The Home and The Heart, part V

Thou comest, much wept for: such a breeze
Compell'd thy canvas, and my prayer
Was as the whisper of an air
To breathe thee over lonely seas.

For I in spirit saw thee move
Thro' circles of the bounding sky,
Week after week: the days go by:
Come quick, thou bringest all I love.

Chapter 5

The Pain of Love

It was not that she wanted me to stop coming to see her, but she wanted me never to abandon her.  If God was with her, so was I.  But the hospital forbade us from being together.  As I, every day, walked through the hallway of the CVICU and approached her room, I stopped for a moment to steel myself at what might await me, and her, that day.  Would this be a day of darkness, or of light?  Would there be agonized moans, or would there be the sounds of a distant flute?

After weeks of delay, she finally was operated again, and given a pacemaker.  By now, she was slowly moving her right leg and foot.  Her feeding tube remained in place, but the therapists had tried to make her swallow spoonful of thick liquids.  She was trying hard to come back to light, as death and darkness had loosened their grip on her.  I would spend my days in learning, doing, all that I could to scatter the clouds still over her.

It had almost been a month that she had been admitted to the hospital, and she had now gradually started speaking simple words again.  I worked hard on her, but with loving gentleness.  Making her count from one to ten, asking her to recite the days of the week.  She managed sometimes, and we celebrated those little but momentous victories.

A nurse painted her nails, and I could not admire the nurse more for her gesture.  The speech therapist, a wispy woman from West Virginia, was kind and understanding, and we looked forward to her visits, as there was an added pleasure when she worked with my wife.

She sometimes brought little bits of jam and ice-cream to try and see if my wife could swallow.  After a month of not having had anything palatable, one day the therapist asked my wife to try a bit of orange sorbet.  I remember the joy on my wife’s face as she nodded her head from side to side, expressing her pleasure at the sugary ice mixture on her tongue.  The exclamation “Delicious!” was on her face, as she found herself unable to utter words of gratitude.

The speech therapist was determined to see her get better, and I remain eternally grateful to her.  My wife was to go through a real-time X-ray to determine if her swallowing was acceptable, or if food was entering her airway.  This speech therapist, Maggie, wanted to oversee this whole exercise, and we of course wanted it to complete successfully.

But it would be many days before that study could be scheduled.  And day after day, waiting in loneliness and disability was taking a heavy psychological toll on my wife.  And one day, as I was sitting by the bed-side, a hospital administrator came and told us that they had done the study on my wife, and unfortunately my wife was not able to swallow, and that soon they would be making a hole in her stomach and feeding her from there.  I was crestfallen.  This setback was crushing.  I explained this news to her, making it seem a very temporary inconvenience, and she nodded in fake understanding.  She did not deny that she had been taken for the X-ray without me.  She had no idea what I was saying.

An hour later, the same administrator returned to the room and apologized.  He said he had made a mistake and it was another patient who had failed, and my wife’s evaluation was still to happen.  I experienced a mixture of happiness and anger.  I was happy that there was a mistake, but I was angry that there was a mistake.  I was so sorry about the woman who had failed the study, but it was an unjust and sloppy insult to my wife who, days ago, in a moment of defiance and resolution, had proclaimed to her mother on speakerphone: “You shall see, I will overcome this.  I will come and see you when I am well again.” 

She was taken down for the swallow evaluation a few days later, and I watched the X-ray screens as she was fed a little water, or a little oatmeal.  She could not chew, and she could not drink plain water.  But she could swallow alright.  She did overcome that hill.  The feeding tube was removed, and bland, thick pastes of food were now to be brought to her three times a day.  She ate almost nothing of those pastes.  I started making some better tasting semi-liquid meals at home and brought them for her.  Those tastes reminded her of home, and she ate a little from those plastic cups.

As the time came closer for her to be discharged from the CVICU, to another section of the hospital, I thought of ways to kindle her memories.  I showed her old photos, and played old, familiar songs.

One of those songs was especially dear to us.  It starts with the words: “The pain of love is sweet, oh so exquisite.  And this beautiful pain nourishes these two hearts.”

I remember the evening when she started slowly humming these words as I played that song.  Did my love nourish her heart?  I have no doubt.

The sun was setting beyond the greyed window, but the light inside her was getting stronger.  Her flame, deep inside her being, had stopped flickering, and was a steady glow now.

She wanted me to take her home, but it was impossible.  She would ask me again and again, not understanding why she was still in this prison.  Was she not well?  What had happened?  Why could she not move her arm, or eat?  I could not explain to her, given her impoverished comprehension.  She still was very, very fragile, and was connected to wires and IV lines.  We made her sit in a chair some days, and she felt a deep unease and would want to lie down again.  Unable to verbalize her desire to go back to bed, she tried getting up from the chair herself, and fell down and stuck her head on the tiled floor.

The doctors came rushing.  They feared that her brain might start hemorrhaging again.  But the steady glow inside her did not flicker.  The CT scan did not show any new bleeding.  Her inner light was pale and still feeble, and cast many shadows, but it was steady.

The gods were now with her.  Her prayers had been answered.  The fragments of that old song, for at least some moments of her agonizing day, day after day, in that vast alienating building, were on her dry tongue and on her dry, parched lips.

(to be continued)

 

The Home and The Heart, part IV

“The strength and the beauty of a tender leaf is its vulnerability to destruction. Like a blade of grass that comes up through the pavement, it has the power that can withstand casual death.”

Chapter 4

The Compliment

We had once been to Africa.  As we were waiting to board a flight from Addis Ababa, a middle-aged woman next to my wife told her: “What beautiful long hair you have.  These are priceless.”

On the CVICU bed, as that oft-complimented woman struggled to breathe, and as her brain swelling showed as yet no sign of abating, her very same beautiful long hair, unwashed for many weeks had irreversibly matted and tangled.  They had become impossible to handle.  The nurses would try, and fail.  They wanted to save her hair, as they could do nothing to save her.  The doctors were in charge of her ebbing life, but the nurses, in their simple kindness, were alarmed about her hair.

The days passed.  Slowly the drugs being pumped into her were dialed down.  She was stabilizing.  She had started murmuring and had nodded when I told her that it was me, her husband and lover who was holding her hand.

Often, she would take my hand and place it against her left cheek, and close her eyes.

She was unaware of what had transpired, and of what was happening to her.  She could not understand the doctors, nor make sense of what the nurses asked her.  She probably remembered that she had been wheeled into a large room and that strange tall men had put needles into her and one of them had wiped her chest and sternum in preparation for something brutal, and after that it was all dark for her.

Her face had darkened considerably.  She had become a pale shadow of her glowing self that attracted glances and compliments in malls and in gyms and in airports.  And as therapist after therapist visited her, she was found unable to speak or stand or to drink a drop of water.  But there were some rays of light through the clouds now.  She was now breathing on her own, and her heart, massively traumatized, was beating feebly but regularly, assisted by the pacemaker.

The days passed.  The swelling of her brain was not worsening. She had started mumbling a few words.  But often uttered something which was completely oblique to what I believed and knew she meant to say.  I understood many of her expressions, but the nurses had given up on communicating with her.  The nurses were trying hard, but they had to attend to many patients, and I was her nurse most of the time when I was there.  My wife did not know that she was in an American hospital, and continued to mumble words in Punjabi.

When I was away from her, I would call on the CVICU room phone, the nurse would hand her the handset, and as my wife listened to me telling her that I loved her, she would mumble back in broken words.  She wanted me to come back to her, and soon, as she was all alone in the strange big building and nothing made sense to her.  And I would promise, and she probably waited and waited and drifted to sleep, in pain and in loneliness.  I could only be with her a few hours a day, due to the Covid restrictions.  I was with her in my thoughts, but it was a pain almost too great to bear to be away from her when she needed me the most.

And when I was with her for the few hours during the day, she would ask me to speak to "them".  She wanted to know something, but I did not know what.  Did she want me to ask them to let her go home?  She would try and try to tell me and finding it impossible to come up with the words, give up in sadness and in tears.

I brought her a mirror to look into.  And she would hold the mirror in front of her, unable to make sense of what she was seeing. 

Was this she, the one who was complimented by strangers in far-off lands?  What had happened to her long, flowing hair?  She would look at me, and I would attempt to brush her hair and soothe her.

But the days passed, and she remained critical.  She continued to be in the CVICU for days and weeks.  Her heart was unable to beat on its own, and another surgery was planned to give her an adaptive pacemaker inside her left shoulder.

At this point, she was in almost total surrender.  She did not complain about the immense pain, about the incessant needling, at the multiple heparin injections in her stomach, at the beeping, at the noisy turbine in the room, at the strange sensations inside her head and in her chest, at her soiled bed sheets, …  She had no idea what was happening to her.  She was being fed through a tube, and was not in control of her bodily functions.  She was unaware that the doctors were planning to cut her up again to implant the pacemaker.  That again she would be sent into the total darkness of general anesthesia.  She was often at peace.

And one day, with covid rules and time and clocks being a cognitive burden too great for her injured brain, and after waiting for interminable agonizing hours for her beloved husband to be with her as he promised her on the phone every night, unable to understand why he went away, she finally told him, through tears and unbearable pain, in words that must have come from a deep reserve of some lingering language abilities in her bleeding left-brain, that he need not come anymore, that she was now with God.

…

Faced with a calamity beyond their powers to address, the tender are strong, because they do not resist.  Their strength is in the acceptance of their fate.  They place their trust in God, and often they find that God does not answer back.  But they still trust.  They will let life take its course, and they have faith that life and the Gods will not let them drown.  And if no help comes, that that is the will of God, and they will perish in peace.  When faced with an utter inability to change their state of affairs, the ones who surrender in silence are stronger than those who flail and struggle.

(to be continued)

The Home and The Heart, part III

Dark house, by which once more I stand
Here in the long unlovely street,
Doors, where my heart was used to beat
So quickly, waiting for a hand,

A hand that can be clasp'd no more -
Behold me, for I cannot sleep,
And like a guilty thing I creep
At earliest morning to the door.

Chatper 3 

The Five Words

It was another day and she was still in darkness.  The doctors had decided to not wake her up to give her more time to stabilize.  It would be 40 hours after she was initially put to sleep before they would try to wean her off anesthesia.  Was that normal?  They assured me it was.  Her motionless body was now warm, but she was absent.  Her brain was pumped with strong strange salts to keep it from even a dream, and her fragile heart was struggling to beat.

There was nothing to do in the hospital, and I returned home. 

My younger brother and a dear friend were with me that day, and I was grateful for their presence.  We talked about many things and tried to take our minds away from the clouds hovering above the home.

I woke up at 2am and looked to see if there was a message.  There were two missed calls.  At my home, the cellular reception is poor and calls are often dropped or not received.  The voicemails said nothing.  The hospital had given me access to her chart via an online tool.  I logged on with her name, and saw a few strange updates.    There was much activity, and many notes.  Many doctors had seen her in the middle of the night.  There was no mention of her waking up, but a note ominously mentioned that she had been taken for a scan of her brain.

What did that mean?  Wasn't it her heart that was to be healed?  Why this sudden interest in her brain?

People say that the well-known three-word gesture of affection is the sweetest sentence in the world.  That night I read another sentence, only it was five words, three adjectives and two nouns, and I hope no one ever has to read those cryptic words juxtaposed together.

The digital letters on her hospital chart coldly said: “LARGE ACUTE COMPLETED MCA INFARCT.”

Now, at present, when I understand what they mean, I realize that each of these words is devastating in itself, but that taken together, these five words are catastrophic.

One wishes it isn’t large.  Or acute.  Or that it is incomplete.  Or that another part of the body instead of MCA (Middle Cerebral Artery) is mentioned.  Or that another word, like occlusion, instead of infarct is used.

But those five words were there, precise, grave, unalterable.  I read those words again and again.  

LARGE.  ACUTE.  COMPLETED.  MCA.  INFARCT.

With trepidation, I woke up my brother and called the CVICU.  My dear friend also sat silently with us as we struggled to make sense of what had happened.

It was the middle of the night.  And that night would not end soon.  It would stretch into days and weeks.

…

When an infant comes into the world, its eyes wander about, unable to fixate.  It does not recognize anything, not even its mother’s face.  The infant cannot hold or turn its head.  It cannot yet eat, or speak, or understand.  But we know that it will do all those things in time.

That confidence is missing for an adult who is suddenly faced with these disabilities.

But the language of love is known to the infant, and I am certain, to the adult.

…

As I saw her on Tuesday, and held her tiny left hand, her now-open but wandering eyes could hardly see me or recognize me, but she squeezed my hand and held it tight, as if imploring me with all her feeble power to snatch her from the reaper who was already dragging her into eternal darkness.

She had prayed before being taken into those nether-worlds.  Had that prayer remained unheard?

I would move heaven and earth, I promised her in silence.

After a major brain stroke, the brain swells and the neurologists worry about what they call the “mid-line-shift”.  The one side of the brain that is injured, is inflamed, and pushes sideways and down.  More than a few millimeters, and it is all over.

Her left-brain was dying and bleeding inside.  The left-brain controls the right side of the body, and it contains the language faculty.  A large left-brain stroke like that, and the individual may never again understand words, and may never again utter one.  And of course, the right side of the face, the right arm, the right leg, all become flaccid and immobile.  The right eye has trouble focusing.  Her stroke symptom score was 22.  It was a very, very, severe blow.

She was on the brink.  They would have to cut open her skull too, if the inflammation increased even slightly.

…

The Harvard-trained surgeon who had mended her heart had come to visit.  And he watched her, somberly, in silence.  He knew and I knew, and we nodded at each other.  Some doctors are more sympathetic than others, but in that grave moment, he remained frozen and waited for me to say something.  I had nothing to say but I stared into his eyes.  And he winced.

He would never come back to see her again.

(to be continued)

 

The Home and The Heart, part II

"During the whole of a dull, dark, and soundless day in the autumn of the year, when the clouds hung oppressively low in the heavens, I had been passing alone, on horseback, through a singularly dreary tract of country; and at length found myself, as the shades of the evening drew on, within view of the melancholy House of Usher."

Chapter 2

The House of Usher

The night had come and wasn't ending, and I slept fitfully. I would wake up and look at the time, and then try to sleep again. Was she asleep? Was she trembling with the thoughts of the morning? I prayed that she was kept alive through the night. Only one more night, and her heart would be mended, and she would be able to laugh again. Or so I thought.

It was four o’clock in the morning. And I woke up and bathed. Soon I was on the empty road to the hospital. I explained to the hospital guards that my wife needed me at that hour, and they phoned someone, and I was allowed in.

The hospital was deserted. There were no visitors at that hour, and the patients were all silent in their beds. Only the beeps attuned to the many ailing hearts broke the silence. I entered the dreaded CVICU, and as I approached her room, I saw that a light had been switched on for her. She was awake and looked utterly exhausted. As I kissed her and gave her some water, I started an Indian hymn of strength on the phone’s speaker. We both listened to it in silence. It was soon going to be time.

The trolleys and stretchers arrived. She glanced at them briefly, and then looked at me, and lowered her head.  With grave dignity and simplicity, she closed her eyes and remained still, with folded hands. Will she live? Will she ever see the stars and the moon again?  She had agreed to be opened up again, but who knew what would happen to her, in the hours and days to come.  Was this her final prayer?  The antim ardaas.  Only she knew, and the Gods knew, what she said in that prayer.  Did she pray for herself, or for the well-being of her parents, of her husband if she was gone?

She was put on the stretcher with all her beeping instruments and wires. I requested that I walk along with her stretcher till the last door that opened into the operation theater. As we went towards it, I held her hand and finally, when it was time to say goodbye, I embraced and kissed her and looked into her eyes and whispered to her: “I am with you, always. I will wait for you.”

The doors closed and the long wait had begun. The doctors had told me that the operation would take four hours or so. I went to the empty waiting room and worried if her weak, slender, and gentle frame was going to be able to take the brutality of the procedure.

The hours passed. It was Sunday, and hers, being an emergency, was the only procedure. A TV monitor showed her patient number with a yellow light against it. Would it remain yellow? What would another color mean?

The hours passed. It was now more than four hours. Another hour. Then another. After the induction of anesthesia, she would have not felt anything. But where was she? After six hours, as I kept looking at the clock and at the yellow light against her number, my phone rang, and it was the chief surgical nurse. She said the operation was still going on, but that she had been taken off the heart bypass and her heart was beating. It took another three hours for the operation to finish.

Those nine hours had passed for her in darkness, and for me. The nurse came to me and told me that I should not be alarmed to see her after the operation. That she would be cold to the touch and that it would not be a pleasant sight. I did not know what to expect. But she was transferred to the CVICU, and I was told to wait a few more hours as she was stabilized and wired up again.

It was not easy to walk to her room and to dare to see her again. She was still under anesthesia. Her face was without color and puffed up, eyes closed, and a shiny glaze was on her eyelids to keep them for drying. A ventilator was doing the breathing for her, and there were dozens of intravenous lines sending her many strange drugs. A brick-like external pacemaker was making her heart beat. There was a large bandage on her sternum, under the hospital gown. There were IV needles in her neck and on her upper arms and on her lower arms. Leads for measuring her blood pressure and oxygen levels were on her body. Her lower legs were wrapped in compression pads which were connected to small pumps.  And she was still in darkness.

The surgeon came and spoke to me. He told me that she had needed eight units of blood. That her heart had been bypassed for more than four hours. A typical heart surgery bypasses the heart for 90 minutes or so. And any time after 2 hours is a predictor of failure.

But she was alive.

I read in the doctor’s notes that, due to her “tenuous state”, she had been “prepped and draped” and lines inserted into her body before anesthesia. I wondered what she must have felt at the strange red antiseptic liquid being rubbed on her cold naked body under the blinding white lights and under the gaze of a dozen strange people holding long metallic tools and strange motors, and as needle after needle was inserted into her. I remembered her anxiety at getting even a regular immunity needle shot. And these were long, heavy needles inserted into her neck and elsewhere. I wondered, with horror.

The surgeon said that her veins were too tiny for the large needles when they started the bypass.  They inserted the needles again and again and stretched the veins.  And that she had suffered a severe vasoplegic shock (a steep decline in blood pressure) after her heart was turned back on. But that they managed to control it. What cataclysms her body must have experienced inwardly then. Nobody, not even she, knew.

But she was alive. Barely, but alive.

I was told she would not be woken up that day. I looked at her with immense love and tenderness, and kissed her cold forehead.

And wearily returned home. I hoped they took care of her ravaged frame.

What would tomorrow bring?

…

Would someone so acutely ailing have survived in an ancient time? Is surgery a blessing? It must be. But how brutal it is.

Empathy is to imagine and to feel another’s pain. Does the surgeon put away his empathy to achieve his aim?

The bonds of humanity are bonds of joy and of pain. There is not one without the other. As one light in many forms, we cannot help but reflect. And the closer the light of the other, the more acute the reflection.

On that day when millions pray to their God, her light was feeble. I had left home in darkness, shared the darkness with my beloved during the day, and returned home in darkness.

(to be continued)

The Home and The Heart, part I

 (I will be writing a series of essays on something that transpired in 2021.  This is the first chapter.)

Strong Son of God, immortal Love,
Whom we, that have not seen thy face,
By faith, and faith alone, embrace,
Believing where we cannot prove;

Chapter 1 

The Last Supper

It was 6pm.  She was all wired up and the instruments were beeping incessantly.  The surgeons were gathered around the bed.  The team of anesthesiologists was taking notes.  They would probably use Fentanyl, or would they use Propofol?  She was overcome with fear and foreboding.  As my beloved lay inclined on that bed, trusting me with her life, I explained her condition and her history to the dispassionate professionals.  They nodded, looked at each other, and tapped on their devices.  They did not look at her.

It was the time of Covid, and the room was intolerable with the noise of a large industrial "negative pressure" turbine placed in the room.  I had asked, and it could not be turned off.

She was a hair’s breadth away from heart failure, and her ashen face was resigned.  After rebelling for days against the re-opening of her body – she had had a prior open-heart surgery ten years ago – that afternoon she had finally fallen to my reason and persuasion, as everyone told her and me that that was the only way to save her life.  The hospital professionals had said that any further delay would be “devastating”.  We could not wait any longer.  The surgical teams were looking at her with disguised concern.  It was going to be very risky to cut open her heart again, but the risks of not doing so were greater.

I was handed the surgical consent form to sign.  I scribbled my signature on it.  It was a quiet, cursory act.  Little could anyone know then what reverberations, what thunderstorms that quiet scribble had set in motion.  The die had been cast.

The tears had dried on her face.  Her breath was more labored than ever.  Not knowing of her critical condition, she had been served a meal at eleven, and she had taken a few nibbles.  This fact was not unknown to the doctors as they were preparing for the operation.  A surgical patient should have an empty stomach.  But this was deemed an emergency.

The doctors, in their worry, finally decided to give her another twelve hours.  The risks were already formidable, and they balked at this additional risk.  She had not had a proper meal in over a day now – the hospital food was not palatable to her, and she had no appetite.  But as the operation was postponed to the morning, she could now eat.  Theoretically, it was now allowed.  But it was 8pm and the hospital kitchens had closed. 

I ran to the cafeteria to see if they had anything.  They were almost closed for the day.  All the "good" food was gone.  All that they had was some awful looking vegetarian lasagna and packaged potato chips.  I bought both.  They had one piece left of a brownie cake and I bought that too.  

I brought her this barely edible lukewarm "food" in the take-away Styrofoam container.  I wanted her to have something, even if it was just empty calories.  She did not like the lasagna at all, as it had some spinach leaves and her fear of green leafy vegetables and what they could do to her already failed mechanical heart valve overwhelmed her.  I separated the spinach from the cheesy portions and made her eat a little.  Seeing that she was forcing herself against her will, I offered her the brownie which she, thankfully, liked.

But she knew that I hadn’t eaten as well.  And on that last evening of her lucidity, with a mind trembling with fear and faded with exhaustion and breathlessness, she implored me to please eat as well.  I was so moved by her kindness and concern for me that I had lumps in my throat.  I could not eat, I felt, even if I was hungry.  But she insisted, and I shared the rest of the cake with her.

As I took a morsel of that cake, I found it indelibly delicious not because of anything in it, but because I knew that another portion of it was giving some life-energy to my wife.

I was heartbroken that I could not offer her something better to eat at what could quite possibly be the last meal of her life.  The hallways of the CVICU, as it was called, were now darkened, and the new shift of night nurses had arrived.  I was respectfully asked to leave.  I told the light of my life that I would be back before sunrise, as she was set to be sawed open at 7am the next day.

I bid her good night, and drove back home with a stone over my heart, and broke down as I sat down in our living room.  Would her eyes ever see this room again?  Would her slender form ever again sit on this sofa?

…

We love the highest in another human being.  The frailties, the flaws, the foibles are of little import because our love is for that light within the other, and for the union of that light with ours.

It is a mistake to think that love makes us weak.  It is quite the opposite, I realize now.  The power of love is not diminished because it includes tears and heartache.  These trials and pains burnish the heart, and make it crystalline with power and strength.  A man with love in his life can do things that others deem impossible.  Is that weakness?  Love for an idea, for justice, for a mountain peak, or for another human being, is what causes man to transcend his humanity and achieve heroism.

 (to be continued)