Loss

After the bone marrow biopsy, but before all results are in, when you have some strength and an appetite, I make your favorites—turkeyburgers, coleslaw, baked beans. You stand in the doorway, eyes on me, just as you did when you were a child, waiting for whatever I’d create. Abracadabra, I’d say, presenting buttered French toast or a plate of still-warm chocolate chip cookies. You ate the cookies and cried for your addict parents who’d left you with me, who’d left a wound I couldn’t soothe.

I was the aunt who tried to replace them. But you were loyal and followed in your family’s tradition of depression and addiction. So many psych wards. So many rehabs, like your parents. Now, your white and red blood cell counts are low. I’ve tried to be your oxygen. I’m old now, foolish enough to think I can still be your breath.

There is a specific kind of devastation in seeing a child failed by the world.

Today, I saw a fourteen-year-old girl who had taken glass to her skin. She came because she had been scratching away at her arm, at her eye. She had been banging her head against the wall. She had been screaming.

As time passes, I no longer remember her face or her name. But I know what brought her in. And I clearly recall how, as an intern, I walked into her grim hospital room, where two tired parents sat by her bedside: a young woman with a small pimple patch on her forehead.

She was twenty-four and had no chronic conditions—but now no sign of life. I’d spent six months as an intern at that point and was still learning to become a doctor. I’d written down all I could find about her medical history and headed toward her room, not for a second pausing to reflect on the fact that she was just twenty-four.

They must have given me something for sleep. My last memory was Madonnas, filled with tears in their eyes. Madonnas?

When I awoke, the lights were out and the door was closed. I could hear voices in the hallway but couldn’t make out what they were saying. I could feel my naked skin as it rubbed against the scratchy sheets. I started to get out of the bed, but I discovered that I was restrained by the side rails.

Right now, it’s dark red. With fifteen days of radiation to go, it seems it will get a whole lot darker.

At least they warned me about the sunburn. They did not warn me about the swelling and the mouth sores. And the red crusted-shut eyes and floaters. “It’s different for everyone,” they say.

The day began like any other in my OB-GYN rotation. A few hours before rounds, I approached a patient who’d just returned from an emergency Cesarean section. I began asking routine questions, until my senior gently nudged me. “Be careful what you ask,” he whispered. “She doesn’t know her baby died in utero.”

Denny was one year ahead of me in grad school and a close friend. We shared so many plans about our future! I knew he was gay, but his bisexual partner was the only other person in on that secret. This was the 1960s, and coming out wasn’t an option back then if you planned to be employed in certain professions.

Has it all come down to this, after a lifetime of quantifying success against arbitrary goals? To achieve, whatever the cost? A competitor by nature, I prefer victory to failure.

Retired and sixty-six, I see my oncologist every month. Just when I’d hoped to be free of success by someone else’s calculation, I’m checking for lab results in my electronic medical record.

Yesterday, I learn that my numbers are climbing up.

The personal question patients used to ask me was “Are you pregnant?” Recently, a patient inquired, after sharing that his wife had started menopausal hormonal therapy, “Do you also take this?”

I have indeed started what I call my Menopause Trifecta: an estrogen patch, a progesterone pill, and a testosterone gel. Estrogen made me miserable during puberty; helped me become a mother of two children; and drove cyclical cravings, cramps, and crying. But my ovaries no longer produce estrogen. My “childbearing potential” is gone. Unused menstrual supplies gather dust in a cabinet.

The chart said that she came into the Emergency Department after an overdose. An older woman, disheveled, who had been found down on the ground. She had a history of schizophrenia and not taking her meds. The Emergency Department stabilized her and then admitted her to psychiatry. On paper, she was like so many other homeless patients: chronic psychosis and layers of trauma buried under ICD codes that adorned her chart.

I was in a good mood. I had just been dismissed early from my shift at the hospital, and I looked forward to an empty house where I could eat lunch, watch reality TV recaps, and take a nap in peace. The sun shone brightly as I drove down the freeway, which was surprisingly free of the infamous Miami traffic. I love my fourth year, I thought to myself. The upperclassmen weren’t kidding when they said that the fourth year of med school is the best. Nothing beat being free from the obligation to study for exams after a long day at the hospital.

“Nice clean cut,” the resident marveled as he examined my wound.

“Sabatier,” I responded with pride.

Back in those days, we lived in a cramped tenement apartment with a shabby, dark kitchen. But at least our low rent gave us enough financial wiggle room to slowly build up a decent batterie de cuisine. It was one of our early acquisitions, a pricey knife, that had sent me to the emergency room.