A Land of the Living/SIX

Art by Turgay Koka

A Jelly of Light

By Steve Watkins

My parents were waiting in Tampa with a borrowed station wagon and a mattress and pillow and blankets in the back. In the fog of my memory, they were all there–Mom and Dad and David, of course, but also Wayne and a host others besides, friends and family mobbing us at the gate, laughing and crying and jostling one another out of the way so they could hug me and tell me they loved me, too. A sort of reverse Tom Sawyer fantasy where you get to attend your own funeral and hear the wonderful things they say about you and how grief-stricken they are now that you’re gone. And then there’s that moment when you walk into the church as they’re all sobbing their hardest and they realize you’re still alive after all and they’re happy and mad both at the same time, but mostly happy and you are, too, because you’re back and you’re safe and nothing bad can happen to you now.

Once they got me set up for the hour drive east to Polk County and Lakeland General Hospital, Mom handed me a milkshake and a Tupperware container with fresh fried eggplant. “I hear you haven’t been eating,” she said. “So let’s get you started.” Mom and Dad thanked Dave, and kept thanking him, over and over during the night drive through Central Florida, for taking care of me, for bringing me home to them from India. Nobody said anything about the accident, or about what would happen next. I’m sure they were struck by how awful I looked, even without seeing my scars. How gaunt and how wasted. I tried to talk, to reassure them that I was okay, better than okay, that a week or two resting up at home was all I needed.

“We’ve already made arrangements with the hospital,” Mom said, as if this was all routine, as if they hadn’t been frantic with worry for weeks, sending telegrams back and forth to the embassy, trying to reach David, trying to get through to the East-West Medical Center, talking to my uncle’s contacts at the State Department, sending money, insurance information–which was pointless. More borrowed money. “They’re expecting us there tonight. We think it’s best that we get you checked out right away. But I’m sure we’ll be able to get you home soon enough.”

The drive from Tampa to Lakeland took an hour. I was admitted right away, and Mom and Dad stayed with me long after visiting hours were over in room 431B, talking and laughing with Dave while I dozed off and on and the nurses hooked me up to a variety of monitors and IVs, drew blood, took a urine sample, checked and rechecked temperature, pulse, and respiration. I could tell Dave was ready to hand me over, to let others take care of me, finally, so he could exhale, but he didn’t want to leave, either. We’d been together for so long. And he’d been looking after me for so long. But he was wiped out and so was I, our yawns dissolving into one another, so finally they left, leaving me alone for the night, or what was left of it, though almost as soon as I fell asleep again the nurses woke me up for the first of what would be two days of tests that in the end just confirmed what Dr. Chawla could have told them in India: That I had a blood infection; that my pneumonia was so bad one lung was completely congested; that I’d suffered a severely damaged liver, and had massive fluid buildup in my abdominal cavity; that I needed surgery immediately; that I was fortunate to still be alive. 

*** 

The surgeon, Dr. Juan Barrios, reopened the two nine-inch incisions that formed the crooked cross on the right side of my abdomen, cut through multiple layers of muscle and tissue, worked his way around the metal sutures left from the operations in India, sliced through a number of lesions–scarring from those previous surgeries–only to discover, after deep exploration around my liver and gallbladder, that he couldn’t access the fluid mass from there–the internal bleeding and the leaking bile that had continued for the past month, since the accident in early December. 

So he closed the incisions, once again suturing the multiple layers of tissue, this time with surgical thread that would eventually dissolve, then had his assistants turn me for what would essentially be a second procedure. Once they had me in position on my left side, Dr. Barrios made a five-inch cut at the tenth rib on the right side of my back. He peeled back the layers of skin so he could saw off half of the rib, leaving a gaping hole–a marsupialization–through which he was able to access and remove half a gallon of toxic fluid that had collected behind the organs. He wasn’t able to stop the bleeding and the leaking bile altogether. Because of that, and because there was significant infection, he irrigated the area around my liver and gallbladder with a saline solution, then inserted two drainage tubes that would remain in place for the next month until the liver injury healed and the infection was mostly resolved. 

All this was done under U-V light, intended to kill bacteria and lower the risk of further infection. It didn’t work. Dr. Barrios couldn’t close the marsupialization because of the tubes, so he packed gauze around the wound, which would remain open, long after the tubes were removed. I would need help multiple times a day replacing the pus-filled bandaging until the lingering infection was finally, finally gone, leaving me with a mass of raw scar tissue and a permanent depression, a scissure, in my back.

The seven-hour surgery finally ended after Dr. Barrios had me turned over once more so he could insert a pigtail catheter in my chest to suction out fluid–pleural effusion–and the thick build-up of phlegm from the pneumonia. 

David sat with Mom while I was in the operating room. Dad paced the hospital floors. Mom prayed Christian prayers. Dad drank his stale coffee and struck up nervous conversations with the nurses, visitors, other patients, anybody out walking the halls. David stayed with Mom and chanted, quietly, under his breath, a prayer to the Hindu god who had been there from the beginning: “Jai Hanuman ki jai.” 

*** 

I was three days in Intensive Care, mostly unconscious or drifting on morphine. I remember being bathed in white light coming out of the anesthesia, but little else. Mom and Dad and Dave stayed with me in shifts. I had tubes in my back attached to one machine, suction tube in my chest attached to another, indwelling urinary catheter, heart monitor, oxygen mask, Dextrose and fluid IV, and morphine drip. 

Even out of ICU, I struggled. They gave me more painkillers, another transfusion. Dave wrote about a day in January, though he didn’t record the date: “Lakeland General, passing time as Stephen sleeps. His whole body shakes at times, but the steady flow of O+ & antibiotics continues as well as the fluids going out…. The infection lingers causing a slight fever and weakness. Pain remains the same so he keeps eating the downers. Steve finishes up the 2nd unit of blood & the IV is removed. Looking better, but after 2 units of blood who wouldn’t? Still remains ignorant as to his condition. Eating downs every 3 hours, refusing a vitamin concentrate cause it tastes bad, bitching about the food, nurses, himself. It’s been a hard six weeks.”

Dave struggled in his own way, reeling from the culture shock of reentry into an America that seemed familiar but also felt like a foreign country to him now. Everything was strange. Shopping malls. Refrigerators. The obsession with cleanliness. It snowed two inches in Central Florida on January 19, something that never happened.

The almost-daily journal I had kept through my travels in Asia stopped after the accident, except for a few entries at the East-West Medical Center. I must have been conscious at times of what was happening to me in the feverish weeks after the Lakeland surgery, but whatever I saw was through a glass darkly, as Mom would say, from 1st Corinthians. I slept much of the time, but it was a restless, fevered sleep that left me exhausted when I woke, worn out from nightmares I couldn’t remember. I complained. Cursed. Lashed out. Apologized. Lost the thread of whatever I tried to say before I could finish. At times I felt as if I was floating above myself, outside my body, or that the body I inhabited had become distorted, foreign, mine but not mine. Everything seemed dulled—the details of the room, the faces of visitors, even my family. I continued to have hallucinations, felt enormous distance from anyone, even if they were sitting on the edge of the bed right next to me. I recoiled at the slightest touch. Cried in the same way I had after the surgeries in India when the nurses entered to draw blood, give me shots, drain the catheter, change the sheets, re-insert tubes, reattach monitors, clean me when I shit the bed. Everything was white or hidden in shadows. I couldn’t see to the far side of the room. Outside was nothing. 

I was near death, but even writing that now gives it more meaning than it had for me then. I never thought about death or dying, not since the accident, never considered the possibilities, didn’t know how close I was. Strangely, for someone who had spent his life since childhood fearful of my mortality and the imminent deaths of those I loved, I wasn’t afraid. Maybe I was working too hard trying to stay alive to worry about dying. But it wasn’t exactly that, either. It was the fog from anesthesia, from drugs, from trauma, from malnutrition, from infection that enveloped my consciousness and wouldn’t let me see far enough beyond myself—wouldn’t let me see beyond myself at all–to understand. Years later, when I read Samuel Beckett’s Murphy, I recognized myself from that time, in  the description of his foggy-brained protagonist: “…but always the moment came when no effort of thought could prevail against the sensation of being embedded in a jelly of light.”

*** 

When I was stable enough, near the end of January, Dave reluctantly left for a long-delayed reunion with his family in North Carolina. I wasn’t aware of him going, was hardly aware of anyone with me during the long days in the hospital, though I’m sure they must have been there, Mom and Dad taking time off from work as much as they could, and more than they should. The drugs, the fevers, the infection, the continuing internal bleeding took their toll. Hospital records described me as suffering from cachexia, the wasting disorder. I’d lost nearly a third of my body weight. I was 110 pounds. 

I have a dim memory of Mom bringing food from home, begging me to eat, being angry with me sometimes, crying sometimes. But those could be false memories, at odds with what was really going on. 

Other things that seemed to happen: Every few days, nurses turned me on my side so they could remove the gauze around the tubes in my back and irrigate the area inside the wound with saline solution from what looked like a giant turkey baster. The way I cringed involuntarily. The nausea that overwhelmed me every time. The drowning sensation when respiratory therapists coaxed me into a tight-fitting mask to force saline mist into my congested lungs. I shuddered every time from one shallow breath to the next, as if breathing was no longer an involuntary thing.

*** 

Robin came to see me near the end of January. Maybe she called the hospital first to let someone know, or maybe it was a surprise. I don’t fully remember. My heart leapt when she walked in, and we both cried when she cautiously leaned over the bed to hug me–checking first to make sure it was okay, that she wouldn’t hurt me in some way. She said, “Your brother told me. He came to my house. I’m so sorry….” She must have been in shock, seeing how I was. She wanted me to reassure her, to tell her I would be alright, that I would recover, that I’d be out of the hospital soon. She said she felt guilty that I went to India because of her, and didn’t seem to believe me when I insisted that I would have gone even if we’d still been together. 

I told her I’d thought about her every day, and wished I could escape this nest of tubes and wires and monitors and climb out of the bed and be with her, and I was sure it was just a short matter of time before I’d be well enough to to stand on my own, and walk again, and leave the hospital, and return to Tallahassee, and her and me….

She steered me away from that part of the conversation. Told me she would be starting graduate school in American Studies. Told me about her family, about her classes, about the summer before, renting a beach house with her cousin and working in a bar, riding her horse on her family’s farm in the North Florida town where she and I had both once lived. She had something for me, she said. Jackson Browne’s new album, The Pretender. I wasn’t sure what to make of the title, but didn’t think she meant anything by it. “For when you get out,” she said.  

I eventually faded. I dozed off, and when I woke I looked over immediately to be sure she was still there. Robin’s eyes were closed. I could tell she’d been crying again. I’d never seen her look so sad. Nurses came in to check my vital signs, to change the sheets, to replace the depleted IV bag, to empty the urine pouch. Robin stepped into the hall when they changed the dressing on my back. Maybe I had told her, or maybe it was Wayne–about the surgeries, the incisions and scars, the missing rib, the tubes, the infections–but I think she couldn’t bear to see how damaged I was. How gaunt. How cachectic. A week ago, she hadn’t even known. 

She said she’d gotten my letters. She’d written me back a couple of times. She was sorry I never got her letters. She said she’d been in a dark place for a long time. 

I kept nodding off. I asked her to stay. She said she had school. She had to be back in Tallahassee. It was a long way, a five-hour drive. I asked if she’d come again the next weekend and she said she’d try. I told her I loved her. I don’t remember if she said she loved me back. But I could see it in her eyes even then—that she was pulling away, or maybe she’d never been there in the first place. More like a dream I’d had of something all along. I must have fallen asleep for longer at some point. When I woke up that time she was gone, and even as needy and as blind and as heartsick as I was, and as kind as she was trying to be, I knew she wouldn’t be back. 

*** 

Mom and Dad’s minister came in a few days later and asked if he could pray with me. I was lucid enough to say sure, but when he started in on how it was God’s will that I was in this terrible condition–emaciated and scarred and sick and lonely and scared–I was furious. When Mom came in that evening I told her I didn’t ever want her preacher anywhere near me again, and I sure as hell didn’t want any more of his fucked up prayers. I was practically shouting at her: “God didn’t want me to wreck my bike and tear my liver! God didn’t want me to get this infection, to end up like this! You can see every one of my ribs! I have a hole in my back! I can’t even stand up! I’ve got all these fucking scars! And if there is a God and he did want all this shit to happen to me, then I don’t want anything to do with him!”

She let me rant, though I knew it hurt her for me to say those things. And even as I went off about the minister, a part of me was envious of their shared faith. Not that anything would ever convince me that their God–that any god–had a plan for my life, for anybody’s life, and especially a plan that involved a catastrophic accident and months of pain and suffering, that involved Robin breaking my heart, that involved my mortality staring back at me whenever I caught a glimpse of my pale, bloodless reflection. Amor fati wasn’t something we were meant to take literally. It was just an expression. Nothing was fated. Amor fati just meant you should embrace whatever happened to you, learn from experience, even awful experience, try to understand how it shaped you and your life going forward because what else was there to do?

I believed in the teachings of Mom’s Jesus–the Beatitudes and the Sermon on the Mount–but I couldn’t for the life of me believe in her Jesus and in her God, though I craved that certainty that I knew sustained her. When Wayne and I were younger, in our early teens, just venturing out on our own into the world, Mom had a vastation, a spiritual purging that washed over her one afternoon like a kind of drowning while she sat alone in a rocking chair in our dark, empty house. She told me this much later. Maybe it was the Christ of the Burnt Men who Thomas Merton wrote about in The Seven Storey Mountain. She’d been praying for guidance to know her purpose in life besides being a good wife and mother. And in the utter calm that followed the vastation it came to her–a vision of the schools she was meant to start for underserved children, a devotion to those in need. She had pursued that vision ever since, dragging the family along with her–giving money, giving time, giving everything she had of herself. 

Mom sat with me well into the night, though I’d exhausted myself with my ranting, and I’m sure I’d exhausted her, too. I doubt we talked much after that. She should have told me I was being an ungrateful shit, that even if somebody’s prayers weren’t the right kind of prayers, I should accept them anyway, because they couldn’t hurt, and the minister meant well, and they were all trying their best to help me through this thing and couldn’t I appreciate it just a little? 

But she didn’t say any of that. Maybe she thought I was too sick to hear it. Maybe she thought I deserved a free pass. Maybe she knew things weren’t going well, and they were going to get a lot worse. She assured me she would speak to the minister, would thank him visiting, but would tell him not to return with his prayers I didn’t want to hear. 

*** 

The fevers, only marginally better for a while, spiked out of control. 104. 105. Dr. Barrios told my parents the antibiotics weren’t working. They’d already tried several combinations of drugs, but the infection was worsening. The tubes in my back, which were supposed to be temporary, had to be kept in as they continued to suction the vile yellow pus out of my abdominal cavity. I could only lie on my side. I wasn’t able to eat. I still labored to breathe on my own. There was talk of a respirator.

I sweated through gowns as soon as they were changed. Drenched my sheets, my pillows. My long hair stayed matted to my face. Nurses covered the bed with plastic and buried me in ice compresses so painful I felt bruised all over. The ice baths backfired. I shivered so hard that it raised my temperature even more. I cried until I was dehydrated. I was delirious, thrashing uncontrollably on the mattress, trying to throw off the blankets, my gown, my skin. 

Dr. Barrios ordered an even stronger antibiotic combination, and another after that, but the fevers and the infection continued. In my lucid moments, which were fewer and shorter as the days went on, I could feel myself shutting down once again. 

*** 

One day in early February, Dad came into my hospital room, just him. It was dark, and I was lying half-sleeping, half-awake, emaciated and weak from the ongoing battle I was losing with the fevers and infection. He found his careful way onto the bed so he could somehow hold me though the nest of IV lines and tubes and monitors. He was crying–something I’d only heard him do once, when he had his breakdown three years before. Seeing it made me cry, too. He told me how much he loved me, as if he was saying goodbye. I didn’t understand, didn’t know until much later that the doctors had just told him and Mom that they would be putting in a subclavian IV line–in a vein under my left collarbone, close to my heart–and begin one last possible antibiotic combination, their only remaining option, hoping, praying, that it would work where the others had failed. 

Dad stayed with me on the bed for a long time. I wasn’t aware when he finally extricated himself, or when Mom came in so she could hold me, too. 

[NEXT: A Land of the Living/SEVEN: The Afterlife]