Introduction Chapter 1: In Praise of Maria: a memoir

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I believe Maria did just that. While she was in the nursing home and the hospital she was still a dynamo of energy for many people in this country and beyond. And for those of us who believe in the Communion of Saints the work continues.

In teaching about teaching, I have often cited a passage from a talk that Elizabeth Glaser gave at the 1992 Democratic convention. Glaser had become infected with the AIDS virus through blood transfusion and she had passed it on to her daughter who died. Glaser said: “My daughter lived 7 years and in the last year of her life she could neither talk nor walk, but her wisdom shone through. She taught me to love when all I felt was hate. She taught me to think of others when all I wanted to do was think of myself. She taught me to be brave when all I felt was fear.” When I had used that passage in the past, I never dreamed that it could apply to a 70 year- old woman as well as to a 7 year-old child.

When we came to Maria Regina residence a year ago, I told friends that we were received like royalty. It was an unusual experience for anyone entering a nursing home to be surrounded by such warmth and love. She could not have received better care than she did here. When she returned from the hospital two and a half weeks ago, we received a second warm homecoming. She had come to die but it was the right place for her.

Both times we were greeted with a large sign that said: Welcome to Maria Regina. I read that sign in two ways: It could mean: Welcome into the residence whose name is Maria Regina. It can also read: Welcome to the one who is named Maria; she will be treated royally. The disease that Maria had was a trial of both body and soul. It was truly a cross to bear. But purified by suffering she has finally transcended the Crucis in her name. No longer Maria Crucis, she is now Maria Gloria, Maria Regina.

I conclude with an Irish prayer. I know she would love me to read this because she chose to read it at two funerals: that of her mother, Mary Tunny Harris, and that of her dear cousin, Brian O’Brien. The prayer expresses the sacramental principle that was the central theme of her writing, her speaking, and her life, the belief that God is revealed in all the elements of ordinary life. I cannot read it as well as she could but I don’t think she would mind:

“May the blessing of the light be on you, light within and light without.

May the blessed sunlight shine on you and warm your heart till it glows like a

great peat fire, so that strangers may come and warm themselves at it, and friends.

And may the light shine out of the two eyes of you like a candle set in two windows of a house, bidding the wanderer to come in out of the storm.

And may the blessing of the Rain be on you - the soft, sweet rain.

May it fall upon your spirit so that all the little flowers may spring up, and shed their sweetness on the air.

And may the blessing of the Great Rains be on you, may they beat upon your spirit and wash it fair and clean,

And leave there many a shining pool where the blue of heaven shines and sometimes a star.

And may the blessing of the Earth be on you – the great round earth.

May you ever have a kindly greeting for them you pass as you’re going along the roads.

May the earth be soft under you when you rest upon it, tired at the end of the day.

And may it rest over you when, at the last, you lay out under it.

May it rest so lightly over you, that your soul may be out from under it quickly, and up, and off, and on its way to God.”

CHAPTER TWO: REFLECTIONS ON AGE AND SICKNESS: A MEMOIR

This chapter is an extension of the previous chapter, “In Praise of Maria.” That essay was in part my reflection on mortality and my experience of Maria’s gentle and courageous approach to dying during four years of a terrible disease. This current essay, as an extension of the previous one; it has three parts describing events in 2010, 2013 and 2014. It touches on some of the same themes, particularly the kindness of friends and the dedication of professionals.

The title of this chapter indicates that it is some thoughts on the experience of serious illness. It is not mainly concerned with medical details, though some of them are unavoidable, but instead on the thoughts a person has during a potentially fatal illness. Thus the reflections now are about the reflections then. The dead cannot do that so it is left to those of us who are still walking about. There is nothing very profound here but perhaps the ordinariness of the thoughts is in some ways comforting. When one is ultimately confronted with one’s mortality, the reaction is not necessarily denial or desperate protests about the injustice of it all. When the great sports writer, Red Smith, was told at age 76 that he was dying, he calmly said: “If this is the end, it was a good run.”

I usually shy away from memoirs of someone’s sickness. The underlying assumption seems to be, “woe is me, no one knows the suffering I have been through,” while in fact everyone knows or will know comparable problems. This essay is primarily therapeutic, to get it out of my system. It is also a thank you note to many people even if all their names are not here. Should anyone else find this interesting, that would be a bonus.

I wrote the memoir about Maria in part because a few similar memoirs by people caring for dementia patients had been helpful to me. Mainly I wrote it for the few hundred readers of the newsletter who knew her. The details of her illness were nobody’s business except the people who really cared about her. I was surprised then to find that the essay was used in a course at a New York medical school. The professor, whom I don’t know, said to the students concerning the contents of the essay: “We have to do better.” I presume he was referring to the systematic problems of communication which I tell of encountering. Certainly I had only praise for the nurses, physicians, technicians and therapists that Maria and I dealt with.

In 2010 I was reinforced in those sentiments by the hundreds of people whose hands – quite literally – I passed through. One can perhaps best appreciate the skills and care of medical people in an emergency room. I was checked into an ER five times during the year. There is not much else to do in an emergency room for 6 or 8 hours except to watch the staff cope with unpredictable problems in a very confined space and with limited help. I do not understand how they sustain it day after day. On one occasion I was in NYU Medical Center for a blood transfusion that lasted for 4 hours and then I waited 8 hours for a bed to become available in the hospital. One nurse – I would guess from the Caribbean – while overburdened with duties, stayed with me for the entire 12 hours. I don’t know what she is paid for her skill and care but I am sure it is not enough.

Before

For a reason that I could not identify then and still cannot, I started reviewing my whole life in January, 2010. I had not been given to such searching in the past. My attitude has always been that whatever happened in the past I did what I could in the circumstances that were present. Disappointment, regret, or guilt about the past seems to me to serve no purpose. So it was a surprise to find myself totaling up the score for my life as a whole. For better and for worse it was now a life. I was approaching the seventy-five year marker; if I had not made a life out of it by now it was not likely to happen with a few years more.



Throughout the years I seldom thought of age. When I was asked how old I was I usually had to go back and calculate from the year of my birth. I barely noticed the often dreaded milestones, such as the fortieth or sixty-fifth birthdays. Then suddenly I realized I was an old man, the previous decade having disappeared in a flash. I started noticing the obituaries in the Times. I regularly am taken aback at the death of famous people; it is not a surprise that they died but that they had been still alive. When I check the age of these newly dead I usually find they are only a little older than I am; occasionally they are even younger. I figure when my obituary appears, someone who remembers me from a brief notoriety in the sixties will say: I can’t believe he was still alive. The experience of our own age does not correlate with a simple objective number. For nearly everyone, “old age” is your age plus twenty. Cicero said that no one is so old that he does not plant crops in the Spring.

About a year before the onset of Maria’s sickness she started putting together albums of photos. The half dozen albums provided a sequence of her life story. I have seen a few other people engage in the same kind of project, aware or not of their coming death. All my photos were inside my head but there seemed to be a similar impulse. I do not put stock in premonitions but perhaps there are sometimes warnings in one’s body or the environment.

Possibly what inspired thoughts of mortality was my first trip to the ER two weeks into the year. I took a bad fall in Trader Joe’s and quickly found myself in an ambulance to Beth Israel Hospital. I could have sued Trader Joe’s; in fact they expected that I would and supplied the name of the person to contact in their legal department. However, it was my fault as well as theirs and I was just glad that I suffered no serious and permanent damage from hitting the floor and the edge of a delivery case about as hard as one can. The young people at Trader Joe’s could not have been more solicitous. The manager who said it was his first day on the job could not have been happy when confronted with this old guy bleeding from the ear.

When I was wheeled into the ER I thought it was total chaos with bodies everywhere and with manned computers that looked like the deck of a spaceship. However, I got great care, far better than I would have expected in an ER. It did take time as they brought in at least three kinds of specialists before a surgeon did a little stitching in my ear and I walked home before midnight.

In April I went to see my primary care physician, something I had not regularly done. I had what turned out to be a minor problem. In a routine blood test, however, the physician found I was anemic, a problem I had never had before. He did not raise any great concern but said that the most likely cause of such anemia is internal bleeding. I had no pain and never saw blood; I had, however, lost a few pounds which was unusual. I saw a gastroenterologist who scheduled a colonoscopy for June but before I could get to that procedure the anemia brought me down – hard.

On June 5, I passed through the thin membrane that separates the Kingdom of the Well from the Kingdom of the Sick. Ordinary life in the Kingdom of the Sick contains practices that in the Kingdom of the Well would be embarrassing or frightening. The living environment in the Kingdom of the Sick involves screams of unbearable pain alternated with endless waiting in which nothing seems to happen. The one thing sure to the people in the Kingdom of the Well is that the Kingdom of the Sick is in a universe far, far away. In fact, of course, it is never more distant than a few moments journey. A sharp pain in the chest, a moment of distraction at the wheel, a patch of ice underfoot and – surprise – one has switched citizenships.

My instantaneous journey happened at 7:30 AM on a Saturday morning in Penn Station. I was on my way to Montauk where I was to host our annual family reunion; I had the shortest distance to travel of any of the family members. A few minutes before I would have been walking down the steps to the train platform, I went completely unconscious from a standing position. I must have hit the floor hard, landing on my lower spine first and then the back of my head. Bad luck for the back but lucky for the head.

If one is going to faint in Penn Station, I had the right day, the right time and the right place. If it had been 4 PM on Friday I might not have been found for hours. But given my spot between the police desk and the railroad office, within ten seconds I had two policemen and a woman from the Long Island Railroad taking care of me. They contacted the Fire Department and within ten minutes there were three EMS workers on the scene. In another ten minutes I was in the ER of Beth Israel Hospital. The only words I remember spoken to me were by the woman medic who said as we entered the hospital: “Thank you for flying today with the NYFD.”

I had suggested Beth Israel to them because I had so recently spent time in their ER. I thought it might speed up things. It was two blocks from my apartment and I was just intent on getting home. I should have gone to NYU Medical where my physician is and the circle of specialists to whom he has access. At Beth Israel I met at least a dozen physicians (every one of them a woman), each of whom were very nice and no doubt skilled in her specialty. However, no one was in charge of me and there did not seem much communication among them. After numerous tests, especially for blood clots, I was released after three days.

What they did not treat was the excruciating pain in my back; I could not seem to get anyone’s attention for that. The night physician scheduled an MRI which was rescinded by the morning physician. I later learned from an MRI and a bone scan that I had fractured the twelfth thoracic vertebra which the rheumatologist explained can radiate pain up to 12 inches. For the next month the pain in my back was perhaps a helpful distraction from the cancer but that was not the way it felt. Painkillers had little effect.

I did eventually get to Montauk for the last part of the family reunion. I do not remember navigating the railroad journey. I must have looked awful which I was not aware of but there is a group photo in a restaurant that supplies the proof. My sister Dotty volunteered to come back to New York with me and stay for an unspecified length of time. Thus began a tag team of my sisters, Dotty and Mary, to take care of me for the next two months. They were my indispensable help, each of them coming down from New Hampshire with unconditional generosity of their time. I guess if it were not for them I would have been sent for rehab to a nursing home.

The colonoscopy revealed what I was expecting though the phrase “large tumor” was not encouraging. I got a quick appointment with the surgeon. After waiting 3 hours beyond my appointment time, I spoke with him for about 15 minutes. Like many (most?) surgeons he brimmed with self-confidence that he could fix me. He seemed blasé about the details, not putting much trust in the colonoscopy picture or the CT scan.

My surgeon’s confidence perhaps rubbed off on me. I did not doubt that he could get the cancer. I trusted in his skill despite his offhand attitude. It is not always easy to distinguish between confidence based on talent and arrogance based on an inflated ego. An advantage to having access to one of the nation’s great medical centers is that the surgeon’s skills are constantly tested.

Some years ago when I had a torn rotator cuff I could not get a clear diagnosis for months until I met the right person, an orthopedist specializing in shoulders. His office was in the World Financial Center, part of the World Trade Center complex. The size of the crowd in the waiting room looked to me like Port Authority Bus Terminal except nearly everybody was a guy my age. After hours of waiting I was tempted to quit but I finally got to see him. I walked in and raised my arm and he said: “I know what’s wrong with you; I can fix it; your shoulder will be better than it ever was.”

His confidence would have seemed misplaced except that he did this surgery several times a day. True to his word, I had a completely healthy shoulder several months before the typical recovery time for rotator cuff surgery. When I saw him several months after the surgery he took a quick look at my rapid recovery and then asked me to talk to a man in the next cubicle who was fearful of having the surgery. The only time after that I saw him was on television on Sept. 11, 2001. He was one of the few physicians immediately on the scene tending to the wounded where he stayed throughout the day and night.

My cancer surgeon does this procedure several times a week. This was all new to me but I knew that he knew what he was doing. The technology has improved considerably over the last few decades so that what was once a death warrant can now be treated. I was astounded to learn that the surgery could be done laproscopically; I cannot begin to imagine how that is possible. The surgeon admitted that they do not really know what they will find until they open you up. I asked if the laprosy is as good in showing whether the cancer is confined. He said it provided a better picture than they could get before.

I went that day to the NYU Cancer Institute accompanied by a professor from NYU. When I had first realized that I would need someone to accompany me for some medical visits, I was at a loss. The close friends I have do not live in Manhattan. I did not want to ask someone to take a half day off from work to be my companion for a medical appointment. It happened, however, that because I had to cancel two speaking engagements at NYU word of my illness got back to the chair of my former department. He immediately contacted me and said he or someone else in the department was ready to help in any way they could, including accompanying me to appointments.

I was relieved to have a solution to that problem. Even more so, I was surprised and touched by the outpouring of support that was backed by action. I had been retired for two years from full-time work. University departments are not known for being well- springs of human kindness, and certainly not for retired members. Even before retirement I was not a prominent member of the department. During Maria’s illness I thought that perhaps I should retire because I was not pulling my weight. The professor who was then chairman very kindly said: “Don’t worry about it; teach your classes and we’ll take care of the rest.”

The department is now filled with bright young people who have recently graduated from top universities. I had come to NYU for the religious education program that died at the time this department was formed. At seminars when we identify ourselves to an outside speaker, my self-description is utility infielder in the department. I taught courses in three or four programs without being located in any one of them. The current department chair, besides being the top person in his field nationally, is one of the kindest and most caring people I have ever met. The department response to my sickness was no doubt rallied by him but many people, including the department secretary, surprised me with their generosity and genuine concern.

My NYU colleagues were one surprise but not the biggest. I was constantly taken aback by the letters and calls that I received. A dear friend, Anthony Fasano, asked me if it would be okay to inform the organization of former Christian Brothers. I said I was neither trying to hide my illness nor publicize it. I was aware that this network was efficiently run but I was unaware of its extent. I heard from people I had not had contact with in thirty, forty or fifty years. Some sent cards; more used email which is an easier and quicker way to express sympathy. Most of the letters were thoughtful and generous in feeling. I found it nice to have people say the things that are usually reserved for funerals when it is a little late. I suppose many people thought my funeral was imminent.

The genuine concern that so many people showed was the central element in my experience of serious illness. I am still somewhat bewildered by it, in part because it made me wonder about my own concern for sick people whom I know. If only just a handful of people had shown concern for me I would have readily understood. Especially since Maria’s death and my retirement, I have not been an integral part of anyone’s life. Why should anyone be concerned, then, whether I live or die when they have much more pressing concerns?

The question is not asked in self-pity; my aloneness is just a fact of life, in large part my own choosing. I live what for many people would be a lonely life although I can never remember feeling lonely (perhaps that is itself pathological). My chief interlocutor these days is probably the building super, a friendly and hard working Puerto Rican, José, who is known to all as Daniel. He keeps the building spotless and as far as I can tell is friendly with everyone in all ninety-three apartments. He was very helpful and concerned during my illness. When each of my sisters stayed in the apartment, he said to me: “If they need anything at all, tell them to just ask me for help.” Not the stereotype of a super in a Manhattan apartment building.

I knew that my four siblings would be concerned about my health. We have been together a long time and keep in touch. I certainly would be missed at our family gatherings, just as Maria still is. But that nieces and nephews were concerned surprised me. I tried to remember when I was young having any interest in the health of some old uncle. Perhaps to the extent my mother was concerned with the sickness or death of a sibling, I took some notice but not much. Weren’t people in their 70’s supposed to die?

The simplest description of love that I know of is St. Augustine’s words: Volo ut sis. That translates as “I want you to be.” It is a simple but profound feeling that gives ultimate affirmation to another being. Nothing is sought; no possession is claimed; no particular actions are demanded. One human being simply says to another: I want you to be. The other person is not necessarily a close friend or even a regular acquaintance. I have often quoted a line of Gorky’s referring to Tolstoy: “So long as this man is alive I am not alone in the world.” I have wondered, however, about the twenty years Gorky lived after Tolstoy died. At my mother’s funeral, I quoted a line of Gabriel Marcel’s: “To say I love you is to say you will never die.” The promise of love is thus rudely contradicted by death; I want you to be but death says that will not be. Yet at some level human beings in the face of all evidence to the contrary affirm that love is everlasting.

During

The surgery (“re-section”) was scheduled for July 7. The surgeon said I should expect to stay in the hospital for about 5 days or as long as it took for my digestive system to be functioning. After that, he said, I would need a month to recover my energy. I thought a month seemed more than enough time. In fact, however, he was exaggerating in the other direction. Whether or not his prediction was part of his conveying confidence, a more realistic guess for recovery would have been three or four months. Certainly the thirty pounds I had lost to the anemia and cancer could not be gained back in a month.



The surgery was scheduled for 3 PM which had its drawbacks. We were in the middle of an extreme heat wave. I was very weak and with my system cleaned out and no food or liquid that day my body reacted. While being prepared for the surgery my heartbeat suddenly doubled. I had had no anxieties up to that point and my only fear then was that the surgery would be postponed. Quick action brought the heart back to normal. Everything went smoothly after that.

I admit to a bias about anesthesiologists based on a small sample. They struck me as grumpy old guys who had no desire to be part of the medical team. They know their specialty and no one should interfere. One would like to think that the person holding you in suspended animation is concerned with more than his fee. The anesthesiologist at NYU shattered my stereotype. He was very friendly, careful to explain every step, and precise in everything he did. He seemed laid back but when action was needed with my heart beat he did not waste a second. When he found I was a professor emeritus at NYU, while he is an assistant professor, he kidded about that all the way into the operating theatre. Wheeling me down the corridor he shouted for everyone to get out of the way because a professor emeritus was coming through. His voice calmly guided me to sleep.




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