The Best American Essays 2015 (10 page)

In other words, heaven is family.

5.

I take a secretarial job at a hospital to make money while I'm in college. I'm assigned to the hematology-oncology floor. On heme-onc, patients are given private rooms and have access to services not offered on other floors: aromatherapy, yoga, and massage. Some days a pianist plays in the lounge; other days a clown goes room to room.

I'm one of the weekend secretaries. I sit at the nurses' station and handle admissions and discharges, relay orders, answer phones, and man the call box. When patients have requests, they press their call button and talk to me through the intercom. When the request is simple, I don't bother the nurses. I bring the pitcher of ice chips, the blanket, or the menu. In their rooms you're pulled into the patients' worlds—children's drawings and get-well cards, headscarves and earrings, self-help books and classical music.

On heme-onc you see the same patients again and again. A complication—such as a fever, an infection, a spike or drop in blood count—and they're admitted to our floor. The emergency department calls up and lets me know a familiar patient is returning, and I make sure that the room has been cleaned and the television is functional. The family members turn the corner before the stretcher, and you see that their shoulders are heavy with portable radios, books, photographs, and linens from home.

The nurses all want the leukemics. They negotiate over acute and chronic myeloids. They say
my patient
and
my leukemic
and trade assignments as if they are baseball cards.
I'll give you Cunningham for Howard, Chakrabarti for Williams.
They maneuver for the ones who are young and very sick, because everyone loves a fighter.

No one, however, wants the anemics.

The sickle-cell anemics are what the doctors call “frequent flyers.” Their multivolume charts are heavy, wrapped tight with thick rubber bands. When their nurses aren't looking, one has sex with her brother-in-law and another sneaks whiskey from a mouthwash bottle. And because I'm young like them and black like them, they let me in on their secrets.

We get a frequent flyer, a thirtysomething sickle-cell patient, admitted with a port-a-cath infection, the result of injecting heroin through the direct line to his heart. He's lost most of his legs—both are amputated above the knee—and he's scheduled to lose more.

He calls the nurses' station and tells me to come. The volume on his television is turned up high, and there are clothes all over the floor. He is jaundiced, but because his skin is dark, I can tell this only from looking at his eyes, which are yellow where they should be white. He's sitting up in bed, basketball shorts covering what's left of his legs. Like my mother, pain transforms him. He tells me he could strangle someone, that he was promised his morphine an hour ago.
C'mon man, c'mon man
, he says. He tells me that I better find his nurse and drag her in here. He's bare-chested and sweaty, and when he pounds his thighs with his fists, he wants to see me jump. He wants to fill the room with the scent and heat of pain, so that it's no longer his alone.

A few hours later, when he's comfortable and feeling more like himself, he shows me a school photo of one of his sons. The backdrop is autumnal and artificial, meant to evoke harvest.

He talks to me about this son and the others, about the sports they play, their report cards, and their talents. His boys, I've been told, haven't inherited his disease.

I don't interrupt him. I don't return to the nurses' station, where the intercom is ringing. I listen quietly as he describes his family, witnessing a different transformation now: from condition to man.

6.

At Yale, genetics becomes my religion. I'm a graduate student, studying kidney disease in lower organisms, namely mice and fish. Ash Wednesday arrives and my forehead is a blank canvas. My father, a devout Catholic, reminds me of the importance of going to mass. My uncle, one of my father's many brothers, is an atheist and a professor. I remember him teasing:
What if your land of milk and honey is right here?

What attracts me to genetics isn't purely the validation of thought or the process of discovery but, rather, what it symbolizes. Our genomes contain our complete ancestral history, a record of where we've been. The history of our evolution has been transcribed and it lives in every one of our cells. And perhaps more inspiring than this record are the vast open regions that represent where we, as a species, have yet to go. These regions are wide open, ready to be filled with fortitude and endurance.

Genetics, like storytelling, is a search for core truths, for what informs the human condition. At its best, it tells an artful story, a narrative meant to inspire and enrich our lives. But it also invokes the worst about living: misfortune, pain, and truncation.

The genetic code is a language, written in a four-letter alphabet. I spend hours at the computer, interpreting its narrative. I read in one gene the story of an ancestor, common to both man and fish, an ancestor of the sea from which man descended. I read in another gene our similarity to other unlikely species—fish and dogs, rats and mice—similarities that make them suitable models for studying human disease. I read in a third gene our connection to chimpanzees: beyond both species having nurturing relationships and problem-solving abilities, we share somewhere near 98 percent of the same genetic material. The blueprints that govern us are nearly identical.

And it's this that preoccupies me: the connectivity of all living things, past and present. What is passed on? Is this record all that remains after we're gone, or is there something more?

And can a single narrative—one single truth—encompass all the forces at work in our lives?

7.

On a Tuesday morning, my father goes to work. He arrives, as he always does, on the E train, which has a stop in the concourse beneath his building. He goes up to the trading floor, boots the computers, and heads to his office in the next building.

He is many floors above the city when a loud seismic boom draws people away from their desks and into doorways. He makes his way to a window of his office building and sees that the adjacent building, its twin, is swaying.

He doesn't know what has happened, but thinking only of the chaos and traffic that will ensue, he and a friend ignore the order to stay put and make the decision to leave. Outside he watches an airplane disappear inside a tower of steel. Around him, clusters of people are—as he is—hands-over-mouth transfixed, stunned and silent. He sees bodies fall from the sky, and he and his friend run, until they find themselves on a train and headed off the island.

At home, my father frets over the welfare of the children who were in the building that morning, at the on-site day-care facility. When he finds out that all of them—more than forty infants and toddlers—made it out alive, his body absorbs the news, releasing tension in the small muscles of his neck. He retreats to the den, draws the curtains, and curls up in the loam of quilts and sheets, further blanketed by the glow of the television. Two days later, he has a stroke.

On my wedding day, my father and I are in the back of the limo, waiting for the ceremony to begin. The night before was the first time he'd seen my mother since their divorce. He doted on her all night, bringing her drinks from the hotel bar and whispering in her ear. He is remarried, but when my mother is in the room, no one else exists.

Outside, a storm rages. Wind shakes the limo. My father tells me he's seen the face of God. I ask him to tell me another story. I ask him not to say anything that will make me cry. God's face, he tells me, is round and full of magnificent, soothing light. He says he spoke to God, that he bargained for his life, offering up his service and devotion, his cigarettes and his alcohol, in exchange for the chance to walk me down the aisle. This is the closest he has ever come to expressing his love.

There are forces at work on my father, forces that are slowly exposing his fragile nucleus. Terror, disease, heartbreak. I have seen him lose everything that matters to him, including my mother. I have seen him kiss the dead. I have yet to see him cry.

He made his deal with God after suffering a massive heart attack, years before the towers and the stroke. The night before his open-heart surgery, he spoke of his father, who was fifty-four when he died—same age as my father at the time—from complications during surgery.

The vision came to my father while he was on the operating table. As I sat in the waiting room, I couldn't help but picture him, somewhere beyond the electrified doors, lying there in a cavernous operating theater. I imagined him in his most vulnerable state: his chest cracked wide open, God and steel rebuilding him.

8.

I harvest organs. I'm taught different methods of immobilization. Cervical dislocation—the pinning of a mouse across its shoulder blades followed by a quick yank of its tail—is one I won't try. Ether doesn't require any manipulation of the mouse, but it has been deemed unsafe for researchers. Ketamine is what we use in our lab.

There is a sweet spot in the belly where the needle slides in smoothly, at an angle that doesn't hit an organ and cause the mouse to buck. When the ketamine is successfully administered, the mouse tumbles out of your hand, staggering in the first minutes before falling still on its side or belly, its inhalations sharp and pronounced. When you hit the sweet spot, it's a good omen.

Once the animal is sedated, there is nothing you can't do to it. I study cystic disease, and because the mouse has been engineered, I hope to find cysts on its kidneys and liver. I pin the mouse, belly up, to the Styrofoam board I use for my dissections. With forceps, I pinch the loose skin below the abdomen, pull it up into a tent, and reach for my scissors.

I cut from the groin to the neck, across the shoulders, then hip to hip, so the final product is an incision in the shape of the letter
I.
The body speaks indisputable truths. To examine the workings of a body is to experience the logic, the divine order, of nature. When the flaps of skin are pinned down, you have a window into the animal, its mechanics more intricate, more intelligent—yet cruder and messier, so more difficult to appreciate—than the clean, articulated movements behind the face of a watch.

I perform harvests, not surgeries, and at some point during the removal of organs the mouse will die. I have performed countless harvests alone, but it's much easier when someone stands over your shoulder, someone interested and experienced, his or her excitement contagious, so much so your nerves masquerade as anticipation. You peel away layers of fat and see what you have, the person beside you—hand on your back—rooting for cysts.

9.

God is taking my mother in pieces.

First her kidneys, now her eyes—her organs are failing her. She loses perspective, colors, and words on the page. It seems to happen overnight: one morning I discover her left eye has drifted off-center. I'm suddenly aware of the shape of her eyeball, elliptical and oblong, the distinct pointedness of the pupil. I no longer know how to look her in the eye. I have a choice: stare into the eye that is dying or the one that still has life.

With the loss of her vision, her prayers increase in frequency, and I buy her a large-print Bible in the hopes it will sustain her. She doesn't want anyone operating on her eyes. She says, in the strange and beautiful way she has of phrasing things, that she had always thought her eyes would outlive her.

She talks at great length about her childhood and tells stories I've never heard. She misses her parents, her father more so, and when she says that all she wants is to see him again, I can't know for certain which world she'd prefer to see him in.

Several times in my life, a deceased relative has visited me in a dream. I remind my mother of one of these times, of one particular dream:

It's my wedding day. It looks and feels like the wedding day of my memory, except that in this version there is no turbulent weather; the mansion's French doors are wide open, and long, white drapes billow in the breeze. As I walk from room to room, I'm met by family.

I enter a room, and there before me are my maternal grandparents, who died long ago. My grandmother is in a white dress, my grandfather in a white suit and fedora. And though I never met my grandfather, I recognize him. He says,
Tell your mother I am proud of her.

Upon waking from this dream, I phoned my mother to relay his message. As I described the details, she cried. When she was calmer, she told me that it was her father's birthday.

My mother hears the end of this story now as if for the first time. For a short while she feels the presence of her father, and there is distance between her and her suffering. In the following days her prayers maintain their frequency, but now they are inflected with hope.

She decides to fight for her vision. While she prays to retain what's left of her sight, she seeks out doctors who hope to save her eyes with surgery. This is her treatment plan: God and medicine.

10.

On a Saturday afternoon, I'm sitting on the living room floor reading, my daughter napping nearby, when I feel the hand on my back. My husband is behind me on the sofa. But he's not within arm's reach, and the hand remains as I stare upon my husband's face.

When I tell my husband that the hand has visited me again, when I describe again the sensation of the palm and the articulated digits, he listens. He doesn't try to explain it away, to interject with a scientific explanation that would undermine its significance to me. The hand is a gift, a force that solidifies moments, that suggests I pause and take inventory. My husband accepts it for what it is: a piece of the larger narrative of my life. He knows that my understanding of this world comes a sliver at a time, in fragments and not as a whole.