the cassandra pages

Recovery - 4

When I walked into the hospital room at 6:45 the next morning, Dad was sitting up in bed with a breakfast tray in front of him. He didn’t look as good as he had the night before. “How are you?” I asked, immediately concerned.

 “Sickish,” he said. “I’ve got a headache and my stomach feels lousy; I don’t feel like eating at all – and look what we’ve got – scrambled eggs. Ugh.” That was odd, since he’d been eating heartily ever since the surgery. “I ordered you a guest breakfast, though,” he said, and before I could look up, someone was bringing it through the door. I was hungry and somewhat sheepishly ate the whole thing while Dad picked at his, although he was right - it wasn’t great. 

The nurses had unhooked all the remaining tubes and equipment the previous night; he was sure they would send him home that day. In half an hour the doctor and his PA came into the room; the talk I’d heard was true – the surgeon was very handsome and just as charming. He was building himself a little empire there – a growing, very successful orthopedic clinic with several other surgeons now, and a reputation for excellent care and outcomes – in fact, during the time I was in the area, a report was released citing this clinic as the fifth best in New York State for knee replacement surgery. He sat down next to Dad’s bed while I perched on the windowsill, and unwrapped the dressing over my father’s knee. I winced inwardly when I saw the incision and the neat row of metal staples holding it together. “32 of them,” my father had noted, dryly. “A thousand bucks apiece.” The cost of this surgery – all paid by Medicare, but even so – was $32,000. 

“Looks great!” the doctor said, sounding and looking pleased with himself, and his patient, who I thought was actually looking pretty peaked at the moment, in spite of putting up a good front.  

“The worst thing was when you took the drain out yesterday,” my father said. 

“Yeah, I know,” said the surgeon, sympathetically, standing up. “Everyone says it’s excruciating. I used to not use that kind of drain because I knew it hurt people so much to take it out – but the recovery is much better and faster when you do use it; you get a lot less swelling in the knee itself. 

“Well, it’s the kind of pain that’s over quickly too,” my father admitted. “Unlike what I’ve had up until now, and what I’ll have while this gets better.” 

“Right – but if you do the therapy you’ll make fast progress. So, you all set to go home today?” 

My father said he was ready if they said he was, and explained that I’d be there for at least a week to help him. The PA and surgeon beamed at him. “I have no doubt but what you’ll do great,” the doctor said, patting my father's good leg. “You’re in great shape and everything went really well,” He got up and headed for the door, then looked back over his shoulder and grinned, “and I know you’ll be excellent advertising for our practice!” 

He was right in his assessment that my father knew and talked to a lot of people, but I doubted if the practice needed any more advertising. Glamour was in short supply in this rural area, and this doctor definitely had it. Everyone I talked to over the next week told me about the house he had built for himself outside town – it was apparently huge, and included a full-size hockey rink for his boys. I was used to local people being pretty bent out of shape about that kind of wealth, but while these remarks had a tone of amazement, they didn’t have that familiar, expected edge of resentment – probably because he had helped people close to them and was clearly a down-to-earth, nice guy. Or maybe things had changed since I lived there, and people were just more used to the widening gap between the haves – always a small minority here - and the have-nots who made up the vast majority of these rural counties. We were never rich, but my family gradually became better off than most of the families of kids I went to school with, and I had always been uncomfortably aware of the fact, trying to understand and compensate for it whenever I could and never flaunt it. Even so, growing up, I never knew anyone with the kind of money this doctor was making; it was only when I went off to college that I found out what real wealth was. 

The physical therapy team showed up then and put my father through his first routine of exercise, showing him what he needed to work on the first week at home, and then they had him walk down the hall with a walker and taught him how to go up and down stairs with a cane. The head guy – a kind and friendly fifty-year-old with the open face that’s so typical of local people - turned out to be the younger brother of an old classmate of mine, so we had plenty to talk about; he bantered with me while maintaining his concentration on my father.

When we got back to the room, my father was exhausted and nauseous, and he lay in bed with his eyes shut until the discharge papers were prepared. A nurse brought a wheelchair. I went to get the car, which was covered with lightly falling snow; we helped him in, putting the seat back as far as it would go and swinging his stiff, braced leg into the empty space - and headed home, just about exactly three days after his surgery. I wondered what we were both in for.

Recovery - 3

I had intended to go to my father’s house first, drop off my things, and have something to eat, but as I got closer I realized I wanted to go straight to the hospital. I got off Rt. 12 at the usual place, but cut up over the hill on the back road to Hamilton instead of heading into Poolville. Soon the forested, uninhabited landscape gave way to lights and the back side of the Colgate campus, and I dropped down into town, turned left, and then pulled into the small parking lot of the community hospital.

Our area of Vermont is served by a major medical center – a huge high-tech facility with thousands of employees, dozens of surgical suites, high-rise patient towers, outpatient wings, a cancer center, research facilities, carefully designed interiors with contemporary upholstery and blond wood and art collections…it even has a helipad. That’s where we’ve gone for our own care, where we visit friends and relatives; it’s what I think of when I think “hospital.” Canada will disabuse me of that image quickly enough, but the little community  hospital of Hamilton, New York put a dent in it as well.

I walked through the single power door, past the little gift shop – some stuffed animals and a few gifts on shelves behind the information desk – into a brightly lit corridor where a half-dozen employees in colored and patterned uniforms were chattering at the nurses’ station. The emergency room, just around the corner, seemed to be empty. A man was mopping the floor, and he pulled the bucket out of my way, smiling and saying, “Excuse me!” I went up to the desk and told the seated nurse I was looking for my father. “Oh yes, Howard!, she said. “He’s right down here in 9A.”

She bent her head over her paperwork and I walked down the  quiet hall, where patients were beginning to sleep in shadowy double rooms. I passed a vaguely-familiar middle-aged man in a hospital gown, walking slowly in the opposite direction; we nodded at each other. My father, so far, had a room to himself and he was bantering happily with a nurse when I walked in. We kissed and grinned at each other; he was bright-eyed and had plenty of color in his face, and immediately introduced me to the nurse. He was already on a first-name basis with everyone, and knew which town they came from and all about their families. They seemed to have his number, too, coming into the room already smiling in anticipation of a joke or some sort of teasing comment. He also told me about the other patients in the hospital whose families I might know: they’d all been in to see him too. "Your old friend Janet's aunt is here, right down the hall," he told me. "And that was John Anderson - he just went by - did you see him? He was about your age, right? He's having some trouble with his heart or some damn thing, I don't know exactly what it is. Think he'll be OK though." I tried to reconcile the face I'd just seen in the hall with the one I remembered from high school, considerably more than thirty years ago; well, I thought, it could be.

“You’ve had a long drive – can I get you anything?” asked the nurse. “Something to drink? A soda?” I refused at first and then relented, asking for some ginger ale; she immediately brought back a liter bottle and two plastic glasses. There was a college basketball game on the television. Dad and I talked for a while, glancing up at the screen, and then I drove to the lake – just four miles away - dropped off my things, fried an egg and made a slice of toast, and drove back to the hospital. Someone brought me a comfortable chair, and I sat at Dad’s bedside and knitted while he watched the end of the game, and chatted with the various employees who came in to check blood pressure, administer medications, or see if he wanted anything. He was pretty sure he’d be getting out the next day. At 10:00 pm we said goodnight, and I promised to be back before 7:00, in time to talk to the doctor, who I'd never met, during his morning rounds.

The house felt very empty. I washed my face, took out my contact lenses, and did my teeth, listening to the interior silence, and the faint honking of geese settling onto the lake for the night. And then I went to bed, too tired to think much about the fact that this was the first time I’d ever stayed in that house alone.

Recovery - 2

Before leaving, I had visited my father-in-law. “I think it’s terrific that you’re going there to be with your father,” he told me. “It shows him that you care.”

“He knows I care,” I said.

“Yes, of course he does, but this is an action.”

“Oh,” I said, trying to keep the annoyance out of my voice.

“In my life, I’ve always felt that care-taking was noble,” he went on. “But it was something best left to…”

“Women,” I suggested.

He laughed and waved a hand vaguely over his shoulder. “Well…other people.”

I looked at him and smiled wanly, this time raising my eyebrows for real. He thought for a minute and then said, “When we moved to this country, my father said, ‘Why so far?’ By that he meant, ‘We’d like to see you, and this makes it impossible.’ He and my mother came to America from Damascus once – you probably knew that – and they stayed with us for two weeks. After that I told them…” - he waved his hand again, this time sweeping his fingers decisively away from his body - “that’s enough!” He gave a little dry laugh, and shrugged. “After a few days, you’ve said all there is to say. I was working, M. was working; neither of us were home, what were we supposed to do? What were my parents supposed to do? They couldn’t communicate, couldn’t go anywhere on their own. So we packed them up and sent them off to my brother. He’s different, he’s good about those sorts of things and so is his wife. He kept them for a month or two, showed them all sorts of things. They liked it.”

I could imagine it. On the surface it was strange: he and his wife had come from cultures where the elderly were always deeply respected and integrated into the heart of the family, and where the extended family was the absolute norm. But I knew that for my mother-in-law, the Arab tradition of Sunday dinners en famille was anathema, as were the constant visits and net of familial expectations and obligations. My father-in-law enjoyed family togetherness, but like most Arab men, he felt no obligation to participate at all in the endless chopping and cooking and serving and cleaning that such a way of life required. My mother-in-law had put her foot down early, and to some extent he had agreed with her; a former student of theirs told me that in their early married days, back in Beirut, they were considered a very modern, even avant garde couple – which meant they adopted western ways and eschewed the Arab ones.

When they came to the united States in the late 1940s, they were on their own, and over the years when various family members inevitably appeared on their doorstep, a polite welcome was given along with a clear departure date. “Give them one inch and you’ll never get rid of them,” I had heard my mother-in-law say, with a shudder, more than once. She was, however, extremely generous with her time and care for people she chose. What she resented was the cultural obligation, and the resulting enmeshment in a web of favors and paybacks. As a result, J. and I had been married for a number of years before we ever met any of the other family members who had actually been living in the U.S. for years. My father-in-law wasn’t present when his parents died in Syria – and, as the favored scholar-son, was probably not expected to be – his work would be “too important” - but my mother-in-law suffered for a long time over the fact that she hadn’t been with her own mother at her death in Alexandra.

Oddly, it was my own family, gone from the Old World for centuries, that had kept to village traditions. I grew up in the same house with my maternal grandparents, and our extended family of cousins and great-aunts and uncles formed the main social tapestry for all of us. My parents were living in the house my father and mother had built, five miles away, when my grandfather died at age 90. That evening my grandmother said she didn’t want to stay alone, so my parents slept in the old house that night, and my aunt slept there the following night. That pattern never altered for two more years, until the day my grandmother died, even though it put a huge burden on both families. So far as I know, no one ever questioned it or suggested alternatives; they just did it. My parents ate lunch with my grandmother every noon, did errands for her, visited with her before going home from work; it was what was expected, and it was what they felt was right to do; the fact that they didn’t move back into the house completely was probably a major compromise. In that small town, there is still no nursing home or “retirement community”; there is one converted mansion that houses a half-dozen elderly ladies, and there are small extended-care facilities in a few of the larger neighboring towns. By and large, people stay in their own homes as long as they can, checked on by a network of family and friends, and then they move in with a son or daughter or hire someone to “come in” and do whatever tasks are necessary.

I was the oddity, the child who had left; now I was driving back to help, but only temporarily. As I thought about it, I realized why I had bristled at my father-in-law’s suggestion that my care-taking trip was a symbolic act: when seen in its full cultural context, it was.

A Recovery - 1

The sun had been in my eyes the entire trip so far, and I was grateful it had set when I crossed the Hudson and got on the New York State Thruway, heading west, at Amsterdam. By the time I passed Canajoharie, it was completely dark. There weren’t too many cars going in my direction. In the opposite lanes, a steady pulse of truck traffic moved east, their yellow lights unthreading like a topaz string along the gentle curves of the highway. The night was quiet; I was alone.

On the tape player I’d been listening to some recorded poetry – 20th century poets reading their own works. A lot of it was unfamiliar to me, and since there was no identifying narration, I found myself guessing whose voices I was hearing. Women read poems about their lovers, giving birth, their aging bodies, their femininity, their blackness, their depression. Men read about death, work, drink, lovers, their depression. I listened, and didn’t listen, the voices went on.

I thought ahead to the hospital and my own father, and thought back to previous trips to visit my mother. My mind felt for her in the emptiness of the night, but there was no answer; she felt as absent as the stars. Instead I tried to think of my father, who was only wounded, not dying. The weight of the past three years seemed to have settled on my neck and shoulders. I massaged my neck with one hand, stretched my shoulder blades, tipped my head from side to side. Love and death; death and love: I felt…old.

My ancestors had made this same trip, on horseback or in wagons, from other parts of New England on their way to settle new farms in central New York. The many-branched Cherry Valley Turnpike loosely followed the Mohawk River that lay nearby and unseen: a black satin ribbon against the black homespun of field and forest. In early days the Turnpike was little more than a path through impenetrable wilderness populated by hostile Iroquois – the infamous Cherry Valley massacre had taken place a scream’s distance from here in 1783 - but by the late 1790s the turnpike had become a toll road, dotted with taverns for travelers going by horse or stagecoach. That trip had taken courage too.

Chords from an acoustic guitar broke into the drone of recorded voices, and then Leonard Cohen began singing about Abraham and Isaac:

You who build these altars now
To sacrifice these children --
You must not do it any more.
For when all has come to dust,
I will kill you if I must,
I will love you if I can.

The continuo of the trucks throbbed into the blackness, and over my right shoulder, a golden moon rose like a cello. I knew I’d find the strength to do whatever I needed to; another hour and I’d be home.