by Rob Rufus
Mom is here. She is silent now. She sits in the corner near the window. Dad stands straight, his hands braced on the back of a chair.
A doctor pulls the tube through my insides and out of my throat. The pain crashes in my chest like lightning over the morphine cloud.
I gasp for air. It feels thin and useless.
I try to speak, but the pain is too much. My throat is as dead and hot as a desert.
They take the tube away. I see blood. Someone places a straw in my mouth. My gasps pull water in—the thin stream trickling down my throat makes me wince.
* * *
A male nurse shakes me awake.
“I need to change your bandages,” he says.
He looks at my parents. “You may want to leave the room.”
They walk out into the hall.
The nurse has stripped me to my waist. There is a giant white gauze pad covering my chest. Below, there are two thick rubber tubes bandaged to my sides. I try to ask him what they are. My throat hurts too much for sound.
“They’re drainage tubes,” he says, as if reading my mind. “They remove the fluid after the surgery.”
I feel him ease the tape around the gauze off my hairless pigskin chest. I feel a tug—painful. Finally, I look down at my chest again.
I instantly want to vomit.
A dark-red knife gash, a quarter inch thick, stretches all the way across the width of my chest. The cut curves up beneath my nipples, which flop dejectedly over it. The red skin is clamped together with twenty thick staples; each caked in the shit-brown crust of dried blood.
I begin to gag.
The nurse sighs sympathetically. Gently, he cleans the blood from the staples with a damp cloth. I can’t watch.
If I don’t see it I can’t feel it if I can’t feel it I won’t see it.
I shut my eyes. Tears leak out through the cracks.
* * *
I open my eyes. He has changed the bandage. I see the blood-soaked gauze sitting idly on the edge of my bed.
Now he removes the gauze around the tube sticking out from my left rib. This tube isn’t going out, it’s going in—sewn to my skin with a thick black thread. I see my stomach muscles tense. The tube moves with them.
There is no blood around this wound, just a yellow-pink ring of pus. The nurse wipes it away. He applies a fresh dressing. Then he moves to the tube on the other side of my stomach.
I don’t want to watch anymore.
* * *
This room is different than the rooms on the cancer ward. There are no children here. The nurses move unsympathetically in and out, in and out. In this place there is no sympathy. No kids, no gods, no illness. Here there is only this pain. And thin streams of air.
Every inch of me aches. I long for the cancer ward in Ohio. I pray to be sick and puking and miserable, anything but in this pain.
I know that I am somewhere in Indiana. I shut my eyes and try to imagine the country surrounding me. The cornfields, rippling like black waves in the night. The stars above them—endless stars, carelessly shining like sparklers on the Fourth of July. I bet they look pretty outside this room.
But it doesn’t matter. Eventually, the pain covers all.
NINETEEN
The Summer That Was
1
They began weaning me off the morphine.
It was harder this time. My pain was all-consuming, even with the drugs. Now, it became more present every day. I was more present too.
Dr. Einhorn came to see me many times, but I was unaware of it. I do remember Dr. Redding. My first clear thoughts were of him explaining again what had happened during the surgery.
When they opened my chest up, they discovered that the cancer had progressed further than they’d expected. Although it had significantly shrunk, the tumorous mass in my chest was gigantic—heavier than both of my lungs, combined—and its black roots were wrapped around my other vital organs like tentacles.
Dr. Redding performed an unprecedented, six-hour surgery.
He worked around my other organs, removing as much of the tumor as he could. But the mass was so big, so enveloped over my organs that, in the end, he decided it would be riskier to leave the tainted sections inside me than to remove them completely.
So, after the surgeon removed the tumor, he went to work removing a large section of my inferior vena cava (the vein that carries blood to my heart). They removed half of my diaphragm. They removed my entire right lung.
They restructured my chest cavity into a jumbled series of pins, rods, and meshing. My heart was now in the center of my chest. My remaining lung now shifted in the empty space. Mesh walls were attached to replace my missing diaphragm and keep my intestines from floating up into my chest.
Then they stapled me back together.
The tube in my throat forced my new body to breathe. The tubes in my ribs sucked the fluid and poison from the now-barren parts of my insides.
I didn’t know how to process the information.
I wanted more drugs now.
* * *
I had been so certain I’d be breathing normally again once the tumor was gone. Now, the chances of that were fucking ripped away. Dr. Redding said they’d begin daily pulmonary-function tests, to measure how well my new body was adapting. Right now, my breathing capacity was down to twenty-three percent.
He said that it would get better.
“Will . . . I be able to . . . play drums again?” I choked out, before Dr. Redding left the room.
He looked at me, pathetic in bed.
“You need to focus on getting your strength back. You haven’t eaten anything in five days, Robert. Your body has been through a lot. It needs energy. When you’re strong enough, we need to get you walking again. You won’t leave the hospital until you can walk. So let’s focus on getting you home, and then we can work our way up to drums.”
* * *
I still didn’t eat. Food was impossible. It hurt too bad to take my pills. And unless I was complaining, it hurt too bad to talk.
Talking also would mean I’d have to talk about what happened, which might cause me to let go of some of the rage I was feeling. And I wasn’t ready to do that. Not yet. The rage was the only feeling I could understand. So I held it in, clinging to it like it was a life preserver or a friend.
* * *
A doctor came into my room the next day. I didn’t recognize her. A nurse and two very large male orderlies followed. The doctor was cheery. She smiled broadly over the turtleneck rising from her lab coat.
“It’s finally time to take out those drainage tubes,” she said warmly.
My breath caught in my throat—I felt way too here for this.
“Don’t I need to get put to sleep?” I was requesting, more than asking.
“No, no,” she said, “nothing like that. This is simple. We can do it right here—it’ll only take a moment.”
“Can I at least have some numbing stuff, or pain medicine? They’re sewn inside me, right?”
She took the chart from the end of my bed. She flipped through it. She shook her head.
“Normally yes, but not for you. Sorry. They’re trying to get you off that bad ol’ stuff.”
“Is it going to hurt?” I asked softly.
She thought it over. She smiled again and then shrugged.
“I guess it depends—some patients don’t think it hurts too bad. Then again, some patients say that it’s the worst pain they’ve ever experienced. . . .”
Before I could respond, the two orderlies held my arms to the bed. The nurse removed my blanket and lowered my gown. The doctor took a pair of nine-inch metal shears from her coat pocket.
“Jesus! Fuck!” I yelled. I squirmed. My chest hurt. The shears glistened. . . .
“Hold the left one, please,” the
doctor said flatly.
The nurse pinched my skin, below the suture. The shears made a metal-on-metal sound as they opened. The doctor quickly snapped the skin that was sutured around the tube completely off.
She yanked the tube out—it was loooong—and I gasped as I felt it move inside my insides, through the muck of my organs and blood until it finally came out of the hole in my stomach in one unnatural slurp.
My mouth was frozen open in shock.
The doctor immediately sewed it shut. Then she cut the second tube. I felt it thrashing through my insides like a fishing lure.
It was the worst pain I ever experienced.
* * *
They brought me Jell-O. Maybe my throat hurt too bad to eat real food—but this wasn’t real food. This was J-E-L-L-O.
It was green. Why the fuck would they bring me green? Nobody likes green.
“You have to eat it,” Mom said.
She and Dad sat together, barely looking at each other. I stared at the Jell-O cup on the rolling tray before me.
“Fuck that,” I grumbled. “Not. Hungry.”
“Well, you want to get outta here, don’t you?” Mom said. “I sure know I do. I know that your dad does too. They won’t let you leave until you start eating.”
I finally picked up the spoon.
Even that small movement made my chest hurt. I brought a spoonful of green to my mouth. I let it linger on my tongue before it slid down my ravaged throat.
I’d been afraid that they might have hooked my insides up wrong. I was afraid that if I ate, soon Jell-O would be floating around inside of me forever.
I braced myself. Nothing happened.
I picked the spoon back up. The Jell-O (even this bullshit green) tasted amazing. I finished the entire cup.
I asked Mom if she could find me some more—preferably red. Mom clapped and ran out into the hall.
Once she was gone, Dad sat his paperback down in his lap. He looked at me squarely.
“You know what Redding said, about you getting your breath back? About drumming?”
“Yeah.”
“Well, the body has ways of making up for missing organs. People who lose kidneys, for instance—that other kidney picks up the slack. Your lung will be no different. It might take a while, but I’m sure your breathing will get back to normal.”
“Seriously?” I asked.
“I don’t see why not. Shit, there was a guy who used to pitch for the Reds—can’t remember his name—but he only had one lung, and he ran those bases faster than any guy on the field. If he can play sports, you’ve got to figure that you can play drums.”
“Are you making that up? That sounds—”
“Listen—do you want to be able to play drums again?”
I nodded.
“Okay, good—then you will. Case closed. You will.”
* * *
They sent the same male nurse to get me—it was time for me to walk.
But first, I had to stand up. It took both him and my parents to steady me as my feet dangled over the floor. I eased one foot down slowly. They held on to my upper arms and helped me forward.
Soon, I had both feet on the cold floor. I took a shallow breath and eased all my weight down. My chest and back hurt, but not much worse than when I was in bed. The nurse hooked my catheter bag to the bottom of my IV stand.
“Your first challenge is walking to the bathroom,” he said. “If you can make it there, I might be able to talk ’em into taking out that cath.”
Fuck you, a voice inside hissed. Fucking shithead fucking nurse prick I don’t have to do it I don’t have to listen to you fuck this fuck this place. . . .
“Let’s do it,” I said.
I took ten pathetically small, incredibly slow steps forward—I was already out of breath. My gasps were shallow and scared. He told me to take my time, to relax, to breathe.
But breathing felt so strange. The air flowed into my mouth the same, but then it seemed to get lost somewhere inside me.
“You just gotta get used to it,” the nurse said. “You gotta let your body get reacquainted with itself. You know?”
I nodded again. I took eight more baby steps forward.
* * *
Twenty-three minutes and forty-one steps later, I was inside the bathroom.
“Yeah,” the nurse said. “Good job! Now catch your breath, and we’ll try to make it back to the bed.”
“Cool . . .” I panted, “. . . let’s . . . do . . . it.”
* * *
The next day, he had me walk to the hallway.
The catheter was gone. No breathing tube, no drainage tubes, no piss tube—I was losing tubes every day. I was once again more man than machine.
I gripped my IV stand and inched down the hall, stopping every few feet. The nurse narrated as we walked, telling me about the patients in each room we passed.
This guy—six gunshots. Six! Room four, right there—motorcycle accident. Keep walking. . . . You don’t need to see that.
The walking was murder on my body. I was still in numbingly constant pain. I labored to breathe air that felt as useless as quicksand in my throat. But the more I learned about my Intensive Care floor-mates, the harder it was to feel sorry for myself.
Room eight, right next door to ya—burn victim. Third degrees on eighty-five percent of his body. Can you believe that? You think you’re in pain, but burn victims are the worst. Imagine every single nerve ending you have frying, twenty-four hours a day. Nothing can help that guy, except maybe a bullet to the head.
Trust me, you don’t wanna see him. Keep walking.
* * *
I kept walking.
* * *
Every day got a little better. Lack of movement gave me bedsores, so I had to rotate from bed to chair, chair to bed, just like I did on the cancer ward. I progressed from eating Jell-O to soup, then up to a few bites of chopped salad.
One day, a psychiatrist showed up at the room. She was young, and pretty-ish. Instead of a lab coat, she wore a tight blazer and tight pants. My parents left us alone in the room. She sat down casually across from my bed.
“So how are you feeling?”
“Fine, I guess,” I said, “considering.”
She nodded sympathetically. “You’ve been through quite a lot.”
“Yeah.”
“That’s why I came to speak with you today, Robert. Many times when someone loses, say, an arm, they go through a transitional period of grief, not unlike when one loses a loved one. Do you understand?”
“Okay.”
“Now, I know you didn’t lose an arm, but those feelings of grief and depression are still very common in these cases.”
I didn’t say anything.
“May I ask—have you been feeling depressed”—yes— “or hopeless?” Yes.
“Not really.”
“No?” she asked.
“Nope.”
“Okay. What about feelings of anger”—definitely—“or anxiety”—of course—“since you’ve been here?”
“No more than what would be normal,” I said, “considering.”
“That is interesting. Your caregivers have been concerned—that’s why I came to visit today. Do you think you might be willing to try an antidepressant while you adjust?”
Yes, I thought.
“No,” I said.
She smiled. She wished me luck.
* * *
Two days later, a nurse told me that I’d be discharged soon. I was surprised—I still felt nowhere near recovered. My walks were progressing, but slowly. My pulmonary numbers had barely improved.
“Honestly,” the nurse said, “we need the space in the ICU for other trauma patients. Compared to others on this floor, you are making great progress.”
“Makes sense,” Dad said.
“You’ll be moved out of ICU and into a more comfortable room for a few days. After that, it shouldn’t be long until your discharge goes through.”
“All right,” I said. Though I definitely wasn’t feeling too excited about it.
The nurse smiled a sad smile. She looked out the window, into the sun. She put her hands on her hips and shook her head.
“My, my, my,” she said, “have you guys had a hard one. Your family sure has a story, though—people won’t know what to think when you tell them about the summer that was . . .”
She paused, searching for a word to finish her thought. She never found it.
2
They moved me into the nicest hospital room I’d ever seen. It was three times the size of a normal room. The floor was carpet, not cold tile. There was a large TV with cable, a couch, and a window. The bed was actually comfortable.
At first, I didn’t notice that they’d gotten me a room in the hospice. Later, they would say that it was the only free bed in the building.
This wasn’t like the hospice I’d imagined in the children’s hospital. This wasn’t so bad at all. If some old fuck was forced to die in a hospital, there were worse rooms than this to do it in. The change in scenery lifted my spirits a little. The move put me that much closer to home.
* * *
A few times a day, a nurse made me do a breathing test using an incentive spirometer—an empty plastic measuring container with a tube on the end. You blow in the tube. When you exhale, the force of your breath moves a measurement dial.
I hated doing it.
Not because it was hard, but because the nurse pushed me, and pushed me—I’d move the dial halfway up, and she would tell me to do better. I’d exhale again—halfway up. She’d again say, “Do better.”
“Jesus, lady,” I finally said. “I just . . . got my lung . . . removed, I . . . think I’m doing pretty . . . good. . . .”
She nodded. “Oh, you are! Now do better.”
* * *
It was alone in the hospice that I finally decided to call Nat. We hadn’t talked at all. My parents hadn’t mentioned him.
I tried his cell—he answered.
“Yo!” he said, excited. “How are you feeling, man?”
