your mistake?”
“We didn’t get to it, actually. We ended up going sideways.”
Roy turns to look at me. He’s tall, with the perfect posture of a choir boy. There’s a youthfulness about him. Vulnerability, a familiar sadness.
“You can tell me now if you want.”
“It’s too late.”
“Why would it be too late?”
I put his windbreaker on, although I’d rather keep it draped over my shoulders because of the tenderness of the gesture. I’ve started to shiver, but I’m trying to hide it, because I don’t want him to suggest that we go back inside.
“It wasn’t really a medical error anyway.”
“You let me tell you about Brian. Can’t we hold it up to the lightbox together?”
“You really want to hear this now?”
Roy nods. I look down at the small drops of rain beading on the surface of his jacket. I feel a surge of something akin to love for him. Not romantic. An intimate kind of gratitude.
“His name was Michael.”
“That’s the angel of protection. Did you know that?”
“Well, he did a bad job for his namesake in this case. He had cystic fibrosis.”
Roy lets out a heavy sigh. He knows cystic fibrosis the same way I do, as an insidious son-of-a-bitch assassin that slowly sucks the life out of young men and women before they reach forty. Condemning them to early death by suffocation, drowning in their own cement-like mucus, unless they submit to lung transplants: torturous, elaborate surgeries with no guarantees.
“He was my age. Just a kid, basically. He wanted to be a writer, Roy. Just like me. We met when I was an intern.”
“How did you meet?”
“I was on the respirology service. He was a chronic inpatient, too sick to manage at home. It was December of my first year in Toronto. We rounded on him every day. He was weak as a kitten. He had these ugly glasses with a bar across them. The kind the guys wear now, because they’re in fashion again. He had a penchant for T-shirts with slogans from old political campaigns. I remember he had one that was, like, Nixon—he’ll get the job done. This kid’s whole life was irony.” I can see Mike’s hair, shaggy, an involuntary mullet because of the energy it took for him to shuffle down to the hospital’s hair salon. It catered to eighty-year-olds bound for long-term care. He told me once he was thinking about getting his hair set in curlers so he could experience a sense of belonging.
We Are All Perfectly Fine Page 16