After the Fire

by Robin Gaby Fisher

  The lonely drone of the respirator filled the room. Shawn couldn’t speak. Instead, he bowed his head and began to pray silently. Please, God, let Alvaro live. Let me help him get through this. Give my friend the same chance you gave me. Then, in utter grief, Shawn broke down. His shoulders heaved and his sobs were deep and mournful. He tore off his gown and ran from the room, into his mother’s open arms. How could he leave Alvaro? How could he abandon him this way? He needed to tell him, Al, you’re going to pull through this. It will take a little longer, but you will pull through. I’m not really leaving you. I promise you I’ll be here to see you through this, no matter how long it takes. But Alvaro couldn’t hear him; Shawn was sure of it. He wondered if he would ever get the chance to tell Al that he cared about him more than he had ever cared about almost anyone except his own family.

  “Let’s go home now, baby boy,” Christine said, pulling a tissue from her purse and leading her son away.

  “Oh, Mom,” he cried. “What is going to happen to Al?”

  Chapter 15

  Shawn had been home from the hospital three days when death began to close in on his college roommate.

  Alvaro had been showing slight signs of improvement in recent days. Then, overnight, his temperature shot up to 105. His blood pressure and heart rate were dropping, and his respiratory system was failing. After weeks of hanging to life by a thread, Alvaro was dying.

  Mansour suspected a catastrophic infection was building in his lungs. He ordered X-rays. They suggested acute respiratory distress syndrome. If it was going to happen, ARDS usually occurred within the first few weeks of burn treatment. It was an insidious adversary, stiffening the lungs of patients and literally stealing their breath until even a respirator couldn’t work hard enough to keep them alive. The low levels of oxygen in their blood often caused massive organ failure. The mortality rate for ARDS was high. A third or more of burn patients died from it, and Alvaro was already so sick . . .

  As the news spread, the burn unit turned as gloomy as the raw, rainy late-winter weather. The burn team took it personally when one of their patients took a turn for the worse. Alvaro had fought a valiant fight, and it was a miracle he had lived this long. But even though Alvaro’s prognosis was grim, they weren’t about to give up on him. “We don’t lose eighteen-year-olds here,” Susan Manzo vowed as she washed out Alvaro’s mouth. “Uh-uh. Not here.”

  If only that were true.

  Even Alvaro’s parents realized their son was on the brink of death. “Why is his fever so high?” Daisy had asked when her son’s temperature suddenly spiked. “He is getting sicker,” a nurse said. “We’re not sure why yet.” Daisy had screamed with grief until her husband could only shake her to make her stop, and then she had sobbed, “Why? Why is he getting sicker when he is supposed to be getting better?” Daisy’s conflicting emotions were tearing her apart. Christine had taken Shawn home and he was walking and even talking about going back to school. Shawn was getting on with his life, and Daisy was glad for that. She really was. But what about Alvaro? “¿Por qué Dios no está tomando cuidado de nuestro hijo?” she cried. Why isn’t God taking care of our son?

  The Llanoses’ life had been one long string of ill fortune since two years earlier, when Alvaro senior had awoken one night with a vicious headache and then watched in the bathroom mirror as the left side of his face involuntarily contorted into a grimace. For three months, he fought back from his stroke, and even then he had only partially recovered. His speech was permanently affected and he still walked with the aid of a cane. He had reluctantly given up his factory job at the Marcal Paper Mills in Elmwood Park, where he had worked nights as a foreman on the production line. Daisy quit her day job as a clerk at the Paterson post office, where she sorted mail, to take care of her sick husband. The family had never had a lot of money before that, but with both parents working, they had been able to make ends meet. After the stroke, what had been hard became harder.

  Family had always been more important than material possessions to Daisy and Alvaro senior. They drove a beat-up Acura and lived in a low-income section of Paterson, a withering city whose claim to fame was that it had once been home to the American Industrial Revolution. But their apartment was spotless and it was decorated with religious icons in the china closet and framed photographs of Jesus on the walls. Their home was within a few blocks of their large extended family, and family get-togethers were a mainstay of life.

  On weekends, dozens of aunts, uncles, and cousins gathered on a tiny patch of asphalt outside the Llanoses’ back door for afternoon cookouts or Sunday dinners. While the women prepared feasts of lasagna and barbecued chicken and rice and beans in Daisy’s kitchen, the children played dominoes or basketball outside, and the men sat on the back porch drinking Corona and talking about béisbol and fútbol.

  Once in a while, Mr. and Mrs. Llanos had gone to a salsa club in the city and danced the night away. After twenty years of marriage, they still had a sparkle in their eyes when they looked at each other. They were gentle people who took joy in simple things. But after Mr. Llanos’s stroke, everything had changed. Life for the family had become a series of doctor’s visits and financial worries. Insurance bills piled up. With no steady income, they became dependent on Social Security checks, hardly enough to sustain a family of five. Alvaro took on two part-time jobs — one as a stock boy in a bird store, and another as an orderly in a nursing home — to help out his parents. When he wasn’t studying, he was working, doing all he could to ease his parents’ burden.

  Daisy was a worrier by nature. After her husband’s stroke, she rarely slept. Her nerves in tatters, she had fallen into a deep depression that couldn’t be shaken even with pills. She wondered what her family had done to anger God. Still, every day, she had picked herself up and walked to Saint Joseph’s Roman Catholic Church in Paterson to give thanks for her good fortune: her husband was alive; her daughters, Shirley, then twenty-five, and Shany, sixteen, were healthy; and young Alvaro — well, he was the greatest blessing of all.

  There was something special about Alvaro. Everyone who met him felt it. He was disarmingly shy and sweet, the kind of kid who was always sticking up for the underdog, even though he was part of the popular crowd. When other boys picked on the class nerd, Alvaro came to his defense. He never stood in the hallways between classes, cruelly poking fun at the fat girls, the way his friends sometimes did. Alvaro could have had any girl he wanted at John F. Kennedy High, but he never had a girlfriend before he met Angie at the start of their senior year. He’s almost too good to be true, Angie thought when she met him. Other girls thought so, too, but their bashful classmate was more interested in baseball than in girls.

  Indeed, baseball was Alvaro’s passion, and he had shown a real talent for it. He had started out in the peewee league and then moved to the midgets and onto a citywide team. Before the fire, he had intended to try out for the Seton Hall team and dreamed of one day playing for his beloved Mets. Some of his coaches along the way had said he was good enough to realize his dream. But first he had to finish college, his parents had said. Education was more important than sports. Education was everything. Alvaro agreed.

  Alvaro was one of nine male cousins who grew up together in Paterson and the first person in his large, extended family to go to college. His cousins, even the older ones, looked up to him, and he took the responsibility of being a role model seriously. Other students skipped classes to go to the beach, but not Alvaro. His studies came before everything except the needs of his parents. Even on weekends, he shut himself in his bedroom, asking his family not to disturb him until his homework was finished. Alvaro was going to make something of himself — he had promised his parents he would. And once he did, he would buy his mother the home she had always dreamed of having.

  “How can I blame God for wanting him?” Daisy said when describing her son to one of his nurses. But the thought of losing Alvaro was so traumatic for Daisy that the burn nurses feared she was heade
d for a nervous breakdown. The longer Alvaro didn’t show progress, the more unpredictable she became, sulking one minute, smiling the next. She had become quick to anger, usually about things that didn’t matter. Alvaro senior held in all his fears because he wanted to spare his wife any more stress, but he, too, was in turmoil. Sometimes the pain in his head got so bad that he thought he was having another stroke, but he kept even those times to himself. Thinking they were sparing each other, the couple simply avoided speaking to each other about their son. Day after day, they drove to the hospital early in the morning, listening to the radio rather than talking. Then they passed the hours in Alvaro’s room, watching sports on TV or reading the Bible.

  As the days passed and Alvaro continued to hover between life and death, the two shut out the world, even the warnings from the medical staff about the precariousness of their son’s situation. “He’s fighting, but he’s very sick,” the nurses would say, and Daisy and Alvaro senior would stare at them blankly or nod their heads. They asked the same irrelevant questions day after day.

  When will Alvaro wake up?

  Were his eyes damaged in the fire?

  Will he ever be the same? Will he ever look the way he did?

  Daisy was a young forty years old, so much so that before Alvaro was burned, people often mistook her for the sister of her eldest daughter, Shirley. But she now seemed to age dramatically with each passing day. Her mouth turned down in a perpetual frown, and deep, dark circles scooped out the soft flesh under her eyes.

  When her husband was sick, she had sought the help of a psychologist to cope. Susan Fischer, the burn unit social worker, had tried to counsel Daisy. Nothing had helped this time. If only she could hear Alvaro’s voice, she told the nurses, she would feel better. If only she could be assured that he heard her when she spoke to him. Bebito, I love you. Mommy is here. If only she could sleep next to him so he wouldn’t be afraid. The nurses listened patiently. There is always someone with Alvaro, they would say, trying to soothe Daisy’s frayed nerves. Save your strength for when he wakes up. That’s when he’ll need you.

  But such reassurances only went so far with Daisy. Alvaro was always so proud of himself and the way he looked. He liked to wear shorts and short-sleeved shirts to show off his attractive brown body. Will he ever look good in his shorts and his short-sleeved shirts again? she would ask. The nurses would shake their heads and wonder how Daisy could be discussing her son’s looks when it was still so uncertain whether he would even survive. But Daisy refused to think about life without Alvaro, or if she did, she was keeping those thoughts buried in a deep and inaccessible place.

  There were occasional moments of lucidity. Once, she stood at the pay phone in the hallway outside the burn unit, commiserating with relatives and friends. “No quiero que mi hijo muera,” she cried bitterly. I don’t want my son to die. Alvaro senior always hovered nearby. “Oh, please, God! No!” he pleaded. “Please! I want him to wake up now.” But mostly the two parents cultivated a fog of denial and sunk deep into the hole of optimism.

  Fischer told a meeting of the burn team that she was worried about the couple. “The family is in hell,” Fischer reported to the staff. “This is their golden child and he’s not getting better. They are looking for answers to comfort them — answers we can’t give them. She’s not sleeping at all. He’s not sleeping at all. They don’t sleep because they are constantly expecting the phone to ring in the middle of the night. Even sleeping medications aren’t working. It’s just an impossible situation, really.”

  “I don’t know what to tell them anymore,” Hani said, but what he was thinking was, whatever I tell them, they don’t seem to grasp it. I’m not sure if it’s a language barrier or denial, but I suspect it’s a little of the first and a lot of the second.

  In mid-March, with Alvaro still teetering between life and death, the situation reached the breaking point. Mansour and his colleagues, burn surgeons Sylvia Petrone and Michael Marano, were standing at the nurses’ station outside Alvaro’s room. The doctors were discussing Alvaro’s deteriorating condition and what more they could do to try to reverse it, when the couple approached them and began their daily inquisition. “What is the tear in Alvaro’s eyelid?” Daisy asked accusingly. “And what is the small sore on his leg?” Petrone, who tended to be direct, decided it was time to jolt Alvaro’s parents into reality. The Llanoses had to be prepared for their son to die.

  “Look,” Petrone said, clearly agitated, “don’t worry about his eye or the thing on his leg. He’s very, very sick. He’s in critical condition. The other things don’t matter right now. At this point we’re trying to keep him alive. We’ll deal with the other things later. Do you understand?”

  Daisy collapsed in tears. “Why aren’t you making him better?” she cried. “Why aren’t you helping him? Why?” As the doctors stood there, with no words left to say, Daisy turned and ran from the burn unit with Alvaro senior close behind her.

  Mansour had seen parents break down before. The burn unit was the last place in the world a parent wanted a child to be. But Alvaro needed his family to be strong. Family support often meant the difference between life and death in the burn unit. Mansour knew that Daisy and Alvaro senior would be beyond consoling if they lost their son. Of course they would. But he worried more about whether they could cope if their boy lived. How would they cope with having a burned son?

  Turning to look in on his sickest patient, Mansour found himself feeling suddenly miserable. “Poor boy,” he said, talking to himself. “He is fighting so hard. He wants so much to live, and his parents are doing everything they can to be supportive. But they are losing their grip.”

  Chapter 16

  The nurses in the burn unit marveled at Alvaro’s girlfriend, Angie. They listened when she whispered in his ear: “I’m here, baby. It’s Angie. I love you. I miss you. I’ll be right here when you wake up.” They watched as she closed her eyes, pretending to be someplace else, gently rubbing lotion on his swollen brown feet, the only part of him she could touch. “Where are you today?” the nurses would ask. “We’re on a Caribbean island,” Angie would say. Or “We’re floating on a big white cloud.” They read her letters, notes written in a big, curly scrawl and taped to the wall at the foot of Alvaro’s bed so that he would see them, Angie explained, if he suddenly woke up and she wasn’t there. Sometimes the nurses felt like voyeurs because the letters were so achingly personal, the words of an idealistic young girl desperately in love: “I love you, baby. I love you so much. We will never be apart. Never. God is taking care of you, and I know that when you come out of this, God will give me the strength to take care of you.”

  Angie was petite and pretty, with wavy auburn hair and mahogany eyes. The nurses often told her, “Angie, you’re more devoted than most of the husbands and wives of our patients.” Privately, they were taking bets about how long she would last. The nurses had seen families break down from the strain of dealing with burns and the time it took for patients to recover. They had seen wives leave husbands because they couldn’t deal with disfigurement, and husbands walk out on wives rather than stick out the long and difficult process of burn recovery.

  The first signs of strain began to surface when Alvaro had been in a coma for nearly two months. Angie came to visit on a Sunday afternoon, after missing a day, which everyone, especially Daisy, had noticed because Angie never missed a day. Her eyes were red and puffy from crying, and her hair hung limply over her shoulders. She usually wore her hair pulled up in a spirited ponytail. She seemed agitated and distracted, not the happy girl who was always trying to cheer up everyone else.

  Daisy greeted Angie with a hug, the way she always did. Angie sat next to Alvaro’s bed and stared at his face. Why doesn’t he do something, anything, to let me know he’s here? she wondered. Why can’t he give a sign that he hears me? As always, Alvaro just lay there, dead to the world, his only movement the rise and fall of his chest as the respirator pushed air into and out of his lungs.r />
  Angie paced around the room for a while, reading and rereading the same cards and letters that people had sent Alvaro, and then left earlier than usual, though not before Daisy asked her what the rush was. Making some excuse about a cousin’s birthday that she couldn’t miss or her father would be angry, Angie fled out the door. One of the nurses caught up with her in the hallway.

  “Are you okay?” the nurse asked, patting Angie’s back.

  “I hate coming here,” Angie said through gritted teeth. “When you come here every day and you don’t see any change, it’s discouraging. It all seems so hopeless. I know he’s not going to wake up for at least another month, and my body is exhausted.”

  “Go home and get some rest,” the nurse said. “It’s okay to take care of yourself, Angie.”

  “But his parents will be mad at me,” Angie said.

  “His parents will have to understand,” the nurse said.

  A few days later, Angie arrived at the hospital, more agitated than before. She had skipped two visits that week. She would not be coming quite as much now, she explained, almost apologetically, to the nurse in the room. Getting a ride to the hospital from Seton Hall wasn’t easy, Angie said. Besides that, she had schoolwork to do, which took up most of her time. And she hadn’t been to the gym in weeks. She was just so tired. Of course, the nurse said, looking at Angie knowingly.

  Angie said she loved Alvaro, but she was starting to despise the hospital. The putrid smells. The hiss of the respirator. She didn’t want to start hating Alvaro, too. If only he would talk to her, comfort her. He had always been able to make her feel better, to calm her when she was afraid.

  “Take a deep breath,” the nurse said.

  The day had begun badly for her, Angie explained, and she started to cry. All of her friends were out doing things — fun things — and she was in her room, listening to music and thinking about everything that had happened. It was as if she had to live two different lives now. In school she talked and laughed with her friends. But then she felt ashamed for having fun when Alvaro was fighting for his life, so she would transform herself into the dutiful girlfriend, spending hours at the side of her comatose boyfriend, hating every minute of it. Angie wanted to live her life, not be trapped in a burn unit. “What’s so wrong about that?” she asked defensively. “I’m a young girl, and young girls are supposed to have fun, right? Right?”