CHAPTER THIRTY-TWO
Grace still hasn’t taken her coat off. She’s standing at a remove from the end of his bed, her suitcase by her side. She arrived about an hour ago, coming straight from the airport. Her face is drawn, her eyes steeled, her expression flat and unfamiliar to him. She feels so far away. This is not her normal face. He wants to tell her to come closer and smile, an absurd request even if he could make it given the circumstances, but he wants to see her face the way he loves it most—bright eyes, rosy cheekbones perched high atop each side of an easy smile, happy. He supposes his face, unshaven with a tube inserted into his mouth and taped to his cheek, looks unfamiliar to her, as well.
Karina asked her many questions about classes and her boyfriend when Grace first arrived, but they’ve run out of conversation. Everyone in the room is quiet. Karina is sitting in the chair next to him, her arms crossed tight in front of her chest as if she’s cold. She looks tired, serious, vaguely alert. Kathy is standing by the ventilator, reading something on her phone. Bill sits at the foot of the bed, rubbing Richard’s feet and calves with his warm, strong hands. God bless Bill.
The sense of waiting is fog-thick, ominous, surreal. The moment feels important, urgent, yet absolutely nothing is happening. It’s absurdly mundane.
A slender woman with a boyish haircut and many silver-studded earrings enters the room.
“Hello. Is this Richard?”
“Hi, Ginny,” says Kathy. “Yes, this is Richard Evans. And this is his ex-wife, Karina; their daughter, Grace; and home health aide extraordinaire Bill. This is Ginny from Hospice.”
Instead of shaking hands, she hugs everyone. She stands over Richard and places a hand on his shoulder. Her eyes are brown and without makeup, clear and calmly confident. She smiles in a way that feels natural and not at all inappropriate for the situation. There is no joy, no pity, no forced falseness in her gesture, and without words she communicates, I’m here with you. Richard wishes he could thank her.
“I’ll let the doctor know that you’re here,” says Kathy, excusing herself from the room.
“Let’s talk about a few things before the doctor comes. Our goal today is to get you comfortably home. The doctor is going to remove the endotracheal tube and switch you over to a BiPAP. We won’t know until he does this, but if your breathing muscles are totally gone, the BiPAP won’t be able to sustain your breathing. If that should happen, I’ll administer morphine and a sedative through the IV line, so they’ll take effect immediately. I’ll be here to make sure that you feel calm. You won’t struggle, and you won’t feel like you’re suffocating. And everyone will be right here with you. Does that sound okay?”
The mechanical ventilator breathes air into Richard’s lungs. Then it draws air out. Absolutely nothing about what she just said sounds okay. He blinks. Karina holds his hand in hers. Bill squeezes his foot. Ginny, whom Richard had never seen before a minute ago, keeps her hand on his shoulder, and he’s grateful, reassured by her presence and touch. This isn’t her first rodeo.
Kathy DeVillo returns with Dr. Connors, a blue tie peeking out from beneath his buttoned white lab coat, a pen and a phone tucked in the front pocket, a stethoscope around his neck. He was clean shaven when Richard was first admitted to the ICU but now has the beginnings of a beard. He’s been in and out, checking on Richard many times over the past three days.
“How we doing?” asks Dr. Connors.
Richard’s trachea feels bruised, dry, and brutalized. His lips are painfully chapped. He’s fixated on an obsessive desire to clear his throat and struggling to ignore an intense itch on the top of his head that seems intent on burrowing into his brain. And if things go sideways, he’s going to die today.
“Are we waiting on anyone else?” asks Kathy.
Everyone looks to Richard. He doesn’t blink.
“No,” says Karina.
“Yes,” says Ginny. “I’ve called for a music therapist.”
“A what?” asks Karina.
“Someone to come and play guitar, something relaxing to keep Richard calm.”
Richard raises his eyebrows in alarm, hoping Karina sees him.
“God no,” says Karina. “No. Call him off.”
“Are you sure?” asks Ginny.
“Positive. He’d detest that.”
Richard blinks several times.
“I’ll play something from my iPhone.” Karina looks to Richard. “Mozart?”
He thinks. No. Keep going.
“Bach?”
He stares, unblinking.
“Schumann?”
He blinks.
“Okay.”
She doesn’t ask him which piece. He trusts that she knows. He watches her search. Then the music begins.
Of course, she knew. It’s Schumann’s Fantasie in C Major, op. 17, his greatest masterpiece, and Richard’s favorite piece to play. He listens to the first few measures of the first movement and wonders.
“Yes, this is you, playing at Carnegie Hall,” says Karina.
His mouth is immobilized, but his eyes are smiling. He blinks.
The serious business of what awaits them pauses as everyone listens. The first movement of this fantasy is dense and dreamy, a passionate lamentation, Schumann expressing his longing for his beloved Clara, separated from him by her father. Richard locks his eyes with Karina’s as they listen, knowing she knows the meaning behind the composition, and his heart aches for her to know how grateful he is to her and how sorry he is. Even if he didn’t have a tube in his throat, even if he weren’t too tired and scared to use the letter board, even if it weren’t too late and he could speak, he’s not sure he could find the words big and true enough to heal what he’s done to her.
He keeps his eyes with hers alone, willing the notes to speak for him, and he’s swaddled in her gaze. Tears spill down his face. Karina squeezes his hand and nods.
The second movement changes mood abruptly. It’s a majestic march, powerful, extroverted, bombastic, fast, and extremely difficult to play. Richard’s professional career passes through his consciousness. Curtis, New England Conservatory, the prestigious concert halls and symphonies, the world-renowned conductors, the orchestras, the festivals, the solo recitals, the audiences, the standing ovations, the press and accolades. It was a beautiful life. It all went by so fast.
Dr. Connors checks Richard’s vitals and explains what he’s about to do.
“Are you ready?”
Richard looks to Grace. Bill notices and extends an arm, inviting her closer, inside their circle. She edges next to her mother.
“I’m here, Dad.” Grace looks terrified. “I love you.”
Richard blinks, loving her back. He prays this isn’t the last time he hears her say those words.
Dr. Connors positions himself over Richard’s face and peels back the tape.
“Okay, on three. One, two, three.”
Dr. Connors yanks hard on the end of the tube, and it slides up from inside Richard for a surprising length, a procedure as brutishly physical and indelicate as the tube’s insertion. The tube is out, and everyone looks at Richard, waiting. No one, including Richard, is breathing.
He’s playing the third movement now. The melody is solemn, a reconciliation. The BiPAP mask is placed over his face, and still there is no air. The ventilator is quiet. There is no sound but for Richard playing Schumann. His head begins to tingle as the room narrows. He stays focused on Grace and Karina and Bill and the music, and suddenly there are no boundaries between the vibrations of the notes and the people in this room. He doesn’t want to leave them. He wants to keep listening, vibrating, breathing, being.
He wants a few more notes. Another movement. Just a bit longer. He doesn’t want to die in the ICU.
His lungs call out to his diaphragm and the muscles of his abdomen, searching, pleading. He plays the final notes of Schumann’s Fantasie, slower, softer, hopeful, a whispered prayer to God. Everyone in the room and Richard’s lungs wait in stillness for an answer.