RIVERHEAD BOOKS
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Copyright © 2020 by Michele Harper
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Library of Congress Cataloging-in-Publication Data
Names: Harper, Michele, author.
Title: The beauty in breaking / Michele Harper.
Description: New York : Riverhead Books, 2020. | Includes bibliographical references.
Identifiers: LCCN 2019022440 (print) | LCCN 2019022441 (ebook) | ISBN 9780525537380 (hardcover) | ISBN 9780525537403 (ebook)
Subjects: LCSH: Harper, Michele. | Emergency physicians—United States—Biography.
Classification: LCC RA975.5.E5 H37 2020 (print) | LCC RA975.5.E5 (ebook) | DDC 616.02/8092 [B]—dc23
LC record available at https://lccn.loc.gov/2019022440
LC ebook record available at https://lccn.loc.gov/2019022441
Cover design by Lauren Peters-Collaer
Cover image: Alan King engraving / Alamy Stock Photo
pid_prh_5.5.0_c0_r1
AUTHOR’S NOTE
I have intentionally altered some details in this manuscript, particularly identifying details concerning patients, colleagues, various hospitals, and other locations. While names and dates may have been changed, the human experience at the center of this story is true and unfolded as described.
To the truth tellers and the truth seekers; to those who live honestly now and to the others who will one day; and last, but not least, to those courageous enough to love in a way that only creates freedom
CONTENTS
Introduction
ONE. Michele: A Wing and a Prayer
TWO. Dr. Harper: The View from Here
THREE. Baby Doe: Born Perfect
FOUR. Erik: Violent Behavior Alert
FIVE. Dominic: Body of Evidence
SIX. Jeremiah: Cradle and All
SEVEN. In the Name of Honor
EIGHT. Joshua: Under Contract
NINE. Paul: Murda, Murda
TEN. Sitting with Olivia
ELEVEN. Jenny and Mary: What Falls Away
Epilogue
ACKNOWLEDGMENTS
WORKS CITED
INTRODUCTION
God breaks the heart again and again and again until it stays open.
—HAZRAT INAYAT KHAN
As I cradled my patient’s head in my hands, I looked past the watery wells of his eyes. For a moment, I didn’t notice the blood that ran in rivulets across my gloves as it poured from his scalp, or the bits of gray and white brain matter that dotted the sheets. The beeping of the monitors around me, the popping sound of IV catheter tops being flicked off by nurses, the screeching of wheels as equipment was dragged across linoleum floors, the nurses and techs yelling directions at one another, the stifled gasps erupting from the two medical students on their first ER shift attempting in vain not to be startled—all were drowned out as I stood over this young man and tried to ease his agitation.
This is the part of being a doctor that medical school doesn’t cover, that case reviews don’t prepare you for. This is the part you can’t really know until you’re in the moment: You are the person responsible for saving the human life that slowly slips through your fingers while silently begging for final redemption under the demanding fluorescent lights.
I am the doctor whose palms bolster the head of the twenty-year-old man with a gunshot wound to his brain. I support the baby as she takes her first breath outside her mother’s womb. I hug the wife whose husband is dying from advanced liver disease as she implores the universe to take away his pain.
I claim no special powers; nor do I know how to handle death any better than you. What I know is that for thirty-six hours a week, I reside in the melee that is a hospital emergency room, where I am called upon to be salve, antidote, and sometimes Charon. Most of the time my job is to keep death at bay. When I am successful, I send the patient back out into the world. When I’m not, I am there as life passes away.
I’m not so deluded as to think that I alone am capable of making that kind of difference. I’m well aware that the determination of who lives and who dies doesn’t happen at my hands alone. There are times when, despite the designs of any patient, family member, friend, or doctor, death will come. Then I am witness. What I can do is be the ferrywoman who holds the body as the last breath escapes, the one who, like the night sentinel, calls out the hour and does her best to convey that all is well.
Like everyone, I am in this world for only a brief time. And as for many, blessings abound in my life, and they abound amid the struggle, amid my struggle. Over the decades I’ve learned to cultivate a personal state of stillness. As a child, that stillness grew from a dissociation I stumbled upon that allowed me to better endure life with a father who was a batterer and with a family legacy of victimhood. As a black woman, I navigate an American landscape that claims to be post-racial when every waking moment reveals the contrary, an American landscape that requires all women to pound tenaciously against the proverbial glass ceiling, which we’ve since discovered is made of palladium, the kind of glass that would sooner bow than shatter.
When I began writing this book, I had started over. My marriage to my college sweetheart had ended. I had moved to a new city to start a new job. Plagued with doubt, I found myself having to reevaluate my life. Living through such changes was difficult; now I see those junctures, when everything I had counted on came to an abrupt end, as a privilege. They gave me the opportunity to be uncertain. And in that uncertainty grew opportunity.
From childhood to now, I have been broken many times. I suspect most people have. In practicing the Japanese art of Kintsukuroi, one repairs broken pottery by filling in the cracks with gold, silver, or platinum. The choice to highlight the breaks with precious metals not only acknowledges them, but also pays tribute to the vessel that has been torn apart by the mutability of life. The previously broken object is considered more beautiful for its imperfections. In life, too, even greater brilliance can be found after the mending.
As an emergency medicine physician, I know how to be still for others. I know how to call down the gods of repose and silence, to take the measure of their power in the moments when I need it most. This stillness I inhabit as I pause, push, breathe, and grow.
The stories I tell here will, I hope, take you into the chaos of emergency medicine and show you where the center is. This center is where we find the sturdy roots of insight that can’t be windthrown by passing storms. In their grounding they offer nourishment that can, should we allow it, lead to lives of ever-increasing growth. I had to find this center for myself as I took stock of experiences that were exceedingly painful yet that ultimately filled me with the promise of a meaningful rebirth, a rebirth that is worth the surviving, worth the healing, worth the repair.
ONE
Michele: A Wing and a Prayer
I am seven and a half. I am bathed in a quiet punctuated only by the rhythmic upsweeping whistle of the northern cardinal’s song. It’s almost never like this, but right now the only sound emerging from our three-bedroom Colonial is the refrigerator’s hum. No one
is screaming or yelling, no one is punching, no one is being hit, no piece of furniture has toppled to the floor. Today there are no new bruises and no new scars. It is Saturday afternoon and it is absolutely tranquil: My brother, sister, and father are out. My mother is down the hall in her room.
I gather up three of my favorite My Little Pony figurines, holding one in each hand and tucking one under my left arm, leave my bedroom, and walk downstairs. All I can hear is the whisper my socks make with each step on the hardwood floor.
After moving to Washington, DC, when I was four years old, my family proceeded to change homes three times within a four-mile distance; homes two and three were less than a mile apart. Each move was precipitated by my parents’ desire to live in increasingly attractive homes in increasingly exclusive neighborhoods. It was a game whose prize was not comfort but prestige, so they bought and sold homes until they ultimately lost. This is home number two, on Sixteenth Street in Northwest Washington, close to the border with Silver Spring, Maryland.
I walk down the staircase that ends in the foyer, then through the foyer to the living room, and finally to the Fish Room, so named by my little sister and me for the large aquarium that is its centerpiece.
The people on my mother’s side of the family were very superstitious. You don’t walk under ladders. At all costs you avoid breaking a mirror. You always look at the new moon over your right shoulder. And you never ever split a pole. The fish tank fit neatly into this paradigm. As my parents explained, it was meant to activate positive chi and block the negative energy in an environment. The tank was home to a small array of tropical fish. Siamese fighting fish, whose fins were a rainbow of fiery plums giving way to reds, were always included in the aquarium selection. What seemed like every several weeks the fish would die, and then my parents would buy new ones, which would suffer the same fate. It struck me as strange that they simply replaced the fish without first conducting a thorough analysis on what had caused the aquatic massacre.
Today, as I enter the Fish Room, I note that the aquarium (a thirty-gallon rectangular glass prism atop a simple, tall, black metal stand) has recently been replenished. Sun pours through the windowpanes, casting shadows on the butterscotch wood. I settle cross-legged on the floor and masterfully jockey my team of horses over each groove and shifting beam of light. They are skilled and graceful jumpers, but what else could be expected of ponies from a peaceful paradise estate?
Completely absorbed in the play, I feel an ease suffuse my entire being. For those cherished minutes, the armor that encases my spirit loosens and I am wholly open to the moment. Then, as if on Pegasus’s wings, I feel a presence floating with me in the room, next to the red velvet sofa, in front of the fish tank, which faces the bay window. When I look for it, it is just me, alone in the softly lit room. I see no one, though I feel and hear a gentle essence. Her voice is so familiar that when she speaks, it’s as if the words were my own.
Michele, you are okay. You will be okay. You will be safe. Your mother will be safe. Your brother and sister will be safe.
Security was perhaps the only thing I ever wanted, and up to that point it had remained a long-ungranted wish.
The benediction continues: You will live. You must. Your mother will live. Your brother and sister will live. You will grow to see that you will help many people. You will grow to do great service. You must.
I sit on the floor, the ponies strewn about me, momentarily forgotten. I feel my eyes widen more with each word. It is the stupor in the face of answered prayer, the astonishment of gratitude. For once, nothing in me is afraid. And just like that, as soon as she has arrived, she is gone. Just one message, and then she vanished.
I knew about guardian angels from TV shows. They are always visions in white gowns with expansive wings who float on beds of cumulus clouds. There was no visual for mine, just a voice that sounded clear and sure, an articulation that permeated the room. I can’t contain my excitement—I fully believe this message has been from an angel. For the first time in my life I am spilling over with joy. I sprint upstairs to my mother to let her know that we will survive.
It is this very message that buttressed me for the next two decades of my life. On so many days, when all signs pointed away from my not only thriving but surviving, I remembered the angel’s whispers and felt saved.
I cannot count how many times I longed to be rescued in my father’s homes. The beauty of this one, on its large, tree-lined, and well-manicured lot, belied the chaos raging within.
You couldn’t hear it from the street. Just the day before the angel came, I had been in my room with my sister, in the midst of a stuffed animal caucus, while our brother, John, was in his room, stereo blaring the latest ’80s R&B hits. Then I felt my brother’s door bang open and the floor shake as he sprinted down the stairs. My sister and I stopped cold and locked eyes. My blood curdled for a terrifying moment. I heard something wooden fall, feet scuffling across the floor downstairs, and a body thrown against a wall. Then my mother’s scream—“Stop!”—was immediately cut off as she was strangled mute.
I had to go downstairs. I had to stop it. I had to help my older brother, who was on his way into the fray. I had to stop my father from killing my mother.
Honestly, I don’t know what’s worse: constructing an image of the brutality in your mind’s eye or actually bearing witness to it. At seven, I didn’t have the power to choose. At seven, you attach in the only way you know how: You think you love even the attacker, the one who hurts you and your family. At seven, you blame yourself. In that split second, as I waited, frozen in terror, I knew only that at any given time, everything I wanted and everything I cherished could be taken from me. I knew that I didn’t deserve to be happy because although I couldn’t understand what and I couldn’t understand how or why, I knew that I must have done something terribly wrong. I knew that I had to run downstairs to save a life, but I couldn’t face yet again the terror in which, somehow, I had played a pivotal role.
Seconds later, I was on the stairs, my younger sister right behind me. Toward the bottom, she stopped short and lost her balance, causing her to accidentally nudge me farther down. I clung to the banister to keep from falling. We stood there, afraid to enter the scene.
After summoning my courage, I walked into the kitchen to see my mother standing alone, bracing herself against the wall. My brother stood in the middle of the room. Two chairs and a broom were strewn across the floor, and shards of shattered glass were everywhere. My father was gone, and the front door was wide-open.
“Be careful, girls. Don’t step on the glass! Go get shoes!” my mother cried out, gasping.
My brother walked over to the chairs and began to right them.
“Oh my, I’ve lost my earring. Dern!” my mother exclaimed. It was an allowable expletive employed by my grandparents. My mother’s parents were Southern, so this was likely the regional variation of “darn.”
“Where in the world is that earring?” my mother continued, acting as if that were the most important detail of the scene we confronted. For her, it was.
My sister had already gone upstairs, put on shoes, and was now hard at work peering into every nook and cranny of the kitchen.
My mother picked up the broom and began sweeping up the glass. “Careful, kids, watch where you step. Gosh, I hope I don’t sweep up that earring.”
I, too, retrieved my shoes and returned to help. I went to the open front door and looked outside. There was no one. In keeping with my indoctrination, I closed the door firmly to seal the secrets inside.
Within minutes, my sister had found the sapphire stud earring that had rolled under the corner of the Oriental rug in the foyer.
“My goodness, how did it get over there?” my mother asked. “I knew it—good old Eagle Eyes gets it again! Thank you, my darling.” She plucked the earring from my sister’s small palm and gave her a hug. “I’ll find another bac
king. That’s less important. I must have an extra upstairs.”
She put the earring on the counter so she could finish sweeping up the glass. As she bent toward the dustpan, her hair fell forward, and when she brushed it back, I could see red marks on her neck. The nail of her index finger was broken, and the ragged edge was covered in dried blood. She winced a little as the pressure from the dustpan dug into her bruised finger.
My brother balled up his fists and silently climbed the stairs—a moment later I heard him resume listening to his latest vinyl album: Prince’s Purple Rain. While my sister sat quivering with my mother in the kitchen, I went into the foyer and sat on the bottom step of the staircase. I waited in the event my father returned. I waited in case my sister cried. I waited for my fluttering heart to be still. I waited even after my mother had put the broom away, retrieved her sapphire earring from the counter, and walked past me to go upstairs to her room. I waited for the discussion our family would never have.
And, really, what kind of discussion would it have been? Would we have all gathered in the living room, we three children on the sofa and a parent seated at either end in antique chairs?
If he were to have spoken the truth, here is what my father would have said:
I come from a place of deep shame and self-loathing. I never learned to forgive my parents for abandoning me, so I never learned to love. Instead of taking the time to heal from my past traumas, I chose to distract myself by marrying before I was fit to be in a relationship of any kind. Every day, by not making a better choice, the right choice, I choose to tether myself to this dysfunction. Because of this, I have made a choice to continue that cycle of pain and suffering. For this reason, I have decided to rob myself of health and genuine connection. For this same reason, I choose to terrorize you and rob you of any sense of security and childhood. It won’t stop until decades from now, when I finally walk out of your lives. And yes, I know that I am wrong. It’s true that I should have committed none of this violence. You will or will not find your own closure as you wish. You will or will not find your own healing as you wish. As for me, I will run from this place. I will hide from myself beneath the cloak of Christianity. I will let these silent compartments of denial and hurt imprison me in this life. That hell is my temple.
The Beauty in Breaking Page 1