We Are All Perfectly Fine

by Dr. Jillian Horton

  “He was listed for a transplant, and he’d waited for months. He kept getting infections, so he went on and off that list. But the way I really got to know him was the coffee shop. There was a Second Cup in the hospital lobby. Right by this big statue of the angel that we walked by every day. Mike would be down there when I was on call, playing solitaire. I’d always say hi. And then I started saying more than hi, because he’d be reading, and I wanted to know what he was reading. And I saw that he was reading stuff I loved. Like Maus. And weirder stuff, too, like Martin Amis. And within a couple of months we were talking every time I was on call and if I was at a different hospital, he’d send these great postcards to my home address. They were never about how he was doing. They were always about the stuff we’d talked about or full of questions about how I was doing, but nothing about him. I think he was so sick of talking about his body and how much mucus he had that day and cystic fibrosis that he just couldn’t handle the spotlight being on him anymore. Except once in a while he’d say, ‘My lungs are coming. I know it.’ And I’d nod, even though I honestly wasn’t sure he was going to live long enough to get them.

  “So then I switched hospitals for my next rotation. I went to Toronto General. Sometimes we called it Toronto’s Genitals, but it was a great place. Very new. Glass and high atriums and a couple of blocks from where insulin was discovered. I’d walk by Banting’s bronze head, and sometimes I’d rub it for good luck. I know it’s weird—don’t laugh. My next rotation was Nephrology. I’d see everybody who was on dialysis for the whole hospital. It was crazy busy. Those people are sick, right? And I showed up on that service and saw the list of consults, and there was Mike’s name. Post-transplant. He was in kidney failure, but it was improving, and he’d had a transplant. This was in the days before we all carried cell phones, so the whole thing was probably just too rushed for him to let me know. But I think he would have if he could have. I think I bridged two worlds he inhabited.”

  “Which two?”

  “Life and death.”

  “That’s what I thought you’d say. But there are others.”

  “Yes, like sick and healthy, right? So I went to see him after the transplant. He was really bloody ill. He was in the ICU, and he just looked like roadkill. They couldn’t get him off the ventilator at first. His lungs looked good, but all this other stuff was going wrong, including with his kidneys. The way he looked at me, that first day, with the tube in his mouth and his eyes half open, I wasn’t even sure if he knew I was there. He told me later it was the lowest point of his life. I didn’t want to see him that way. I avoided his mom. I couldn’t face her fear. Usually I could handle anything, but I couldn’t even look at her. Mike’s dad died when he was a kid. He had a heart attack. It was just the mom and Mike and another brother. I don’t think they had anybody else. She clung to Mike.”

  “Maybe even the way your parents clung to your sister?”

  “Yeah, maybe, Roy. Good pickup.”

  “Kind of obvious.”

  “Maybe to you. So Mike started to get better. Every week or so he made progress. He got up in a chair. He walked a bit. He made it out of the ICU. He slowly jettisoned all the gear that goes along with acute illness. Oxygen. Foley catheter. Central line. All that stuff. He had a birthday. I brought him a cake. It was stale, though. It’s a dumb regret I have—I didn’t go to a real bakery.”

  “That’s a total Captain Sullenberger. ‘How could I have landed the plane better?’ You know . . . Miracle on the Hudson?”

  “God, of course I know. He’s one of my heroes.”

  “Sorry. What happened next?”

  “He got discharged. He kept writing me postcards. We went out shopping together once in Chinatown. He had one of those old cameras where you develop the photos yourself in a darkroom. He took a picture of me and sent it to me in the mail. I was in this old long plaid wool jacket I used to love, kind of the way I liked to picture myself, with the wind in my hair and my mouth open because I’m laughing.”

  Roy tucks his chin down. He looks at me skeptically. “Was he in love with you?”

  “Oh! No, I really don’t think so.” I’m shivering now. The wind has picked up, and the surface of the pond is rough and pricked with little white waves.

  “Well, were you in love with him?”

  “Oh my God, no. Never with a patient. Gross.” I blow on my fingertips, then rub my hands together like I’m trying to light a fire with them.

  “I don’t see what the problem was.”

  “There wasn’t a problem.”

  Roy pauses. He looks at me for a long time before his gaze travels to the ground, then back up to my eyes.

  “So where are we going with this?”

  I’m holding my breath. Roy sees that I’m shivering.

  He wants to go with me.

  “Should we walk?” he asks. I nod. My teeth are chattering. “We can go inside if we have to.”

  “No, we can’t, because it’s silence and we’re breaking it right now. Let me just tell you the rest of it. It’s not long.”

  We stand up at the same time, our boots cemented into the wet mud. We extract them and walk, following a path that loops around the pond.

  “Remember I said I didn’t have a phone. But I had a pager.”

  “The box of pain.”

  “Yes.”

  “So several months go by. They’re bad months. My sister is really sick. My parents are falling to pieces back home. I’m getting caught up in some really dysfunctional coping of my own. We don’t need to get into it—I’ll tell you about it another time. I’m really hitting a new low point, though. Just getting through the days, going through the motions, except everybody is telling me how great I’m doing. I’m kind of withdrawing from the world after I get home. Closing the blinds, watching movies and letting my machine take all my calls. I’m not calling my friends. I’m not responding to half my emails, and I haven’t answered Mike’s postcards for months. I’m a senior resident now, and I’m at another hospital. It’s called The Western. And one day, out of the blue, I start getting these five-digit pages. I call back, and they’re always these automated not-in-service numbers. Nobody there. And these calls keep coming, Roy. They happen every day for about three weeks. They make me crazy. I phone the Toronto Western switchboard, and I’m practically yelling at them to stop putting these calls through, right, because it’s annoying and you’re in the middle of seeing a patient and you keep wondering who’s paging you and whether they’re going to call you again. They say they’re not paging me. And then one day they stop. I don’t even notice for a few days that there haven’t been any of the pages. It’s like in M*A*S*H. where they always say, ‘Do you hear that?’ when they’re in the OR and the shelling’s over.”

  Roy and I come to the end of the path. We turn around, heading back to the faceless Buddha.

  “You know it was him paging me, right?”

  “I do. But why couldn’t you answer the pages?”

  “Because they were numbers you could only call from inside the hospital, where he was. Like when you call a business, and you have to dial the extension of the person you want to reach. He was paging me to an extension. Just an extension, without a location. Like telling someone to call you at a local number without giving them the area code when you’re in a different state. You can’t answer the call from that other state without the area code. He wasn’t a doctor. He wouldn’t know how to call someone on a pager. Get it?”

  “I think so,” Roy says thoughtfully. “But why was he paging you?”

  “Because he’d been readmitted. He’d gone back to work, gotten run down, and started having recurrent infections. He was just so hungry to live a normal life again and make up for lost time. He’d taken a trip to the U.S. with some friends. It was one of the last postcards I’d had from him before all of this. There was some fast-food restaurant he always wanted to go to, like an In-N-Out burger. He did it. That was the one pathetic dream he got to realize. A on
e-dollar shake. He was trying very hard to be normal.”

  “So what did he say when he got hold of you?”

  We’re back at the Buddha without a face. It’s pouring raining now.

  “He didn’t get hold of me, Roy. The calls stopped because he died.”

  His voice is breathless, gentle. “Oh, Blue,” he says. “How did you find out?”

  “I was back on the respirology ward where we first met, seeing an internal medicine consult. And I said to one of the nurses I knew up there, ‘Hey, I haven’t heard from Mike in a couple of months. But we keep in touch, and last time I heard from him he was doing great!’ And her face went white and she said, ‘He had an overwhelming fungal infection. He just died.’”

  Roy and I are standing next to the fake Buddha, like we’re hovering over a gravesite. He puts his arm around my shoulder, gingerly, as if I might lose my balance and fall down the embankment. “I didn’t even believe her. I thought it had to be a mistake, but she showed me the obituary. It was taped up onto a filing cabinet. I missed the funeral by two days.”

  Two days. The moment comes back to me. Mike is dead. His picture in the paper, above a few short paragraphs, the ones that could never do justice to him or his complexity or his short, difficult life.

  “I don’t know how I got through the rest of the day. I guess I went on autopilot. It’s all a blur. On the subway I just kept thinking, I have to get home. I have to get home. And when I did, I fell onto the carpet and had one of those cries where you can’t even move afterwards. I couldn’t sleep that night. It was probably 2 a.m. when I figured it out. All those pages I couldn’t answer: they were from him.”

  “What do you think he made of it all, Roy?” The question has a new urgency, an angle I haven’t considered for years. “That I thought I was too big a deal to answer him?”

  “I doubt that, Jill,” he says with immense tenderness. “Nobody who knows you could think that.”

  “Why didn’t I connect any of the dots?”

  “You know why. Those dots just keep coming at you when you’re a resident. You don’t have time to brush your teeth. How could you have figured that out?”

  “I should have.”

  “Is that a pattern, for you, that you berate yourself?”

  “Isn’t it a pattern for everybody here?”

  “You know about the ‘curse of knowledge,’ right?”

  “Of course I do. God, what do you think, Roy—I’m visiting from another planet?” He reclaims the arm he had around my shoulder. He must be cold in his thin shirt. “Let’s go back in. You’re soaking too.”

  “No, this is too important. So, the curse of knowledge is when we can’t imagine other people not knowing what we know, because it’s impossible to see as if we don’t know, right? Our minds can’t do that.”

  “I know what it is!”

  “It hits the brakes on our compassion for other people when they make mistakes. We think, how could they do anything that stupid? But it also puts the brakes on self-compassion. An area where people like you and me don’t tend to excel. Would you say that’s right?” I don’t answer him. I’m looking at the wet ground. I’m thinking about Mike. And Mike’s voice. His jokes. That stack of postcards I never answered.

  “The other thing is, Jill, something else you said struck me. You said at the start, ‘He was just a kid.’”

  “He was.”

  “And you said you were the same age.”

  “I did.”

  “That must mean you were just a kid too.”

  Roy, don’t screw with me. I feel an ache in my chest, my breath coming faster and faster.

  “Can we agree that it’s not your fault?”

  “I don’t need that from you right now,” I tell him, and I mean it. What does he think this is, Good Will Hunting?

  There’s a long hush between us, like we’re in the Zendo. The main building glows in the distance, illuminated from within. It looks like it’s part of a toy village.

  After a while he asks me, “Since you keep erroneously telling me you’re a failed writer . . . I’m guessing you’ve read Joseph Campbell. The Hero’s Journey?

  “I have it in my office.”

  “Good, so you know where I’m going with this.”

  “With what?”

  “Your arc. Your hero’s journey.”

  “My ‘arc’?” I can’t help rolling my eyes at him. “Don’t you think a person on a hero’s journey should be an actual hero?”

  “I think the greatest heroes are anti-heroes.”

  “Well, then you’ll love me, Roy. I’m an anti-anti-hero.”

  “Double negative equals a positive. My point is just, you can move through all the stages, or you can get stuck in one. And maybe you’re stuck in the third one. Do you remember what it is?”

  I shake my head.

  Roy pauses. “It’s ‘atonement.’” He looks at me for a long, quiet moment. “If you won’t let yourself leave atonement, you’re never going to get to the next stage. Do you remember what that is?”

  No, I don’t remember it either. I’m sick of the teaching session. I notice he’s shivering now too.

  “It’s the journey home.”

  There’s a long pause.

  I start unzipping his windbreaker to give it back to him. It’s too much. I’m too much. Roy’s too much. Fuck him. Fuck all these weirdos, except maybe Jodie and Greg and Ikiru and Joss. This feels like some kind of fucking Care Bear cult.

  Roy makes a tsk sound, the way he did the first time we spoke, when he admonished me for saying he was crazy. “Why are you taking that off?”

  I thrust his coat towards him. My eyes are filling with tears, and there’s nothing I can do to stop them. I want to go inside.

  “Maybe you don’t think things are allowed to get better for you, for some reason,” he says gently. “Or maybe you don’t want to go home?”

  This is the most weirdly accurate thing anyone I barely know has ever said to me. What’s weirder is how it affects me, like a band tightening around my heart. A visceral, reflexive pain, like when you cut yourself. I’m temporarily overcome with a desire to pretend I don’t know what he’s talking about, to tell him he’s mistaken me for somebody else, a person with another kind of past.

  I don’t want to go home. A sudden, guilt-ridden flashback to the time I read my sister Heather’s journal. I found it in her bedroom. I was just a bratty teenager, rummaging through her things while she was out, only looking for pocket change or fodder for low-grade blackmail. She was eight years older than me—a lifetime, really, at that age. She’d saved all the money she’d earned waiting tables at the university cafeteria, taken a trip to California, come home with a diary with a picture of the ocean on it. I’d seen it sticking out of her backpack, and I intended to plunder its secrets. I ran that journal to my bedroom and hid under the covers, cackling to myself, expecting to find lists of boys she liked or the name of the ABBA member she wanted to marry. Instead, a handful of grief-stricken lines.

  I don’t want to go home. I feel like a terrible person for saying it because things are so hard for Mom and Dad, but I wish I could never go back. There’s nothing there for me. Nothing.

  I stared at the words.

  The dawning, in that moment. How much we were all suffering, privately, pretending we were fine. How brutally difficult it was, living with Wendy, caring for Wendy, grieving for Wendy and everything we’d lost as a family, my brother seemingly vanished off the face of the earth. How it consumed my parents, totally, how their own lives and dreams were shoved to the side, how they somehow managed to plod through indescribable conditions for decades. How Wendy’s needs always had to be at the centre of everything. How profoundly, how biblically she suffered. How her illness was a wildfire that tore across all of our lives, how there was nothing we could do to stop it. How hard it was to say that I suffered. How hard it still is, to say that.

  Maybe I surrounded myself with the sickest people I could fin
d so I would never have to say that, so there would always be somebody around me who was suffering more. So I could minimize my own problems for the rest of my life.

  It was an impossible situation. And it was nobody’s fault. Even the doctors who had been awful, even in light of how awful they had been. They were products of a sick environment.

  It wasn’t their fault.

  What did Don Henry, my old piano teacher, say to me all those years ago, when I was trying to decide between Oxford and medical school? How could I not have thought of it before now, his choice of words? He said I should remember that it was okay for me to want a good life for myself too, that I was entitled to a good life. That you have to live for yourself and not just for everybody else. I guess I must have looked stricken, because he said he felt as if he had said something terrible to me or misspoken. I hurried home from my lesson that day, something I couldn’t name boiling up inside me.

  After we stand in silence for a few minutes, Roy asks, “Why do you say you’re an anti-anti-hero, anyway?”

  “I was supposed to save my family.”

  “From what?”

  “I don’t know.”

  “Were you supposed to go back in time?”

  “I didn’t have a plan, Roy. It’s not literal.”

  “But your guilt is literal.”

  “I’m sure yours is too. What about your friend Brian?”

  He pauses. I hear him take a breath, and as he does, I notice my own breathing, cold air moving into my mouth and throat, rain matting our hair, rain leaving fleeting craters in the surface of the pond, our arms and legs stiffening in the cold. Light is just giving way to dark, dusk settling on top of the forest. I’m shivering hard now; I can barely feel my fingers.