Weekends at Bellevue

by Julie Holland

  “Camera,” I wheeze, and my photographer husband obliges.

  It takes me a while to get better at pushing. It is exhausting, and it hurts, and I have a strong instinct to avoid doing something that both requires energy and brings me enormous pain.

  “Charley horse!” I groan, as my left thigh seizes up, hard and tight. It distracts me entirely from my all-consuming task, forcing another person out of my body. The nurse massages my thigh expertly as the pain subsides.

  “I don’t want to tear,” I remind Joan.

  “Just don’t push if you feel a burning,” she replies.

  After a few more pushes, it burns, and I tell her so.

  “Wait. Breathe. Don’t push.”

  I wait. I pant, just like they do in the movies. Pretty soon I can’t not push. I have to push, the way I would have to breathe if I held my breath. There is a white hot ring of fire between my legs and I need to extinguish it. Joan tells me to go ahead and push, even though it is burning. And then I feel myself tear. It is unmistakable—a separate, serrated layer of fire-engine red pain on top of the white-hot searing pain.

  “I’m tearing, aren’t I?” I ask her, unable to conceal the panic in my voice.

  “Yes,” she answers matter-of-factly. She tells me where, and I ask her a few questions, slipping into doctor mode for just a minute, to make sure all the important parts are still intact. She assures me they are.

  “What do I do?” I ask her.

  “Push!” she answers.

  The head is out. I can see it between my legs as Joan tells me to stop pushing for a minute. I pant again, glad for the respite as she suctions the baby’s mouth. But I know from my obstetrics rotations in medical school that the shoulders are the killers, the widest part of the baby. I start pushing again and, sure enough, the pain becomes even more intense. “Joan, I don’t care what you have to do, just get this thing out of me!” I am yelling, panicking, on the edge of something, tipping, falling.

  And then the baby is out, slippery, bluish, covered in mucus, blood, and creamy white vernix.

  “It’s a girl!” Joan announces.

  I had forgotten that we didn’t know the sex of the baby, or even that we get to find out; it had been obscured by the pain. A girl. It’s what we both wanted. I break into a wide grin as I meet Jeremy’s eyes.

  Onto my chest is placed my baby girl, all purple and cheesy and slimy and warm, with her eyes wide open.

  Jeremy cuts the cord once it stops pulsating. After Joan is done sewing, I can finally sit up and relax with my baby girl.

  Later, as I unpack my overnight bag, Jeremy and I have a good laugh at all I had stowed in the bag to occupy our time during the labor: scented candles, massage oil, relaxation tapes. Molly, my lovely, perfect, beautiful new daughter, took all of forty-five minutes to come into the world from the moment we walked into the hospital.

  You’re Gonna Make Me Lonesome

  When You Go

  I take three months off for maternity leave, and we spend part of the summer on Cape Cod. When I return to the city, I stop by Daniel’s apartment, one block from my own, to show off my new baby. When she starts fussing and I begin to nurse her, I am surprised by Daniel’s blush as he turns away. Any dirty jokes we may have shared over the years as I pretended to be one of the guys are now completely off-limits. I have become a mother in his eyes, and if there’s one thing I know about Daniel, he reveres his mother.

  I start back up at work in September, delighted to see how Lucy’s cancer has responded to a new medication called Herceptin. It puts her into a remission of sorts, and so she continues to come to work nearly every day. I get the feeling that she is pulling back from our friendship, though, and I take her cue. As the months go by, I work my weekends, see her briefly on Monday mornings, and pull back as well. With a new baby at home, it’s easy to lose touch. Too easy. And too convenient an excuse not to do something that is painful for me.

  Mary and I move into a holding pattern of our own. My life is more settled now. Jeremy and I have eased into our roles as parents, and I am no longer taunting the patients and putting my safety in jeopardy. We’ve mined my childhood and CPEP behavior for three years, and the sessions are starting to seem like a coda to a song, repeating and fading.

  Termination is a big deal with therapists; typically, there are months spent discussing how the patient feels about stopping the sessions. Abandonment issues always crop up in these situations. I am actually more worried about how Mary will take my leaving, and much less worried about how I will do without her. I attempt to terminate much more quickly than usual, trying to wrap things up in one session.

  “I was watching this movie, and there was a little girl trying to learn how to ride a bicycle. The father teaching her was running alongside her, helping to steady her, and once the girl had enough speed and balance on the bike, he let go. As the girl wobbled away, I started to get a little teary.” I stop for effect here. “I realized I was like that girl, and you were the grown-up helping me learn how to ride my bike. Well, now I think I can do it on my own. I think I can take it from here.”

  Mary looks at me skeptically. At least I think it’s skeptically. “What are you getting at, Julie?”

  “I think I’m ready to end our therapy,” I state, with as much assuredness as I can muster. If she detects any hesitance, she’ll pounce on it, and we’ll have to discuss this ad infinitum.

  “I think you may be ready too,” she replies.

  Wow. Does this mean I’m fixed?

  We spend two more Mondays wrapping up, summarizing and solidifying all I have learned in her office. Mary assures me I can always come back to her if I need to in the future, and I thank her profusely for all she has done for me.

  When Lucy develops pneumonia during the winter and ends up in the hospital again, I don’t go to visit her. I assume it is a small fire to be put out, and then she’ll be back to business as usual. I don’t realize that she is seriously ill, or else I’m merely pretending that it isn’t a dire situation just yet. I tell myself that I need to get home to my daughter Molly after my long nights away. I need to nurse her and feel her in my arms again. On my drive home from Bellevue, I go right by the NYU hospital where Lucy is, but I don’t take the time to stop in and sit with her.

  I convince myself and all the other CPEP staff that this isn’t the final round, that they haven’t seen the last of Lucy Jones. At a faculty meeting, when the issue of Lucy’s health arises, I assure everyone that she’s not dying anytime soon, that she’ll probably be back at work in a few weeks.

  Daniel, who is now running the show in her absence, glares at me, to let me know this is an unreasonable thing to say, that I shouldn’t assure them of her resilience at this stage of the game. He’s been going to visit her most days after work, to keep her briefed on what’s happening at Bellevue, and also just to be with her, which is what I should have been doing. He is much more up-to-date on her current medical situation.

  So is it getting close to the end? My mind starts racing. What does Daniel’s glare mean? That if I had been sitting at her bedside, I’d have understood her medical condition as accurately as he does? I honestly thought she wasn’t that sick yet. Was that just wishful thinking, or more precisely, denial? Does he think she’s going to die soon? I take his glare to mean: You should know this as well as I do. You are failing her as a friend.

  And still I avoid going to visit her.

  I am insulating myself, I know, but it hurts too much to see her so sick. Her star is fading, receding, and I cannot bear it. I can’t fix it. I can’t control it. I turn away to protect myself, even though I know it is selfish. When Sadie confronts me with my absence, I have no excuse for my behavior. I don’t fully understand why I’m at such a loss for how I should be acting. It’s as if I’ve used up all my emotional intelligence at the office and have none left over when I get home. Everyday life is just as complex as what I deal with at CPEP, but I am ill-equipped when out of my element.
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  Sadie is with her day and night, a steadfast companion. She leaves Billy with a sitter and sleeps next to Lucy. What can I do to prove my allegiance except to be there for her too?

  I’ve already talked to Mary about it incessantly; at this point, there’s only one thing left to do: go.

  I finally make my way to the NYU hospital. I’d visited her there when she had her secret brain surgery, but that had been nearly a year ago. I’d brought her a plant then, a small chili pepper bush, with multiple red and orange peppers coming off the greenery at various angles. I thought it was a good symbol of her feistiness. Now, when I go to visit her in the ICU, I am empty-handed. I bring nothing to the table.

  The unsinkable Lucy Jones is on a respirator. She is awake, but she cannot speak. I feel awkward and terrible as I rack my brain for things to fill my side of the one-sided conversation. I tell her about some inane gossip at work. I show her a flyer honoring Valerie, one of our favorite social workers, as employee of the month. None of this means a damn thing. She is fighting for her life and I have nothing to offer, not even a worthwhile distraction.

  There is a book on the windowsill, and I flip through it as I take a break from my monologues. The book cover says Worst Case Scenario Survival Handbook. I leaf through it, and there is advice for all sorts of difficult situations: what to do if you are attacked by a bear, or if you are lost in the desert. Of course, there is no advice for how to act when your friend is dying. I become engrossed in the book when I am interrupted by a chirpy voice.

  “Hi, Lucy! How’s Billy?” asks the nurse, as she checks the monitors and documents the patient’s blood pressure, her respirator settings. Lucy smiles and nods. Every nurse asks Lucy the same thing. There are pictures of her son up on the walls, and everyone knows his name is Billy. So they pretend they’re friends with her and they know her son. It is maddening, but I don’t know whether it’s bothering Lucy. I want to ask her, but it seems too complicated for her to answer. She can write a word or two on the small chalkboard by her bed, she can nod yes or no, but we can’t get into the intricacies of the nurses’ behaviors, the little tricks of connection they use that nonetheless add up to genuine acts of kindness and compassion. I don’t even know if she’s picked up on it. I’m just not sure how with it she still is, if her searing intellect is still on fire.

  After one more stab at failed small talk, I leave the ICU, telling her I’ll be back, but I don’t say when. I don’t know if I’ll feel capable of seeing her deteriorate even further. I want to have the healthy, strong, bullish Lucy in my head to keep me company when she’s gone, not this one.

  A week later, I visit Lucy one more time in the ICU. She has just been wheeled back into the room from having a CT scan of her torso. She is sedated in the bed. Her feet look flaccid, her lax toes pointed toward the wall instead of flexed toward the ceiling, and it strikes me as a bad sign. Since Lucy is sleeping, I go find Sadie in the lounge. We sit together and talk for a bit, and then Lucy’s doctor comes over to speak with us. He’s just seen her CT scan. He makes it clear that there’s not much else he can do. The cancer has taken over Lucy’s liver. I sit quietly next to Sadie for a moment and then say, “I’m just going to go say good-bye to her.”

  “You think she’s going to die?” Sadie asks, panicked.

  “I’m just going to say good-bye for now,” I explain as I head back to her room. She is still asleep, or perhaps unconscious, as I kiss her cool forehead. It is the last time I see her.

  Sadie calls me a few days later and wants my help. She wants Lucy to get an emergency liver transplant. She has Daniel calling the transplant service at Mount Sinai to see if this is possible. She also wants to get Lucy back on chemotherapy and is enlisting Daniel and me to call several drug companies to release experimental medicines for breast cancer.

  These are all “Hail Mary passes” as far as I am concerned, and I have resigned myself to the fact that Lucy will die any day now, but Sadie is not ready to let go. Lucy was very clear with Sadie that she wanted everything done. She is not a “do not resuscitate.” She is a “fight tooth and nail to pull out of a nosedive.” I indulge Sadie’s request, because at least now there’s something I can do. I sit on my couch and call Astra-Zeneca, Novartis, and Bristol-Meyers-Squibb, talking to oncology researchers willing to part with some experimental potion. I get one man on the phone who is very kind and concerned, and he faxes me some forms for Lucy’s oncologist to fill out to get a “compassionate use protocol” up and running. By the time he calls back asking for follow up, it is too late, as I knew it would be.

  Now You’re Gone

  Sadie calls me the day that Lucy dies, Saturday, March 24, 2001. I am upstate at the house, which Jeremy and I bought in 1999. She tells me what it was like at the very end, though I can’t bear to hear it. I pull the phone away from my ear as she conveys the details of her death.

  I drive down to the city and head into work a few hours later. I leave a couple of messages with Daniel saying I need to speak with him, but he doesn’t return my calls. Saturday night, and again on Sunday night, I spend most of my shifts breaking the news to the nurses, psych techs, social workers, clerks—anyone who knows and loves Lucy, which is everyone.

  On Monday morning just before rounds start, Daniel comes in and makes the official announcement. There will be a private funeral service, and then later a more public memorial. Daniel says he isn’t sure if the family wants flowers or donations, and I make the mistake of interrupting him to say that I have the name and number of a florist near Lucy’s house in East Hampton.

  “Can I finish, please?” he asks angrily, and my eyes tear up. He is furious with me for interrupting him, and my shame liquefies and pools on the edges of my lower lids.

  I am so raw with her loss. All weekend, every time I passed by her office door on the way to my office, the waterworks would come right on cue. It doesn’t take much now, in front of everyone at rounds, for me to start up all over again.

  I am upset that my friend is gone, bitter that her life was cut short, and for a moment, like an angry child, I wish it were Daniel instead. When he is done with his speech and it is my turn to give the morning report, I can’t speak. Dave, Daniel’s right-hand man, is sitting next to me and I can’t tell if he feels sorry for me, or thinks I am a stupid bitch for interrupting Daniel. All I know is he can see my tears. I stare down at my blurry paper willing them away so I can give sign-out.

  I drive out to Long Island for the funeral with Jeremy and Molly, not yet one year old, and we stop at the ocean before going to the church. The sand is littered with starfish, more than I have ever seen. It is a blustery spring day, and the waves are high in the wind. I pick up four starfish, two big ones and two little ones. Years later, when I am trying to conceive my second child, I will stand in front of the four starfish on my windowsill and concentrate on a fourth member of my family, offering up a prayer to Lucy, telling her that I still miss her, and chanting to myself, “Mommy, daddy, daughter, son.”

  We arrive a bit late, thanks to screwy directions from Mapquest. We sit in the back, apart from my colleagues, who are all sitting together. As the funeral progresses, I cannot shake the feeling that I have been ostracized by my fellow physicians and their mates. We have traveled here separately, we are sitting separately, and I have the bitter feeling that I don’t belong in their little clique. It is a way to distract myself from the business at hand, mourning.

  At the back of the small church, Molly is playing with Billy. Lucy would have been pleased to see them on the carpeted floor next to each other. Why didn’t we ever get our kids together? Was she too sick by the time Molly was born, or did I become too busy being a working mother? I feel awful that we never tried to orchestrate it. I cheated myself out of having more good times with her, and now I have no more chances to make things right.

  During his eulogy, the minister does a good job of acknowledging the emotions of guilt and anger that always surround a death that comes too early i
n life. I am angry that she has been taken away, and Lucy was angry that she had to leave, and I am glad that anger is a recurring theme as people get up to speak. (When I speak at the public memorial months later, the anger that is still so vivid in my mind will be a major theme of my eulogy.) We are also being regaled with some funny anecdotes from the dais, and people are laughing, which I’m sure Lucy would have wanted.

  There is a long drive from the church to a protected cove that Lucy thought was especially beautiful, where Sadie wants to say a few words. I remember Lucy talking about kayaking in that cove this past summer, and how she was afraid it would be her last. She said it made her appreciate the sunsets more.

  The limo drivers get lost on the way to the beach; the whole line of cars in the funeral procession has to make a U-turn, and it adds another layer of levity to the day’s events. Later in the day nearly everyone notes how Lucy would have gotten a kick out of our getting lost en masse.

  “Care to join us down here, Julie?” Sadie asks as I lag behind the crowd at the shore. Still feeling ostracized, I am defending myself from feeling left out by a preemptive aloofness. I apologize as I close in on the huddle standing on the wet sand.

  We all have white flowers in our hands. We are supposed to throw them onto the water to symbolize our letting go, or saying good-bye, or something. It is windy and absurdly difficult to toss the flowers into the water. When they finally land in the ocean, the tide carries the flowers back to us, not out to sea. I know Lucy would’ve loved that too, rejecting our mourning, mocking our symbolic flower-tossing. You can’t conquer the wind and the tides; nature triumphs over our puny plans. Death trumps all.

  After the gathering at the bay, we go back to Lucy and Sadie’s house. Sadie is doing a private burial so we don’t go to the cemetery, which is fine with me. The part where the casket is lowered into the ground would have delivered a bone-crushing sense of loss and finality.