Man in the Empty Boat

by Mark Salzman

  Daniel got a call from the hospital before seven that morning and rushed out. Dad walked over from his garage apartment to give Isabela a birthday present. He’d bought her a kit that comes with a pair of flip-flops and some paints and glue and appliqué stuff so the flip-flops could be customized. Isabela pulled them out of the box and right away you could see they were way too big for her; they were adult-size. But Isabela, bless her heart, didn’t give any sign of being disappointed. Without missing a beat, she said to her sister, “Livia, let’s make them for Mom when she comes home!” So they did. It was too much for Dad to watch; he went back to his apartment.

  I made butterscotch chip pancakes for the girls, but they didn’t like them, so we settled on eggs and toast. Livia seemed very angry that day. I gave Isabela and Livia the gifts and goodie bags that Jessica had chosen for them and sent with me, and Livia was glad to have something to open. It rained all morning, and we had a lot of thunder.

  When afternoon came, it was still very dark and gloomy, and I had a headache that wouldn’t go away no matter how many pills I swallowed. The girls watched TV. Erich was at the hospital, and he called to say Rachel had developed a secondary viral infection in the other lung. Because she was not getting enough oxygen, the doctors had injected her with a paralyzing drug to shut the rest of her body down and conserve energy. This prompted Dad to wonder if the doctors were aware that Rachel had been taking antidepressants up until the day she’d been admitted to the hospital. He left a message with Rachel’s psychiatrist’s answering service, and a few minutes later the psychiatrist called back to say that yes, the doctors should definitely be informed. Rachel was on two antidepressants simultaneously and, in addition, had been taking Xanax four times a day to cope with anxiety.

  We called the nursing station at the hospital, hoping we might have stumbled upon the key to Rachel’s recovery, but it turned out that Rachel had provided all this information the day she had checked in.

  The rain eased up, and we had the barbecue over at Erich’s. There were a lot of people there. I felt tired, and my head was pounding the whole time. I went out onto the porch, thinking I would be by myself, but it turned out I had company. It was Livia. I said hello but she didn’t answer. She was staring out toward the woods, all six years and fifty pounds of her, light brown curls, green eyes just like her mother’s. In profile she looks exactly like Rachel; the resemblance is haunting. I sat down in the rocking chair, and we were quiet for a while. Suddenly, Livia turned her face up toward the sky, clenched her fists, and yelled with all her might, “Dear Mommy, I miss you! Love, Livia!”

  I felt like I’d been stabbed with an ice pick. I said good night to everybody, drove back to Rachel’s house, and went to bed.

  The next day, Daniel came back from the hospital before lunch and announced that it was time for a break: He wanted to take all of us to Norwalk for lunch and a visit to the aquarium. Dad came along too. We watched an IMAX movie about a stretch of ocean off the east coast of Africa. It was just what I needed to see—images of nature without any narrative or moral commentary. No melodrama, just spectacle. Awe rather than agitation.

  That night at dinner, I encouraged Daniel to talk about his childhood in Romania, and he told some good stories. Seeing the way his daughters looked at him while he talked was very touching. I found myself thinking that if Rachel didn’t make it, the girls might be OK, with the father they’ve got. And then I felt guilty for thinking that.

  Daniel put the girls to bed while I did the dishes. At 9:30, the phone rang. I answered. It was a resident from the hospital. Rachel’s heart rate was dropping; they were about to do CPR. I had to tell Daniel, and he rushed out without a word. I went upstairs and read a couple of books to the girls. I spent the whole night with them—Daniel didn’t return from the hospital until after dawn. At 4:00 a.m. Livia woke up screaming, then she said she was hungry and wanted Cheerios. I hesitated for a moment, and she started screaming again, so I went downstairs and fixed the cereal for her. Isabela said, “I know it’s late, but could you read to us again? I don’t think we’re going to be able to sleep anymore.” I turned on the lights and we read more books.

  Daniel came back at six thirty to take a shower and change his clothes. He said that Rachel’s weight was up from 120 pounds to 190 because her body was swelling up with fluid. The drugs that would make the fluid drain out of her affected her heart adversely, so they couldn’t give them to her anymore. She wasn’t getting any nutrition—any protein—which meant the fluid wasn’t being absorbed in her body, so even though she was filled with water, she was completely dehydrated. One of many concerns at that point was that her bladder might burst.

  That day happened to be Ava’s birthday—my daughters’ birthdays are only two days apart. As I had done with Esme, I called Ava to wish her a happy birthday and apologized for not being there. She sounded as cheerful as ever. She asked me, “How is your sister?” and I had a hard time thinking of what to say, so I changed the subject.

  The next day, Rachel weighed 206 pounds and her kidneys had failed. She didn’t look real at all; she looked like a wax museum figure. The doctors started her on dialysis to remove the toxins from her blood, but they warned us that she might not be able to tolerate the procedure in her condition.

  Twenty-four hours later, a doctor informed us that Rachel’s liver had been irreparably damaged. But then he said that the dialysis seemed to be working, and her vital levels were rising. This planted the idea in Daniel’s mind that Rachel would survive. He was certain of it.

  My father and I had a long talk about what to do if it looked like Rachel could be kept alive indefinitely but in a vegetative state. We agreed that that must not happen. If either of us were in that condition, we would want our spouses to pull the plug. But how did Daniel feel? We didn’t know, and we didn’t know how or when to bring it up with him. At that point, he seemed sure that Rachel would recover. And what about the girls? When would the time come to prepare them for all this? Up until then, Daniel had insisted that they be shielded from the full gravity of the situation. Mommy was sick and the doctors were taking care of her and she would get well; that was what he had been telling them all along, and it seemed like as good an idea as any to me.

  I suggested that we call Rachel’s psychiatrist to ask if he had any suggestions for how to handle this. You might think that my father, given his bias against psychotherapy, would have balked at this suggestion, but he didn’t. He trusted this particular psychiatrist, and with good reason: Rachel had convinced our dad to give this doctor—and medication—a try, and his experience with antidepressant medication was positive. “If only they’d had these drugs fifty years ago,” Dad lamented, after he’d found the combination that worked for him. “I might have painted happy clowns on velvet and made a living at it.”

  Dad called the psychiatrist, and he agreed to see us right away. He hadn’t known about Rachel’s illness before getting my father’s message, and he looked stricken when we described her condition. We asked him if there was anything we could be doing to help Isabela and Livia through this. Should we be encouraging them to talk about what they were feeling, or just leave them alone? Was there anything we should especially avoid doing?

  He didn’t pretend to have all the answers, and I liked that about him. Under circumstances like these, he said, simply being there for the girls and playing it by ear was probably the best anyone could do. But then he took the conversation in an unexpected direction. He suggested to my dad that he needed to step up and become more of a father figure to Daniel. Right away.

  “You’re Rachel’s father; you’re the paterfamilias, he’ll listen to you.” He recommended that Dad let Daniel know how we felt about keeping Rachel alive if she were truly brain dead. He also recommended that we encourage Daniel to tell the girls that their mother might not recover, because if she died before he had prepared them in some way, they might feel that they’d been deceived.

  My father listened atten
tively, but I found it difficult to imagine him suddenly taking on the paterfamilias role. Still, I was impressed by the way the doctor had handled our meeting. I decided that if I ever had trouble with panic attacks again, I would call him.

  Later in the afternoon, I met with the director of a grief counseling center in Danbury that offers various kinds of support to families, especially children who have lost a parent. I asked him what we should do about Isabela’s birthday party that Sunday if Rachel died before then. Should we cancel it? He said, ”Ask the child. If the child wants to have the party, have the party and don’t make her feel guilty for wanting it. So much is being taken away from her; if she wants something that she’s looked forward to for a long time, let her have that. If she says she would rather not have the party, then cancel it and don’t make her feel guilty for not wanting to celebrate.”

  That seemed like sound advice. But if Rachel died, I didn’t know how we would pull that off, with a house full of kids and lizards and horned toads and god knows what else that outfit was supposed to bring. How do you sing “Happy Birthday” to a girl whose mother just died? I truly did not want to find out the answer to that question.

  So much was going to change. Daniel was going to need a lot of help. It was good to know that there was a place he could go to ask for it. The center offered help with everything from counseling to recommendations for temporary childcare and housecleaning services. I wouldn’t be able to stay in Connecticut forever, and Dad told me that as soon as this was over, he was going to move back to Arizona. He couldn’t stay in that garage apartment anymore—Rachel’s ghost would haunt him.

  The next day was Saturday, May 30. Daniel was home, and Dad came over to join us for breakfast. After we’d eaten, Isabela and Livia asked if they could go across the street to where one of their friends was having a tag sale. I walked them over and chatted with the friend’s mom, Annie. She offered to watch the girls for the rest of the morning to give me a break.

  I went back into the house. Dad was still sitting at the table, when he turned to Daniel and said, in a very matter-of-fact way, that we needed to talk about Rachel. He said that none of us wanted Rachel to live like a vegetable and that it was time to get a neurologist to examine her. “If she’s brain dead,” he said calmly but firmly, “we’ve got to turn off the machines. We’ll do it together, all of us. It won’t be just you.”

  At first I couldn’t tell what Daniel was thinking. He was quiet, looking at the table. Then he started to cry and he said, “No, Grandpa—don’t say that.” Dad got up and hugged him, and Daniel wept silently in his arms for a few moments, then they both sat back down. Dad said, “And you’ve got to prepare the girls before that happens.”

  “When?” Daniel asked.

  “Now.”

  Daniel stood up, went to the front screen door, and called out to the girls. “I need you to come here. Daddy needs to talk to you.”

  This was it—this was what I most feared. Having to be present at the moment when those girls learned that they would never see their mother again.

  The girls came in and Daniel had them sit next to him at the dining room table. He reached out to touch their hands and he said, “There is something I have to tell you. The doctors have done everything they can to help Mommy, and Mommy has done everything she can to get better, but the sickness she got is too strong. She may not get better. She may not come home.”

  His voice broke, but he managed to keep going. “But I want to make sure you understand something. It’s not because she wanted to leave us. She tried so hard to come back to us, so very hard. It’s not anyone’s fault. It’s not your fault, it’s not her fault. Mommy loves you very much. Do you understand?”

  Isabela started to cry. Livia picked up a little ball and wrapped it in a white tablecloth and began moving it across the table, like a little ghost, and she made the sound a ghost makes: “Whoooooo . . .”

  “Do you understand what Daddy is telling you, Livia? Do you understand that Mommy loves you? I need for you to tell me that you understand that.”

  Livia nodded.

  “It’s not fair,” Isabela said through tears.

  “No, it isn’t,” Daniel said. “But Mommy loves you, she will always love you, and I will always love you, and I’m not going anywhere. I’m not going to leave you. And I don’t want either of you to worry that you might get sick and die. This is something very rare. Not even the doctors know what it is. If you girls get a cold, I don’t want you thinking you’re going to die. Do you understand what Daddy is telling you?”

  The girls nodded.

  Daniel hugged them and kissed them and then asked if they had any questions. Isabela, looking very determined, asked, “Can we go back now? Across the street.”

  “Yes,” Daniel said, and he let them go, and they walked out the front door.

  Daniel asked me if I would follow the girls and watch them to make sure that they were OK. Then he called Erich and said to meet him at the hospital. It was time to find a neurologist.

  I walked across the street, and Annie offered me a lawn chair to sit on while I watched the girls. I was still trying to digest what I’d just seen and heard: my father, behaving not at all like a rabbit; Daniel delivering the awful news to his children with perfect simplicity and tenderness; the girls, absorbing only as much of the news as they could bear and then seeking refuge in the distraction of the tag sale. I watched in awe as they helped their friend draw up little price tags for the old toys. Isabela made a large notice advertising the sale and asked if I would walk up the street to help her attach it to a stop sign. As we walked up the long hill, she asked me if Ava and Esme ever had tag sales, and if I had ever held one when I was a kid. She seemed to want to talk about tag sales only, so I followed her lead, and that was our conversation as we taped up the notice and walked back down to the neighbor’s house. I bought a few dolls for my kids, which delighted Isabela and Livia, and when another neighbor stopped by and bought a few things, they were just as excited.

  I stayed at the tag sale for an hour or so, and then Dad came over. “Erich just called from the hospital,” he said. “It’s time.”

  I asked Annie if she could watch the girls, and she said she’d be glad to—she’d give them lunch too. I stopped by the neighbor Lisa’s house and told her what was going on, and she said she could take the girls all afternoon and all evening if necessary. I pulled Rachel’s car out of the garage, Dad got in, and we drove to the hospital. We didn’t say anything to each other on the way. Just as we were parking, my cell phone rang. It was Erich, asking us to hurry. We stepped out of the car, and Dad suddenly clutched his left arm against his body with his right hand and started running. I caught up with him, and we rode the elevator up to the ICU floor. As soon as it opened, Dad ran past the nursing station to Rachel’s room.

  Erich and Daniel were on either side of the bed. Erich was holding Rachel’s good hand (the other had turned completely black from the arterial pressure monitor), and Daniel was stroking her forehead. Rachel looked ghastly. She was still swollen—her neck was wider than her head, and it didn’t look real at all—and still intubated, and one of her unseeing eyes was half open. Erich explained to us that the neurologist had examined her and confirmed that she was gone. She’d probably been that way since the first attempted operation. The subsequent operation, all the procedures, all the machines and drugs and alarms and phone calls and crises—they were probably all for nothing. A technician came into the room and Erich said to him, “We’re all here now.”

  The technician called a nurse over, and she explained that she would be giving Rachel an injection of something to prevent muscle spasms. Those spasms would give the false appearance that Rachel was struggling to breathe once the tube had been removed. “This is for the family, really, not for the patient,” she said. “The spasms are pure reflex; they aren’t a sign that she’s conscious. The drug will help her muscles relax until her heart stops. It’s more peaceful that way.” The
technician advised us to step outside for a moment while he and the nurse removed the tube that was doing the breathing for her. “You don’t want to see that,” he said, and he didn’t have to ask us twice. The four of us stepped behind a screen and tried not to listen to the gurgling sounds coming from inside the room. We didn’t talk. I felt as if I were standing inside a virtual body rather than a real one. My physical senses were heightened, but I felt no emotion at all. If I could have projected the contents of my consciousness onto a screen, the images would have been unrecognizable.

  The technician called us back in, and there was Rachel, without any wires or tubes connected to her. Her lips were bluish purple and her lower lip was misshapen from where the tube had rested for so long. Her eyes were still half open. The four of us surrounded her bed and placed our hands on her arms, her face, her legs, and her feet. There was nothing to do, nothing to hope for, nothing to expect. The nurse returned and used a stethoscope to check for a pulse. She nodded to us and it was done.

  “The worst day in my life has come,” Daniel said.

  I kept my hand on Rachel’s foot, but I looked out the window at the puffy white clouds and blue sky and the hills rolling south toward Long Island Sound, and a strange thing happened. I heard a voice say, “The peace of green fields.” I heard the voice clearly, but a quick glance around the room confirmed that I was hallucinating. I didn’t recognize the phrase; it meant nothing to me.

  Dad stood up and said, “I can’t stay here anymore,” and he walked out. I told Erich and Daniel that I would take him home. I kissed Rachel good-bye and followed Dad out to the parking lot. We got into the car, but I didn’t feel like starting it yet. It was windy out—the gusts were so strong they rocked the car. Dad was still clutching his left arm against his chest with his right hand. Was he having a heart attack? I figured he would tell me if anything was wrong. Or maybe he wouldn’t. What did it matter, after what he’d just seen? Rachel was his only daughter. If I had to watch one of my girls die, I’d be grateful for a heart attack. He was staring out the window at the valley beyond the hospital. Then he spoke, and he sounded angry.