A low-grade buzzing in the ears, a ringing in the ears as of a distant alarm, an alarm in a shuttered room. That was all.

  Eventually, hospice came to be more frequently spoken.

  Eventually, Gerard came to utter the words final days.

  As if shyly. On the phone. So that you would not have to see his face. Or he, yours.

  Like stammering I love you.

  For some, an impossible statement—I love you.

  But Gerard had managed it, and you’d managed it—not easily, not glibly, but earnestly, tearfully: I love you.

  I think these might be my final days. Quietly, calmly Gerard had told you.

  And so you heard, but hadn’t heard. No.

  But yes, you’d heard. The walls of the (bath)room reeling around you, you’d almost fainted and struck your head on the porcelain bathtub.

  Like a frightened child protesting—No! Don’t say such things, these are not your “final days” . . .

  You could not bear it. Not knowing, at that time, the vast Sahara that lay ahead of all that you could not, cannot bear.

  For always, each step of the way, you’d resisted.

  Until a day, an hour. Always there is a day, an hour.

  When you began to speak of hospice yourself.

  At first you too were shy, faltering. Your throat felt lacerated within as if by lethal metal filings.

  Gradually you learned to utter the two syllables clearly, bravely—hos pice.

  Soon then, you began to say our hospice.

  Soon, you began to draw up your vows. Quaintly stated to yourself as if to God, a formal decree.

  It is my hope: I will make of our hospice a honeymoon.

  My vow is to make my husband as comfortable as he can be.

  To make him happy. To make us both happy.

  To fulfill whatever he wishes, that is within the range of possibility.

  First: a new setting for him. NOT the Santa Tierra Cancer Center.

  Our hospice will be in the glass-walled house on Vista Drive. We have signed a lease through the end of August. The living room is flooded with morning light, there is a view of the San Mateo Mountains.

  Always there are beautiful sculpted clouds! Gerard will lie propped up in his bed, staring.

  Holding hands, we will hold hands. I will sleep beside him holding him.

  A hospital bed so positioned that Gerard will always be facing beauty: mountains, sky.

  I will scatter seed on the redwood deck outside the window. Gerard will be thrilled to watch the birds . . .

  And Gerard loves music! We will bathe him in the most beautiful music through his waking hours.

  Holding hands. Listening to Beethoven, Mozart. So long as it is possible I will lie beside him, holding him. Listening together to Beethoven’s “Ode to Joy.”

  Falling asleep together. Head on the pillow beside Gerard’s head.

  I will bring home art books, his favorite artists, we will look at beautiful works of art together. I will hold his hand, we will look at beautiful works of art together.

  His favorite foods . . . Well, we will try!

  Perhaps in a new setting Gerard’s appetite will return.

  I will fly back to Cambridge, Mass., for just one day. Select photographs for Gerard to look through. His childhood, his parents. His family. His first marriage, his children. Eventually, photographs of us together—our marriage . . . We will not be hurried as we look through these precious photographs recording Gerard’s life. We will hold hands, we will weep together and comfort each other.

  Our hospice will not be sad but joyous, a honeymoon.

  Another possibility is to establish our hospice in Cambridge, on Monroe Street. Set up Gerard’s hospital bed in his study on the second floor, with a view of the back lawn, trees. A foreshortened view, not a view of mountains, but Cambridge would mean a familiar setting: Gerard’s friends, colleagues, students; Gerard’s books, both those Gerard McManus had written and those thousands of books that Gerard McManus owned.

  (For Gerard is begging to be brought home. Home! Home!—Gerard is pleading. And by home Gerard does not mean Santa Tierra.)

  But how to transport Gerard from Albuquerque to Boston? If he is not well enough to fly commercially? A medical transport plane would cost thirty thousand dollars (I have done the research) and then an ambulance would be required to bring him from the airport to the house, and hospice nurses would have to be waiting to take care of him . . . The danger is, it’s been pointed out, that a seriously ill patient might be stricken en route, might not survive the journey of an estimated eight hours.

  No matter. We will establish our hospice/honeymoon here.

  We will be happy here, Gerard’s final days.

  IN FACT, NOTHING REMOTELY LIKE this happened.

  Hospice, yes. Honeymoon, no.

  25

  The Unbearable

  When Michaela was a very young child of three or four it began: the dream of the unbearable.

  A sensation of something pushing inside her head. Opening its black-feathered wings wider and wider squeezing her skull out of shape.

  Or, a vise around her head. Tighter and tighter the vise squeezing her skull out of shape.

  Screamed, screamed until her throat was scraped raw. Eyes rolled back into her head sightless. Skin hypersensitive scalding.

  Michaela, wake up! Stop that screaming!

  Just a bad dream, it’s nothing.

  Heaven’s sake—stop.

  YOU’RE NOT A BABY NOW, you’re a big girl.

  Waking us all up—just stop.

  MAYBE IT WASN’T A DREAM. Maybe it was sheer sensation. A rapid and abnormal firing of neurons precipitating acute anxiety, a sensation like convulsion, epilepsy.

  (Has Michaela ever been tested for epilepsy? MRI to detect subtle abnormal brain waves?)

  (No, and she doesn’t intend to. Best not to know.)

  For years she’d forgotten. Outgrown the dream. Then, in her thirties the dream has returned.

  Hard to determine if you are awake or asleep. And if you are sleeping beside another person, should you try to shield that person from the nightmare; should you try to muffle your panic, your screams . . .

  A bad dream, that was all it was. Christ!

  (Or was it life?)

  Sheer sensation of something tightening, ever-tightening, to the point of the unbearable. Squeezing her skull out of shape, eyeballs bulging from their sockets. Never has Michaela been able to describe this dream, if it is a dream, to another person.

  Intimacy is a risk. Step by step on ice you can’t know: is it thick, or is it not-thick? Is it thawing?

  The next step you take, will the ice crack beneath your feet and plunge you into freezing water? Making you, along with your terror, something of a fool.

  Many times she’d tried to explain the unbearable except not to Gerard McManus who’d come late into her life. By which time she’d grown cautious, wary.

  Not wanting Gerard to know. To suspect. That Michaela wasn’t the radiant-faced young woman he believed she was. That she was not placid-souled, as he’d liked to think.

  When they’d first met he’d been charmed by her youthfulness, her vivacity. He’d thought she was ten, twelve years younger than her age. He was the older man, emotionally battered, wry, a person of some public reputation, that was his role. She could not disillusion this man that she might be older and more battered in her soul than he in his.

  BABIES THAT HAD CLUNG TO the insides of her uterus as to life itself. Bleeding out at last in a hemorrhage of suety-thick black blood. Even when she’d wept with relief yet she’d wept also with grief. For such bleeding is a kind of weeping.

  The body weeps, that part of the body drains away in sorrow each month. Michaela had been stunned when she’d first begun to bleed at the age of fifteen, later than most of her girlfriends, still somewhat disbelieving that such a thing could happen, especially to her.

  Interludes in her life when she’d lost so much weight, she had ceased menstruating without realizing. Light-boned, effervescent in her soul. Seeing nursing mothers bare fat white blue-veined breasts to their infants in public she’d stared in astonishment as one might stare at the antics of another species.

  Have you ever been pregnant?

  Well—not that I know of. No.

  But wouldn’t you know?

  I—I’m not sure. Would you always know?

  No one knew, she’d told no one. Whom would she tell? A fetus conceived by chance in lonely sorrow has no father.

  Pregnancy: a foreign substance has made its way up into the cavities of the body then takes root and grows, grows and grows by degrees forcing the body out of shape.

  Something that has crawled into her ear? As she lies vulnerable, unaware? Could be a spider, scorpion, tick. Once inside the ear, burrowing.

  Or, making its way up into her nasal passages. Swarming into the brain.

  If the brain is lacerated, bleeding. Nowhere for the blood to go. Pressure increases, the pain is excruciating.

  As if something too large is being forced inside the skull.

  Late-night hours of the vigil in the Final Days, the unbearable has become the very oxygen she craves. As if all of her life has led her to this. As all of her prior life—fear, panic, terror—has been a preparation for this. To cry to the one whom you love Breathe! Breathe!—even as breath begins to fail. Yet to cry Breathe!—fitting your mouth to his. What words to describe this ordeal, there are no words. Words fail, very breath fails. A high-pitched whistle that becomes ever more higher-pitched, slowly drives the hearer mad. The slowly increasing temperature that results in a boiled brain.

  She has failed utterly: in her distraction she’d forgotten to bring her (secret) cache of pills. In the night as Gerard labored to breathe she might have ingested enough pills to convulse her heart yet of course she hadn’t prepared, she has not prepared, in any case she would have been discovered slumped on the couch beside her husband’s bed, a barely discernible pulse, still alive, rushed downstairs to the ER where technicians would have revived her. For of course no one will respect a naive suicide’s wish do not resuscitate.

  Any way you consider it, a failure of courage and of imagination.

  And now, too late. Of course she is going to hold her husband as he dies. Of course she is not going to allow her husband to die alone, unloved. Hours she will hold him, beg him—Breathe! I love you.

  In her exhaustion recalling how one day her mother asked her almost casually, as if the subject had just come to mind, if she remembered when she’d been a little girl and so sick, she’d almost died: “Your father and I were in the Peace Corps, in Uganda. In our late twenties. We’d committed to some idea of ‘public service’—‘helping.’ But we had a child—you. That wasn’t so practical, I don’t know what the hell we were thinking. Things were going OK until we all got sick. Then you got really sick, some kind of fever, like measles but worse than measles, you were just two years old. Your temperature just kept rising no matter what the doctor told us to do. I remember the thermometer climbing to 102.1 degrees Fahrenheit. You were burning up! I was crying and terrified we were going to lose you, your poor skin was so hot. Sometimes we couldn’t tell if you were breathing. Other babies in the clinic were dying—dehydrated. Their little veins were too small for IV lines. The doctor was this bearded American guy who looked like pictures of Charles Darwin except he was only about our age. He’d kind of inherited the clinic, he said. Might’ve been he wasn’t an actual doctor, like an accredited doctor, or licensed, whatever—he said he’d graduated from Penn Medical School but didn’t have an M.D. He was a kind, caring guy, turned out to be a morphine addict, but that was later. He hadn’t slept for a week, he told us, with this kind of ‘plague’ like measles. I remember how scared we were, and powerless, kind of hopeless like God had sawed off the tops of our skulls and was grinning down at us. This guy we wanted to believe was an actual doctor telling us that in another few hours we would know, and we said, know what?—what? And he said, if your daughter will survive the fever and if she does survive, whether she will survive as the daughter you know.”

  FINAL DAYS. FINAL TIME. But never do you know it is the final time.

  Approaching the hospital. Your mind is a sieve through which such random thoughts flow in a continuous stream. H’lo, ma’am—the last time the (morning) receptionist nods and smiles yet nonetheless insists that you sign the ledger as you have signed it unvaryingly for weeks:

  MICHAELA MCMANUS 771 ONCOLOGY (DR.) GERARD MCMANUS

  Wanting to tell the receptionist—But we will have our hospice, in our home. Our honeymoon.

  Wanting to explain—So you won’t be seeing much of me, soon.

  But there are no words. Already you are turning away.

  Rising in the elevator to the seventh floor. That stunned compliance, as of cattle struck by mallets, rendered unconscious on their feet as they stumble along the chute to slaughter. As the unbearable seeps into your brain. Such pressure in your brain! Breathe!—you plead with yourself. Dare not faint, Gerard has no one but you.

  MICHAELA, COME WITH ME!

  There is a place for you. With me.

  26

  Canceled

  This day, April 14, a notice is taped to the door of the seminar room on the ground floor of Memorial Hall, University of New Mexico at Albuquerque.

  DUE TO UNAVOIDABLE CIRCUMSTANCES CREATIVE WRITING 343, MEMOIR (INSTRUCTOR M. MCMANUS) WILL NOT MEET TODAY.

  27

  “Good News”

  A hospital vigil is notable for sudden interruptions for (often) you lapse into exhausted sleep at the bedside of the patient without knowing where you are or even why you are where you have no clear idea where you are, and (often) when you wake there is a pulsing pressure in your ears, inside your head trying to determine: where, why?

  Not at your husband’s bedside on the oncology floor but in another place not known to you though also (evidently) a clinical—chilly!—setting. (Why are hospitals so cold?—it’s to discourage the [inevitable] growth of bacteria. Colder the temperature, less bacteria fecundity though never [of course] no bacteria fecundity so long as there is the warm pulsebeat of life.)

  Roaring in your ears through which you are having difficulty hearing a doctor’s jovial voice.

  Good news, Mrs. ___!—there has been a new development in the patient’s prognosis.

  Good news, Mrs. ___!—bone marrow transplant has been approved provided you are still willing to donate bone marrow for your husband.

  Good news, Mrs. ___!—there is a strong possibility that you can save your husband’s life.

  You are very excited to hear this. Yet, you are terrified.

  You are in a conference room in the hospital. Several staff physicians are in attendance whose names are told to you, which you immediately forget. Oncologist Dr. N___ is explaining the marrow extraction procedure which involves a minimum of two hours of surgery under a partial anesthetic, performed by a bone marrow specialist. There is some risk (of course). There will be some pain (of course).

  An eighteen-inch needle will be sunk into your hip bone and a minute quantity of marrow extracted.

  In fact, as Dr. N___ points out, the “gravest risk” to the donor isn’t the bone marrow extraction itself but the anesthesia.

  Dr. N___ makes this pronouncement in a voice of such flatness, you understand that it is a witticism of some sort. Or perhaps it is an affectionate reproach. One of the physicians lifts a rueful hand to self-identity—Dr. T___, anesthesiologist.

  Another physician is the bone marrow surgeon Dr. R___ who waves at you boyishly.

  WEEKS BEFORE YOU’D TOLD Dr. N___ that you would like to donate bone marrow if it would help your husband. At the time Dr. N___ had shrugged off your request as if its naivete had offended him.

  Overhearing, your husband had protested—Don’t be ridiculous! I wouldn’t allow you to take such a risk and anyway, it isn’t going to be necessary.

  You will note afterward how the prospect of weakening, failing, dying is viewed as “ridiculous” by many of the afflicted daring you to contradict them and so indeed you rarely contradict them.

  Now, confronted with the prospect of the eighteen-inch needle sunk into your hip bone you are growing faint. You can feel blood draining from your head. In a voice of the most subtle reproach (for he can decipher your panicked thoughts) Dr. N___ says that the bone marrow transplant procedure is far more dangerous for the recipient than the extraction is for the donor: the mortality rate for the recipient is ___ (you do not hear this mumbled statistic) while the mortality rate for the donor is less than 3 percent.

  Meaning, 97 percent chance of (donor) survival.

  Such excellent odds of survival, you would be shamed into saying anything less than Yes.

  Though you are shivering. Though you have begun to perspire. You feel a need to grasp at the edge of the conference table, to steady yourself.

  Dr. N___ cups his hand to his ear. What is your response, Mrs. ___?

  I said—yes. I will.

  You will—?

  —donate bone marrow for my husband.

  There! The words are uttered.

  Around the table the physicians stare at you, gravely nodding. In their eyes you believe you see respect, admiration. The (brave, good) wife will donate bone marrow for the husband!

  Y-Yes.

  A legal document is presented to you by a (female) notary public. It is oversized, with numerous pages and addenda. With difficulty you read the small print which even as your eyes move across lines of type fades rapidly, you cannot glance back to reread. And by the end of the (thirty-page) document you have forgotten what you’ve read.

  Sign here, Mrs. ___. The notary public is witness to your signature.

  Though your hand is badly shaking you manage to sign your name with a pen provided for you.

  Such hoarse breathing! You hope it isn’t your own.

  Your skin is burning, the fever has made you delirious. Slick clammy sweat on your forehead, in your armpits.