It starts with an uneasy feeling. A flutter, but not in his heart. No anywhere he can put his finger on. The shrapnel in his shoulder migrating, he thinks. He knows this isn’t true. The ache is the same as it’s always been. He bounces up on the balls of his feet, lifts his arms up straight and relaxes. There, again, a flutter. He puts it away in a box in his mind, along with some of his memories from Nam, and goes outside to mow the lawn.
Dale sleeps soundly that night. In the morning, the coffee doesn’t wake him up. He can’t shake the sleepiness. Getting old, he thinks.
By the next day, the sleepiness has progressed to lethargy. He has to stop moving frequently and catch his breath, like he’s just run a 5K. His wife does not notice this because he remains still much of the day, pretending to read. In the afternoon, he tells himself,iIt will be better in the morning. He hates summer afternoons. Something about the harsh angle of the light, the loss of the day’s promise. Summer days are meant to filled and by afternoon, intentions never line up with reality. Tomorrow is already bright with promise, with projects and ideas.
In the morning, he wakes up sharply and sits on the side of the bed. A coughing fit assails him, and by the time he’s done, he’s panting like he’s run a marathon. A serious 26.2. He’s utterly depleted and as he grips the edge of the bed, he’s nearly felled by a wave of dizziness. He waits for the questions and concern from his wife, but he’s forgotten. It’s her day to go in early.
He spends most of the day drowsing uneasily in a recliner. He sends her a text, tells her he’s got a cold. It’s much much worse than that and he knows it. Fear eats away at him, but he needs to get to know this fear, the shape and manner of it, before she meets it. Has to know how he’s going to deal with his own fear before he deals with hers. Because everything is shared. He is unaccountably grateful that she’s kept a little late at work and can go to bed early before she gets home. He feels her settle in beside him and does not think of the blankness he is going to leave her with on his side of the bed.
That night, he tosses and turns with fitful unease, not asleep and yet not awake. he awakens in the black hours of the morning with sharp belly pain. He can’t breathe. God has taken away all the oxygen in the world and they will all suffocate. His bowels spasm and cramp. He stumbles to the bathroom and crouches on the toilet, gasping for air.
When he finally manages to stand up, he sees that the stool in the toilet is black. His vision is black. He’s holding onto the sink for support. “Brenda!” he cries out hoarsely. “Brenda!”
In the emergency room, they have him on oxygen, and he feels unspeakably better. Chipper, in fact. He manages a smile at Brenda. These tired Indian men with unpronounseable last names and assuring intelligence will figure him out and fix him up. A nurse without a name badge draws blood and puts in two IVs and frowns at the monitor, all without talking to them.
They send him to the ICU, and tell him he’s got a GI bleed, a slow leak in his bowels making his stool black. He’s uneasy again, there’s the flutter. And The Plan keeps changing; a CT scan, no an endoscopy , no just monitor and medicate. If he keeps bleeding, they’ll scope Monday. Why am I bleeding, he wants to know? He’s cold and sweaty and suddenly he can’t breathe. The nurse gives him a mask and he feels better, but he still can’t even sit on the side of the bed to pee without feeling, well, like he just ran a marathon. Or walked the breadth of the Hoh valley. He didn’t know it was possible to be this tired.
His blood counts are all off. Where did his blood go? He didn’t have enough black stool to account for it, and it’s not a dietary deficiency. They give him blood and he’s supposed to feel stronger, but he can’t breathe. They have to keep giving him more air. A nurse frowns at the monitor, smiles at him, and changes out his mask. Each time the flow increases, he knows he’s got less options for when he gets worse. Brenda smiles and jokes with the nurses and Dale can see how nervous she is. She learning it too, the shape of this fear.
A hematologist comes in, because of the anemia. She is Vietnamese, and Dale has to fight to keep his expression neutral. He can’t put his finger on any particular way he feels about her; it isn’t hate or fear or pity, it just makes him remember things about Vietnam. He hears her voice as if through static, from a mile and a half away. After she leaves, he asks Brenda what she said.
TTP. Thrombotic thrombocytpenic perpura. Could be caused by a hundred and twenty things. He sighs. He is so weary. Only two weeks ago he was weeding the garden, mowing the lawn and remembering what sort of bulbs he already has planted. Now he has a terrible premonition he won’t see spring time. He wonders if Brenda feels this way too but he doesn’t want to ask her.
They treat him for TTP. When will things get better, he asks? No one knows. A week, a month. Hopefully. But why can’t he breathe? If he could just breathe.
In the middle of the night, he wakes up to an elephant on his chest. His breath is short and whistling. He grips the siderails of the bed. His vision is a tunnel, and at the end of the tunnel is the VietCong, and the hematologist. He’s a tunnel rat and the walls are closing in, the ceiling is falling down and the alarms are going off. The tunnel is lit with gaudy daylight suddenly and filled with the sound of voices. He’s been found out. He struggles. He tries to cry out but he can’t even breath. The alarm is shrill and and he gasps and gasps.
Oxygen. There’s a tight mask over his face and blessed cool oxygen pumping into his lungs. If he lays still, he can just about get a breath. His watery vision starts to clarify. Nurses and doctors are gathered around, looking at him, looking at the monitor above his head. He shuts his eyes. He can breathe.
It’s called facial bipap. It’s a tight facemask with a windy airflow that makes him feel like he’s sticking his head out of a car window. It’s his lover and his curse. They are together, he and the bipap, til death do us part. He breathes with it, but woe unto him should he try to part with it! Not for food, conversation or even a sip of water. He’ll pay for this infidelity with paralyzing breathlessness.
This can’t be explained by TTP, so he’s sent off to CT scan.
In the end, it’s cancer. Some silent lung cancer has metastasized to three other places before he even felt that twinge. He rages and cries, but there is nothing to be done against death. He danced and evaded this old enemy during the war, beating the odds, and now it’s come back to claim him. He can’t reconcile with this darkness, this final ending. He grips Brenda’s hand, re-memorizing the familiar lines of her face, the muted light in her eyes. I’m so tired, he tries to tell her. I’m so sorry, he wants to say, that this happened. That I can’t be a cancer survivor for you. That you’ll have to hire someone to mow the lawn and maybe start sleeping on the couch. I’m so sorry to leave you alone.
Brenda holds his hand and sobs as if the world were ending (it is) while he rages and fights even as the morphine eases his tortured breathing and ushers him away from this life.