by Tilda Shalof
When Cindy left the room for a cigarette break, I decided to get a closer look at what I was so afraid to face. Sam’s head was thrown back against the pillow, his neck arched like some science-fiction horror-movie blob, yet he also had acne and hairy armpits, like any teenage boy. He was drooling profusely and was making ugly, raw noises. As he flapped his arms around the bed, his webbed fingers splayed out in all directions. He coughed frequently, and each time he did so, bubbles of green sputum gurgled out and around his tracheostomy.
I could not bring myself to speak to this creature. I could not address him as a nineteen-year-old boy and I wasn’t prepared to speak any of the sweet baby talk that I used with my own baby.
But, oh, how his mother adored him!
“Sam loves music,” Cindy said when she returned. She slipped a cassette into a tape recorder on his bedside table. It played quacking ducks, ticking clocks, chiming bells, rolling waves, and roaring trains. I watched Sam and could discern no sign whatsoever that he was even aware of these sounds, much less that he loved them.
“See what I mean?” she said. “You love that music, don’t you, sweetie? See how he loves it?”
Later when Sam’s oxygen saturation dropped a little because of a buildup of lung secretions, Cindy got up to suction him and said, “Come on now, Sam. Stop acting up!” She grinned at me. “He can be a bit of a show-off.”
It was exactly what I said about my own baby when he did something wonderful for our friends.
To get through the day, I busied myself with tasks. I checked the oxygen tank and the ventilator, and straightened out the iv tubing. I did everything I could think of to avoid contemplating that face and that body in the bed.
Cindy left his side only to go to the bathroom, or for a cigarette, or for a take-out meal that she brought back to eat in the room beside him. When she returned after even a few minutes, it seemed as if she had missed him terribly during her brief absence. She bounded back into the room and threw herself on him, told him how much she loved him, and asked him had he been a good boy while she was gone? Not giving the nurses any trouble, she hoped?
When Sam slept, she watched him sleep, her eyes rapt with love, just as they were when she watched him drool, groan, or have the occasional seizure. She did everything for him, cleaned his bum, changed his diapers, and cleaned out his mouth, nose, and ears. She gave him his medications, took his vital signs, and suctioned out his lungs.
“How do you do it, Cindy?” At last I had to ask her. “My baby had a cold last week and I was up all night, listening to his cough. I was so worried about him. And you, you’ve coped with so much. How do you get up four or five times during a night to attend to him? How have you been able to clean him up and talk to him all these years without getting any response in return?”
“He responds to me,” she said.
“Well, no meaningful response,” I tried to correct myself.
“To me it’s meaningful.”
I watched while Cindy massaged Sam’s feet, paying full attention to each foot, one at a time. Finally I understood one small thing. Like Cindy, I loved every part of my own baby’s body. Sometimes I even put one of his little feet in my mouth, after his bath. When I held one of my baby’s little feet, my love for his whole body and the person inside him, swept right through me.
As the day wore on, I kept watching Cindy from the corner of my eye. The expression on her face was serene. She was utterly content. She had no desire to be anywhere else, to be doing anything else, or to have Sam any other way than the way he was.
I watched Cindy give him a back rub. “You like that, don’t you, sweetie?” she asked him.
How could she tell whether he liked it or not? What were his signs of pleasure or discomfort? His eyes, askew on his face, opened, then shut, then opened again, but registered nothing.
I would have imagined that Sam’s hospitalization would be an opportunity for Cindy to take some time off for herself. I, myself, had such guilty pleasure returning to the work I loved and leaving my baby at home in the care of someone else. Yet child care could be so tedious and draining at times. At least that’s how I found it.
Sam didn’t sleep much, but when he did take a nap, sometimes Cindy would relax and pull out a book from a plastic bag she kept at her feet. She hadn’t gone home to their apartment since Sam had been admitted to the hospital, so she wore the same clothes every day – running shoes, a grey T-shirt that said “Gone Fishin’” on it, and blue jeans. She sat with her ankles wrapped around the legs of the chair, reading an eight-hundred-page paperback that she’d borrowed from the patients’ lending library.
“Cindy, may I ask you something?”
She looked up from her book and said, “Shoot.”
“Do you ever take a holiday?”
“I could never leave Sam,” she said. “I couldn’t be away from him.”
“What I really want to ask you, Cindy, is this. How do you do it? That’s what I want to understand. All the doctors and nurses marvel at you and your devotion to Sam. It’s remarkable. I’ve never seen anything like it.”
“He’s my son.” She shrugged her shoulders. “I love him.”
She saw that while I believed her, her answer did not satisfy me.
“I love him as you’d love any child. When he was born, they’d just invented all these life-saving devices and they used every single one of them on him. Boy, did they save him, but good! But they told me he wouldn’t live to be one year old. Then they swore he’d never make it to two. Would never see three. But here he is, nineteen years old and a fine strapping young man, too. He even has to fill out an income tax return, can you imagine that!”
“It never seems to get you down, taking care of Sam, I mean.”
“You know, you go to the waiting room at the children’s hospital – that’s where we spent the last eighteen years, until we had to come here – and you see parents who are crying. Those are the ones whose kids are having their tonsils out. The others over there, those ones who are laughing, telling jokes are the ones whose kids have cancer but their kid had a good day. Those ones laughing are the ones whose kid was in an accident, but survived.”
“I see,” I said, and I think I did, a little.
“I remember one little boy, Kevin, who had been a perfectly normal four-year-old. Then – bam – he was in a car accident that left him permanently brain damaged. A vegetable. Now, that’s a loss. I never had that, so I don’t miss it with Sam. We are very happy together, Sam and I. Happier than most married couples, from what I can tell. I have only one wish …”
“What’s that?”
“I wish he could have children. I would love to have grandchildren.”
I gasped at the very thought. Of all things.
“But of course, I know, it isn’t possible. I’m too old.”
Was I missing something here?
“Well, I think I’ll head out for lunch now. I feel like some Taco Bell. I hope for your sake those refried beans don’t act up on me!” She picked up her tattered copy of the Wilbur Smith tome she’d been reading, gave Sam a big kiss on his lips, and said to him, “See ya later, alligator!” and waved goodbye to me.
That evening, before I left at the end of my shift, I changed my plan for the next day. “I want the same patient tomorrow,” I told the night nurse coming on. I pencilled myself into the assignment book. “I want to follow up with Sam and his mother.”
“CINDY JüRGENS IS a saint, a philosopher, a hero,” I said to the others the next morning at breakfast in the cafeteria.
“No, she’s not. She’s a nut case,” said Laura. “A psycho. You’d have to be crazy to sacrifice your life for another human being.”
“I don’t think Sam quite qualifies as a member of the species,” said Morty. “He’s a perfect example of the kind of thing the Church is so bent out of shape about saving,” added Morty, a Catholic herself. “We’re going all out for this guy when there are people we can actually save who need t
he ICU bed he’s taking up. But we’re treating her, not him. She insists on all this. That’s our health-care system for you! Welcome to Canada. You can have whatever you want.”
“I thought you voted NDP,” I said, trying once and for all to trip her up.
“Being a socialist doesn’t mean that I believe in wasting money,” she shot back.
“I’m trying to figure out how Cindy does it,” I said, returning to the subject that probably only I wanted to discuss. “She never seems to tire, never despairs. I’m in despair every time I take a look at Sam. I can’t bring myself to talk to him or touch him.” I pushed aside my cranberry muffin.
“Don’t feel sorry for Cindy Jürgens. She’s getting something out of it, too,” said Doris, one of the older veteran nurses who had come over to join us at the table.
“What makes you say that?” I asked.
“Have you taken a look under the sheets?” she asked.
“I don’t know what you’re talking about,” I said, “and I don’t think I want to, either.”
“I took care of him last week,” said Morty, “and there’s no doubt in my mind about it. Don’t be so naïve, Tilda.”
Even Frances nodded in agreement.
Later when Cindy went out for lunch, Doris, the nurse I had spoken with at lunch, came over to my room. She said she wanted to show me something.
“Have you taken a good look at that boy?”
“What are you talking about?”
“His penis. Have you seen it?”
“Of course I have. I did a thorough nursing assessment of him this morning when I started my shift.”
“Come over here.” Doris closed the curtains around Sam’s bed. She pulled back the sheets and there, springing out at me, was the most enormous penis I had ever seen. That wasn’t there before, I thought. Bulging and bobbing, it seemed to demand satisfaction. It made me think of a stallion, or a German shepherd dog eager and pent-up, springing to attention, urgent for relief. To bring it down would be like felling a tree – and we would have to shout “Timber!” Pushed down, it would have touched his knees. Without a doubt, it was the biggest I had ever seen in either my extensive professional, or decidedly more limited personal, experience. How could I have missed it earlier?
“He had a diaper on earlier, that’s how I missed it,” I said.
“I see she’s taken it off,” Doris remarked.
“For his dignity.”
“Or for easier access.”
“You could choose to see it either way, couldn’t you?”
“Be honest,” said Doris, “you can see that that’s an experienced one. It’s been around. It knows what it wants. It’s been well used. If it hadn’t been in use, it would have been more withered, wasted away. You know, if you don’t use it, you lose it. This muscle has been getting a good workout. It’s used to getting satisfied. Who else, but with Cindy? She needs it too, she’s a single mom on her own, she’s not likely to be out meeting guys, at least not one who’d want to come home to this.” She nodded in the direction of Sam.
We covered it up, but it pushed up against the sheets. Sam, himself, was oblivious, neither in distress nor at rest. He didn’t react to anything that I could see, not to cold or hot, light or dark, pain or pleasure, not to anyone’s presence, or if they walked away. Strangely enough, it was his extraordinary penis that communicated more than Sam himself ever would.
“Let me ask you something,” Doris said. “Just before she left for lunch, did she kiss him? On the lips?”
“Yes, but what are you saying, Doris? That she and Sam …? That a mother would …? With her own disabled son? But she’s so devoted to him.”
“All the more reason. It’s the way they communicate. He gets some tactile stimulation and – who knows if it’s pleasure? – I daresay that with that,” she pointed, “she does too. They both get off in one way or another and I suppose no one is hurt in the process. The nurses at the children’s hospital had their suspicions, too. They called in the Children’s Aid Society, but no one could prove it.”
I didn’t know what to think. I do know that I never saw Cindy act in an inappropriate way.
“OH, WHERE IS Father Szigetti when I really need him?” I said to Morty at the nursing station where I went to think this through.
“Okay, I’ll be him for you,” she said, crossing herself and making a pious gaze in the direction of Sam’s room. “Good Lord, my dear. But Sam is one of God’s creations too … however, it certainly must have been an off day, even for Him.”
I had to laugh. I smiled, too, at her choice of earrings that day: tiny silver Greek masks of the theatre – Comedy hanging from one ear lobe and Tragedy from the other.
EARLIER I HAD asked Cindy if she was religious and if she wanted to see a chaplain, but she’d waved away the suggestion. “I have no use for the Church, any more. I mean no disrespect, but my Catholic boyfriend left me when Sam was born and all he gave me was Sam and we’re no Catholics.”
Now it was time to take Sam’s vital signs, and since Cindy wasn’t back yet from her lunch, I took them myself. He had spiked a fever and when she walked in I told her.
“No, he hasn’t,” she scoffed. “Couldn’t be.”
She took his temperature herself and stared at the thermometer: 38.8°C. I drew blood cultures and the doctor changed the antibiotics. Cindy gave Sam some Tylenol and prepared a basin of water for a sponge bath.
That day Faizel El-Bakshy was the medical resident on duty for the ICU. He was just emerging from his on-call room, straightening his lab coat, a few minutes late, to join us for the short late afternoon rounds. He had been sponsored by a large corporation in Riyadh, Saudi Arabia, to come to Canada to specialize in critical care. “I am ready … for to perform arterial puncture procedure on Jürgens, Samuel, the patient,” he said in his halting, formal English.
Dr. Daniel Huizinga was the attending staff doctor that week, and he decided that given this new spike in temperature, Sam’s intravenous and arterial lines should all be changed to new sites to prevent the spread of a possible infection. Cindy knew exactly what was going on. She’d probably been through it many times before, so I didn’t need to explain a thing.
“Did you just finish saying your prayers?” I asked Faizel quietly as he took his place with the team.
“Yes, how did you know?” He smiled. “If I don’t pray, I get nervous. I must to pray four times a day, and once during the night.” I nodded and he continued, “It is a physical need that I must satisfy, as if my bladder were full, or even, like … sexual intercourse.”
I had never heard prayer described as an essential need, as if it were a life-saving procedure. We all have strong needs, I thought. Is it wrong to get them met in whatever way we can, if no one gets hurt? Isn’t what goes on between two people private, as private as between this man and his God? If whatever goes on between Cindy and Sam brings them closer and helps her to do the yeoman’s work of caring for him, day in and day out, who am I, or anyone, to judge?
“Did you manage to get some lunch?” I asked. “It’s been pretty busy in the unit today.”
“I must not eat until the sun has set. It is Ramadan. I am starving to eat, but I must wait. There is a call in the Emergency department that I must go see.”
I knew that there was an untouched lunch tray still in the pantry that would go to waste. I grabbed a slice of banana bread and a carton of milk off the tray and brought it to him. “Here, you’ve gotta eat. Save this for later, for when the sun sets.”
“God bless you.”
He told me he had recently received disappointing news. The company was sending him back home sooner than he had expected, as a lowly internist. They would not continue to sponsor him to specialize in cardiology, as he had wished.
“I bet your wife is happy about that.” He had told me once how homesick she was.
“Yes, she misses the desert, the sand, and muezzin calling us to prayer. The weather here is difficult for her.
She is lonely.”
I had never met her, but felt her presence. I pictured Lai’lah, Tabiyah, Ashnoor, their three daughters whom he had told me about and whose pictures he had shown me. I knew of his disappointment at not having a son to carry on the family name.
THERE WERE STILL a few more hours left of my shift. Sam’s fever was raging and Cindy looked worried. She knew what it meant when I told her that his white cell count was up: a serious infection, possibly in the blood, and in Sam’s case, given all his chronic medical conditions, life-threatening.
After I finished removing Sam’s right radial arterial line and helped Faizel put in a new radial art line on the inner aspect of Sam’s left wrist, Cindy wanted to wash his hair and give him a shave. I dashed off to the linen cart for more towels. In the hallway I ran into Dr. Huizinga, who looked worried. He wanted to know if I had made any progress in weaning Sam off the ventilator and if his fever had come down. He told me about a twenty-four-year-old woman downstairs in the Emerg who was in a coma and liver failure from a rare drug reaction. She needed to come to the ICU urgently. I knew we didn’t have any empty beds.
Later, I stood at the sink and watched Cindy fussing over Sam, cooing softly to him, clucking to herself, staring at the thermometer and fretting over his fever. I was dreading telling her that we might have to rush Sam along so that he could be transferred out of the ICU. She decided she would give Sam yet another sponge bath. Again, she hauled out the large metal basin that we kept under the sink, along with his special soap, shampoo, and conditioner. Then she changed his already clean sheets and smoothed and rearranged them.
