by Joshua Cody
She walked into the room for the first time, and the part of Nothereal’s whole in question was, to the best of my recollection, a vermillion, classic patent leather peep-toe pump outfitted with a heel of (I’ll wager) three inches. Thus it was less a question of form (as if!) than color. Scarlet is unofficially prohibited by the “color psychologists” that hospitals and prisons hire, at God only knows what rates, to employ Pepto-Bismol pink and Slim-Fast ecru, as tasteless as the food is colorless, to calm patients and prisoners, soothe their eyes and souls during that interval of time before they find themselves on the way out, whichever the way out is. Nothereal’s ruby slippers ordained their owner, then, as an iconoclast, a purveyor of audacity: this is the color of blood, ambition, Che Guevara, the Roman Catholic Church, and the stop sign. And one might say that the brilliant point of the self-covered heel glimpsed under the hem of the starched white hospital robe was, in a sense, the first hint of the piercing cry of pleasure and, later, outrage that was to come. I really did look up from the shoes to the face, inadvertently inverting the direction of the origins of fetishism, so I was both mocking it and acknowledging it. Sometimes a pocket is just a pocket, but sometimes the whole is contained in the part, as sometimes the entire weight of the female body, say, is concentrated on two single points: fashion inflicts a fine violence against the woman’s body, as any true member of the haute couture culture knows and, for that matter, freely admits. Surely Carine Roitfeld, the celebrated former editor of Paris Vogue, knows the name of Vanessa Duriès. So if this initial encounter were a painting, it would not be a Klee, not even a Picasso; we would have to look to the perversity of the Surrealists who, like Picasso, took women apart, but unlike him never put them back together. I couldn’t help it, though. The shoes and the face were all I had to go on so far, because the rest was whited out. It added up to Italian: dark eyelids, quick dash of hair, the high cheekbones and olive skin. I complimented her on her shoes. This type of thing, incidentally, really does work—it’s just like in the movies and on TV, the stretcher pauses to let the patient crack a joke to the kindly surgeon, and an angelic black nurse smiles and the skin around her eyes crinkles in close-up; this cadence is then cut short by the percussive jolt of the single-action hermetically sealed swing doors, and there’s no turning back from the operating room. It’s the patient who must reassure his caretakers, not the reverse. Take the case of Willem de Kooning, our gentlest poet of sexual horror, and the last great painter only in that narrow sense of “great painters,” on his deathbed in East Hampton. He couldn’t use the stairs; his diet was through an IV; one of his ex-wives, although he didn’t know it, was dead, and another he couldn’t recognize.
Since his condition had deteriorated dramatically, no one was allowed to visit him anymore. The last of his old friends stopped seeing him around 1989. Molly Barnes [an ex-lover] noted that he no longer raised his head to look at her. But she was amazed to hear him mutter, “Nice legs.”14
When I complimented Nothereal on her shoes, she, fashion-conscious, was flattered. I asked her if she was Italian.
She said, Close.
I said, Let me guess, Greek?
No, but I’m in love with Greece.
Hungarian?
Not too bad. Serbian.
Oh and that made sense: the serious, almost-almond-shaped eyes, slightly Oriental, a touch of the Turk: unblemished olive skin, as if I’d met her before. I’m in love with Serbia, I said. (True!) “Really?” she asked. How odd that we were on our way; everyone in the room, a couple of nurses, noticed it too, I could tell: I’d looked at them for verification.
That night I had a dream about her. We were standing together under an immense dome, which itself was encircled by four smaller domes. We were gazing at a fresco that depicted the Resurrection. Christ was painted emerging through a gleaming archway that framed him perfectly. Two supplicants were kneeling on either side of Him, each softly taking a hand. The one on the left was wearing a white robe; the one on the right, red. Above Christ’s head, two words were inscribed. The words were spelled with an alphabet that seemed to flicker between Latin and Cyrillic. The strange beauty of the fresco—not Italian, not Greek, not Turkish—struck me as unsurpassed and profoundly moving. Odd, because I’m not religious. Then we walked outside, into midwinter. We stood alongside this silvery building of five domes, a towering dome set upon four domes, situated on a hill overlooking a city of small buildings that formed a kind of tessellation. In the distance was an incongruously modern sports arena. All was snow, ice, and blinding sunlight, an Antarctic brilliance that was almost painful, as brilliant as light hitting a splintery shard of anthracite: we were holding hands.
The next morning I mentioned the dream to her. Have you been to Belgrade? she murmured.
I had indeed. We had been in the Temple of Saint Sava, in Belgrade, the largest Eastern Orthodox church not just in Serbia or in Eastern Europe but in the entire world, and neither of us needed to consult the psychoanalyst on staff to figure out what the dream meant.
The Temple of Saint Sava (detail), Belgrade.
I know it sounds like the nurse and the wounded soldier; or two doubles of Narcissus, vainly staring at a pool of black, undisturbed water; or the twin masks of delusion and pathology. But actually it wasn’t any of those things. Had it been, there’d be no need to write about it. It was simple; we knew each other, were glad to have finally met, and wanted to be around each other. We wanted to have conversations. But now there might not be enough time: this time we weren’t too young. We both knew this; our eyes would narrow about it, in a good way. As a result, we wrapped around each other as swiftly as two electric currents encircling some wobbly magnetic pole.
I recall that her visits after that became at first lengthier, only later more frequent. Each appearance was more quietly joyous than the last. Do I imagine that she was already making the occasional reference to Jews? Surely not just my imagination and I just as surely took them as completely innocuous. But if I took them as innocuous, why would I imagine I remember them? Of course I had noticed them—they were salient as a fluorescent traffic cone on the freeway—and of course she said them because with her I started with the part and moved to the whole, but the whole is contained within each of its parts, just as the traffic cone, sliced in any direction, produces a curve; just as the cause of my particular illness, and therefore the cause of my encounter with Nothereal, is not to be found in factors of lifestyle or environment but in a flaw in the DNA, an error present in the whole of my body that afternoon in the hospital room when the sun shone brightly for the first time in a few days and Nothereal, for the first time, sat at the side of the bed without saying a word, and I was glad to have her there: an error present as well in each individual cell of my body that afternoon and the afternoon before, and the year before, and ten years before that, when I wandered around Italy, realizing I was in love with two women at the same time, realizing the double bind was in fact inescapable; and ten years before that, in suburban Milwaukee, when my father collapsed from a stroke in the next room and later told me he’d had a vision of Charon telepathically inviting him into the canoe on the river Styx; and ten years before that, when I discovered my parents’ hidden collection of books on Picasso and Klee and de Kooning and Mozart records, while, in distant Paris, the Rolling Stones were recording Some Girls, an album about New York.
Bone marrow can be extracted directly from the bone, which is highly painful and requires general anesthesia; but much of the same blood-growing material can be removed from the blood itself in basically the same way caffeine can be extracted from coffee (although assumedly the marrow is not subsequently sold to PepsiCo or Coca-Cola). Your veins are hooked up to a vast machine that looks a little like a prop from either The Elephant Man or Dune (I always think David Lynch really envisioned them as one film), and a centrifugal apparatus starts spinning your blood around until the cells separate according to their weight. The plasma, clear fluid, rises to the top; the red
blood cells sink to the bottom; and in the middle rests what they call the “buffy coat,” which is, unfortunately, not named after Joss Whedon’s delightful vampire-slayer immortalized in the public’s eye by the lovely Sarah Michelle Gellar (but portrayed in the original film by Kristy Swanson, thus rendering her the Pete Best of the “Scooby gang”). The buffy coat corresponds to the line of espresso in a latte macchiato; this is where the white and green cells and platelets are trapped, and then grabbed (“harvested”) and thrown in the freezer. This procedure can take a few days, although in my case they had enough in about an hour. With the harvest safely in the fridge, the doctor can destroy the body’s cells right down to the level of the bone marrow itself, which is where blood cells, necessary for life, are produced. In other words, it allows the doctor to chemo the patient as close as possible to death. The relationship of this high-dose chemo to conventional chemotherapy—which was discovered, in the first place, when medical combat units in the trenches during the First World War noticed that victims of both leukemia and mustard gas had been miraculously cured, and put two and two together—is roughly analogous to that of what Little Boy could do in a moment to the body of Hiroshima in early August of 1945 versus, let’s say, what mustard gas could do in a moment of similar duration.
Now there’s this relatively narrow window of opportunity when the chemo does its stuff, slaughtering everything in its path like a Mongol army. And just at the last minute, the bone marrow is taken out of the freezer and injected back into the body. This procedure, called engraftment, is almost cartoonish: a special orderly comes in with a huge plastic syringe like something you might see a Tim Burton character wielding; it’s semiopaque and full of all your bone marrow; she sticks it in your arm and just pushes it right back in. The cells, like Canadian geese or spermatozoa, intuitively know where to go and, most important, what to do when they get there, which is no simple task: reigniting the production of blood cells, introducing themselves to their new neighbors (i.e., the liver, the heart, the kidneys), and rebooting and organizing the entire immune system.
The only problem with all of this is that sometimes—one in about ten cases—the patient dies. Sometimes from a simple infection, since at this point in the transaction there aren’t white blood cells to protect the body from infection. Sometimes the liver can’t handle all the stress, throws up her hands, eyes rolling, says to the body, you know what? fuck you, and leaves, slamming the door behind her. Sometimes—in the case of an allogenic, rather than autologous, transplant, when the bone marrow is donated instead of borrowed from the patient’s own supply—the new bone marrow mistakes its new host for an alien and commands the immune system to destroy it.
And then sometimes, nobody really knows what the fuck is going on, but the patient’s dying anyway. That’s what happened to me. I have vague memories of this period, when something started to go wrong. I have to depend on my mother’s diary.
There is a problem with Joshua having a temperature of unknown origin. A team of infectious diseases specialty is summoned by Dr. Q., who says no one has figured out what underlying bacterial disease is causing the fever. He admits he and his staff are stumped. He orders different IV antibiotics and many additional blood-draws.
I remember sensing a change in tone on the part of the staff, and I remember the blood-drawings, the transfusions; but I don’t remember feeling that I was actually in real danger. I might not have understood; my memory may be failing; or I might not have been made aware of the situation.
Throughout this period Joshua receives several blood transfusions, day and night. He is supposed to have 3mg of IV Tylenol before each transfusion, but because his platelet counts are in a dangerous state and his hemoglobin level is so low, there is no time to administer the Tylenol. Now the orders are to “transfuse STAT.” This is a very serious time for us.
Since he cannot talk, he writes me a note which reads—as well as I can make out his handwriting, because he is in so much pain (and it is in the middle of the night)—
“—what kind of side effects will happen without the 3mg of Tylenol not being used prior to the transfusions?
“—Doesn’t the Tylenol reduce the fever?
“—What was I given at ten—what pain killer? I got relief.
“—Should I take . . .” [Unfinished sentence.]
Here, Nothereal first appears in my mother’s diary. My mother’s transcription of the dialogue between patient, doctor, caretaker, and pain management staff is fascinating in its expression of the fragile complexity in calibrating the collaboration of different specialists.
After the next morning rounds with Dr. Q., the pain management team again returns. I notice that a lovely, petite, dark-haired female doctor is part of the group. Another P/M doctor or nurse asks Joshua what his pain level is on a scale of zero to ten. Joshua cannot reply. F. says, “I know you are in a lot of pain, Joshua. Are you at ten?” Joshua then whispers, “No, seven.”
The doctor increases the Fentanyl. The conversation continues (some paraphrasing):
JOSHUA : I am not sleeping. Does the Fentanyl lead to sleep deprivation? I haven’t slept for one full hour [i.e., without interruption] in a month.
F. : You are not supposed to have hallucinations. They are related to the pain meds. If we get rid of the pain meds, you will have more pain and you will not and cannot get any sleep at all.
Then F. turned to me.
F. : [to me] We don’t want him sleeping all day and then not at night.
ME : What does it matter? The bottom line he needs sleep. He’s not going anywhere. Why does it matter when he sleeps?
F. : Has he tried the throat lozenges?
ME : Obviously, he can’t use the lozenges because he cannot swallow.
F. : If he needs a rescue every fifteen minutes, then the pain management is not working.
ME : Well, I know that. That is why I want more attention brought to pain management. That is why you’re here, right?
F. : Maybe you’re not pressing the rescue button hard enough.
ME : Well, here is how I press it. (I get up and walk over to the card and press the rescue button and, of course, it registers.) And, Joshua definitely knows how hard to press the rescue button. Plus I’m with him all the time, and I see when he presses the rescue button. All I know is this (and I look at the entire pain management team): my son is in constant pain and pain management, I’ve been told, is part of his treatment and recovery. I don’t see any decrease in his pain and I want to see some pain management action NOW.
The lovely, petite, dark-haired female doctor (who, we learn later, is Dr. [Nothereal]) says something to F. about can’t she (F.) see the effect Joshua’s pain is having not only on him but also his mother who is here 24/7 observing this? The pain management team exits.
Shortly thereafter, the nice nurse-practitioner, A.G., comes in to talk to us. Obviously, she has been told by Dr. [Nothereal] that I had “words” with F., that there are issues between me and the Pain Management team. A.G. is encouraging, pacifying, and compassionate. She assures me that she is “on top of the situation.”
My friend Mark had given me his wife Bonnie’s sister’s daughter’s discarded iPod—a little pink Nano obviously more suited for an eight-year-old Asian girl than for me. This fact was funny, and it was also funny that Mark gave it to me without earbuds. Like—gee, thanks. An iPod, with no earbuds. This deeply troubling situation provided my mom the opportunity for a break (she needed one), and so she embarked on a strange odyssey to the Apple flagship store, an odyssey that involved several wrong turns, a memorable encounter with a kindly Madison Avenue doorman, and (really!) a frenzied rickshaw ride down Fifth Avenue during rush hour. When she returned to the hospital, long after sunset,
Dr. [Nothereal] is alone with Joshua. It is long after her shift, but I am glad Joshua is not alone. She tells me that she would like Joshua to be put on a sedative medication called Haldol instead of Ativan. She also tells me she suspects that Joshua
has reached a plateau with the Ativan, that it is no longer helping. She says she has left orders to the nurse to administer Haldol every five hours, but that if it seems like Joshua needs more, I should call the nurse and say “he’s worse and more confused,” and that he needs another Haldol, even if the five hours has not elapsed. She tells me she has put this into his night order book.
Nothereal at vigil, long after her shift has ended. This I remember; not words, but the feelings, and I’ll bet there weren’t a lot of words anyway.
Around this point—not a terribly good omen—old friends from college and high school started flying in to the city from all over the country. I was just happy to see them; I didn’t really realize why they might have been doing this at this point. Again, we must rely on my mother’s record of events.
Joe, a friend of Joshua’s from high school, arrives from Chicago to stay for a few days to see Joshua and give me a little relief. Joe is staying at a nearby hotel, but stays each night until about one or two in the morning. He tells us he’s going to get another meal and sleep. He will return very early the next morning—which he does. During the course of the day, Joshua has several more vomiting episodes of increasing violence.
Joe also observes the frequent visits and phone calls from Dr. [Nothereal]. Joe asks me if it looks to me like Dr. [Nothereal] “has a crush” on Joshua. I reply affirmatively. We both smile at each other. We both feel that Joshua is also aware of the extra attention he is receiving from Dr. [Nothereal] but he (Joshua) says out loud that maybe it’s just the medication that is influencing his observations or feelings.
Now very late Saturday night or, perhaps, very early Sunday morning, an emergency chest x-ray is suddenly ordered. Dr. [Nothereal]—who is present as a visitor, not a doctor—and Joe are in the room with me. An x-ray attendant arrives and helps Joshua into a wheelchair. The attendant pushes the chair, I guide the IV cart and Joshua grabs hold of my free hand and says, “Mom, are you coming?” I tell him yes, and that Joe is coming also. Dr. [Nothereal] speaks up and indicates that she is coming as well. As we all get on the elevator to go to radiology, I notice that Dr. [Nothereal] is in tears. Joshua is still holding my hand and he’s facing the elevator doors; the wheelchair fits snugly in the elevator. So Dr. [Nothereal] and Joe are behind him and, therefore, he is not aware of Dr. [Nothereal] crying.