Please Talk about Me When I'm Gone

Machinery (5)

(2001)

The sights and smells, never welcome, quickly become recurring, then established. Once you've patrolled the hallways of a recovery ward, or helped your mother to and from the bathroom when she can hardly walk-or stand-or changed her bandage after surgery (and seen the scar, like a breathing fissure that might open up and suck you in if you looked too long), you become mostly immune to the fluids and gases the body emits, the peculiar emanations that take on an artificial tinge in the too-cool air inside a hospital room.

You become accustomed to things you could not imagine for the simplest reasons: you have no choice. You slowly become attuned to the sights and smells of cancer. These are not confined to the places you go or the patients you help protect-they include what you detect around your house and inside yourself. You become philosophical by default, and find yourself thinking about how things used to be: a generation before, a century before, a millennium ago. You contemplate operations without anesthesia, or a time when operations weren't possible or even considered; if you suffered certain symptoms, you became expendable.

Natural law only became intolerable once our capacity to relieve-and understand-pain evolved with our brains and our contraptions. And you get perspective: it's better now than it's ever been, and that's all anyone living in the moment can reasonably ask for. This is progress: people used to die at home because they had to, because they had no say in the matter. Now, there are doctors who have been trained to treat you and there are few symptoms they can't find an explanation for. The things that used to kill us came to be treated by medicine that made us stronger.

We came to treat the body more like a machine than a soul covered with skin, and this is what saved us. As soon as we stopped soliciting the sky for answers-or assigning divine agents the acclaim for our survival-we started to consider the connected parts that make us all alike. We began to look inside, figuratively and then literally, and this is how the art of medicine was developed, and then refined to the point where any ailment seemed treatable, any death preventable. It's a tribute to our instinctual insistence on improvement that we won't tolerate explicable barriers if we can help it. Being human, we can contemplate our flaws and the ways to improve; we are also capable of acknowledging how far from the ideal we fall. In other words, we control what we can, and when we are unable to exert our will we make war (or peace) with our minds. Mind over matter is what we say when we can't say anything else; it is intended to inspire but it also is an illusion. Trying to control our minds is another matter altogether.

And sometimes it doesn't make a difference how compelling or rational your thoughts might be. Sometimes having perspective is not good enough when you're obliged to watch someone you love struggle with pain and fear-the two things that our minds and machines ultimately are powerless to protect us from.

You may find yourself an adult, keeping watch over a grown infant (who happens to be your mother) in a hospital room, who licks her dry and cracked lips. She would be salivating if she had any spit, craving the simple, now sublime pleasure of an ice chip. An ice chip that she isn't allowed to have; even this paltry, pathetic pleasure must be denied, for her own sake.

And you might think: Is this as far as we've come? Someday, hopefully in the foreseeable future, we'll look back on these ordeals and find them cruel yet amusing. After a procedure that removes a portion of a woman's guts, where she gets stapled together like a flesh textbook, after having a vacuum tube snaked through her nostrils to suction out the leftover mess in her stomach; after all this and being compelled to find solace with a prognosis of maybe, all she wants, all she can imagine (all she is reduced to craving?) is a tiny chunk of frozen water. And she isn't allowed to have it.

We worked shifts to ensure she was never alone. Even when she was asleep. Especially when she was asleep, because that was when the staff expected patients to sleep, and if you couldn't, you were on your own. (This isn't an indictment of the nurses, already overworked and tasked with too many patients to keep up with even in ideal circumstances-and conditions in any hospital, practically by default, are never ideal.)

The anesthesia mixed with the meds occasionally caused a curious fugue state that made her at once childlike yet frail like an older woman. Under almost any other circumstances this could have been somewhat cute and endearing, but there's nothing cute or endearing about watching your mother toss and turn, speaking to people who aren't there and seeing things no one else can see. After a while, as you sit with her in the darkness, it occurs to you that she may know exactly who she's seeing and what she's saying.