The Beauty in Breaking

by Michele Harper

  My forehead throbbed. Each pulsation pounded against the affirmation regarding the good day I was supposed to have had.

  Then again, many events don’t unfold the way we think they are “supposed to.” Leaving Colin had felt like an amputation, an amputation of the love we used to have and the love of the child he said we were destined to have. Colin had even named him. When I told him I knew that my destiny was to have a girl, he laughed and said, “No, dear. I only make boys.” So, I had lost two boys that day: Colin and the son he imagined we would have, a familiar loss that echoed the ghosts of Nella and August but was magnitudes more painful the second time around. I would get through this, too, no matter what. Over the next couple of weeks, I would set my mind back to the career stuff. It was strange to be balancing all this on the heels of my recent rebuilding. My foundation wasn’t yet set, so I certainly didn’t feel strong enough to weather this storm.

  I had just listened to an interview with Astro Teller, the director of Google X, who explained that failure isn’t making mistakes, it’s not launching one project after another that fails. No, Teller defined failure as identifying that a course of action you’ve taken doesn’t work, but proceeding with it anyway. So, I guessed that in my course-correcting, I actually wasn’t failing repeatedly.

  I felt myself breaking into a smile as I gazed out on my herb garden. A new reality seeped in: I would have to destroy it. The ladybugs I’d put there to take care of the aphid infestation had proved only a temporary fix; as expected, after they’d feasted, they’d flown away to explore other parts of Center City. The diluted cayenne pepper spray had failed as well. What I had was an herb garden overrun with insects.

  I promised myself that I would get to it, and even considered that I’d start another organic garden in a week or two.

  I considered the energy and love that had so peacefully radiated from Joshua. I considered what it must feel like to live free from fear and to connect so closely with bliss. He had lived the way he wanted to, on his own terms. When he was faced with cancer when he wasn’t yet fifty, he had refused chemotherapy and radiation. This decision had been radical twenty years ago, when Western medicine was even more paternalistic than it is today and when complementary medicine had an even smaller platform. Even now, though I embraced the therapeutic benefits of healthful nutrition, physical fitness, acupuncture, aromatherapy, mindfulness, and meditation, and believed that living well with integrity imparts greater benefits than most of what can be dispensed in a pillbox, I couldn’t know what decision I would make in those circumstances. I understood the compulsion most people had to wage the hardest war with the strongest drugs Big Pharma could fathom. I could imagine that refusing chemo and radiation might feel like a death sentence, especially with so many scientific articles, doctors, and hospitals touting their efficacy. These voices can be hard to ignore. I also know that a person’s medical decisions are both arduous and deeply personal.

  In Joshua’s embrace, I had sensed a life well lived. Of course, I didn’t know the details, but I felt a body that was strong and loving now. I felt a man who said, No matter what, I will live this life on my terms. I will decide who I am and what is right for this body. And I received this second boon of the day: the knowledge that I, too, could elect to live this way now, while (as far as I knew) I wasn’t riddled with tumors, while my lungs still worked and my heart still beat. I could live this way now while I had sight and touch, while I could still learn from experience and maintain an open heart and mind, and could share this gift with others. Some of us do this: When we select partners who live free, when we choose work that is a calling, when we see life as an adventure—it’s all the same contract.

  The statuesque man with smooth, dark skin and the waist-length locs had offered me a gift: the power to choose what was most nurturing to me. Even if that choice challenged the zeitgeist, the power was mine. In his embrace were new green shoots: the choice to grow.

  NINE

  Paul: Murda, Murda

  In a last-ditch effort to stay alert for the final hours of my shift, I fully inhaled the moist summer air. I had walked out to the ambulance bay for a couple of minutes of twilight serenity. As I noted the first glow of tangerine clouds rolling over the smoky blue sky at the western end of the methadone clinic, I yawned and stretched my arms over my head. Today there was no man nodding asleep as he crossed the intersection, no circle of women ashing cigarettes over strollers holding sleeping infants clutching bags of barbeque potato chips. No, today the methadone clinic was closed, as were most businesses in the University City section of West Philadelphia on Sunday morning. Only the rare vehicle rolled by: buses transporting shift workers like me, trucks on their way to and from the highway. No pedestrians just yet. Presumably, both the walk-of-shamers and the faithful had not yet made their way out of the house.

  After I reveled in a few more moments of tranquility, I took the long way back to the ER, walking out through the ambulance driveway and then making my way to the front entrance. I had told the nurses where I was, but I always felt guilty stepping even three feet away from the ER for more than a few minutes. Walking through the VA’s automatic front doors, I saw not a soul except my favorite police officer, Charles, making his rounds. Throughout the year, without notice or apparent precipitating event, Charles delivered trays of turkey sandwiches with cranberry sauce to the ER. But the reason he was my favorite was because when he saw me, he always smiled as if he were being reunited with a long-lost friend. Now I returned Charles’s wave with a grin indicating that I remembered our story, too.

  With gratitude, I saw that the department was still sleepy. Near 5:30 a.m., I settled in to enjoy uninterrupted time to clear out the inboxes of two old email accounts, vestiges of times past. I had kept them open so I could use them for store mailings, utility bills, my student loan automatic payment reminder, and other notices I wanted to see only sporadically. I deleted the emails twenty at a time. Every once in a while, I stumbled upon something interesting: Martha Stewart’s tips on the perfect summer sandwich; an email from the Oprah site on the twenty questions to ask yourself before getting married; the latest edition of Shambhala Sun, a bimonthly magazine that explores Buddhist topics.

  I clicked on one of the links in Shambhala Sun: “No Big Deal: On Metta and Forgiveness,” by Heidi Bourne. It discussed one woman’s journey toward forgiveness as she explored loving-kindness (Mettā) for her abusive father during a Mettā practice retreat. Through exercises, she had touched the depths of pain that were buried in the pit of her belly. She faced the nausea and released the tears and simply let go. The article concluded with a phone call to her father, after an estrangement of more than a decade, which led to the following realization: “The experience was like talking to someone from my very distant past. He was still him, I was still me, and that was it. No big deal. And yet, it was everything.”

  Another confirmation of the synchronicity of life. That week, I had received a letter from my father through the VA mail at work. Not surprisingly, the letter had languished in a bin with other mail for the emergency department for more than six months before it was finally delivered to my medical director’s office. My boss handed me a stack of mail consisting of a couple of thank-you notes, Christmas cards from patients, one of the VA magazines, a job recruitment letter, and one other item: a letter with my address handwritten. Even after a decade of no communication or correspondence, even through the fog of disbelief, I recognized the handwriting immediately. I managed to mute my shock and took the mail with me back to the ER. After recycling the magazine and recruitment letter, I smiled at the patients’ notes, trying to recall the faces of the veterans behind the season’s greetings, but it was impossible.

  Then, for the rest of the shift, I contemplated what to do with the remaining piece of mail. I couldn’t read it at work, and risk losing focus. As far as I was concerned, I had forgiven my father years ago and could coast through the rest of
my life father-free. It was a kind of forgiveness that happened when I wasn’t paying attention, on some date and time that had passed in peaceful anonymity. Given that he was the one who had abandoned me, who had walked out of my life without giving the explanation I already knew, I had no regrets about the one-sidedness of the forgiveness. In his absence, forgiveness felt easy. It’s always easier to maintain a positive vibration away from negativity than in its presence—for the same reason that it’s easier to be kind on the yoga mat than while stuck in traffic. He was gone. I was free. I had dealt with it honestly. I had done the right thing—I had forgiven him. I was content that I had moved on.

  Now that he had returned to my life, in whatever capacity his letter might hold, what did that mean for me and my easy forgiveness? I ran through the many possibilities for his having sent the letter. He might have been totally transformed and was reaching out now, in the ultimate expression of enlightenment. I decided quickly that that was definitely not the case. If that was true, he would have done more than passively sending a letter via hospital mail, which roughly approximates the delivery rate of a balloon telegraph. He was a physician himself, so he had to know that.

  Maybe he was slowly dying, and as his last vestiges of vitality ebbed, he had had an unshakable awakening and was reaching out so he could finally convey his remorse.

  Nah. More likely—actually, yes, definitely the case—the letter was a half-inflated test balloon released into the sky, merely a wisp of an effort to see if I might be willing to do the work, to ameliorate his feelings about his life. (That’s how he had always operated, and I had never observed in him anything indicating that he would ever change his way of being in the world.) But the last thing I had time to do right now was someone else’s emotional, psychological, and spiritual work—especially since I had already learned that it was impossible anyway.

  I crammed the envelope into the bottom of my bag and returned to my own duties.

  The letter was still in my bag, unread, when Nurse Bill knocked on the entrance to the doctors’ section of the ER. “I just put in a guy with a cut on his hand. A Mr. Williams. He’s a little nutty. Hopefully, you can just get him in and out fast.”

  “How’d it happen?” I asked.

  “He said he doesn’t know. He’s odd. He was out, and it happened on something or other. He said he cleaned it up before coming in. Looks simple. I irrigated it and put the laceration cart at the bedside. Want an X-ray?”

  “Since I don’t know the mechanism of injury, we’d better get one, to screen for foreign body or bony injury. Please give a yell when he’s back.”

  “Okay. I’ll walk him up now. Lorraine will take over when he’s back from X-ray.”

  “Coolio. Thanks.”

  After reading a couple more articles in Shambhala Sun, I was notified that Mr. Williams was back from radiology. As I approached the room, I saw a young man pacing. He was talking to himself, at times attempting to muffle shouts as he alternated between wringing his hands and slapping his forehead with his fist. I scanned the room. No one else was with him. Nurse Lorraine was sitting in the nurses’ station writing up her notes. When she saw me, she said, “We got a live one, Doc. In and out, please. His wound is ready.”

  I pulled up the X-ray on my screen and was happy to see it was normal: bones intact with good alignment, no foreign body and only minimal soft-tissue swelling in the palmar region, which was, presumably, where I’d see the laceration. With the hope that this would be a quick suture and discharge, I approached the patient’s room.

  I tapped at the room’s entrance. “Hello, Mr. Williams.”

  He looked up at me, blurting, “Hi, hi, hello, ma’am. Doctor. I mean, hello, Doctor, ma’am.” He glanced away and continued to pace.

  Maintaining my position in the doorway, I said. “Mr. Williams, why don’t you have a seat on the stretcher here while we chat?” He was clean shaven with olive skin and large hazel eyes and other features that would have made him look like a native in most parts of the world. His straight brown hair was neatly cut, but disheveled at his forehead. A blood streak on his half-untucked oxford shirt was only barely perceptible against the dark background of the navy-blue cotton material.

  He lowered his head. “Yes, ma’am.” He sat down, flopped his body back on the bed, and began repeatedly crossing and uncrossing his legs. I approached the right side of the stretcher, leaving both the door and the curtain to the room open. When interviewing patients, my practice is to provide them with whatever privacy I can, but in this case, I felt it more prudent to interview Mr. Williams in full view of the rest of the department. Doctors gain this instinct with practice. Sometimes we misread, but often we do not.

  Mr. Williams’s chatter stopped, but he kept crossing and uncrossing his legs. Every once in a while, his entire body would jump as if he had been startled, and his eyes would dart back and forth as he squealed, “Shhhh!”

  I interrupted his dialogue with himself. “Mr. Williams, I’m Dr. Harper. I don’t think I said that when I first came in. I hear you have a cut on your hand. Just so you know, I looked at your X-ray and it looks normal, which is good news. What happened?”

  His movements stopped for a moment. “I cut my hand a little while ago. My friend cleaned it off for me. She brought me here,” he said, flinging his right hand toward my face.

  “How did it happen?”

  “I don’t know. I don’t know. I was out with my friend, and it happened. Fast. I don’t know. But she cleaned it.” He began to rock and rub the back of his hand. “She cleaned it. She cleaned it. She cleaned it and wrapped it up,” he replied as he jumped. “Oh!” he exclaimed, then covered his mouth with his left hand.

  “Are you sure you don’t remember anything about how this happened? I just ask because most people remember at least something.”

  He looked at me but said nothing. His eyes were glassy pools of erratic terror.

  “Hmmm, well, do you recall if your injuries involved a knife or a gun?” Because these are potentially reportable injuries, I always made sure to ask this when the cause of injury was unclear.

  “No. No. It was fast. I don’t know, I don’t know. We were out. No. My friend, she told me. She brought me here. She cleaned it.” He suddenly yelled, “Oh!” and then jerked his head to the side as his legs began to quiver. He ran his left hand over his head and down his neck before placing it on his chest and curling it into a fist, which he then raised to his mouth in what appeared to be horror. “No, no, it’s okay. It’s okay. It’s okay,” he muttered into his chest.

  “Huh. Well, can you feel and move your fingers?”

  “Yes,” he responded, holding his hand in front of his face, moving each finger in wide, slow, undulating movements, before plopping his hand back on the table palm up with a thud that made both of us jump.

  “Mr. Williams, are you okay?”

  His attention darted back to me. “Yes. I’m okay, I’m okay. I’m okay, I’m okay,” he said as he curled and uncurled his fingers into a fist, which he brushed over his mumbling lips.

  “Mr. Williams, what’s going on?” I asked gently.

  “They’re following me!” he exclaimed, covering his mouth again. He looked from side to side and then down at his chest as he began to whimper incomprehensibly.

  “Who is following you?”

  “They are. You can ask my sister. She called. I can call her. But she bothers me. But we can call her. I don’t know.”

  The evaluation was becoming more complicated. My priority now had to be to address the laceration quickly so we could move on to the more pressing concerns.

  “Now, Mr. Williams, the cuts on your hand are a little deep, so I recommend I put in some stitches to close them up.”

  “Okay, Doctor.”

  “Have you had stitches before?”

  He shook his head.

  As I set up the
instruments on the bedside table, I explained the procedure. He lay back on the stretcher like a rod. It was anyone’s guess what he heard between me and the voices in his head. “Now, Mr. Williams, we will begin. Again, the numbing medicine will burn at first, and then your hand will feel numb. It’s very important that you stay very, very still. You can say whatever you want, just don’t move, okay?”

  “Okay.”

  “Ready?”

  His left hand was balled up into a fist. He chewed on his thumb as he mumbled, “Yes,” and then squeezed his eyes shut tight.

  “You’ll feel a pinch now.” He lay there stiffly as I pierced his palm several times to deposit the anesthesia. “All done with that part.” He sighed and glanced down at the V-shaped cut at the fleshy part of his palm, near the base of his thumb, which now oozed a red mixture of blood and lidocaine. Testing the area to make sure it was properly anesthetized, I inquired if he felt any pain. He indicated that he did not. As I placed the lidocaine and needle aside, he gasped again and then looked away. I loaded the suture on my needle driver before looking up to inform him that I was about to begin. But before I could, his entire body jumped. The instruments slid to the side of the tray, and the bottle of lidocaine toppled to its side and then clanked against the raised edge of the table.

  He looked to the far corner of the room and yelled, “Stop it!” to whatever ghosts were there.